Objective To investigate the pathogenesis of avascular necrosis of the femoral head(ANFH) and to observe the effects of uhrashortwave diathermy treatment of ANFH through animal experiments.Methods A total of 30 New Zealand white rabbits were randomly divided into three groups:a control group,a model group,and a diathermy group.All the groups were injected with horse serum and methylprednisolone to induce ANFH.The path- ological effects were observed.Results The amount of osteoblast in the model group was significantly less than in the control group,while in the diathermy group it was significantly increased compared with the control group.The a- mount of osteoclast in the model and diathermy groups was significantly higher than in the control group,and in the diathermy group it was significantly more than in the model group.The thickness of femoral head cartilage in the mo- del and diathermy groups was reduced compared with the control group,while it was thicker in the model group than in the diathermy group.The empty cartilage cell lacunae ratios of the model and diathermy groups were significantly higher than for the control group,and the diathermy group showed significant degradation compared to the model group.The density of blood vessels under the cartilage in the model group was significantly less compared with the control group,while in the diathermy group it was significantly increased compared with the control group.The width of bone trabeculae in the model and diathermy groups was significantly less compared with the control group,while they were significantly wider in the diathermy group compared with the model group.The diameters of fat cells in the model and diathermy groups were increased compared with the control group,while they were significantly smaller in the dia- thermy group compared with the model group.The adipocyte area rates in the model and diathermy groups were signifi- cantly elevated compared with the control group,and rates in the model group were significantly elevated compared with the diathermy group.Conclusion Ultrashortwave diathermy is an effective treatment for early stage ANFH.

Adult ; Endoscopy ; Epistaxis ; etiology ; surgery ; Female ; Humans ; Middle Aged ; Nasal Cavity ; surgery ; Telangiectasia, Hereditary Hemorrhagic ; complications ; surgery

Objective To study the clinical significance of P - selection expression in children with viral encephalitis and the correlation between this expression and the cerebral infarction with critical viral encephalitis. Methods Flow cytometric was employed to detect the expression of P- selection on the surface of platelet membrane in 44 children with viral encephalitis(20 light patients and 24 critical patients) and 20 healthy control children. The area of the cerebral infarction was determined by computed tomographic scan in 20 patients with critical viral encephalitis. The correlation between the two variables was analyzed. Results The expressions of P - selection on the surface of platelet membrane on less than 5 days and on 2 weeks after the onset of viral encephalitis were significantly higher in critical patients than those in normal control children and light patients( P

Objective To analyze C4d deposition in the patients with late acute renal allograft rejection,and explore the role of C4d in grafts survival and grafts loss. Methods Thirty-six patients clinical and pathologically diagnosed as having acute rejection more than one year post-transplant were selected. C4d was detected by immunohistochemistry in renal allograft biopsies. The effect of C4d deposition on long-term graft survival was studied. Results Among 36 recipients with late acute renal allograft rejection, 16 cases were positive for C4d (44.4 %) and 20 negative for C4d (55.6 %). Five cases experienced graft loss in C4d positive group (31.3 %), while 6 cases in C4d negative group (30.0%). There was no significant difference in the graft loss rate between C4d-positive group and C4d-negative group. Log-Rank test demonstrated there was no significant difference in graft survival between C4d-positive group and C4d-negative group. The count of the interstitial infiltrated eosinophils in renal allograft was (9.4 + 4.5) and (2.6 + 1.8) respectively in the C4d-positive group and C4dnegative group (P＜0.05). Conclusion C4d deposition in peritubular capillary of the recipients with late acute renal allograft rejection might not be a prognostic marker for graft outcome.

Humans ; Infant ; Male ; Pulmonary Alveolar Proteinosis

Objective To observe the effect of ultrashort wave diathermy on collagen type I expression in early stage of hormon-induced avascular necrosis of the femoral head (ANFH) in rabbit.Methods A total of 40 New Zealand white rabbits were randomly divided into two groups:a control group (n=10) and a treatment group (n =30).All the animals in the treatment group were injected with horse serum and methylprednisolone to establish the ANFH model,and then divided into 2 subgroups:a model group and a ultrashort wave diathermy group,which were treated accordingly.After 12 weeks of treatment,all the animals were sacrificed and collagen type I expression in the femoral head was observed.Results It was shown that the expression of the collagen type I was significantly lower in the model animals than that in the controls as indicated by the stronger immunohistochemistry staining for rabbit collagen type,while that of the ultrashort wave diathermy group was significant higher than the control group ( P

OBJECTIVE: To generally, regularly, and continuously evaluate single renal function in donors following living renal transplantation, to study functional changes of single kidney, and to analyze clinical feasibility of living renal transplantation. METHODS: A total of 117 living kidney donors had been selected in this study. Following renal transplantation, indicators of creatinine (Cr), glomerular filtration rate (GFR), urine microscopic examination, blood pressure were monitored and followed up so as to generally evaluate the variation of single renal function and health status of living donor. RESULTS: All 117 living donors accepted kidney transplantation successfully. There were untoward events including 2 cases for drug anaphylaxis, 8 cases for microscopic hematuria, 5 cases for proteinuria, 15 cases for urinary tract infection, 3 cases for anxious emotion after operation, and 22 cases for wound pain. The blood pressure was increased in 19 cases and glomerular filtration rate (GFR) was decreased 4-25 mL/min with the average value of (9.4±4.7) mL/min in all cases, but the rates did not exceed the normal level. Nearly all of the cases displayed creatinine rising and 43 cases still had high creatinine level in 2 months after operation. There were no significant differences between creatinine level and sex, and left or right kidney of donor, but creatinine level of patients (> 50 years old) was significantly higher than patients (< 50 years old) (P < 0.01). Indicators of all cases returned the normal value after operation; however, creatinine level of 5 cases was still abnormal (135 μmol/L). CONCLUSION: The function detail could be fluctuated after living donor renal transplantation, or even exceeded the normal value, but the variation did not impact the whole function for the single kidney and influence the holistic health for donor, thus it could be safe and feasible for living donor renal transplantation.

Objective To investigate the scope of application of precise hepatectomy and its value.Methods The clinical data of 112 consecutive patients with liver neoplasm who received hepatectomy at Renji Hospital from November 2006 to March 2009 were retrospectively analyzed.Precise hepatectomy technique was applied to 88 patients(precise group),whereas pringle maneuver was applied to the rest 24 patients(prince group).Patients in precise group had undergone lobectomy,segmentectomy or local resection,while patients in pringle group received segmenteetomy or local resection.The perioperative conditions of patients in the 2 groups were compared via Fisher exact probability and l test.Results No perioperative mortality,hepatic failure,reoperation due to massive hemorrhage or bile leakage was observed.The blood transfusion rate,blood loss,postoperative total bilirubin(Tbil),prothrombin time(PT)were 7%(2/29),220 ml,20 μmol/L,13 seconds in patients who received segmentectomy and local resection in precise group,and were 4%(1/24),210 ml,19μmol/L and 13 seconds in patients who received segmentectomy and local resection in pringle group,with no significant difference(t=0.248,0.263,0.246,P>0.05).The operation time,postoperative white blood cell (WBC)count.alanine aminotransferase(ALT)value and fever incidence were 60 minutes,7.5×10~9/L,66 U/L,10%(3/29)in patients who received segmentectomy and local resection in precise group,and were 15 minutes,14.0×10~9/L,335 U/L and 42%(10/24)in patients who received segmentectomy and local resection in pringle group,with significant difference(t=4.962,4.961,4.959,P<0.05).In precise group,the blood transfusion rate,postoperative WBC count,ALT value.PT and fever incidence were 9%(4/45),8.3×10~9/L,153 U/L,17 seconds and 13%(6/45)in patients who received Iobectomy,and were 12%(5/43),8.2×10~9/L,133 U/L,14 seconds and 14%(6/43)in patients who received segmentectomy or lncal resection,with no significant difference (t=1.652,1.225,1.236,P>0.05);the blood loss,operation time and postoperative Tbil level were 350 ml,250 minutes and 32μmol/L in patients who received lobectomy.and were 240 ml,150 minutes and 21 μmol/L in patients who received segmentectomy or local resection(t=4.915,4.967,4.829,P＜0.05).Conclusions Precise hepatectomy can decrease damage to patients,but it should be applied in selected patients according to the tumor location and the excision range.Precise hepatectomy is recommended to be applied in lobeetomy.

Objective To compare the clinical effect of off-pump coronary artery bypass grafting (eft-pump CABG)and on-pump coronary artery bypass grafting(on-pump CABG).Methods The clinical dates of 152 cases with coronary artery bypass grafting(off-pump CABG group 85 cases,on-pump CABG group 67 cases)were received from June 2005 to December 2008,the preoperative dates,postoperative mortality and the rate of complication were compared between two groups.Results The preoperative dates of two groups were no significant difference(P>0.05);2 cases(2.35%)were died in off-pump CABG group and 13 cases(15.29%)had complications in off-pump CABG group;9 cases(13.43%)were died in on-pump CABG group and 25 cases(37.31%)had complications in on-pump CABG group.The mortality and the rate of complication in off-pump CABG group was significantly less than that in on-pump CABG group.it was significant difference(P<0.01).Conclusion Off-pump CABG is safe therapy of mieosurgieal operation.

Objective To evaluate the safety,feasibility and efficacy of emergency percutaneous coronary intervention(PCI)on the spot in the patients with acute myocardial infarction(AMI)in country hospitals by interventional cardiologists from higher-level hospitals(converse transport).Methods A total of 81 AMI patients received emergency PCI on the spot by interventional cardiologists from other higher-level hospitals (transported doctors)from Mar 2004 to Sep 2008 in our hospital.The mean age of patients was 68.6 ± 3.6 years (36.0-83.0 years).Forty-six patients were male and 35 were female.There were 56 cases with anterior myocardial infarction and 25 with inferior myocardial infarction(including 11 cases combined with right ventricular infarction).The average time from symptom onset to admission was 6.2 ± 1.8 hours(2.0-12.0hours).Results Three cases were transported to higher-level hospitals for CABG because of severe conditions.The other 78 cases received emergency PCI on the spot,among whom 66 cases received primary PCI.Another 12 cases received rescue PCI.Eight one stents were implanted in total into the infarcted arteries.One operation was failed because the balloon could not go through the lesion.The success.rate was 98.7％.Four patients occurred peri-operative cardiac adverse events and 2 cases died.Four cases died during the 32-86 months follow-up,of whom I was cardiac death and 3 was non-cardiac deaths.No fatal cardiovascular events occurred in the remained cases.Conclusion Emergency PCI on the spot by interventional cardiologists from other cities(converse transport PCI)in AMI is safe,feasible and effective.But it needs to be confirmed in a large-scale study in the future.