Objective To analyze surgical diagnosis and treatment effect of 25 cases with gastric stump carcinoma.Methods The clinical manifestations and therapies of 25 cases with gastric stump carcinoma in our hospital from 1992 to 2003 were analyzed retrospectively.We sum up the surgical methods and postoperative survival rate.Results The postoperative survival rates of 1,3 and 5 years in 25 cases with gastric stump carcinoma were 60.2%,34.2% and 18.6% respectively,and were 81.4%,48.2% and 36.7% respectively in cases treated with radical resection.Conclusion No specific symptoms were identified,endoscopy examination periodically is the key point to detect gastric stump carcinoma.Radical resection is the most effective surgical style for surgical treatment of gastric stump carcinoma.

Objective To evaluate the value of three-dimensional color power angiography(3D-CPA,) in osteosarcoma diagnosis. Methods Forty-three cases with osteosarcoma were detected with 3D-CPA to assess the vascular classification(3D-CPA Ⅰ to Ⅲ) and measure the vascular parameters including vascularization index(VI), flow index(FI) and vascularization-flow index(VFI). Results All of the 43 cases were classified into 3D-CPA Ⅲ type. The space structure shape of blood vessels and the origin of nutrient vessels was clear. The quantitative measurement showed that VI was 25.84±6.87,FI was 34, 18±2.93, VFI was 9.02±4.04. Conclnsions It is a new method to analyze and diagnose osteosarcoma with 3D-CPA because it can show the nutrient vessels and the embranchments of blood vessels clearly, tridimensionally and integrally and Bake quantitative or partial-quantitative analysis.

Background Researches showed that CD4+CD25+ natural regulatory T cells (nTregs) play an important role in maintaining peripheral immune tolerance, while immunotherapy using in vitro-expanded induced regulatory T cells (iTregs) suppresses allograft rejection in multiple organ transplantation.The inducing method of iTregs still needs to be optimized.Furthermore,the effect of iTregs on grafts of keratoplasty is unclear.Objective This study was to investigate the inducing and expansion method of iTregs and explore its inhibitory effects on corneal allograft rejection.Methods Bone marrow-derived dendritic cells (BMDCs) were isolated from C57BL/6 mice femora and cultured.CD4+ CD25+ T cells and CD4+ CD25-T cells were isolated from mouse spleen and separated using flow cytometry.The CD4+CD25-T cells were divided into negative control group (CD4+CD25-T cells), CD3/ 28 antibody bead group (CD4+CD25-T cells+CD3/28 antibody bead) ,2.5 ng/ml transforming growth factor (TGF)-β1 induced group and 10.0 ng/ml TGF-β1 induced group.The iTregs was formed after induction of different concentrations of TGF-β1 and CD3/CD28 antibody bead (1 : 1).CD3/CD28 antibody bead (1 : 2) , interleukin-2 (IL-2) and TGF-β1 were used to expand iTregs.The phenotype and proliferation of iTregs were assayed by flow cytometry,and the inhibitory effect of iTregs on effector T cells (Teffs) was analyzed by mixed lymphocyte reaction.Allogenic keratoplasty model (C57BL/6→BALB/c) was build,and 0.1 ml iTregs or nTregs suspension or PBS was injected via posterior venous plexus of fellow eyes to assess the graft survival time.The use and care of the mice followed the ARVO statement.Results The CD4+CD25+ T cell proportions were (6±3)％ ,(91±4)％ ,(91±3)％ and (86± 6) ％ in the negative control group,CD3/CD28 antibody bead group, 2.5 ng/ml TGF-β1 induced group and 10.0 ng/ml TGF-β1induced group, showing significant increases in the CD3/CD28 antibody bead group, 2.5 ng/ml TGF-β1 induced group and 10.0 ng/ml TGF-β1 induced group compared with the negative control group (all at P＜0.01).The Foxp3+ T cell proportions of the CD3/CD28 antibody bead group,2.5 ng/ml TGF-β1 induced group and 10.0 ng/ml TGF-β1 induced group were (1.18 ±0.20) ％ , (8.70± 1.80) ％ and (21.80±3.36) ％ , showing significant increases in the 2.5 ng/ml TGF-β1 induced group and 10.0 ng/ml TGF-β1 induced group compared with the CD3/CD28 antibody bead group (both at P＜0.01).Compared with the nTregs, the expression of CD69 was lower, and the expressions of PD-1 and Foxp3 were raised in the iTregs (all at P＜0.01).The proliferation of Teffs were decreased when cocultured with iTregs in comparison with nTregs at 1 : 1,1 : 2,1 : 4,1 : 8,1 : 16 Tregs/Teffs rations (all at P＜ 0.01).The survival time of mouse corneal grafts was 4 weeks with the permanent tolerance of 50％ in the iTregs injected group,which was superior to the 3 weeks survival time and 17％ permanent tolerance in the nTregs injected group(P＜0.05).Conclusions TGF-β1 can induce CD4+ CD25-T cells to form iTregs, which highly express Foxp3.iTregs show a stronger inhibitory effect on the growth of lymphocytes than nTregs, and therefore suppress the graft rejection after keratoplasty.

Etrotic Company produced thermoplastic diaphragm (ERKOLODC-pro, 595115) can be shaped according to dental arch form under vacuum heating pressure, resulting in good fixation and baffle effect. Nine cases with soft and hard palate defect caused by tumor, who needed the repair of temporal obturator prosthesis made by thermoplastic diaphragm (1.5 mm of thickness), were selected in this study at the Department of Stomatology, General Hospital of Chinese PLA from September 2006 to January 2007. Different diaphragms were used according to periodontal status. Only one case with more soft palate defect felt naupathia when wore this kind of denture near throat. After 1 week, the uncomfortable feeling disappeared. Three patients felt pain, and the main reason is tissue dropsy around wound entry and denture crackdown. After grinding, pain disappeared. This indicated that no adverse reaction in biocompatibility was detected between thermoplastic diaphragm and host. Temporal prosthesis can improve swallowing and voiced function of soft and hard palate defect patients by closing nasal cavity.

Objective To compare the neonatal outcomes of different gestational age at which elective cesarean sections at term were performed. Methods All the cases of cesarean section registered in Peking Union Medical College Hospital from September 2002 to November 2009 were collected. Women with viable singleton pregnancies delivered before the onset of labor and without recognized indications for cesarean section after 37 weeks at term were included and their general information and outcomes were compared with one-way ANOVA. All the maternal data and neonatal adverse events were compared with Cochran-Armitage test among different gestational weeks, including respiratory complications (respiratory distress syndrome or transient tachypnea of the newborn), infections, admission to the neonatal intensive care unit (NICU), and hospitalization in NICU＞5 d. Results Of 8122 primary cesarean sections and 594 repeat cesarean sections at term, 4565 and 409 cases were performed electively as the primary or repeat cesarean section. Among the 4565 women underwent primary elective cesarean sections, 2194 (48.1%) were before 39 gestational weeks,and 1828 (40.0%) at 39-39+6 weeks. While, among the 409 repeat elective cesareans sections, these figures were 275 (67.2%) and 120 (29.3%), respectively. No fetal or neonatal death occurred during perinatal period. Compared with births at 39-39+6 weeks, births at 37-37+6 weeks or 38-38+6 weeks were associated with increased risk of the neonatal adverse events. For the primary cesarean section cases, the odds ratio (OR) for births at 37-37+6 weeks and 38-38+6 weeks was 1.4 (95% CI: 0.9-2.0) and 1.1 (95% CI: 0.9-1.4), respectively. For the repeat cesarean section cases, OR for births at 37-37+6 weeks and 38-38+6 weeks was 2.5 (95% CI: 1.1-5.8) and 1.3 (95% CI: 0.6-2.7) respectively. Conclusions Elective cesarean section before 39 weeks of gestation is popular and associated with adverse neonatal outcomes. Elective cesarean section performed after 39-39+6 gestational weeks might decrease the risk of adverse neonatal outcomes.

[Objective]To study the effect of arthroscopic reconstruction of anterior cruciate ligament with hamstring tendons and mini-plates.[Method]Thirteen cases of anterior cruciate ligament ruptures were reconstructed arthroscopically with over six strands of hamstring tendons in way of one-bundle and two-tunnel reconstruction.The grafts were fixed with suspension technique by mini-plates.The patients were followed up for one year.The clinical results were evaluated according to Lysholm rating scale.[Result]Twelve patients(92.31%) had negative Lachman test,and one patient showed positive Lachman test.Pivot shift test was negative in 12 cases,and was positive in one case.The Lysholm score increases from 47.77?1.96 to 95.38?4.74(P

Objective To investigate whether and how CD4 + CD25 + regulatory T cells(Tr) affect oxidized low density lipoprotein(oxLDL) induced proinflammatory response in macrophages.Methods Tr were isolated from lymphocyte suspensions by magnetic cell sorting-column and analyzed by flow cytometry.Macrophages were cultured alone,with CD4 + CD25 + Tr or CD4 + CD25 - Tr in the presence of oxLDL for 48 h.The phenotype of macrophages was determined by flow cytometry.NO production was assessed by Griess reaction an iNOS mRNA was isolated by RT-PCR.ELISA were used to measure the production of cytokine/chemokine like MCP-1,MMP-9,TNF-ct,TGF-β and IL-10 in macrophages response to oxLDL.Results Our data showed that with oxLDL challenge,the Tr modulated macrophages have decreased NO production and iNOS expression,decreased HLA-DR and CD86 expression,and down-regulated proinflammatory cytokine/chemokine production.Conclusion Tr can inhibit the proinflammatory properties of macrophages and steer macrophage differentiation toward an anti-inflammatory cytokine producing phenotype.

Objective To observe the effects of aerobic exercise on low-and high-density lipoprotein cholesterol,and to investigate the relationship between exercise intensities and high-density lipoprotein cholesterol (HDL-C) changes.Methods Sixty patients with low HDL-C were randomly allocated into a high intensity exercise group,a moderate intensity group or a low intensity group with 20 in each group.According to each patient's maximal heart rate in a restrictive electrocardiogram exercise test,the different aerobic exercise intensities were formulated as follows.The target heart rate of the high-intensity training group was 90％ of each subject's maximum heart rate; in the moderate-intensity group it was 70％ ; in the low-intensity group it was 50％.All 3 groups jogged on a medical treadmill for 20 minutes every other day with their heart rates monitored at all times.They maintained the target heart rate for 20 minutes.The experiment lasted 2 months.Results In the high intensity group HDL-C increased from 0.81 ± 0.22 to 1.04 ± 0.33 mmol/L after training; in the moderate intensity group it increased from 0.82±0.20 to 1.03 ±0.37 mmol/L; in the low intensity group it increased from 0.79 ±0.25 to 0.82 ± 0.27 mmol/L.That increase in the low intensity group was not statistically significant.After high intensity or moderate intensity training the HDL-C increases were statistically significant,but the difference between the groups was not.After training,in 15 cases among the high intensity group,13 cases from moderate intensity group and in 1 case from the low intensity group the HDL-C level achieved a normal value (≥ 1.04 mmol/L).Comparing the high intensity group to the low intensity group or the moderate intensity group to the low intensity group,there were significant differences in the number of patients who achieved normal HDL-C readings,but there was no significant difference between high intensity group and the moderate intensity group.Conclusion Low intensity aerobic exercise has no obvious effect on low HDL-C levels.High or moderate intensity aerobic exercise can effectively raise the HDL-C level,but there is no significant difference in the fraction of patients reaching normal values between high and moderate intensity aerobic exercise.So moderate intensity is recommended for improving low levels of HDL cholesterol.

Objective To identify the nutritional risks of the hospitalized children with congenital heart disease (CHD) during perioperative period and the relationship between nutrition risks and the clinical outcomes.Methods Totally 780 CHD children (522 cases of ventricular septal defect,133 cases of atrial septal defect,70 cases of tetralogy of fallot,and 55 of patent ductus arteriosus) were recruited.The STRONGkids (Screening Tool for Risk on Nutritional Status and Growth) was used to analyze the nutritional risks of CHD children and to identify the nutritional risks of these children at different ages.Also,the potential effect of pulmonary hypertension on malnutrition and effects of the possible nutritional risks on the clinical outcomes were analyzed.Results Of these 780 CHD children,260 (33.3％) were found to be with high and moderate nutritional risks.The incidences of these risks were 49.2％ (187/380) in the 0-1-year-old group,which was significantly higher than that in the 1-3-year-old group (26.2％,60/229) (x2 =25.174,P ＜0.001) and the ＞ 3-year-old group (7.6％,13/171) (x2 =36.029,P ＜ 0.001).Both pulmonary hypertension and malnutrition showed synergic effects on the clinical nutritional risk,and higher nutrition risks were associated with poorer clinical outcomes.Conclusions STRONGkids can effective evaluate the nutritional risks of CHD children during the perioperative period and thus can inform the standardized nutrition support.

Objective To evaluate the value of computed tomography(CT) and magnetic resonance imaging(MRI) in diagnosis of avascular necrosis of the femoral head(ANFH). Methods The literatures of ANFH diagnosed with CT and MR imaging published in the last ten years were collected by searching. Of that,21 literatures were correspond for the standards in this study and were select-ed. These literatures in diagnosing ANFH with CT and MR imaging were analysed with Meta-analysis by the sofeware of StataSE10.1. Results MRI was more effective than CT in diagnosing ANFH. There was significantly different in statistics between them [OR=0.13,95%CI(0.03～0.51)]. Conclusion In comparison with CT,MRI is the better method in diagnosing ANFH.