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 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.

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).

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 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.

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.

Objective　To evaluate the clinical efficacy of dihydroartemisinin—mefloquine on acute uncomplicated falciparum malaria. Methods　Fifty-four patients with symptomatic falciparum malaria were allocated to receive oral dihydroartemisinin at a single dose of 120?mg on day 1, followed by mefloquine, 750?mg and 500?mg on days 2 and 3, respectively. Follow-up was performed on days 1,2,3,4,7,14,21, and 28. Results　All patients had a rapid initial response to treatment. The parasite clearance time (PCT) after treatment was 30.7±3.6 hours. The fever subsidence time (FST) after treatment was 21.2±2.8 hours. Two patients had a recrudescence 21 and 25 days respectively after the disappearance of parasitemia, hence the recrudescence rate was 3.7% and the cure rate was 96.3%. No serious adverse effects were observed, only mild and transient nausea, vomiting and loss of appetite. Conclusion　A combination of dihydroartemisinin and mefloquine is effective in the treatment of acute uncomplicated falciparum malaria.

Objective To survey ST-segment resolution in STEMI patients undergoing emergency percutaneous coronary intervention (PCI) and to find the specific clinical features of patients with inadequate ST-segment resolution.Methods A total of 198 patients were divided into two groups according to the ratio of ST-segment resolution:relatively adequate ST-segment resolution group (＞ 50％) and inadequate STsegment resolution group (＜ 50％).The clinical features,infarct-related artery and PCI-related evants were evaluated,and major adverse cardiovascular events (MACE including target vessel revascularization,recurrent myocardial infarction,or death) were recorded during hospitalization and follow-up period.Multivariate logistic analysis was used to identify relevant factors influencing ST-segment resolution of STEMI patients after treatment with PCI.The Statistical analyses of data were carried out using SPSS 10.0 software.Results (1) There were 156 patients with relativey adequate ST-segment resolution and 42 patients with inadequate ST-segment resolution.Of them,there were higher percentage of patients aged over 75years in the inadequate ST-segment resolution group than those in the relatively adequate ST-segment resolution group (9 cases,21.4％ vs.14 cases,9.0％ ; P ＜0.05).(2) In inadequate ST-segment resolution group,thetotal ischemic time was significant longer [(5.2 ±2.2) h vs.(3.0 ± 1.6) h,P ＜0.01].The infarctrelated artery (IRA) was more common at left anterior descending coronary artery (LAD) (27 cases,64.3％ vs.69 cases,44.2％; P ＜ 0.05) and there were fewer patients with TIM grade 3 of IRA in inadequate ST-segment resolution group after primary PCI than that in relative adequate ST-segment resolution group (32 cases,76.2％ vs.140 cases,89.7％ ; P ＜ 0.05).There was a lower rate of using GP Ⅱ b/Ⅲ a receptor antagonist and a higher rate of prescribing IABP in inadequate ST-segment resolution group.(3) There is a higher incidence of MACE during hospitalization and follow-up period in patients with inadequate ST-segment resolution.(4) Multivariate logistic analysis indicated that age over 75 years,LAD occlusion,the total ischemic time were related to ST-segment resolution.Conclusions The patients with age over 75 years,LAD occlusion,longer ischemia time,and unemployment GP Ⅱ b/Ⅲ a receptor antagonist before PCI were prone to get inadequate ST-segment resolution and poor prognosis.Age over 75 years,LAD occlusion,and longer ischemic time were independent risk factors of the inadequate ST-segment resolution in STEMI patients after emergency PCI.

Objective To investigate the diagnosis and treatment of anorectal malignant melanoma,in order to regulate surgical methods and explore multi-modality treatment.Methods Clinical pathological features,diagnosis and treatment procedures of 38 patients with anorectal melanoma were reviewed,and their correlation with prognosis were analyzed.Results In 38 patients,10 of them were male and 28 were female,with the mean age of 58.7 years old (ranged 28-75 years old).28 patients underwent abdominoperineal resection,10 patients underwent wide local excision.The 1-,3-,and 5-year disease-free survival rates were 64.9 ％,18.5 ％ and 5.7 ％,respectively.The 1-,3-,and 5-year overall survival rates were 85.8 ％,24.1％ and 6.4 ％,respectively.Tumor thickness (≥ 1.51 rm) and tumor diameter (≥3 cm) were associated with lymph metastases (x2 =13.093,4.449,P =0.011,0.020),tumor thickness was also associated with distant metastases (x2 =11.965,P =0.018).According to the Kaplan-Meier method,comprehensive treatment after surgery had significant effects on disease-free survival (x2 =7.441,P =0.006).Tumor thickness,lymph metastases,and clinical staging had significant effects on overall survival (x2 =16.741,16.474,16.775,P =0.002,0.000,0.000).Cox proportional hazards model indicated that comprehensive treatment after surgery was the independent prognostic risk factors of disease-free survival (95 ％ CI 1.420-17.621,P =0.012).Tumor thickness and lymph metastases were the independent prognostic risk factors of overall survival (95 ％ CI 0.250-0.949,1.033-2.573,P =0.035,0.036).Conclusion Early detection,reasonable surgical procedure,generalized systemic focus on immunotherapy treatment are the key to improve quality of life and prolong the survival time of anorectal malignant melanoma patients.