0.4,P0.05)with HHS.[Conclusion]The result of this study suggest that HHS can not capture additional important quality of life domains except for physical function and pain relief that are influenced by THA.So it's necessary to combine HHS and a quality of life survey such as SF-36 to allow a more global assessment of THA.

Clinical data of 27 children with renal calculi (11 cases on the right side and 16 on left)who were treated with extracorporeal shockwave lithotripsy (ESWL) using HB-ESWL-VG lithotripter from April 2006 to October 2008 were retrospectively reviewed.The size of stones ranged from 5 mm to 17 mm in diameter (mean 11 mm).In 22 out of 27 cases (82%) stones were crushed completely after the first course.Eleven of 27 ESWL cases were stone-free in 7 days,8 patients in a month after treatment;the stonefree rate was 96% when patients were followed up for 1 year.The results suggest that ESWL is a safe and effective method for treatment of renal calculi in children.

OBJECTIVETo explore the clinical effects of minor bone anchors and palmaris longus tendon graft in treating chronic mallet fingers deformity.

METHODSFrom January 2008 to June 2013, 26 patients with chronic mallet fingers deformity were treated with minor bone anchors and palmaris longus tendon graft. There were 18 males and 8 females, aged from 18 to 52 years old with an average of (32.0±1.3) years. Among them, 8 cases caused by machine injury, 6 cases by fall injury, 6 cases by sprain from fight, 4 cases by tendon spontaneous rupture, 2 cases by knife trauma. There was no tendon attachment of extensor tendon check in 16 cases, and with 0.3 to 0.5 cm tendon attachment in 10 cases. All patients had the flexion deformity and the disability of dorsiflexion activity. During operation, the distal interphalangeal joint was fixed in 10° to 20° dorsiflexion by a Kirshner wire, the minor bone anchor was used to reconstruct the extensor tendon insertion, the palmaris longus tendon slice was transplanted the decayed area of extensor tendon insertion. Four weeks postoperatively, the Kirshner wire was removed and the plaster external fixation was used, and the patient began function exercises. Postoperative complications were observed and fingers functions were assessed according to Dargan standard.

RESULTSThe patients were followed up from 6 to 14 months with an average of (5.0±0.3) months. Wound superficial infection occurred in 2 cases, the skin pressure ulcer in 2 cases, joint activities disability in 1 case; these symptoms got improvement after symptomatic treatment. Traumatic arthritis occurred in 2 cases, 1 case was improved after treatment, and 1 case had chronic pain for a long time. No internal fixation loosening or breakage and tendon rupture were found. According to Dargan standard to evaluate the finger function, 17 cases got excellent results, 8 good, and 1 poor.

CONCLUSIONIt is an effective way to treat the chronic mallet finger deformity using minor bone anchors and palmaris longus tendon graft, and the method has advantages of reliable fixation, easy operation, satisfactory effect and less complication.

Adolescent ; Adult ; Female ; Finger Injuries ; surgery ; Fracture Fixation, Internal ; Hand Deformities, Acquired ; surgery ; Humans ; Male ; Middle Aged ; Suture Anchors ; Tendon Transfer

Objective To improve clinicians'understanding of nephrotic syndrome and myasthenia gravis as adverse events of penicillamine(D-PA).Methods Two patients were reported to develope adverse reaction after taking D-PA.The related literature were reviewed.Result The first case was a systemic sclero- sis(SSc)patient treated with D-PA who developed nephrotic syndrome and blepharoptosis.The second case was a rheumatoid arthritis patient treated with D-PA who developed dysphagia and drinking bucking.The clinical symptoms were improved after disconting D-PA.Their conditions were stable up to now.Conclusion D-PA is used widely for various of autoimmune diseases.Clinicians should pay attention to these special and rare adverse effects.

Objective To evaluate clinical application of the gastrocnemius blood vessles as recevier ones to anastomose with free flaps. Methods From June 2005 to July 2011,twenty adult lower limbs were infused with red glue to observe the origin,streching,branches and communication with other blood vessles of the gastrocnemius blood vessles and to measure their outer diameters and pedicle length. Operations were also simulated on these specimens to make the above chacracters of the vessles clear further.CT images of 16 fresh adult lower limbs were got to observe the effects of obstruction of one side of the gastrocnemius blood vessels to the blood supply of the gastrocnemius muscles. Fifty-two free flaps were transplanted to legs with large defects of skin and soft tissues where the gastrocnemius blood vessles were anastomosed with the flaps to supply artery blood and receive vein blood. Results The main blood vessles of the gastrocnemius muscles were medial and lateral gastrocnemius blood vessles. They both origined from the popliteal arteries and communicated with other blood vessles. The pedicles of the medial gastrocnemius blood vessles were 8.0 -13.8 cm in length which averaged 11.1 cm and their outer diameters were (1.8 ± 0.3) mm when they entered the muscles. The pedicles of the medial gastrocnemius blood vessles were 5.4 - 12.3 cm in length which averaged 8.8 cm.The outer diameters of the two accompanying veins were (1.8 ± 0.3)mm when they entered the muscles.When one gastrocnemius blood vessle were obstructed,the gastrocnemius muscles could got enough blood supply by co mmunicating branches between the obstructed vessle and other blood vessles.All the 52 free flaps survived. Through one to two-years follow-up, the defects cured with no infection and the knees' motions were normal. Conclusions With a long pedicle and wide diameter,the medial or lateral gastrocnemius blood vessle can be a reliable alternative used in free flap transplautation for repairing large defects of skin and soft tissues of seriously injured legs with no other choice of blood vessles, which causes unobvious effects to the blood supply of the legs and can simplify the free flap transplantation.

Objective To study change of the declarative memory in patients with the calcification of the pallidum.Method The Chinese version of Wechsler Memory Scale(WMS-RC)test and dmwing forgetting curve were applied in 30 patients and 30 normal controls.Results There was no differences in the WMS-CR test's scores between the two groups.The patients had poorly memory preservation rate at the delays of 2 hours((64.10±0.87)%Vs(44.83±1.57)%,P<0.01),despite normal memory preservation rate over 30 mins and the similar slope after the delays of l day in the forgetting curve.There were negative correlations between the size of calcification and the memory preservation rate at the delays of 2 hours and 9 hours(r=-0.743,r=-0.483.P<0.01).Conclusion The results may reflect the effect of the pallidum on"slower confiolidation"declamtive memory process which aroused by a consequence of the repeated firing of hippocampal-neocortieal connections while the patients have normal memory encoding and retrieval.

Objective To evaluate the role of multiple sequences MRI in diagnosis and preoperative evaluation of non-palpable undescended testis.Methods 58 patients with unilateral or bilateral non-palpable undescended testis underwent abdominal and pelvic MRI 2 weeks before surgery.Multiple sequences MRI included diffusion-weighted imaging(DWI)with b values of 400 and 800 s/mm2,T1 and T2-weighted sequence,and T2-weighted fat-suppressed sequence.Preoperative images including the conventional MRI images,DWI images,and the conventional-MRI and DWI images together.ADC value was detected.Pathological findings were used as the gold standard to evaluate the diagnostic accuracy of multiple sequences MRI in detection of non-palpable undescended testis and its differential diagnosis with lymph nodes.Results The combination of DWI and conventional MRI was the most sensitive method in detection of non-palpable undescended testis,with the sensitivity,specificity and accuracy of 96.5％,87.5％,and 95.3％,respectively.Malignant non-palpable undescended testes were all detected.The ADC value of the non-palpable undescended testis,lymph nodes and malignant non-palpable undescended testis was(1.18 ± 0.17) × 10-3 mm2/s,(1.49 ± 0.27) × 10-3 mm2/s,and (0.84 ± 0.20) × 10-3mm2/s,respectively.The difference had statistical significance (P ＜ 0.05).Conclusion Multiple sequences MRI improves the diagnostic accuracy of non-palpable undescended testis,which can be routinely used in preoperative evaluation of non-palpable undescended testis.

Objective To investigate the effect of continuing nursing on elderly patients with high risk of pressure sores. Methods High-risk elderly patients with pressure sores healed in our hospital in January 2014 to December 2014 were divided into control group and observation group with 130 cases in each group by random number table. The control group received routine follow-up service, while the observation group were intervened by continuing nursing care. To observe the differences before and after the interventions in both groups on the patient's quality of life and the incidence of pressure sores. Results There was statistically significance on mental function scores (t=12.393, P=0.000), social function score (t=8.459, P=0.000) and overall quality of life score (t=12.750, P=0.000) between the two groups after the interventions. Meanwhile, there was no statistically significance on material life score (t =-1.913, P=0.057) and physical function score (t=-0.328, P=0.744). The difference of the re-occurrence of pressure sores in the two groups was statistically significant (χ2=35.96, P=0.000), either. Conclusions Continuing nursing intervention can obviously reduce the risk the re-occurrence of pressure sores on high-risk elderly patients, in particular to improve the quality of life aspects of mental function and social function in patients, meanwhile with no obvious improvement in that of material life and body functions.

ObjectiveTo explore the effects of glycomacropeptide (GMP) in human milk and formula milk on proliferation ofbifidobacterium infantis and their dose-response relationship.Methods Casein was isolated from the milk of 30 healthy postpartum women from Guangzhou Women and Children's Medical Center in September 2014, and hydrolyzed by rennet to obtain GMP, which was then purified by ultrafiltration and ion exchange chromatography. Human milk GMP and cow milk GMP (0, 250, 500, 1 000, 1 500, 2 000 and 3 000 mg/L) were added tobifidobacterium infantis liquid medium, and cultured under anaerobic conditions. Concentration of bacteria was measured by turbidimetric microplate assay (detection of OD600 nmvalue of medium). Difference of proliferative activities ofbiifdobacterium infantis in human milk GMP and cow milk GMP was compared with independent samplest-test.ResultsPurified human milk GMP concentration was 1 712.20 mg/L, with a purity of 80.3%. Increasing the cow milk GMP initial concentration in the culture medium at 250-2 000 mg/L could increase the concentration and proliferation rate ofbiifdobacteria infantis. When cultured at 36 h with GMP of various concentrations, the proliferation ofbiifdobacteria infantis maintained at a logarithmic phase. Therefore, 36 h was chosen as the test time point to compare the proliferation ofbifidobacterium infantis. At 36 h, when GMP in the medium was 1 000, 1 500, 2 000 and 3 000 mg/L, concentrations ofbiifdobacteria infantis in human milk GMP were 2.255±0.036, 2.583±0.088, 2.877±0.080 and 3.219±0.081, respectively, which were significantly higher than those in cow milk GMP (2.115±0.053, 2.312±0.064, 2.542±0.090 and 2.894±0.076;t=4.867, 5.569, 6.192 and 6.516; allP<0.01).Conclusions Both human milk GMP and cow milk GMP can promote the proliferation ofbiifdobacterium infantisin vitro, and the proliferative activity in human milk is greater than in cow milk at the same concentration of GMP.