Objective To study the cause, prophyl ax is and management of the complications of laser treatment for varicose veins of the lower extremity. Method From Sep 2003 to Dec 2004, 52 patients (65 limbs) underwent endovenous ablat ion procedures. The laser was introduced into the vein to achieve venous occlusi on. Results Postoperative complications included ecchymosis in 12 cases, skin burn in 14 cases, saphenous nerve injury in 7 cases, thrombophlebitis in 3 cases, and subcutaneous fat liqu idation and infection in 2 cases. Most of the complications subsided after sympt omatic treatment in 2 to 3 weeks. Conclusion Most complications of laser treatment for varicose veins are transient and self-healing.

Objective To observe the neuroprotective effect of atorvastatin and its influence to tumor necrosis factor-alpha(TNF-α) and intedeukin-10(IL-10)in intraeerebral hemorrhage(ICH)rats,and to explore the possible mechanism of its neuroproteetive effect.Methods ICH WaS induced by stereotaxic infusion of collagenase into the right baSal ganglia,the expressions of TNF-α,IL-10 in the serum and brain tissue were analyzed by enzyme linked immunosorbent assay(ELISA),HE staining was used to evaluate the number of activated microglia.Results (1)The numbers of activated mieroglia,TNF-α and IL-10 were have significant differences between group A and group B(all P＜0.05).(2)In comparision with group B,numbers of activated mieroglia in group C,D and E were significantly redueed(P＜0.05).Atorvastatin cause a dose-dependent regulation,which decreased the level of TNF-α and inereased the level of IL-10 significantly(all P＜0.05).Conclusion The down-regulation of TNF-α and up-regulation of IL-10 might partly attribute to the neuropmtection of atovastatin.

Objective To study the changes of serum protein spectrum in patients with systematic lupus erythematosus (SLE) in order to screen specific protein markers. Methods Serum samples from 72 patients with SLE and 85 age- and sex-matched controls were assessed using surface-enhanced laser desorp-tion/ionization time-of-flight mass spectrometry (SELDI-TOF-MS) with weak cation exchange (CM10) pro-rein chip. Forty samples from the patients and 50 control samples were randomly selected to serve as a pre-liminary training set; significantly different protein peaks were automatically chosen for the system training and development of a decision classification tree model. The validity of the model was then challenged with a blind test set (including another 32 samples from patients and 35 from human controls). Results A total of 73 effective protein peaks were detected within the mass/charge ratio (m/z) interval 2000 - 50000, among which, 15 protein peaks significantly differed between patients with SLE and controls (P < 0.01). Three pro-tein peaks with an m/z value of 4001, 6305 and 7356 were automatically chosen as a biomarker pattern in the training set that discriminated patients with SLE from controls with a sensitivity of 90.0% (36/40), speci-ficity of 92.0% (46/50) and accuracy rate of 91.1% (82/90). When the SELDI marker pattern was tested with the blinded test set, it yielded a sensitivity of 87.5% (28/32), specificity of 91.4% (32/35) and accuracy rate of 89.6% (60/67). Conclusions SELDI-TOF-MS protein chip could be used to screen serum protein for SLE, and the decision classification tree model with these biomarkers may favor the diagnosis of SLE.

Objective To explore the effectiveness of sandplay therapy combined with family counseling in children with school phobia and its influence of child′ self-consciousness. Methods Integrative sandplay therary with family consulting were used to treat 28 patients with school phobia regularly for 2 months. Sandplay and family consulting therapy were given once a week for 45 minutes . Clinical outcomes were assessed using CGI-GI and Piers-Harris children′s self-consciousness scale before and after treatment as well as 3 months posttreatment. Results Overall response rate was 85%. In addition, the physical appearance and characteristic factor before and after treatment were no significant difference (P>0.05). The rest of the various factors and total score compared with pre-treatment significantly improved (P<0.05). After treatment for 3 months, every factor in self-consciousness of children and total score were no significant difference (P>0.05). Conclusion Integrative sandplay therapy with family counseling has better and long-lasting treatment effect to self-consciousness of children with school refusal.

Objective To observe the clinical efficacy of staphylococcal protein A immunoadsorption plus nonmyeloablative chemotherapy with CD34+ autologous peripheral blood stem cell transplantation in the treatment of refractory systemic lupus erythematosus (SLE). Methods Three patients with active SLE were enrolled into this study. All patients were diagnosed with lupus nephritis by renal biopsy and poorly responded to routine therapy. Before transplantation, patients were given 6 sessions of immunoadsorption apheresis using columns of staphylococcal protein A-silica with an interval of 3 days; each session processed 3 L plasma and a total of 18 L plasma was processed over the 6 treatments. Three days following the immunoadsorption apheresis, the mobilization of stem cells was realized by intravenous cyclophosphamide at a dose of 2 g per square meter of body surface area and subcutaneous recombinant human granulocyte colony-stimulating factor (G-CSF) at a dose of 5 g per kilogram of body weight per day for 5 days. Then, peripheral blood raonoclonal cells were obtained by CS-3000 Cell Separator, and passed through the Clini Macs CD34+ cell selection device, with the final concentration of CD34+ cells being 2.6×106, 2.1×106 and 2.4×106 per kilogram of body weight respectively, and that of CD3+ cells being 3×105, 2.1×105, and 2.0×105 per kilogram of body weight, respectively, in these three patients. The conditioning regimen consisted of oral fludarabine of 50 mg/d for 5 days plus intravenous pig anti-human thymocyte immunoglobulin (ATG) at a daily dose of 90 mg/kg for 5 days. After 72-hour treatment with ATG, the frozen stem cells were infused back to the patients. Clinical manifestations and lupus-correlated immune parameters were compared in patients at baseline and after transplantation. Results Following immunoadsorption apheresis, an obvious decrease was observed in the level of serum anti-dsDNA, antinuclear antibody and IgG antibodies, while an increase in the level of serum complement 3. All patients achieved the reconstruction of hemopoiesis 2-3 days after the transplantation. Also, an apparent clinical remission was achieved with the SLEDAI score being less than 3. Six months after the transplantation, serum anti-dsDNA and antinuclear antibodies as well as urine protein were undetectable, the level of complement 3 reached the normal range, and renal function was restored. Conclusions Staphylococcal protein A immunoadsorption plus nonmyeloablative CD34+ autologous peripheral blood stem cell transplantation are effective and safe for refractory SLE, but the long-term effect remains to be connfirmed by further studies.

Objective To analyze the clinical and immunological manifestations of antiphospholipid syndrome(APS)in a cohort of 100 patients.Methods The clinical and serologic features of APS(Sapporo preliminary criteria)in 100 patients were analyzed retrospectively.Results The cohort consisted of 79 female patients and 21 male patients witb a mean age of 36?13 years at diagnosis.Primary APS was presented in 37% of patients;APS was secondary to systemic lupus erythematosus(SLE)in 46%,lupus-like syndrome in 14%. Eighty percent of the patients had thrombosis,43(54%)patients had venous thrombosis,18(22%)had arterial thrombosis,15(19%)had both arterial and venous thrombosis.4(5%)had thrombosis of microcirculation. Forty-two(52%)patients presented thrombosis at a single site,26(32%)at two sites,12(15%)at three or more sites.Forty-five(56%)patients experienced one thrombotic episode,20(25%)patients had only one re- currence,and 15(19%)had more thrombosis.The most common manifestations of thrombosis were deep vein thrombosis(36%),pulmonary embolism(30%)and stroke(26%),with heart,kidney,gastrointestinal tract and other organs involvements.Thirty-four(51%)female patients had spontaneous fetal losses including intrauter- ine fetus death and recurrent spontaneous abortion.Seventy-one(71%)patients developed thromboeytopenia. The presence of antieardiolipin antibody(ACL)was detected in 84 patients(84%).Among 90 patients with APS,alone ACL was detected in 38 patients(42%),both ACL and lupus anticoagulant(LA)were detected in 36(40%),LA alone in 16(18%).Patients with APS associated with SLE or lupus-like syndrome had higher frequency of arthritis,leukopenia,antinuclear antibodies(ANA)and low complement levels.Female patients had a higher frequency of leukopenia,ANA and ACL.Male patients had a higher prevalence of deep venous thrombosis in the lower limbs and LA.Conclusion APS is an autoimmune disorder characterized by recurrent arterial and venous thrombosis,fetal loss,or thrombocytopenia with the presence of ACL and/or LA.In APS secondary to with SLE,the patient's sex can modify the disease expression and define specific subsets of APS.

Objective To check the neutrophil count and the expression of cell surface adhesion molecule,lymphocyte function associated antigen?1(LFA?1)in peripheral neutrophils in severe preeclamptic patients and normal pregnant women in order to investigate the correlation of neutrophil activation with preeclampsia. Methods Totally 28 pregnant women in the department of gynecology and obstetrics in Shengjing Hospital from No?vember 2013 to January 2014 were included in the study,and divided into the severe preeclampsia group(n=14),and the control group(normal pregnant women,n=14). There was no statistically significant difference in age and gestational weeks between the two groups. The expression of LFA?1 in peripheral neutrophils was detected by flow cytometry in the two groups. Mean blood pressure(MBP)was measured in the severe preeclamptic group,and the correlation of MBP with expression of LFA?1 was analyzed. Results The neutrophil count was 8.40±2.23 ×109/L in the severe pre?eclamptic group,significantly higher than(6.71±1.58)×109/L in the control group,(P<0.05). The positive rate of LFA?1 in peripheral neutrophils was 63.25±38.025%in the severe preeclamptic patients,significantly higher than 8.32±38.65%in the control group(P<0.05). The expression lev?el of LFA?1 in peripheral neutrophils was significantly correlated with mean blood pressure in severe preeclamptic patients(r=0.64,P=0.013). Conclusion The neutrophil count and the expression of LFA?1 in peripheral neutrophils were significantly increased in severe preeclamptic pa?tients compared to normal pregnant women,and significantly correlated with severity of preeclampsia,suggesting that neutrophil activation participat?ed in the pathogenesis of preeclampsia.

Objective To report the clinical outcomes of open reduction and internal fixation for capitellum fractures in adolescents.Methods From January 2010 to January 2015,14 adolescents with capitellum fracture were admitted to our department.They were 12 males and 2 females,aged from 12 to 16 years (13.7 years).By the Dubberley classification,we had 2 cases of type ⅠA,8 cases of type ⅡA,3 cases of type Ⅲ A and one of type Ⅲ B.We summarized their clinical characteristics and injury mechanisms.At the last follow-up,the therapeutic efficacy was assessed by the Mayo elbow function scores,and the ranges of motion of the elbow and forearm on the affected side were recorded.Results The 14 patients obtained an average follow-up of 12 months (from 6 to 18 months).All the cases achieved fracture union within 3 months,but malunion appeared in one.At the last follow-up,the ranges of flexion and extension of the affected elbow averaged 120.6° (from 110° to 135°),and the ranges of lateral rotation of the affected forearm averaged 160.3° (from 150° to 175°).According to the Mayo scores at the last follow-up,the elbow function was rated as excellent in 12 and as good in one.Mild traumatic arthritis occurred in 3 cases.Conclusions Capitellum fractures in adolescents are often Dubberley type A ones without a complicated fracture of the posterior condyle.Usually,the capitellum is impacted by the radial head in the process of elbow extension with valgus stress.After definite diagnosis,open anatomical reduction and reasonable and reliable internal fixation can result in good clinical results.

Objective To analyze the causes and management of the late complications after transurethral resection of the prostate (TURP) for benign prostatic hyperplasia. Methods The clinical data of 102 patients who were hospitalized for the late complications after TURP were analyzed retrospectively. Results The causes of readmission were residual prostatic hyperplasia for 32 patients (31.37%),bladder neck restriction for 22 patients (21.57%),urethral stricture for 18 patients (17.65%),hematuria for 15 patients (14.71%),epididymitis for 6 patients (5.88%),urinary tract infection for 4 patients (3.92%),carcinoma of prostate for 3 patients (2.94%),and neuropathic bladder dysfunction for 2 patients (1.96%). All patients were satisfied with their therapeutic efficacy after different treatments. Conclusion The main complications after TURP include residual prostatic hyperplasia,bladder neck restriction,urethral stricture and hematuria. Best therapeutic approach should be chosen according to different causes of the late complications after TURP.

SUN Shu-chun,the chief researcher,is one of the famous expert of osteo-traumatology of TCM.He makes systematic sort and study on chirismus on basis of succeeding experience predecessors and his own years of clinic experience.He is good at treating cervical syndrome with TCM chirismus,especially combine it with drugs.In osteo-traumatology academic circles,he is called "the best doctor at home".Professor SUN advocates that the rule of applying various therapies according to different conditions,combination of rigid-flexible,light,skill,gentle,harmony should be obey when we use chirismus.His diagnostic and therapeutic methods and thoughts are original and ingenious.In this article,the author analyzes the academic experience of tendon trauma of professor SUN.