Objective To observe the long term results of intertrochanteric varus medial displacement osteotomy(IVMDO) for Perthes disease. Methods Thirty eight patients with Perthes disease treated with IVMDO were reviewed. The results were evaluated based on a criteria made by the authors including clinical and radiographic parameters. The duration of follow up ranged from 3 to 15 years, with an average of 7 years. Results Fifteen patients were evaluated as having excellent result, 17 good, 3 fair and 3 poor respectively. The overall excellent or good rate was 84.2%. Considering the relationship between the outcome and staging of the disease, the overall excellent or good rate was 94.7% in stage Ⅱ lesion, 85.7%in stage Ⅲ lesion, and 40.0% in stage Ⅳ lesion. Conclusion The treatment of Perthes disease with IVMDO has the advantages of simple manipulation, less trauma and good results, and is worthy of populariztion.

Objective To explore the relationship of peritoneal transport patterns and the nutritional status in continuous ambu-latory peritoneal dialysis(CAPD) patients .Methods 89 patients who took CAPD in 2010 January to December 2012 in the perito-neal dialysis center of our hospital were selected in this study .According to the ratio of creatinine in peritoneal dialysis solution and in blood(D/Pcr)of the peritoneal equilibrium test(PET) ,all CAPD patients were divided into HA group(high average transport) and LA group(low average transport) .Nutritional status including serum albumin(ALB) ,prealbumin(PA) ,transferrin(TF) ,hemo-globin(Hb) ,Lean body mass(LBM) ,subjective global assessment(SGA)and normalized Protein Equivalent of Nitrogen Appearance (nPNA) were compared in both groups .The relationship of D/Pcr and the nutritional status were analyzed .Results D/Pcr in HA group were significantly higher than in LA group(P<0 .01) .ALB ,PA ,TF ,Hb and SGA in HA group were significantly higher than in LA group(P<0 .01) ,but nPNA in two groups has no statistical differences (P>0 .05) .D/Pcr was negative related to ALB , TF ,Hb and SGA(P<0 .01) ,but not related to nPNA ,PA and LBM (P>0 .05) .Conclusion The nutritional status is related to peritoneal transport patterns in peritoneal HA patients ,it is necessary to strengthen nutritional guidance ,as the nutritional status is worse compared to LA ones .

Objective To evaluate the effect of methylprednisolone on hepatic ischemia-reperfusion (I/R) injury in the patients undergoing hepatolobectomy.Methods Sixty ASA physical status Ⅱ or Ⅲ patients,aged 30-64 yr,weighing 45-75 kg,scheduled for elective hepatolobectomy,were randomized to control group or methylprednisolone group (n =30 each).After induction of anesthesia,methylprednisolone 500 mg (in 100 ml of normal saline) was infused intravenously at 5 ml/min before skin incision in group M.Anesthesia was induced with propofol,fentanyl and cisatracurium.The patients were endotracheally intubated and mechanically ventilated.PETCO2 was maintained at 35-45 mmHg.Anesthesia was maintained with 1％-3％ sevoflurane inhalation,remifentanil infusion,and intermittent iv boluses of fentanyl and cisatracurium.MAP was maintained at 70-100 mmHg and HR at 50-90 bpm.At 10 min before induction of anesthesia,and on postoperative day 1,3 and 5,venous blood samples were collected for determination of the plasma levels of alanine aminotransferase (ALT),aspartate amminotransferase (AST),total bilirubin (TBIL),tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6).Results Compared with group C,the plasma levels of ALT,AST and TBIL were significantly decreased on postoperative day l and 3,and the plasma concentrations of TNF-α and IL-6 were decreased on postoperative day 1,3 and 5 in group M.Conclusion Methylprednisolone can reduce hepatic I/R injury in the patients undergoing hepatolobectomy and inhibition of systemic inflammatory responses is involved in the mechanism.

Circular RNA (circRNA) is a widely present endogenous noncoding RNA that is covalently bonded at the 3' and 5' ends via trans-splicing to form a closed-loop structure with high stability, biological evolutionary conservatism,and tissue expression specificity. CircRNA has important biological functions, such as playing the role of microRNA (miRNA) sponge, regulating the expression of a par-ent gene, and improving transcription and translation levels. In gastrointestinal tumor, circRNA mainly plays the role of miRNA sponge, which affects the proliferation, differentiation, apoptosis, and invasion of cancer cells. In addition, circRNA was specifically expressed in the tumor, and the expression level significantly differs from that of paracancer. Therefore, a highly conserved and stable circRNA se-quence is expected to be an early diagnosis and prognostic marker for gastrointestinal tumor. In this study, we review research advanc-es on circRNA and its relationship with gastrointestinal cancers (esophageal, gastric, colorectal, and liver cancers).

Objective To investigate the expression of pro-inflammatory cytokines in lumbar dorsal root ganglions (DRG) of rats model of high-dose fentanyl induced hyperalgesia. Methods 64 male SD rats were divided into 2 groups (n = 32), fentanyl group and normal saline (NS) group. The rats were injected with fentanyl (60 μg/kg) or NS 4 times in total subcutaneously with a 15-minute interval. Mechanical and thermal nociception were measured via the tail pressure test (tail flick thresholds, TFT) and paw withdrawal test (paw withdrawal latency, PWL) at 1 day before, at 1, 2, 3 and 4 hour and on 1 ~ 7 day after administration. 4 rats were sacrificed and the lumbar DRG were harvested to analyze the expression of PGE2 , IL-1β, IL-6 and TNF-αvia ELISA. Results There were no significant changes of TFT, PWL and the expression of pro-inflammatory cytokines in DRG compared to baseline of rats in NS group. The value of TFT , PWL in fentanyl group were above the baseline at the 1 ~ 4 hour and below the baseline at 1~3 day after fentanyl injections. PGE2 , IL-1β, TNF-α and IL-6 increased on 1,3,5,7 day after fentanyl injections significantly. Conclusions High-dose fentanyl induced significant hyperalgesia and up-regulation of pro-inflammatory cytokines in DRG. The expression pro-inflammatory cytokines peaked later and were more protracted than the change of behavior test and show no direct relationship between the two.

AIM: To investigate the preventive effect of PNS on chronic hypoxic pulmonary hypertension in rats. METHODS: Pulmonary arterial pressure observation, hematocrit (Hct)measurement, biochemical analysis and transmission electron microscopy were conducted to investigate the role of PNS. RESULTS: (1)Mean pulmonary arterial pressure(mPAP), right ventricular mean pressure(RVMP) and Hct were significantly higher in hypoxia group (H group) than that of control group (C group) and were much lower in hypoxia with PNS group (HT group) than that in H group;(2)Nitric oxide (NO 2-/NO 3-) concentration and nitric oxide synthase(NOS) activity in the plasma and the lung tissue, total superoxide dismutase(T-SOD) and copper/zinc-containing enzyme (Cu/ZnSOD) activities in the plasma were all significantly lower in H group than that in C group and were much higher in HT group than that in H group, but NO 2-/NO 3- concentration and NOS activity were still markedly decreased in comparison with C group;(3)Injury of endothelial cells in pulmonary arteriole was improved obviously in HT group compared with H group. CONCLUSIONS: These results suggest that PNS reduces the increase in mPAP, probably through adjusting NO level, anti-damaging effect of free radicals, inhibiting the injury of endothelial cells and decreasing Hct.

Objective:To assess the effect of rosiglitazone on inflammation in peritoneal dialysis patients. Methods:Fifty patients undergoing continuous ambulatory peritoneal dialysis were collected in our hospital. The treatment group was assigned to receive regular peritoneal dialysis and rosiglitazone 4mg once daily while the control group was received regular peritoneal dialysis for 12 weeks. Such serum examinations as fasting blood glucose (FBG), glycosylated hemoglobin A1c, haemoglobin, serum total cholesterol, high density lipoprotein cholesterol(HDL-C), low density lipoprotein cholesterol, triglycerides and high sensitivity C reactive protein (hs-CRP) were measured, tumor necrosis factorα(TNF-α) and interleukin-6 (IL-6) levels were measured by ELISA, and homeostasis model as-sessment of insulin resistance( HOMA-IR) was also evaluated before and after the treatment. Results:After the 12-week treatment by rosiglitazone, the levels of FPG, HOMA-IR, hs-CRP, TNF-αand IL-6 were declined significantly(P<0. 05), and the level of HDL-C was increased significantly(P<0. 05). Conclusion: Rosiglitazone shows significant anti-inflammatory, insulin resistance improve-ment and anti-lipidemic effects in peritoneal dialysis patients.

Objective To compare the efficacy of dexmedetomidine versus remifentanil in combination with sevoflurane for gynecological laparoscopy. Methods Forty ASA Ⅰ or Ⅱ patients aged 18-64 yr with body mass index of 18-30 kg/m2 undergoing gynecological laparoscopy were randomly assigned to one of two groups ( n =20 each): dexmedetomidine group (group D) and remifentanil group (group R). Starting from 5 min before induction of anesthesia, dexmedetomidine was infused at 0.05 μg · kg - 1 · min- 1 in group D and remifentanil at 0.1 μg· kg- 1· min-1 in group R for 10 min, then dexmedetomidine infusion rate was increased to 0. 3 μg· kg-1 · h-1 and remifentanil infusion rate was increased to 0.15 μg· kg-1 · min-1 . Anesthesia was induced with propofol 1.5-2.0 mg/kg and fentanyl 2 μg/kg. Tracheal intubation was facilitated with cis-atracurium 0.15 mg/kg. Anesthesia was maintained with sevoflurane and fentanyl 1 μg/kg and intermittent iv boluses of cis-atracurium. Narcotrend index was maintained at 40-50. Blood sample was taken from external jugular vein for blood gas analysis and determination of serum concentrations of corticosteroid, norepinephrine and epinephrine before administration, at 5 min after intubation, at 10 min of aeroperitoneum and at 5 min after extubation. The pH value and concentrations of lactic acid and glucose were recorded. The time for recovery of spontaneous breathing, eye-opening time, extubation time, orientation time and perioperative side-effects were recorded. Numeric rating scale was used to assess the intensity of pain during 2 h after operation. The analgesics used were also recorded. Results The serum concentrations of norepinephrine and epinephrine were significanfly lower at 10 min of aeroperitoneum, the time for recovery of spontaneous breathing was shorter, eye-opening time longer and the incidence of shivering and nausea and vomiting lower, the percentage of patients requiring rescue opioids lower in group D than in group R ( P ＜ 0.05). Conclusion The efficacy of dexmedetomidine combined with sevoflurane anesthesia is better than remifentanil combined with sevoflurane anesthesia for gynecological laparoscopy.

Objective To explore the experience in treatment of primary retroperitoneal tumors (PRPT).Methods The clinical data of 62 cases with primary relroperitoneal tumors from 2001 to 2007were studied retrospectively.Results The abdominal mass was the main symptom in PRPT.There were 29 cases of benign tumors and 33 cases of malignanat tunlors respectively.Complete resections were performed in 47 patients(76%),partial resection was conducted for 10 patients.Resection could not be performed in 5 patients so only biopsy was conducted,12 patients accepted combined organ resections,2 patients died.Conclusion Adequate preoperative preparation and excellent surgical technique are the keys to compele tumour resection.

Objective To study the molecular characteristics of the Staphylococcus aureus isolated from the intensive care units (ICUs) of children's hospital.Methods From January 2016 to December 2016,a total of 39 S.aureus strains were collected and identified from various clinical specimens that were obtained from patients who were confined in the neonatal and pediatric ICUs of Beijing Childreng Hospital.Methicillin-resistant S.aureus (MRSA) and methicillin-susceptible S.aureus (MSSA) were identified using the cefoxitin disc method and the detection of the mecA gene.Multilocus sequence typing (MLST) and spa typing were analyzed using the PCR,and the staphylococcal chromosomal cassette mec (SCCmec) type was analyzed for the MRSA isolates.Twenty-one superantigen genes and the Panton-Valentine leukocidin (pvl) gene were also detected by PCR.Their susceptibility to 12 antibiotics was evaluated using the E-test method.The differences in prevalence of virulence genes and antimicrobial resistance were compared between the MRSA and MSSA isolates by Fisherg exact test.Results All the S.aureus strains were isolated from secretion inside the airway of pneumonia (including severe pneumonia),the blood of patients with bacteremia,and exudate of skin and soft tissue infections.ST59-SCCmecⅣa-t437 (55.6％) and ST398-t571 (28.6％) were the most predominant clones of MRSA and MSSA,respectively.Of the 39 isolates,26 strains (66.7％) had at least one superantigen gene,and seb (38.5％),sek (30.8％),and seq (20.5％) were the most common genes;seb-sek-seq (18.0％) was the main virulence genotype.The pvl geneg positive rate was 25.6％,and no significant difference between MRSA and MSSA was observed (P ＞ 0.05).Notably,79.9％ of the S.aureus isolates were multidrug resistant,and 94.9％,53.8％,and 51.3％ of the isolates were resistant to erythromycin,clindamycin,and chloramphenicol,respectively.The tested isolates were susceptible to trimethoprim/sulfamethoxazole,rifampicin,and vancomycin.Conclusions The S.aureus strains from the ICUs of childreng hospital were isolated from the secretion inside the airway of pneumonia (including severe pneumonia),the blood of patients with bacteremia,and exudate of skin and soft tissue infections.ST59-SCCmecⅣa-t437 (55.6％) and ST398-t571 (28.6％) were the common clones of MRSA and MSSA,respectively.The prevalence of superantigen genes and the multidrug resistant rate were relatively high.