Objective To explore the surgical methods for unstable fractures of distal radius and evaluate the clinical results. Methods A retrospective analysis was conducted on 87 patients with unstable fractures of distal radius treated surgically from May 2001 to June 2008. According to AO classification and comminution severity, three methods including plate fixation, external fixation and Kirschner' s pins and plate fixation plus external fixation were employed accordingly. Results Of all, 78 patients were followed up for average 18 months. The result of Cooney's assessment of the wrist was excellent in 44 patients, good in 21, fair in 11 and poor in 2, with excellence rate of 83%. Conclusions The surgical methods should be selected based on different types of unstable distal radius fractures. In the meantime, maximal recovery of the relative length of the radius and ulna, formation of articular surface, volar tilting angle and ulnar inclination angle and reasonable rehabilitation exercises are helpful for the functional recovery of the wrist to a largest extent.

Objective The aim of this study was to discuss the technical details on laparoscopic total cyst excision with Roux Y hepatoenterostomy for the treatment of choledochal cyst in children.Methods Eight patients with type Ⅰ choledochal cyst (median age 3 6 years) underwent laparoscopic cyst excision with Roux Y hepatoenterostomy from July 2001 to April 2002.Under laparoscopic guidance, intraoperative cholangiogram was performed, the gallbladder and the dilated bile duct were completely excised. Roux en Y jejunojejunostomy was performed extracorporeally through umbilical incision (2 cm), and an end to side anastomosis was carried out intracorporeally.Results Median duration of operation was 4 8 hours (3 6 to 6 0 hours), intraoperative bleeding was between 10 to 50 ml. Hospital stay after the operation ranged from 3 to 8 days. There was no intra or postoperative complication.ConclusionLaparoscopic total cyst excision with Roux Y hepatoenterostomy was effective and safe procedure for children with choledochal cyst.

Objective To compare the reliability of erythrocyte parameter mean corpuscular volume(MCV)and mean corpuscu-lar hemoglobin(MCH)for screening thalassaemia trait.Methods A fresh venous blood sample with the cut-off value of MCV was sent to 21 hospitals of Zhuhai city for conduct the full blood cell analysis within 1 d.Then the inter-and intra-coefficient of varia-tion (CV)as well as bias values of MCV and MCH were calculated and compared.In addition,10 EDTA-anticoagulant venous blood samples were divided into two parts,the effects of stored temperature and time on MCV and MCH were observed.Results The coefficient of variation(CV)of MCV (4.1%)was significantly greater than that of MCH (2.8%)among 21 laboratories,the qualification rate of MCH detection results was 100%,which was significantly higher than 66.7% of MCV (P <0.05).When the whole blood samples were stored under 2 kinds of the temperature condition(room temperature and refrigeration)for 72 h,MCH changed little (P >0.05).When these samples were stored under the refrigerated condition for 72 h,MCV had no statistically sig-nificant difference compared with the instant detection results of MCV (P >0.05),when stored at the room temperature for 48 h, MCV was significantly increased (P <0.05),MCV had statistical difference in storage for 48 h between the room temperature and the refrigeration.Conclusion Among laboratories and under different temperature conditions,the reproducibility of MCH is better than that of MCV and is more stable than MCV.MCH as the clinical first-line screening for thalassaemia is more reliable than MCV.

Objective To study the feasibility and efficacy of laparoscopic operation for choledochal cyst. Methods Under laparoscopy,intraoperative cholangiography was performed.The dilated commom bile duct and the gallbladder were excised,a Roux-en-Y cholangio-jejunostomy was constructed outside the abdominal cavity. Results 5 babies underwent the total cyst excision and hepato-cholangio-jejunostomy successfully and quickly recovered.Only a girl transferred to open operation because of previous operative history. Conclusions Laparoscopic treatment of choledochal cyst is feasible and satisfied outcome.

Objective To investigate the feasibility of laparoscopically assisted anorectal pull-through in the repair of high imperforate anus. Methods Four infants (3 boys and 1 girl, age range, 1 d～90 d) with high imperforate anus entered this study. During operations, the rectum was exposed via laparoscope down to the rectourethral fistula, which was ligated and dissected out laparoscopically; and then, by way of a passage through the center of pelvic floor musculature, the rectum was exteriorized to the perineum to perform anorectal anastomosis. Results Laparoscopically assisted anorectal pull-through was successfully performed in all the 4 cases as a primary procedure. The mean duration of the laparoscopy was 71 8 min (range, 45 min～90 min) and the mean blood loss 8 3 ml (range, 5 ml～20 ml), no blood transfusion required and no intraoperative complications occurred. All patients recovered uneventfully. In 3～12 months of follow-up, 1 patient was found anal stenosis at 1 month after the operation and was cured with secondary anorectoplasty. No postoperative complications were seen in the other 3 cases. By now, all the 4 patients have normal fecal continence. Conclusions Laparoscopically assisted anorectal pull-through is an effective technique in the repair of high imperforate anus. Experience has shown that this approach offers minimally invasive wounds, excellent visualization of the rectal fistula and accurate identification of the center of pelvic floor musculature.

Objective To investigate the relationship between body mass index (BMI),total body fat (TBF),body fat distribution,and dyslipidemia in the elderly.Methods A total of 395 healthy elderly people who had annual examination at Peking Union Medical College Hospital were consecutively enrolled from October 2013 to March 2014.Body weight (BW),TBF,abdominal fat (AF),visceral fat (VF),visceral fat area (VFA) and waist-to-hip ratio (WHR) were measured with multi-frequency bioelectric impedance analysis.Serum triglyceride (TG),total cholesterol (TC),high-density lipoprotein cholesterol (HDL-C) and low-density lipoprotein cholesterol (LDL-C) were measured at the same time.The relationship between BMI,TBF,body fat distribution,and dyslipidemia were analyzed.Results The incidences of obesity (17.8％ vs.9.6％,P=0.036),overweight (49.6％ vs.30.4％,P=0.000) and dyslipidemia (67.0％ vs.44.8％,P =0.000) in male were significantly higher than those in female;while female showed a significantly higher percentage of TBF (60.0％ vs.41.1％,P =0.001).TC was positively correlated with TBF (P =0.020),AF (P =0.018),VF (P =0.015) and VFA (P =0.017);TG was positively correlated with BMI (P =0.000),TBF (P=0.000),WHR (P=0.000),AF (P=0.000),VF (P=0.000) and VFA (P=0.000);LDL-C was positively correlated with BMI (P =0.049),TBF (P =0.005),AF (P =0.004),VF (P =0.003) and VFA (P =0.004);while HDL-C was negatively correlated with BMI (P =0.000),TBF (P=0.020),WHR (P=0.000),AF (P=0.021),VF (P=0.024) and VFA (P=0.022).Receiver operating characteristic curve analysis showed that the predictive curves of BMI,TBF,WHR,AF,VF and VFA were above the reference line.TBF (P =0.000),WHR (P =0.000),AF (P =0.000),VF (P =0.000),VFA (P =0.000),TG (P =0.000) and LDL-C (female:P =0.021) in obesity/overweight group were significantly higher than those in normal weight group.Conclusion Obesity/overweight,high TBF and large WHR may increase the risk of dyslipidemia in the elderly.

Objective To study the connection between MRI characteristics of spinal cavernous hemangioma(SCH)and its clinical and pathological features.Methods 20 cases of SCH confirmed by pathology were retrospectively analysed.The characteristics of MRI signal intensity were analysed in comparison with the clinical manifestations and pathology.Results Among the 20 cases,5 lesions located in the cervical segment of spinal cord,12 lesions in the thoracic segment,2 in the lumbar segment and 1 in the thoracic-lumbar segement.SCH could be devided into four patterns:intramedullary lesion,epidural lesion,intradural-extramedulary lesion and vertebral lesion.The typical MRI characteristics of SCH were mixed signal intersity on T_1 or T_2 weighted images,low signal intensity ring could be seen around the lesions and more pronounced on T_2 images.Spinal cord compression syndrome was the main clinical manifestation.Cavernous hemangiomas were red or purple mulberg-like lesions which were composed of dilated,thin-walled vessel with a simple endothelial lining and a variably thin fibrous adventitia under the microscope.Conclusion MRI is the most reliable method in diagnosing SCH,MRI characteristics of signal intensity of SCH are correspond with their clinical and pathological features.

0.05).Subsequent stratification revealed that MICA*A5 was present at significantly lower frequency in patient group with chronic granulocytic leukemia(CML)(RR=0.635,P=0.038 0);MICA*A4 at significantly lower frequency in patient group with lyphololastic leukemia(ALL)(RR=0.120,P=0.029 7);MICA*A5 at significantly higher frequency in patient group with acute non-lyphololastic leukemia(ANLL)(RR=2.229,P=0.021 8),all compared with control group.Conclusion:MICA-STR allelic variation is associated with leukemia in Hunan Han population;The data also suggest the heterogeneity of MICA-STR allele associated with different clinical types of leukemia.

Objective:To study the expression levels of nuclear factor kappa B, Bcl-2 associated K and TNF-αproteins to discuss the effects of NF-κB and Bak proteins in the pathogenesis of UC.Methods:Eighty clean grade of adult Sprague-Dawley( SD) rats were used,male and female in half and then rando mly selected sixty as the model group,another twenty as the control group.SD rats model were manufactured by a compound method:Trinitrobenzene sulfonic acid ( TNBS )+ethanol.We observed and assessed colonic mucosa by the general morphology and histological changes.To applicated immunohistochemistry and RT-PCR methods to detected the protein and mRNA expression levels of NF-κB,Bak and TNF-αin the model groups and the control group and to analysed their relationships.Results:The successful rate of making model was 97%.The number of inflammatory cells in the model groups more than the control(P<0.01).Group immunohistochemical and RT-PCR,NF-κB and TNF-αproteins and mRNA in UC colon epithelium cells and inflammatory cells were higher than the control(P<0.01).Bak protein in inflammatory cells were lower than the control(P<0.01),but there was no statistical significance in epithelial cells(P>0.05).The expression levels of NF-κB,TNF-αincreased as the histological grade increased(P<0.05),however,the expression level of Bak decreased(P<0.05).NF-κB in colonic mucosa of rats with UC had a significantly positive correlation with that of TNF-α(r=0.892,P<0.01),and negatively correlated with that of Bak(r=-0.793,P<0.01).Conclusion:The levels of NF-κB and Bak may be related to the occurrence and development of UC.

Objective To explore a new therapy for Hirschsprung's disease ( HD). Methods From Jul 2001 to Aug 2003,72 cases underwent transanal pull-through plus partial myoctomy of internal sphincter. Rectoanal manometry was done for 27 patients perioperatively. Forty-eight patients were followed-up and evaluated according Reding standard. Results Pre-and post-operative rest pressure was (38 ?8) mm Hg and (22?6 ) mm Hg respectively (P