BACKGROUND:Deep venous thrombosis has already been recognized as an important serious postoperative complication because it can cause fatal pulmonary embolism and long-term deep venous dysfunction. With the constant development of artificial joint operation and the popularization of such surgery, much attention has been paid to the formation of deep venous thrombosis following artificial joint replacement.OBJECTIVE: To observe the anatomical property of acetabular surrounding arteries and veins, as well as their injury during total hip replacement,so as to explore the cause of deep venous thrombosis in lower limbs following artificial total hip replacement.DESIGN: Single sample observation and before-after self-control.SETTING: Gross anatomy was carried out in the anatomical laboratory of the Medical School of Huzhou Teachers' College; total hip replacement was carried out in the Orthopedic Department, Xinhua Hospital of Zhejiang Traditional Chinese Medicine College.PARTICIPANTS: Pelvic samples were collected from 60 normal adult corpuses (30 from men and 30 from women); meanwhile, 30 patients (18 males and 12 females) received total hip replacement in the Orthopedic Department of Xinhua Hospital, Zhejiang Traditional Chinese Medicine College, between March 2002 and August 2003.METHODS: Gross anatomy was carried out at the anatomical laboratory in the Medical School of Huzhou Teachers' College between March and May 2003. The running course of bilateral external iliac artery and vein, as well as the relationship between the branches of femoral artery and vein and acetabulum were observed on 60 pelvic samples. In order to make the observation easier, 12 o'clock division mode chart of acetabulum was established, that is, a line drawn from anterior superior iliac spine toanterior inferior iliac spine, with the crossing point of its extension line and acetabular edge taken as 12 o'clock, therefore the other points should be arranged clockwise. Totally 30 patients received artificial total hip replacement by acetabular lateral-posterior approach. One week later, bilateral deep venous radiography was performed to observe the state of deep venous thrombosis in lower limbs.MAIN OUTCOME MEASURES: ① The anatomical relationship between the branches of external iliac artery and vein, femoral artery and vein and acetabulum. ② The formation rate of deep venous thrombosis in lower limbs after total hip replacement. ③ Adverse events and side effects.RESULTS: Totally 60 adult normal pelvic samples and other 30 pelvic samples of patients who received total hip replacement remained in the results analysis. ① Anatomical observation of external iliac artery and vein,as well as femoral artery and vein: the branches of femoral artery and vein: Medial and lateral circumflex femoral arteries were found running across acetabulum and entering acetabulum; the safe position for the retractor was from 12 o'clock to 3 o'clock and from 5 o'clock to 9 o'clock. However, 9o'clock to12 o'clock and 3 o'clock to 5 o'clock were taken as fragile regions. ② The incidence of deep venous thrombosis following total hip replacement: Bilateral deep venous radiography was carried out after operation and revealed that 11 patients developed deep venous thrombosis with the incidence of 37%. ③ Adverse events and side effects: Postoperative bleeding of over 1 000 mL occurred in 3 cases. In order to fully expose operative field, the retractor should be used to hold off muscles and other tissues, which contributed to long-term vascular compression and blood flow retardation.CONCLUSION: Artificial total hip replacement is liable to injure the internal wall of acetabular vessels, thereby leading to blood flow retardation and platelet aggregation, and ultimately thrombosis. In addition, the massive bleeding during operation will increase blood mucosity, which also increases the risk for thrombosis. From the mode chart of fragile regions and safe regions, we can deduce that deep venous thrombosis in lower limbs can be reduced.

BACKGROUND: At present, the artificial total hip replacement(THR) is the first choice of the hip joint disease for the old, and the choiceness rate is 84% according to the Harri' s grade, and the therapeutic effect is content. The occurrence rate of the sciatic nerve injury in the THR is reported to be 0.46% in and 0. 08%-9.7% abroad.OBJECTIVE: To study the influencing factors of the sciatic nerve injury in the THR through the anatomical location analysis.DESIGN: Single sample study based on the human anatomical samples.SETTING: Human Anatomy Laboratory in the Medical Department of the Huzhou Normal University.PARTICIPANTS: The study was completed in the Human Anatomy Laboratory in the Medical Department of the Huzhou Normal University from March to May in 2003. There were 56 pelvis samples of the normal human adult cadaver, 27 males and 29 females.METHODS: The origins and the pathways of the sciatic nerves and the relation of the sciatic nerve and the acetabulum were analyzed, and the sciatic nerve injury induced by the clasp and the screw fixation in the THR was measured and analyzed.MAIN OUTCOME MEASURES: The location relation of the sciatic nerve and the acetabulum.RESULTS: The distance between the sciatic nerve and the bottom of the acetabulum was(6.00 ±0. 85) mm on the left and(6.00 ±0. 71) mm on the right. The distance between the sciatic nerve and the edge of the acetabulum was(13.00 ±0. 75) mm on the left and(14.00 ±0.06) mm on the right. The SN circumference on the edge of the acetabulum was(32.00 ± 0. 28) mm on the left and(31.00 ± 0.68) mm on the right. The distance between the bottom of the acetabulum and the greater sciatic foramen was(29.00 ±0. 36)mm on the left and(29.00 ±0.24) mm on the right.CONCLUSION: It is confirmed that the clasp and the screw fixation can be done on the safe region at the 1-3 o' clock and the 5-6 o' clock. The obsolete fracture and dislocation of the acetabulum, the unsuitable clasp location and the unsuitable location of screw fixation may induce the iatrogenic sciatic nerve injury.

Objective To research on the proliferation and differentiation in vitro of primordial germ cells. Methods We got plenty of primordial germ cells(PGCs) by co-culture of PGCs with sertoli cells(SCs).The primary cells formed embryoid bodies(EBs) by suspension culture.furthermore,these EBs were plated on gelatin-coated culture plates for spontaneous differentiation. Results We got plenty of PGCs by coculture.Primary PGCs and passaged PGCs for histochemistry staining with AKP and immunohistochemistry staining for SSEA-1 display positive character.The EBs by suspension culture differentiated into epithelial-like,fibroblast-like and neuronal-like cells in vitro. Conclusion Primordial germ cells can proliferate and keep the character of stem cells by co-culture with SCs.PGCs can form EBs by suspension culture,most of these EBs can differentiate into neuronal-like cells,they also can differentiate into epithelial-like and fibroblast-like cells in vitro.

To measure esophageal manometric parameters in liver cirrhosis, patients with different liver function grades were chosen. In the normal control group ( n =72) gastrointestinal disease history and symptoms, abdominal surgery and injury history were all negative. In liver cirrhosis group ( n =94) liver cirrhosis was diagnosed by clinical picture or pathology, and their liver function in Child grade was: grade A, 38 cases and 8 had ascites; grade B, 37 cases and 20 had ascites; grade C, 19 cases and 18 had ascites. Taking no motility medicines within seven days before measurement, esophageal motility parameters of these subjects were taken by a Biolab System made by Sandhill Company. The data were analyzed with SAS statistical software. The results showed that from Child grade A to C, LESP in cirrhosis group reduced, relaxation pressure increased, and relaxation percentage become lower successively; from Child grade A to C, onset peristaltic wave velocity in upper esophageal body became slower, peristaltic contraction reduced, and abnormal contraction increased; from Child grade A to C, peristaltic wave amplitude reduced in lower esophageal body, and velocity of onset peristaltic wave velocity became slower, peristaltic contraction reduced, and abnormal contraction increased. It suggests that more severe injury in liver function, more serious impact in esophageal motility. At the same time complications of portal vein hypertention such as esophageal varices and ascites behave synergetically.

Objective To investigate the possible way through which transplanted Sertoli cells support the nerve tissues in vivo.Methods Culture the isolated cells from the fetal mouse cerebral cortex alone(coated the culture plate with poly-D-lysine previously),the control group,or with prepubertal homologous Sertoli cells(planted Sertoli cells beforehand),the coculture group.To observe the morphological changes of the cultured neurons,neural stem cells(NSC) and neuroglial cells every day and compared the differences in their growth between the tow groups.Sertoli cells,neurons and NSC were identified by the expression of Fas ligand,neuron-specific enolase(NSE) and Nestin in the cytoplasm respectively.Results A significant increase of both the survival of neurons(P

Objective To study the promotive effect of SCs on neurons in vitro Methods SCs feeder layer was made as conditioned medium(SCM), then used in coculture with neurons respectively. Count the survived neurites of the cultured cell and observe the cell size by a medical image analyzer. Results The number of surviving cells, neurites outgrowth and cell size cocultured either with SCs feeder layer or SCM was markedly increased than that of control cultures(P

Objective To study the morphological characteristics of tumor microvasculature in primary hepatic cell carcinoma (HCC). Methods From Jan. 1998 to Feb. 2002, 32 cases, consisting of 26 male and 6 female, with age ranging from 28 to 76 years [mean (50.56?10.52) years], underwent preoperative digital subtraction angiography (DSA) without theraputic embolization in General Hospital of PLA and 307 hospital of PLA. The diameters of the tumors measured 2～23 (8.05?6.17) cm. The tumor microvessel density (MVD), type and diameter of the tumor microvessels, width of tumor trabeculae, and the size of the malignancy were measured and statistically analyzed. The outcome of the each patient was also statistically analysed. Results The size of tumor tended to be positivly correlated with the pattern of microvasculature of the tumor. The size of the tumor was negatively correlated with MVD, white the tumor size and the diameter of tumor related vessels were positively correlated with the diarneter of tumor trabeculae. Hoverer, the size of the tumor was not correlated with the diameter of vascular trabeculae. Conclusions The density, configuration and the distribution of tumor microvessels were not even in HCC. The features of tumor microvasculature were distinctive at different phases of tumor growth, having definite rules in the development.

Objective To investigate the features of non-senile colonic diverticula as diagnosed by coloscopic examination in 47 cases. Methods 47 cases of non-senile colonic diverticula were diagnosed by colonoscopy in the Department of Endoscopy, General Hospital of PLA, from Jan. 1996 to Dec. 2001. Results There were 38 males and 9 females, whose age was under 60, with a mean age of 43.2 years. The incidence and detectable rate for simple and multiple diverticula showed no relationship to patients' age. The detectable rate of colon diverticula was higher in males than in females. Right colon was the predilection site for both simple and multiple colonic diverticula, especially for simple diverticula. The ratio of incidence for right to left colon was 20.5∶1. The ratio was 2.8∶1 in senile patients (aged above 60, detectable rate of colon diverticula was16.9‰). Conclusion The incidence of colonic diverticula in non-senile patients showed no relationship to age. The incidence of diverticulum in right colon was higher in non-senile patients than in seniors. The incidence of diverticulum in the left colon or both sides of colon was lower in non-senile patients was in seniors.

To evaluate the influences of sclerotherapy and band ligation on esophageal motility, EVS and EVL were measured before and after treatment respectively. After sclerotherapy, lower esophageal sphincter pressure (LESP)and residual pressure were decreased while relaxa tion was increased , relaxation duration became shorter; band ligation only influenced LESP.After EVS, the amplitude of motor waves in the sites of EVS and lower esophagus body was reduced ,and peristaltic wave duration was prolonged ,velocity of propagating contractions became faster , band ligation made the peristaltic wave duration in the sites of EVS and lower esophagus body become shorter, abnormal contractions increased. After EVS, antiacid medicine should be ased to reduced pH of gastric and raised LESP, and drugs to increase esophageal motility should be used after band ligation.

Objective To establish a new method for inducing the primordial germ cells to differentiate into hepatocyte-like in vitro.Methods The primordial germ cells(PGCs) from the gonadal ridges of the mouse embryos of 13 days postcoitum from Kunming pregnant mice were cultured in vitro.Then embryonic hepatocytes enclosed in microcapsule and liver tissue extract of newborn mice were added into medium to co-culture with PGCs for committed differentiation.Albumin(ALB) and ?-1-antitrypsin(AAT) were assayed by immunocytochemistry.Results The morphology of cells differentiated from PGCs likes star or ovum,the ALB and AAT immune positive expression were detected in those differentiated cells.The ratio of positive cells was above 70% in 2 weeks.Conclusion Microenvironment of embryonic hepatocyte microcapsules and liver tissue extract could effectively induce PGCs to differentiate into hepatocytes.