Objective High tibial osteotomy was an alternative in the management of knee osteoarthritis, it could release the knee pain, correct the mechanical axis of the affected limb, and delay the total knee replacement. We were aimed at measuring the change of posterior slope angle of tibial medial plateau after high tibial osteotomy and probe its clinical consequences. Methods From 1998 to 2001, there were fifty-eight knees of 38 patients with medial unicompartmental osteoarthritis treated with closing-wedge high tibial osteotomy. The present included 8 male and 30 female patients with the average age of 55.2 years ranging 41 to 65 years. The osteotomy line was 2 cm distal to articular surfaces, and the tibia was fixed with Giebel bladed plate and two oblique long screws. The posterior slope angles of tibia and Insall-Salvati index were measured both pre and postoperatively on lateral radiographs. The posterior slope angle of proximal tibia in this study was defined as the angle between vertical line to tibial axis and the surface parallel to subchondral bone. Insall-Salvati index was defined as the ratio of the length of patellar tendon to the largest vertical diameter of patella. The alteration of the above features was calculated and analyzed statistically with paired t test. Results The mean tibial posterior slope angle was 9.4??3.0? preoperatively and 5.6??2.6?postoperatively. The tibial posterior slope angle was averagely decreased about 3.8??2.0?, Insall-Salvati index was 1.05?0.16 and 0.94?0.18 before and after high tibial osteotomy respectively. This index was averagely decreased about 0.15?0.10. Statistical analysis indicated that there was significant difference of posterior slope angle or Insall-Salvati index between pre and post operative(P

Objective To investigate the intelligence development status of the low birth weight infants and its influence factors. Methods The intelligence developments of 135 low birth weight infants aged 6-30 months were investigated using Bayley Scales of Infant Development, and the self-development influential factors were analyzed with questionnaire.Results The average of MDI was 86.76±18.95 in 135 infants,of which the detection rate of MDI<80 points accounted for 17.8%and the detection rate of PDI<80 points accounted for 29.6%;birth weight of infant,age,the degree of parents,culture and feeding way had significant effects on MDI in infants;age and birth weight had significant effects on PDI in infants. Conclusion The development level of infants is influenced by multi-factors. More attention should be paid to reduce premature and low birth weight infants,improve the degree of parents' culture, advocate breastfeeding and conduct early intervention in order to assure the intelligence development of infants.

ObjectiveTo investigate the correlation between single nucleotide polymorphism (SNP)of complement factor H (CFH) gene and exudative age-related macular degeneration (AMD) susceptibility.MethodsThis is a retrospective case control study. 136 exudative AMD patients (AMD group) and 140age and sex-matched normal subjects (control group) were enrolled in this study. The peripheral blood was collected,polymorphism genotypes and frequency of CFH Y402H(rs1061170),CFH-257C ＞ T (rs3753394) and CFH IVS15 (rs1329428)were measured by polymerase chain reaction (PCR) and allelespecific restriction endonuclease digestion. The SHEsis software was performed on haplotype construction to analyze the frequency.ResultsThere are TT, TC, CC genotypes and T, C allele in CFH Y402H (rs1061170); CC, CT, TT genotypes and C, T allele in CFH-257C＞T (rs3753394); AA, AG, GG genotypes and A, G allele in CFH IVS15 (rs1329428). The differences of genotypes and allele frequency between 2 groups were statistically significant (P＜0. 05). The TC genotype in CFH Y402H, TT genotype in CFH-257C＞T (rs3753394) and GG genotype in CFH IVS15 (rs1329428) were associated with exudative AMD susceptibility (OR=4. 11,2. 55,3.11;P＜0.05). The T, C and G allele were the risk alleles (OR=3.14,1.72,1.79;P＜0. 05). The differences of frequency between TCG, CTG and CTA haplotype were statistically significant(X2 =10.53,6.60, 32.82;P＜0.05). ConclusionThere is correlation between SNPs of CFH gene and exudative AMD susceptibility.

Objective To investigate the coupling of tibial rotation and extension-flexion motion of knee joint both before and after total knee arthroplasty. Methods Six fresh-frozen left lower limbs from cadavers were tested using a modified Oxford motor rig for the knee joint. Anatomically based multiple loadings of the quadriceps mechanism were applied (Vastus medialis: 24.5 N, Vastus intermedius/rectus femoris: 29.4 N, Vastus lateralis: 19.6 N). The tibial rotation was tracked using a custom-made laser tracking device while the tibial-femoral flexion was measured with goniometer. Total knee arthroplasty (TKA) was performed using ?PFC-PS posterior cruciate ligament substituting knee system. Results Before TKA, when the knee flexed 10?, 20?, 30?, 60?, 90?, 120? and 150?, tibia rotated 5.1??2.3?, 9.3??3.3?, 10.2??4.8?,11.7??3.5?, 13.5??8.4?, 22.0??8.6? and 29.6??9.3? respectively. After TKA, tibia rotated -2.2??1.7?, -2.5??1.5?, -2.0??1.3?, 1.7??2.5?, 3.9??2.4?, 13.5??6.1? and 18.6??4.7? respectively (Tibial rotation was defined as 0? in knee extension; internal rotation as positive and external rotation as negative). Conclusion The tibial internal rotation is coincident with tibial-femoral flexion, its magnitude of tibial rotation varies in different degrees of knee flexion. The tibial internal rotatation is significant in early knee flexion(0? to 30?), then enters into a platform stage on knee bending from 30? to 90?, Once the knee bends over 90?, the tibia rotates internally markedly again, maximum internal rotation is achieved in fully flexion, probably due to relaxation of soft tissue. After TKA, in early flexion (0? to 30?) the external rotation occurs abnormally, but later on 30? to 150?, it rotates again intenally as normal.

Objective To investigate the medial-lateral tilting of patella in two different coordinate systems before and after total knee arthroplasty (TKA). Methods Six fresh-frozen left low limbs from cadaver were tested using a modified Oxford Rig. Anatomically based multiple loading of the quadriceps mechanism was applied(Vastus medialis 24.5 N, Vastus intermedius/rectus femoris 29.4 N, Vastus lateralis 19.6 N). In a three dimensional coordinate system, patellar tilting was tracked using a custom-made Laser tracking device. The femoral trochlea was used as the other coodinate system in skyline view of patellar-femoral joint. Total knee arthroplasty was performed using PFC? posterior cruciate ligament substituting knee system. The tilting angles of patellar were measured before and after TKA. Results In three dimensional coordinate system, when knee flexed 30?,60?,90?,120?,150?, the patella titled :-3.10??2.25?,2.50??1.07?,5.46??2.60?,6.32??2.16?,-2.10??1.90? respectively before total knee arthroplasty was undertaken. After total knee arthroplasty, the patella tilted 3.24??0.35?,2.30??1.39?,1.65??1.17?,1.29??1.03?,-0.86??1.42? respectively. When femoral trochlea was taken as coordinate, the patella tilted 0??0?,0??0?,0??0?,0.24??0.35?,-3.21??1.80?; 0??0?,0??0?,0??0?,0??0?,-1.12??1.20? respectively both before and after TKA (Lateral patella tilting was defined as positive and medial patella tilting, negative). Conclusion Even the relationship between patella and femoral trochlea remains normal, the mode and magnitude of patellar tilting changes significantly after TKA. In early flexion of knee joint, patella tilts medially before TKA while it tilts laterally after TKA. After TKA, patella tilts less laterally than it does before TKA when a knee flexes from 60 to 120 degrees.

[Objective]To measure the change of anatomic configuration of proximal tibial after high tibial osteotomy and probe its clinical consequences.[Method]From 2001 to 2005,there were 59 knees of 35 patients with medial unicompartmental osteoarthritis treated with closing-wedge high tibial osteotomy.Anatomic configuration of proximal tibia were measured both pre and postoperatively on radiographs.They included posterior slope angle of proximal tibia,tibial angle,lateral shift of articular surface of proximal tibial and level of the joint line.The alteration of the above features was calculated and analyzed statistically with paired t test.[Result]The mean tibial posterior slope angle were(8.9??2.6?)preoperatively and(5.0??2.3?)postoperatively.The tibial posterior slope angle was averagely decreased about(3.9??1.7?).Tibial angle were(99.1??4.3?)and(91.1??3.8?)before and after high tibial osteotomy respectively.Lateral shift of articular surface of proximal tibial were(46.2?3.6)% and(53.1?3.9)% in pre and postopratively.Level of joint line was(41.2?3.6)mm and(38.0?3.2)mm in pre and postopratively.Statistical analysis indicated that there was significant difference of posterior slope angle or tibial angle or lateral shift of articular surface of proximal tibial or level of joint line between pre and post operative(P

ObjectiveTo recognize risk factors, types and prognosis of cerebral white matter injury i n preterm infants. MethodsThrough image examination, we obse rved the development of periventricular white matter injury in 64 preterm infant s. Follow-up was done to evaluate the mental development of them. We also anal yzed the perinaltal risk factors (maternal complications during pregnancy, and n eonatal diseases at early age) that related to periventricular leukomalacia (PVL ). Results Sixty-four preterm infants showed different d egrees of periventricular white matter injury: (1) Eighteen infants had PVL, of whom 6 had multi-site PVL, and 12 presented local PVL; (2) Eight infants had pe rsistent periventricular hyperecho; (3) Thirty-eight infants had transient abno rmality. Forty-six infants were followed up. The incidence of DQ≤75 was 100% a nd 33 33% in 6 infants with multi-site PVL and in 6 infants with local PVL res pectively. Logistic analysis showed that intraventricular hemorrhage (IVH) combi ned with expanded ventricle coorrelated with cerebral white matter injury. Babie s of mother who had pregnant complications had high incidence of PVL. ConclusionPeriventricular white matter injury, especially PVL is har mful in the prognosis of preterm infant. IVH combined with ventricular expansion is an important high risk factor of periventricular white matter injury.

Objective To investigate the relationship between carotid plaque and serum C reactive protein(CRP) levels, leukocyte count in patients with acute cerebral infarction(ACI) Methods Carotid duplex examination was performed in 121 patients with ACI by an Advanced Technology Laboratories HDI (high definition imaging) 5000 triplex system Serum CRP was measured by nephelometry Results of carotid ultrasonography were divided into two groups: M1: normal (IMT 0 05) The number of patient with elevated CRP levels was increased in the M2 group( P

Objective To investigate the effect and mechanism of lipoxin A4 (LXA4) on uric acid (UA) induced oxidative stress of human umbilical vein endothelial cells (HUVECs).Methods The HUVECs was treated with uric acid to constructing the model of oxidative stress,and intervene the model with LXA4 and xylene based iodine (DPI),rotenone.Reactive oxygen species (ROS) of HUVEC were detected by a fluorescence probe 2',7'-dichlorofluorescin diacetate (DCFH-DA).The activity of reduced nicotinamide adenine dinucleotide phosphate (NADPH) oxidase and p47phox protein was measured by Lucigenin enhanced chemiluminescence and Western blotting among control,uric acid (UA),LXA4 and UA +LXA4 groups,respectively.All the results were described by the relative expression of the control group,repeated measure variance analysis and least significant difference test (LSD) were used for statistical analysis.Results UA could stimulate HUVEC to generate ROS with different concentrations and times (F=7.286,F=4.532,P＜0.05).Compared with the control group(100±l 1),the ROS production of group with 80 mg/L UA (177±18),120 mg/L (226±29) and 160 mg/L (225±16) increased significantly (t=4.127,t=7.591,t=7.236,P＜0.05).Compare with baseline(100±8),the ROS production increased significantly (t=3.688,t=3.513,t=4.526,t=8.269,t=3.829,P＜ 0.05) at 3 h(143±16),6 h(140±17),12 h(183±20),24 h(240±29) and 48 h(160±22).LXA4 could inhibit ROS generation at different concentrations and times (F=4.008,F =4.497,P ＜0.05).Compared with LXA4 concentration of 0 nmol/L,the LXA4 concentrations of 10 nmol/L (162±16) and 100 nmol/L (132±15) could significantly inhibit ROS generation(t=3.712,t=4.083,P＜0.05).Compared with pretreatment (269±39),the ROS generation decreased significantly (t=6.373,t=6.426,t=7.125,t=6.981,P＜0.05).with LXA4 pretreated for 15 min (160±16),30 rain(158±21),1 h (136±13) and 2 h(140±13).Compared with the UA group(252±31),LXA4 and DPI could significantly inhibited ROS generation (145±29,154±27;t=6.356,t=5.853,P＜0.05),but Rot was not significantly intervented (241±32;t=1.027,P＞0.05).The NADPH oxidase activity in the UA group was significantly higher than that in the control group (144±16,100±13;t=3.659,P＜0.05),but the group of LXA4+ UA was significantly lower than that of the UA group (119±14;t=3.124,P＜0.05).The cytoplasmic expression of NADPH oxidase subunit p47phox of UA group was significantly lower than that in the control group (47±6,100±8;t=7.562,P＜0.05),but the LXA4+UA group was significantly increased compare with the UA group (83±6,t=5.386,P＜0.05).The cytomembrane expression of p47phox of UA group was significantly higher than that in the control group (328±36,100±4,t=12.817,P＜0.05),but the LXA4+UA group was significantly decreased compared with the UA group (183±30,t=5.129,P＜0.05).Conclusion LXA4 inhibits UA induced ROS production in HUVECs.This mechanism might be through inhibiting p47phox trafficing from cytoplasm to cytomembrane,results in inhibiting the activation of NADPH oxidase.

Objective To investigate the diagnosis and treatment of hepatolithiasis complicated by bronchobiliary fistula.Method The data of 35 patients with hepatolithiasis and bronchobiliary fistula treated in our department in the last 10 years were retrospectively studied.Results The operations were:-repair of fistula in the diaphragm (n=35),hepatic segmentectomy (n=22) biliary stricturoplasty (n=13),T-tube drainage of common bile duct (n=19),hepaticojejunostomy (n=3) and bilateral hepatojejunostomy with a Roux-en-Y loop of jejunum (n=13).Residual stones were left in 4 patients.There was no recurrence of the bronchobiliary fistula on follow-up.Conclusions Expectoration of bitter and purulent yellow sputum was an important clinical feature of bronchobiliary fistula.The key steps in a successful operation were reliefing the obstructed bile duct and re-establishment of adequate biliary drainage.