Patients who suffer from recurrent patellar dislocation frequently complain of diffuse pain around the knee, swelling and dislocation or subluxation of the patella. Anatomical abnormalities should be responsible for the condition, such as increased Q angle, a high-riding patella, dysplasia of the femoral condyles, abnormal shape of the patella, atrophy of the vastus medialis and hypertrophy of the vastus lateralis. We reviewed 45 reports about the treatment of recurrent dislocation of the patella. The current more than 100 methods can be classified as: lateral release, proximal realignment, distal realignment, proximal and distal realignment, patella-tomy and plastic repair of quadriceps. Of all these methods, proximal realignment is the best, but there has been no method which can successfully and generally repair the recurrent patellar dislocation.

Objective To evaluate the effect of enteral nutrition emulsion on the immunologic function and intestinal mucous barrier in diabetic patients. Methods Eighty diabetic patients were randomly divided into con-trol group (n=40) and enteral nutrition group (n=40). The urine lactulose (L) and mannitol (M) levels and the blood immunologic indicators recorded on day 1 and day 8. Results The L/M ratio was significantly lower in enteral nutrition group than in control group on day 1 and day 8 ( P < 0. 05 ). The IgG level was significantly higher in enteral nutrition group than in control group on day 8 ( P = 0. 02 ). Conclusion Enteral nutrition emulsion can decrease the permeability of intestinal mucous membrane and improve the immunologic function in diabetic pa-tients.

BACKGROUND:Hepatic vascular exclusion is important for liver transplantation that can reduce blood loss and make for liver recovery. A variety of favorable hepatic vascular exclusion techniques occur in the development of liver surgery technology, which is stil a research hot in surgical study. OBJECTIVE:To introduce the latest research and the hot spot of hepatic vascular exclusion techniques. METHODS:A computer-based online search of PubMed and Wanfang databases for articles relevant to Pringle maneuve, total hepatic vascular exclusion, selective hepatic vascular exclusion and sectional vascular exclusion under hepatectomy published from January 1999 to January 2014. Totaly 50 articles were included in result analysis. RESULTS AND CONCLUSION:There are a variety of hepatic vascular exclusion technologies, and intermittent hepatic vascular occlusion and semihepatic vascular exclusion are used most commonly. The applicable principles are as folows: (1) Surgery without vascular exclusion is suitable for < 5 cm lesions at the liver edge. (2) Semi-hepatic vascular exclusion is fit for semi-hepatic lesions, especialy for patients accompanied by liver cirrhosis. Hepatic vascular exclusion with preservation of semi-hepatic artery and liver hanging maneuver are also reported to have a certain value in clinical practice stil need further studies. (3) Intermittent hepatic vascular exclusion is suitable for lesions over half a liver or spanning liver halves (huge lesions). (4) Total hepatic vascular exclusion and its modified technologies are suitable for lesions involving the inferior vena cava and (or) hepatic vein, or lesions closely related to the second and third porta hepatis. (5) Segmental hepatic vascular exclusion is considered for smaler lesions confined to the liver segment under alowed conditions, but semi-hepatic vascular exclusion and Pringle maneuver can be also considered. Depending on patient’s conditions, to select the appropriate method is the key to reduce bleeding and to ensure patient safety.

Objective To investigate the clinical value of the bedside color Doppler in the assessment infants with periventricular-intraventricular hemorrhages (PIVH).Methods Sixty-eight cases of PIVH newborns and 156 healthy newborns were involved in the study,dynamic monitoring were undergone within a week after birth.The middle cerebral artery(MCA) hemodynamic parameters of velocity systolic (Vs),velocity diastolic(Vd) and resistance index (RI) were recorded,and the differences of the parameters were compared between different grades as well as those of the normal newborns at 1 d,4 d and 7 d after born.Results Total 68 PIVH infants were diagnosed by bedside color Doppler accurately.Prevalences of premature and low birth weight infants were higher than term infants and normal birth weight children,respectively (P ＜0.05).Vs and Vd of 4 groups of children with PIVH showed an increasing trend in a week after born.The differences of Vs between grade Ⅰ and normal newborns in 4 d and 7 d were not statistically significant (P＞ 0.05),the differences of the other three groups compared with normal newborn group in1 d,4 d and 7 d were statistically significant (P ＜0.05).Vd of grade Ⅱ newborns within 7 d were greater than those of other 4 groups (P ＜0.05),grade Ⅲ and grade Ⅳ within 7 d were less than healthy newborns (P ＜0.05).The difference of RI between all groups were not statistically significant (P ＞ 0.05).Conclusions The diagnostic accuracy rate of PIVH by bedside Doppler is high and the dynamic monitoring of neonatal hemodynamics could provide an important basis for assessing the occurrence and development of PIVH.

Problems such as detached knowing and doing , utilitarian tendency , moral practice ability is weak and so forth are now existing in the medical college students'moral practice in the new period .There are not only medical students'personal factors , but also school and social factors .Therefore , it should excavate potential , build good medical students moral practice platform , innovative form of moral practice , motivate medical students to par-ticipate in the moral practice enthusiasm , strengthen the construction of management system , ensuring the medical students moral practice into effect .

Objective To compare clinical effect of MTA and Vitapex for young permanent teeth with periapical incomplete apical closuret . Method Teeth 90 were chosen from 80 patients at 7-25 years old young permanent teeth with periapical and randomly divided into MTA group and Vitapex group 45 in each group.Two groups were treated with MTA and Vitapex paste treatment respectively.6-month and 12-month after treatment followed up, observed clinical efficacy of two groups.Results The six-month recall, X-ray ( MTA group 93.33%, Vitapex group 88.89%) and clinical parameters (MTA group 95.56%, Vitapex group 86.67%) success rate of two group was no significant difference.When the 12-month followed up, X-ray examination of MTA group's success rate was 93.33%, significantly higher than 68.89%Vitapex group (P<0.05), clinical indicators of success rate of 95.56%MTA group,significantly higher than the 71.11%Vitapex group (P<0.05).Pain during root canal therapy (EIP) of the occurrence, MTA group than Vitapex group (P<0.05).Conclusion The effect of short-term treatment of MTA in treatment of young permanent teeth with periapical incomplete apical closure is definite,it is an ideal induce apical molding material.

Although chronic lateral instability of the ankle is a common disorder, there are not many reports and researches on it in China. This is because most patients with the condition do not seek a thorough cure of it and consequently surgeons pay little attention to it. In this article, we discuss some of the problems about its diagnosis, describe and compare several surgical procedures for reconstruction of the lateral ligament. We hope this paper can help surgeons know more about how to make an accurate diagnosis of the chronic lateral instability of the ankle and how to deal with it.

0.05). Nine foots (18.0% ) reported soft tissue problems in the plate group, and three foots (5.5% ) in the limited internal fixation group. The difference between the two groups was statistically significant (P

[Objective]To evaluate the outcome of thoracolumbar fracture with spinal cord injury treated with short-segment pedicle instrumentation.[Method]47 cases of thoracolumbar fracture with spinal cord injury from 1999 to 2004 in our department were collected,all of them were treated with short-segment pedicle instrumentation.The radiologic,neurologic,and functional outcome were assessed.[Result]All of the 47 cases were followed up,the mean follow-up were 51.9 months(18~ 86 months),the average of vertebral anterior and posterior height were corrected from 43.6%,71.4% to 92.2%,96.4%;and 88.3%,93.1% at the last follow-up separately.The Cobb's angle were corrected from 23.5?to 4.3?,and 8.8? at the last follow-up.62.8% of the vertebral canal was occupied pre-operation,and 11.4% post-operation,6.2% at last follow-up.There was significant deference in targets between pre-operation and post-operation(P0.05).Neurologic status improved at least 1 Frankel grade in the patients who had preoperative incomplete paraplegia.61.7% of patients returned to work.[Conclusion]Short-segment pedicle instrumentation can provide good reduction,strong fixation,complete decompression and fusion.The treatment outcome is good.Moreover,it is a less traumatic,simple and safe technique.

Objective To discuss pathogenic effects of low high-density lipoprotein cholesterol(HDL-C)on atherosclerosis and thromboembolism,the influences of HDL-C on platelet cytosolic free calcium concentration([Ca2+]i),platelet release reaction products beta-thromboglobulin(?-TG)and platelet factor 4(PF4)were observed in dyslipoproteinemia patients with low HDL-C.Methods i,?-TG and PF4 were measured by fluorescent probe Fura 2-AM and ELISA skills respectively,in 42 patients with low HDLC(LHDL-C)and 25 healthy controls(CONT).Results Compared with those in CONT group,the platelet[Ca2+]i,?-TG and PF4 were all higher in LHDL-C group(all P