[Objective]To explore the outcome of treatment of traumatic talipes equinus with Ilizarov technique.[Method]From Dec 2004 to Feb 2006,Ilizarove technique was used for treatment of traumatic talipes equinus in 8 patients,5 male and 3 female,aged from 28 years to 52 years with an average of 34.6 years.The main reasons of the food deformity included rupture or defect of the anterolateral muscle group of the leg in 3 patient,compartment syndrome of the leg in 2 patients,peroneal nerve injury in 2 and supercondylar fracture of the femor combined with popliteal artery injury in a patient.Ankylosis of the ankle ranged from 50 to 65 degrees.During operation,Ilizarov fram was placed in relative position of the foot and leg,and cross Kirschner wires 2 mm in diameter were inserted and fixed the limb with the frame in different level rings.Form 3～5 days after operation,distraction 1～2 turns four times per day was conducted till the ankle was placed in neutral position and the deformity corrected satisfactorily,then,discontinued the distraction and maintained the external fiation for another 2～3 months.[Result]All of the patients were followed up for 10 months to 21 months with an average of 12.5 months. No severe complications,such as necrosis of skin,neurovascular injuries occurred in any patient of this group.All of the affected foot and ankle got neutral position with satisfactory ambulation function,and 3 of them had 10 degrees of active dorsal flexion.No recurrence of the deformity occurred in any patient at the latest follow up.[Conclusion]Ilizarov techinque for treatment of traumatic talipes enquinus has significant advantages over other methods,it is recommended extensive application in clinic.

[Objective]To investigate surgical protocol for treatment of thoracolumbar fracture with ankylosing spondylitis. [Method]A retrospective study was performed in 8 thoracolumbar-fracture patients with ankylosing spondylitis. Of them, 6 patients were neurological intact and 2 had neurological defect(Frankel grades the C level). Under general anesthesia, all of the 8 patients underwent open reduction and internal fixation with pedicle screws at two segments in both ends of the fracture. Laminectomy for decompression of the nerve tissue was performed in the 2 patients with neurological defect simultaneously.[Result]All of the 8 patients were followed up for 8 to 30 months. Solid bone healing was achieved in all of the patients. Two patients with eurological compromise had improved by two Frankel grades (complete recovery).[Conclusion]Thoracolumbar fracture in ankylosing spondylitis traverse both bone and ligaments, producing an extremely unstable situation similar to a shearing type of fracture. Reduction of the displacement and stabilization is best achieved with a pedicle screw system at two segments in both ends of the fracture.

0.05). No procedure related complications and malignant arrhythmia were found during 6-12 months follow-up. Conclusion Intracoronary transplantation of ABMMNCs is safe and may improve the heart function.

Objective To analyze the prognostic factors and trerapy strategy of lung cancer in the patients aged 80 years and over.Methods Totally 107 patients aged ≥ 80 years with lung cancer were retrospectively reviewed.Patients' clinical characteristics and treatment were analyzed.Results Median survival time of the patients was 6.9 months.92.9％ (13/14) of small cell lung cancer patients and 34.4％ (31/90) of non small cell lung cancer patients were treated.Life cycle of patients who accepted effective treatments and supportive treatments were 16.5 months and 8.7 months,respectively (P=0.008).In the early stage of tumors,survival time of patients undergoing surgery was 36.7 months,15.5 months in patients without surgery (P=0.023),while in the late stage,survival time of patients receiving combined chemotherapy was 13.4 months,4.6 months in patients receiving single agent chemotherapy(P=0.002).In small cell lung cancer,survival time of patients who received radiotherapy was 12.8 months,6.4 months in patients who did not receive radiotherapy (P=0.049).Performance status (PS),clinical stage,early surgery,late chemotherapy and radiotherapy(x2=38.236,18.831,5.187,9.827,4.186,P＜0.05),but not sex and pathology type affected the prognosis.PS score (P=0.003)and clinical stage(P=0.046) were the independent influencing factors.Conclusions Performance status and clinical stage are the independent influencing factors of lung cancer in the patients aged over 80 years.Patients may improve survival if receiving surgery,chemotherapy and/or radiotherapy when they have good PS,otherwise patients may choose best supportive care.

Objective To investigate the clinical significance of precursor of gastrin‐releasing peptide(ProGRP) for the differen‐tial diagnosis between small cell lung cancer (SCLC) and non‐small cell lung cancer(NSCLC) and efficacy assessment .Methods The levels of ProGRP were detected by ELISA in 210 healthy adults ,200 patients with lung benign disease ,260 patients with NSCLC and 182 patients with SCLC before treatment and after chemotherapy .Results The level of ProGRP in the SCLC group was significantly higher than that in the NSCLC group ,healthy control group and lung benign disease group(P<0 .01) .The sensi‐tivity of ProGRP for detecting SCLC was 56 .3% and the specificity was 92 .6% .When combination detection of ProGRP and NSE was used ,the sensitivity increased to 82 .6% ;the level of ProGRP in the patients with SCLC after 2‐cycle chemotherapy was signifi‐cantly lower than before treatment (P<0 .01) .Conclusion The tumor marker ProGRP has very important guidance significance to assisted diagnosis ,differential diagnosis and efficacy assessment of chemotherapy in the patients with SCLC .

Objective:We aimed to explore the clinical features, computed tomography (CT) findings, treatment, and prognosis of bronchopulmonary carcinoid. Methods:Clinical data of 31 patients with primary carcinoid tumor of the lung were retrospectively re-viewed. The prognostic factors were analyzed via Cox univariate and multivariate analyses. Results: Clinical symptoms included coughing or expectoration in 17 of the 31 cases, hemoptysis or blood-stained sputum in 7 cases, and chest pains or shortness of breath in 8 cases. Six cases were asymptomatic. The CT scans showed round or oval nodules with clear boundaries, and enhancement CT scans indicated mild, homogeneous enhancement. Immunohistochemistry results revealed the positive expression rates of synaptophy-sin (Syn), chromogranin A (CgA), and neuron-specific enolase (NSE) were 90.3%(28/31), 87.1%(27/31), and 90.3%(28/31), respec-tively. Therapy and prognosis results were as follows:28 of the total number of patients underwent surgery, among which 3 underwent postoperative adjuvant therapy, 2 received chemotherapy; and only 1 refused treatment. The 1-year overall survival rates were 100%(18/18) and 92.3%(12/13), whereas the 3-year survival rates were 94.4%(17/18) and 69.2%(9/13) in the typical and atypical carcinoid cases, respectively. Cox univariate analysis results revealed that lymphatic metastasis (P=0.02), tissue types (P=0.017), TNM stage (P=0.005), and therapies (P=0.01) were the prognostic factors. Cox multivariate analysis results showed that lymphatic metastasis (P=0.032) and tissue types (P=0.002) were the independent prognostic factors. Conclusion:Compared with other lung cancers, the bron-chopulmonary lung carcinoid has no special clinical manifestation in clinical and radiographic images. The diagnosis was mainly based on histopathology results. Surgery was the main and effective treatment, whereas chemotherapy and radiotherapy showed unsatisfactory results. The overall prognosis was satisfactory. However, the atypical carcinoid was inferior to the typical carcinoid in terms of progno-sis. Pathological typing and lymph node metastasis were significant prognostic factors.

Objective To understand biochemistry study situation in clinical medicine undergraduates and to improve biochemistry teaching quality.Methods Totally 120 clinical medicine undergraduates were enrolled randomly to receive investigation on problems related to biochemistry.Corresponding statistic analysis was made using softwares of Excel and SPSS 16.0 in view of the main problems.Results One hundred and twenty copies of survey questionnaires were finished.There were 114 effective copies and the effective rate was 95％ after checking on these questionnaires.61.4％ of the students neither liked nor disliked biochemistry course; 56.1％ of the students thought that learning biochemistry was difficult; students thought that chapter 4 sugar metabolism,chapter 5 lipid metabolism and chapter 6 biological oxidation to be very difficult.Only 11％ of the students did preview,further analysis found positive relation between preview and understanding (rj =0.288,P ＜ 0.01 ).Conclusion Clinical medicine undergraduates like biochemistry insufficiently with few doing preview.It suggests that teachers should pay attention to the cultivation and stimulation of students' interest in biochemistry course,improve teaching method for the difficult sections,strengthen experiment teaching and try combination and separation teaching mode.

Objective To evaluate extended criteria donor liver in adult cadaveric liver transplant.Methods 126 liver transplantations were performed from January 2003 to June 2009,of them,74 patients received standard criteria donor livers,52 patients received extended criteria donor livers.These 52 donor livers could be divided into two groups:E1 group (a graft with 1 to 2 risk factors) and E2 group(a graft with 3 to 4 risk factors).Results There was no significant difference in half a year and 1 year survival rates between patients received E1 group extended criteria donor livers and those received standard criteria donor livers(respectively x2 =2.55,3.64,all P ＞0.05).But 2 year survival rate of patients received E1 group extended criteria donor livers was lower than those receiving standard criteria donor livers (x2 =4.9,P ＜0.05).Half a year,1 year and 2 year survival rates in patients receiving E2 group extended criteria donor livers were less than those receiving standard criteria donor livers (respectively x2 =3.91,8.67,11.34,all P ＜ 0.05).The half a year,1 year,and 2 year survival rates of patients received extended criteria donor livers with MELD score more than 20 was less than those with MELD score ＜ 20 (respectively x2 =0.16,0.16,0.07,all P ＜ 0.05).Conclusions Extended criteria donor livers can be used safely if the risk factor of donor liver was less than 3,or when recipient's MELD score was ＜20.

ObjectiveTo explore the surgical approach and therapeutic efficacy of injury of liver and vascular approaching to liver.MethodsThe clinical data from January 1997 to May 2010 of 35 patients with injury of liver and vascular approaching to liver were retrospectively analyzed.Results Among 35 cases,32cases were cured by surgery ( cure rate 91.43％ ) and 3 cases died ( mortality rate 8.57％ ).Postoperative complications occurred in 5 patients ( complication rate 14.29％ ).There were 2 cases of pulmonary infection,1case of biliary fistula,1 case of multiple organ failure and 1 case of incision infection.Conclusion Urgent surgery need to be performed for injury of liver and vascular approaching to liver and effective recovery was important.In the operation,careful handling,complete dissociation and sufficient exposure were the key to successful repair.

Objective To approach the efficacy of urgent liver transplantation for acute liver failure.Methods The clinical data of 22 patients with acute liver failure undergoing urgent liver transplantation in our hospital from January 2003 to January 2009 were retrospectively analyzed.The prognosis,survival rate and complication were summarized.Results Among 22 patients,there were 14 cases of hepatitis B-induced acute liver failure,and 8 cases of drug-induced acute liver failure.The mean waiting time was 2.3 days.Three patients died perioperatively.Retransplantation was done in 1 patient.Complications after urgent liver transplantation included:abdominal cavity hemorrhage (2 cases),biliary complications (2 cases).There were no vascular complications.Renal dysfunction of different degrees occurred in all patients.Psychiatric symptom occurred in 17 cases,epilepsy in 1 patient,pulmonary infection in 11 patients,and acute cell rejection in 3 patients.The 1-,2-and 3-year recipient survival rate was 81.8 ％,81.8 ％,81.8 ％,respectively,and the 1-,2- and 3-year graft survival rate was 81.8 ％, 77.3 ％, 77.3 ％, respectively.ConclusionUrgent liver transplantation has a good efficacy for acute liver failure.Reasonable preoperative evaluation,length of waiting for graft,and effective treatment of various kinds of complications are the key point to improve the prognosis of patients with acute liver failure undergoing urgent liver transplantation.