Objective To investigate the mid-term outcome of high tibia osteotomy (HTO) combined with tibial tuberosity limited rotation in the treatment of disorder of patellofemoral joint with knee varus.Methods HTO was performed in all 42 patients.The lower limb alignment,lateral femoral tibial angle,medial proximal tibial angle,Q angle and TF-TG were measured before and after operation.All the patients with disorder of patellofemoral joint were divided into three types based on preoperative patellar trajectory and TF-TG.According to different types we chose the limided rotation of distal tibia through adjustment of tibial tubercle location to improve patellar track.Type Ⅰ in 10 cases and type Ⅱ in 12 cases only accepted HTO,type Ⅲ in 20 cases accepted HTO and tibial tubercle rotation.The rotation angle was determined according to preoperative imaging results and foot forward angle.Before and after operation patellar tilt angle,patellofemoral angle and lateral patellar angle were measured.Results 42 patients were followed up for more than 5 years,an average of 72.20± 12.60 months (60-88 months).No nerve damage,infection and bone nonunion occurred.The patellar tilt angle was improved from 12.45°±3.76° to 6.98°± 1.78° 5 years after operation.The patellofemoral angle was improved from 12.51°±4.71° to-4.70°±2.57° 5 years after operation,and the lateral patellar angle was improved from 1.50°±4.90° to 7.80°±3.10°.Preoperative lateral femoral tibial angle was improved from 182.45°±2.20° to postoperative 174.60° ±3.50°,medial proximal tibial angle was improved from preoperative 78.75°± 3.50° to postoperative 93.25°±1.95°.The Lysholm score was improved from preoperative 53.10±5.60 to 92.70±5.50.The preoperative IKDC subjective score was improved from 47.50±6.40 to 91.30±6.90.The Kujala score was 62.40±8.70 before operation and 87.30±4.10 5 years after operation.Visual analogue score (VAS) was 7.50±2.45 before operation and 1.50±0.90 5 years after operation.The short and mid-term follow-up,knee patellar trajectory and lower limb alignment was good,postoperative symptoms was satisfactory and acceptable.Conclusion HTO combined with limited rotation of the tibial tubercle could improve patellar trajectory and lower limb alignment to relieve pain,and has satisfactory mid-term outcome in the disorder of patellofemoral joint with knee yarus patients.

ObjectiveTo study the effects of liver cancer vaccine activated TIL on primary liver cancer (PLC).Methods Twenty-six patients with PLC were treated with stimulated TIL by liver cancer vaccine. The CD3?CD4?CD8?CD4/CD8, NK activity and levels of serum sIL-2R were assayed before and after the treatment, the survival tates of 1, 2 and 3 year were analysed. ResultsCD3?CD4?CD4/CD8 and the activity of NKC were 55?3?76?5;28.3?1.6?44.6?2.3;1.19?0.22?2.21?0.36;9.8?1.2?17.4?2.2, at 19th and 30th day, respectively after treatment of TIL. The difference was all significant compared with the controls (P

BACKGROUND:Conventional prosthetic vessel replacement has been gradually replaced by endovascular covered stent graft exclusion in the treatment of abdominal aortic aneurysm (AAA).However,whether it has advantages over conventional prosthetic vessel replacement in clinical curative effects and biocempatibility produced in the implantation of new type of biomaterials remains unclear.OBJECTIVE:To compare the curative effects and complications of endovascular covered stent graft exclusion and prosthetic vessel replacement in the treatment of AAA.DESIGN: A controlled observation analysis.SETTING: Department of Vascular Surgery,Wuhan nion Hospital.PARTICIPANTS: Forty-two patients with AAA (renal artery not involved) who received the treatment in the Department of Vascular Surgery,Union Hospital,Tongji Medical College,Huazhong University of Science and Technology between September 2001 and July 2006,were recruited in this study.They were all confirmed by CT angiography (CTA) and other examinations.According to the selected operative way,patients were allocated into interventional therapy group (n =17) and conventional therapy group (n =25).In the interventional therapy group,the patients,including 16 males and 1 female,were averaged (68±10)years old,and their mean tumor diameter was (6.4±1.3) cm.In the conventional therapy group,the patients,including 23 males and 2 females,were averaged (64±9) years,and their mean tumor diameter was (6.2±1.1) cm.Significant difference did not exist in the baseline material between two groups (P ＞ 0.05).This study was approved by the Hospital Ethics Committee.Written informed consents were obtained from all the patients.METHODS:In the interventional therapy group,patients underwent ndovascular covered stent graft exclusion by an interventional means.After being generally anesthetized,patients were dissected at unilateral femoral artery.Under the perspective condition,a covered stent graft was placed at a proper position with a forwarder,and then it was released and expanded.Following the position and xpansion of a covered stent being examined by CTA,femoral artery was anastomosed and incision was closed.If arteria iliaca was involved,then another covered stent was implanted from contralateral femoral artery and connected to stem.In the conventional therapy group,patients underwent prosthetic vessel replacement by a conventional means.Postoperatively,patients in the two groups all received anti-inflammation,anti-coagulation and other symptomatic and supportive treatments necessarily.MAIN OUTCOME MEASURES:① Postoperative complications of patients in two groups.② Recovery was observed by B-ultrasonography and CTA examination 1,3,6 and 12 months after operation.③ Follow-up of biocompatibility of biomaterials and host during 1 year postoperatively.RESULTS:Forty-two patients participated in the finial analysis.①Patients who exhibited pulmonary infection and renal function deterioration in the interventional therapy group were fewer than those in the conventional therapy group (P ＜0.05).② In the interventional therapy group,patients with covered-stent graft displacement,aortic injury and hematoma formed at the puncture point of femoral artery were not found.In the conventional therapy group,one patient died of acute large-area myocardial infarction at the 6th week postoperatively,and patients,who suffered from stomal leakage,prosthetic vessel thrombogenesis and infection,etc.,were not found.③ Neither obvious inflammatory reactions in the peripheral tissue of prosthetic vessel nor thrombogenesis in the prosthetic vessel was found in patients of two groups.It was demonstrated that both covered stent graft and prosthetic vessel had good biocompatibility.CONCLUSION:Endovascular covered stent graft exclusion can treat AAA due to its less surgical trauma,rapid postoperative recovery,good biocompatibility and other advantages.

Objective To analyze and compare the clinical effects of comprehensive treatment and liver transplantation for hepatocellular carcinomas (HCC)exceeding Milan criteria.Methods A retrospective analysis was performed on the clinical data of 157 patients with HCC (exceeding Milan criteria)who received comprehensive treatment (99 patients,including 48 cases meeting Shanghai criteria)and liv-er transplantation (58 patients,including 26 cases meeting Shanghai criteria)in our hospital from January 2006 to January 2010.The medi-an survival times and 1 -,2-,and 3-year survival rates were calculated by the Kaplan-Meier method,and the log-rank test was used for survival difference analysis.Results For all patients,the median survival times of the comprehensive treatment group and liver trans-plantation group were 18.00 ±1.15 and 23.40 ±4.44 months,respectively,and their 3 -year survival rates were(18.2 ±3.9)% and (39.7 ±6.4)%,respectively;the survival was significantly improved by the treatment of liver transplantation (P=0.009).For patients meeting Shanghai criteria,the median survival times of the comprehensive treatment group and liver transplantation group were 20.00 ±1.17 and 36.00 ±0.00 months,respectively,and their 3-year survival rates were (25.0 ±6.3)% and (57.7 ±9.7)%,respectively;there was significant survival difference between the two groups (P=0.008).For patients exceeding Shanghai criteria,the median survival times of the comprehensive treatment group and liver transplantation group were 16.00 ±1.78 and 16.00 ±1.69 months,respectively,and their 3-year survival rates were (11.8 ±4.5)% and (25.0 ±7.7)%,respectively;there was no significant survival difference between the two groups (P=0.221).Conclusion Compared with comprehensive treatment,liver transplantation leads to a significant higher long-term survival rate in HCC patients exceeding Milan criteria but meeting Shanghai criteria.However,the two therapies cause no significant survival difference in HCC patients exceeding Shanghai criteria.

Objective To study the efficacy, safety and tolerance of the therapeutic schedule of GemOx±R regimen suitable for elderly patients with B-cell lymphoma. Methods 11 elderly patients with B-cell lymphoma were enrolled in this study, which were diagnosed by biopsy. All the patients were treated according the GemOx ± R therapeutic schedule as described: rituximab (375 mg/m2 on day 0),gemcitabine (1000 mg/m2 on day 1),oxaliplatin (100 mg/m2 on day 1).Treatment response,therapy related toxic and sideeffect were assessed after inductive and consolidated treatment. Results The median age of 11 patients were 72.18 years(range 55-83 years).The overall response rate(ORR) after inductive treatment was 90 ％(9/10).The ORR of 4 DLBCL patients using GemOx+R as initial treatment was 100 ％. GemOx regimen were used for 4 refractory/relapse patients,and 3/4 patients got PR after inductive treatment.No patient got dose adjustment.The hematological toxicity was controllable and nobody got renal function impairment. Conclusions The GemOx ± R regimen is feasible,tolerable,effective for elderly patients with B-cell lymphoma.

Objective To assess the value of multislice spiral computed tomography (MSCT) in diagnosing pulmonary hypertension.Methods One hundred and forty-two patients on hemodialysis were divided into the group with pulmonary artery hypertension and the group without pulmonary artery hypertension.The diagnosis of pulmonary artery hypertension (pulmonary artery systolic pressure,PASP ＞ 35 mmHg) was according to the guideline from the American Society of Echocardiography.All patients were received the check of MSCT and the diameters of the main pulmonary artery,ascending aorta and descending aorta were recorded.PASP and left ventricular ejection fraction were assessed by echocardiography.High sensitivity C-reactive protein and rumor necrosis factor were measured by automatic analyzer and enzyme linked immunosorbent assay.Results There were significant differences between the two groups in systolic blood pressure,hemoglobin,serum albumin,high sensitivity C-reactive protein and TNF-α (P ＜ 0.05); There were significant differences between the two groups in diameters of the maim pulmonary artery,ratio of the diameter of the main pulmonary artery to the diameter of ascending aorta and ratio of the diameter of the main pulmonary artery to the diameter of descending aorta (P ＜ 0.05).In different heart function groups,there were significant differences in diameters of the main pulmonary artery,ratio of the diameter of the main pulmonary artery to the diameter of ascending aorta,and ratio of the diameter of the main pulmonary artery to the diameter of descending aorta,and left ventricular ejection fraction (P ＜ 0.05).Ratio of the diameter of the maim pulmonary artery to the diameter of ascending aorta was positively related to PASP (r=48.77,P ＜ 0.01),and left ventricular ejection fraction was negatively related to PASP (r=-0.40,P ＜ 0.01).In multivariate linear regression,TNF-α,ratio of the diameter of the maim pulmonary artery to the diameter of ascending aorta and ejection fraction were independent factors of PASP (P ＜ 0.01).Conclusions MSCT measurements play an important role in diagnosis of pulmonary hypertension and in evaluation of clinical prognosis in patients on hemodialysis.

Objective To investigate the killing activity of tumor infiltrating lymphocytes (TIL) stimulated by dendritic cells (DC) on gastric carcinoma cells in vitro. Since DC is the strongest antigen presenting cell (APC) which has been known, it can present antigens to T lymphocytes, including TIL, and can induce cytotoxic T lymphocyte (CTL) responded in vivo and vitro. Methods DC were isolated from the peripheral blood of patients with gastric carcinoma and stimulated by granulocyte/macrophage colony stimulating factor (GM CSF), interleukin 4 (IL 4) and tumor antigen. Then TIL were stimulated by DC and their killing activity on autogenous gastric carcinoma cells and SGC 7901 cells in vitro were observed. Results TIL stimulated by DC had very high killing activity on autogenous gastric carcinoma cells and the killing rate was (89.39?3.05)%, which was much higher than those of TIL not stimulated by DC and T lymphocytes stimulated by DC as well as T lymphocytes not stimulated by DC on autogenous gastric carcinoma cells. The killing rates of the last three ones were (54.37?1.50)%, (53.92?1.46)% and (3.55? 0.25) % respectively. However, their killing activity on SGC 7901 cells was lower. Conclusions The results indicate that DC from patients with gastric carcinoma can induce efficient and specific anti gastric carcinoma immune responses.

Objective:To study the dynamic frictional resistance in the buccal segment between preadjusted brackets coupled with different archwires,at different times under artificial saliva condition.Methods: The dynamic friction of different combinations of 4 kinds of preadjusted brackets and 4 archwires were tested simulating archwires sliding in the buccal segments at 4 different times(0,15,30,45 d)under artificial saliva condition by using Instron universal testing machine.Results: The dynamic frictional resistance of combinations of 3M MBT bracket and all archwires were the smallest.The combinations of 0.46 mm inch stainless steel round wire and all brackets produced significantly lower dynamic frictional resistance than that of other archwires.The 0.48 mm?0.64 mm inch stainless steel rectangular wire produced the highest dynamic frictional resistance combined with all preadjusted brackets.The dynamic frictional resistance of combinations of archwires and brackets were highest at the 15th day and smallest at the 30th day under artificial saliva condition.Conclusion: 0.46 mm stainless steel round wire produces the smallest dynamic frictional resistance combined with all preadjusted brackets.3M MBT brackets are more favorable to sliding mechanics compared with other brackets.As for time,the lowest dynamic frictional resistance exhibits at the 30th day under artificial saliva condition.

Objective:To investigate the possibility of producing vaccine with higher effect of anti-hepatoma by means of freezing the tumour cells which have been modified by TNF-? genes before. Methods: H22 cells which had been modified by TNF-? genes were treated by means of freezing and 60Co radiation or of 60Co radiation, respectively. Then, they were put to use to produce two kinds of vaccines. Effects of these two kinds of vaccines on anti- plant-hepatoma in mice were compared. Results: Effects of increasing the inhibiting rates, the levels of lectin-induced IL-2 and TNF from splenocytes, and the splentic NK activity, were all obviously seen stronger in vaccine made up of cells treated by the method combined with freezing, than that in vaccine made up of cells by no freezing. Conclusion: Method of freezing, after procedure of TNF-a gene modifying, could raise up the immunogenicity of the tumour cells, thereby enhance the anti-plant-hepatoma effect in mice induced by the vaccine.

0.05).This study was approved by the Hospital Ethics Committee.Written informed consents were obtained from all the patients.METHODS:In the interventional therapy group,patients underwent endovascular covered stent graft exclusion by an interventional means.After being generally anesthetized,patients were dissected at unilateral femoral artery.Under the perspective condition,a covered stent graft was placed at a proper position with a forwarder,and then it was released and expanded.Following the position and expansion of a covered stent being examined by CTA,femoral artery was anastomosed and incision was closed.If arteria iliaca was involved,then another covered stent was implanted from contralateral femoral artery and connected to stem.In the conventional therapy group,patients underwent prosthetic vessel replacement by a conventional means.Postoperatively,patients in the two groups all received anti-inflammation,anti-coagulation and other symptomatic and supportive treatments necessarily.MAIN OUTCOME MEASURES:① Postoperative complications of patients in two groups.② Recovery was observed by B-ultrasonography and CTA examination 1,3,6 and 12 months after operation.③ Follow-up of biocompatibility of biomaterials and host during 1 year postoperatively.RESULTS:Forty-two patients participated in the finial analysis.①Patients who exhibited pulmonary infection and renal function deterioration in the interventional therapy group were fewer than those in the conventional therapy group(P