Objective To investigate the safety and efficacy of transvaginal hydrolaparoscopic pelvic adhesiolysis (THLPA) treatment in the infertile women.Methods From May 2007 to Sep.2008,30 infertile patients underwent THLPA.The dye-test,hysteroscopy,and dye-test using catheterization of tubal ostium by hysteroscopy were performed at the same time.Pelvic adhesions were scored according to the revised American Fertility Society classification of endometriosis (1985).The adhesions were graded as mild (score 1-9),moderate (10-19),and severe (≥20).Twenty-four cases were in mild adhesions,5 moderate adhesions,and 1 severe adhesion.The duration of the operation and discharge,pelvic adhesions score,tubal patency,complications,and pregnancy rate were investigated.Results (1) THPLA:the majority of pelvic adhesions in all patients were successfully performed adhesiolysis.Only a little filmy adhesions of proximal peritube of 7 tubes and proper ligament of 5 ovaries and cohesive adhesions of 4 ovaries did not underwent surgical lysis.(2) Tubal patency:35 tubes were of proximal occlusion by dye-test,of which 21 (60%,21/35) were unobstructed and 4 (11%,4/35) were partly unobstructed after the dye-test using catheterization of the tubal ostium by hysteroscopy.(3) The duration of operation:the overall operative time were (32±6) minutes in mild adhesion,(52± 6) minutes in moderate adhesion,and 83 minutes in severe adhesion.Of which the time of THLPA were (11±5) minutes in mild adhesion,(35±7)minutes in moderate adhesion,and 62 minutes in severe adhesion,respectively.(4)The duration of discharge:the postoperative discharge time was 120-175 minutes.No complications occurred.(5)The rate of pregnancy:in the (15.8±4.3) months' follow-up,the rate of pregnancy was 45% (13/29),which one patient lost follow-up.Conclusions THLPA is safe,efficacious and not being hospitalized management.When compared with laparoscopy,it is simpler,more economic,and less minimally invasive approach.The appropriate indication of THLPA is to treat filmy,especially mild pelvic adhesions.It could partly avoid transabdominal operative laparoscopy for the infertile women.

[Objective]To evaluate the outcomes of treating thoracolumbar burst fractures in young adults with posterior short-segment pedicle screw fixation without fusion by analyzing the clinical and radiographic parameters.[Method]Fifty-four patients with thoracolumbar burst fractures from June 2002 to April 2006 were investigated retrospectively.Thirty-one patients were male and 23 were female.The mean age was 31 years.All patients underwent open reduction and posterior short-segment pedicle screw fixation without bone graft fusion,and had their implants removed at 12 to 20 months post-operatively.Pain status was evaluated using the visual analog scale(VAS).Changes in the anterior vertebral height ratio,Cobb′s angle,and vertebral wedge angle were measured preoperatively,postoperatively,before implant removal,and at 2 years after implant removal.[Result]Thirty-two patients were available to follow-up,with an average period of 43 months(range,36-56 months).A good correction was gained and pain was released significantly after surgery.The loss of correction was statistically significant and there were 4 patients suffering from screw broken before the instrumentation removal,however.A progressive kyphotic deformity (Cobb′s angle increased while vertebral wedge angle unchanged) was caused by the collapse of the intervertebral disc space while the reduced vertebral height was stable after the implant removal.No significant correlation was found between the final kyphosis and pain scale.[Conclusion]Short-segment pedicle screw fixation without fusion can provide good reduction and sustained corrective height if adequat indication of thoracolumbar burst fractures has been choosen.Earlier implant removal can regain local segmental motion.

Objective To exoplore the causes in healing difficulties of osteoporotic fracture, and to study the feasible approaches and methods for clinical treatment of osteoporotic fracture. Methods Forty female Sprague-Dawley rats, used as donor animals, were divided randomly into ovariectomized (OVX) group and control (CON) group, with each group of 20 animals. OVX group was subjected to bilateral ovariectomy and CON group was subjected to sham operation. Four months after surgery, the rats were sacrificed, and long bones of the extremities were harvested respectively for preparation of bone matrix gelatin (BMG) in terms of Urist's method. BMG implants obtained from OVX and CON rats were implanted into left and right femoral muscle pouches respectively of 17 female SD rats. The host rats were killed after 14-day feeding, and tissue block of BMG implants were removed for histologic study, alkaline phosphatase (ALP) activity, and calcium content (CA) determination, respectively. Results ALP activity of BMG tissue block from OVX group was (7.22? 2.59)U/g, and that from CON group was (12.01?6.18)U/g. Significant difference was found between the two groups (P

Objective To investigate epidemiological characteristics and differences in anklebrachial index (ABI) among the natural population in Shanghai and Inner Mongolia,and to observe the prevalence of lower extremity peripheral arterial disease (PAD).Methods A total of 2604 volunteers from Shanghai and Inner Mongolia were selected by stratified cluster random sample.ABI was measured and related data were collected.Results The A BI value in Shanghai was 1.074 ± 0.095,while it was 1.062 ±0.075 in Inner Mongolia (P ＜ 0.001).The prevalence of lower extremity PAD in Shanghai was 4.2％,while it was 1.9％ in Inner Mongolia (P ＜ 0.01).For males,the ABI value in Shanghai was 1.078 ±0.105,and it was 1.075 ± 0.080 in Inner Mongolia (P ＞ 0.05).For females,the ABI value in Shanghai was 1.073 ±0.089,while it was 1.052 ±0.070 in Inner Mongolia (P ＜0.001).For males,the prevalence of lower extremity PAD of the in Shanghai was 4.7％,while it was 2.0％ in Inuer Mongolia (P ＜ 0.05).For females,the prevalence of lower extremity PAD of in Shanghai was 4.0％,while it was 1.8％ in Inner Mongolia (P ＜ 0.05).The ABI values in age group of ＜ 50 years in Shanghai and Inner Mongolia were 1.037 ± 0.082 and 1.055 ± 0.068,respectively (P ＜ 0.05).The prevalences of lower extremity PAD in age group of ＜50 years in Shanghai and Inner Mongolia were 7.6％ and 1.2％,respectively (P ＜0.001).There were no significant differences in ABI value and the prevalence of lower extremity PAD between Shanghai and Inner Mongolia in both age group of 50-69 years and ≥70 years (all P values ＞ 0.05).Conclusions The ABI value in Shanghai is higher than that in Inner Mongolia and the prevalence of lower extremity PAD in both males and females in Shanghai is significantly higher than that in Inner Mongolia.But they are lower than the level of western countries.In different age groups,the difference of the prevalence of lower extremity PAD between Shanghai and Inner Mongolia is only displayed in the age group of ＜ 50 years,which may be related to the limited sample size.The natural population in Shanghai exposed artery atherosclerotic disease risk factors may increase and we need to pay more attention to the lower extremity PAD.

BACKGROUND:Basic research demonstrated that type Ⅰ collagen exhibited prominent effect on osteogenesis,bone mass and bone fracture,which also participated in the bone fusion.However,few reports concerning the polymorphism of type Ⅰ collagen gene and spinal fusion.OBJECTIVE:To investigate the polymorphism of type Ⅰ collagen and to explore its relationship with the spinal fusion rate following metal implant or autogenous bone transplantation.METHODS:A total of 200 volunteers who need to receive spinal fusion in the Affiliated Hospital of Qingdao University Medical College were selected,including 102 cases received anterior cervical subcorpectomy combined with lilac bone implantation fusion following decompression,and 98 cases received posterior laminectomy for decompression combined with intertransverse process fusion.Meantime,223 normal adults were served as the control group.The peripheral blood was drawn-off and genomic DNA was extracted from white blood cells.The specific fragment which includes the objective gene was amplified by polymerase chain reaction (PCR),with length of 293 bp.The genotypes of Pcol2 site in type Ⅰ collagen were detected by PCR-restriction fragment length polymorphism (PCR-RFLP) method.The PCR product was digested with restriction endonuclease Eco311 and the result was observed by agarose gel electrophoresis.The G gene represented for the presence of the restriction endonuclease site,while the T gene for the absence of the restriction endonuclease site.The fusion rate of the bone graft was evaluated by x-ray film prior to and at months 3,6 and 12 after operation,and the results were compared by stages including quick (＜3 months),middle (3-6 months) and slow (6-12 months).RESULT AND CONCLUSION:There were the-1997G/T polymorphisms of the type Ⅰ collagen gene in 423 cases,including 166cases with GG,232 cases with GT,and 25 cases with TT,in addition,there was some correlation between the GG genotype and the lilac bone implantation fusion (P =0.004).The GG genotype accounted for 50% in the fast group,which was obviously greater than that of the middle and slow groups (33.3% and 16.7%,respectively).However,the-1997G/T polymorphisms had no correlation with the bone graft fusions inter transverse process of lumbar vertebra (P=0.831).The GG genotype in the-1997G/T polymophsim of the type Ⅰ collagen gene may be the essential factor which can promote the C-spine auto-ilium graft fusion.

Objective To compare the epidemiological characteristics and differences in brachialankle pulse wave velocity (baPWV)among middle-aged residents between Shanghai and Inner Mongolia autonomous region (Inner Mongolia),and to observe the prevalence of arterial stiffness in the two populations.Methods A total of 922 volunteers aged between 45 and 59 from Shanghai and Inner Mongolia were selected by stratified cluster random sample method.BaPWV was measured and related data were collected.Results A total of 903 cases were enrolled in this study,including 441 from Shanghai and 462 from Inner Mongolia.The baPWV value of middle-aged residents in Inner Mongolia was higher than that in Shanghai [(1 548 ± 281) cm/s and (1 476 ± 254) cm/s,P ＜ 0.001].The abnormal rate of baPWV (baPWV ≥ 1 400 cm/s) in Inner Mongolia was also higher than that in Shanghai [67.5 ％ (312) and 57.4％ (253),P ＜0.001].The baPWV value of middle-aged men in Inner Mongolia was (1 568 ±299) cm/s,while it was (1 508 ± 260) cm/s in Shanghai,no statistical difference was found (P ＞ 0.05).The baPWV value of middle-aged women in Inner Mongolia was (1 534 ± 268) cm/s,which was higher than that of Shanghai [(1 468 ±252)cm/s,P ＜0.01].The abnormal rate of baPWV of middle-aged men in Inner Mongolia and Shanghai was 67.0％ (126/188) and 60.8％ (59/97),respectively (P ＞ 0.05).The abnormal rate of baPWV of middle-aged women in Inner Mongolia and Shanghai was 67.9％ (186/274) and 56.4％(194/344),respectively.Conclusions The difference of baPWV value and abnormal rate of baPWV of middle-aged residents between Inner Mongolia and Shanghai exists.Middle-aged people in Inner Mongolia should be more alert to the incidence of arteriosclerosis and cardio-cerebrovascular diseases.

ObjectiveTo observe the synergistic action of lower He-sea and Front-mu points in treating functional dyspepsia by adopting electroacupuncture at the lower He-sea and Frong-mu points of stomach.MethodSixty patients with functional dyspepsia were randomized into a lower He-sea group, a Front-mu group, and a combining group of lower He-sea and Front-mu points, to receive treatment once daily, 5 sessions a week, totally for 4 weeks. Nepean Dyspepsia Index (NDI) was tested before and after intervention, and the general therapeutic efficacy was evaluated.ResultThe total effective rate was 100.0% in the combining group, versus 90.0% in the Front-mu group and 90.0% in the lower He-sea group, and the differences were statistically significant (P<0.05). The follow-up study showed that the total effective rate was 100.0% in the combining group, versus 90.0% in the Front-mu group and 85.0% in the lower He-sea group, and the differences were statistically significant (P<0.05). Before treatment, therewere no significant inter-group differences in comparing Nepean Dyspepsia Symptom Index (NDSI) and Nepean Dyspepsia Life Quality Index (NDLQI)(P>0.05), while there were significant differences in comparing NDSI and NDLQI after treatment (P<0.05). ConclusionIt can improve the functional dyspepsia symptoms by using the lower He-sea point and Front-mu point together or using them separately, while the combining use can produce a more significant efficacy.

Objective To assess the clinical results of the treatment of the 211 cases of long bone shaft fractures at lower limbs with intramedullary interlocking nails. Methods 211 cases of femoral and tibial fractures were treated chiefly with unreamed intramedullary interlocking nails and postoperative functional exercises including continuous passive motion (CPM). Results 189 cases were followed up for an average of 9 months (ranging from 4 to 26 months). All the cases achieved bone union, and no nonunion occurred. Delayed union occurred in 7 cases and limited knee joint function in 4 cases. According to the Johner-wruhs criteria, 178 cases were assessed as excellent, 24 as good and 9 as fair. The total excellent and good rate was 95.6%. Conclusions The intramedullary interlocking nail is a good device for the treatment of long bone shaft fractures at lower limbs. Its indications have become wider. It is correct to pay equal attention to the blood supply of the fractured bone and the reduction of the fracture during the operation.

To examine the histological changes of diabetic rats' skin and the effects on the percutaneous absorption of hydrocortisone (HC, a glucocorticoid), male Wistar rats were randomly divided into five groups: control group, diabetes one-week group (W1), two-week group (W2), three-week group (W3), and four-week group (W4), while each group contained 6 rats. Diabetes mellitus (DM) rat model was prepared with the method of streptozocin (STZ, 40 mg x kg(-1)) intraperitoneal injection. Abdominal skin was cut to carry out an in-vitro penetration experiment on an improved Franz diffusion cells, and phosphate buffer (PBS, pH 7.4) was used as receptor solution. The solution was analyzed with HPLC, and then the penetrating rate can be calculated. Meanwhile, rats' abdominal skins of different DM periods were HE stained and made into tissue slices to find if any histological changes occurred. The penetrating rate of control, W1, W2, W3, and W4 groups were 2.39 +/- 1.25, 3.22 +/- 1.72, 3.02 +/- 1.89, 3.63 +/- 2.02 and 5.00 +/- 3.36 microg x h(-1) x cm(-2), respectively. There was significant difference between the control and the W4 group (P < 0.05), but no significant differences were found between any other two groups (P > 0.05). The tissue slices showed that compared to the normal rats' skin, little change was observed in one-week DM rats' skin, but the skin of one-month DM rats' skin was observed thinner, and it became much thinner than that of rats with two-month diabetes, especially the epidermis. After making a rat into diabetic, the rats' skin goes through a pathological change, and this change is closely interrelated with the increase of the permeation of HC. Therefore, it is necessary to adjust the dose while some drug was applied on the skin in case of diabetes mellitus.

Objectives To evaluate the effect of probiotics enteral nutrition therapy on the inflammatory reaction and immune function in acute necrotizing pancreatits(ANP)in rats.Methods 100 SD rats were divided randomly into control group(C group,n=20),ANP gruop,enteral nutrition group (EN group,n=20),probiotics group(P group,n=20)and enteral nutrition plus probiotics group(PEN group,n=20),ANP were induced by retrograde injection of 5% sodium tautocholate(1.5ml/kg)into the biliary and pancreatic duct.The nasojejunal tube was placed via gastric route.The rats were sacrificed at 12h,24h,48h and 72h after ANP modeling.Serum MIF and amylase levels,as well as CD_3~+,CD_4~+,CD_8~+were measured and MIF was determined by immunohistochemistry and the histopathological changes in pancreatic tissue were observed.Results Serum MIF and amvlase levels were all increase when compared with that in C group.72h after ANP modeling,srum MIF leves in EN,P,PEN groups were(117.59±1.86)μg/L,(108.39±1.99) μg/L and (95.33±1.96) μg/L,respectivdy;serum amylase levels were (2799±161)U/L,(2482±140)U/L and (2146±572 )U/L,respectively;the values in P and PEN groups were significantly lower than that of EN group(P＜0.05),the values in PEN groups were significantly lower than that of P group (P＜0.05 ).After ANP induction,CD_4~+/CD_8~+ values in EN,P and PEN groups were 0.93±0.12,1.31±0.13,1.51±0.10,respectively;the values in P and PEN groups were significantly higher than that of EN group(P＜0.05 ),the values in PEN groups were significantly higher than that of P group (P＜0.05 ).MIF positive rates in C,ANP,EN,P and PEN group were 45%,96%,95%,65% and 60% ,respectively;the values in P and PEN groups were significantly lower than those of ANP and EN group (P＜0.05 ).At 72 h,the damage of pancreatic tissue was more severe in EN and P groups than that in PEN group.Conclusions Probioties enteral nutrition could effectively regulate inflammation mediator and cytokines in rats with ANP,and enhance immune function.