Chiari Ⅰ malformation is a congenital anomaly of posterior brain.There has been many theories for its pathogenesis.Recent years,researchers have sunmarized new theories about the pathogenesis of syringomyelia associated Chiari Ⅰ malformation.However,the exact pathogenesis of Chiari Ⅰ malformation has not been clarified.There are a lot of surgical treatments of Chiari Ⅰ malformation.Importantly,there remains no consensus about the best and generally applicable treatment.

BACKGROUND: There are many criteria used to evaluate the curative effects of hip-preserving treatment for osteonecrosis of the femoral head (ONFH), and there have been no consistent criteria, so the curative effects of hip-preserving treatment lack comparability to some extent. OBJECTIVE: To review and analyze a variety of criteria for evaluating the curative effects of hip-preserving treatment and to develop a specific quality of life scale of hip-preserving treatment. METHODS: A computer-based retrieval of Pubmed database using key words "osteonecrosis, femoral head, quality of life", or "osteonecrosis, femoral head, curative effect" for manuscripts published from August 2000 to August 2010 and of CNKI database for manuscripts published from January 1994 to December 2009 using key words "femoral head necrosis, curative effect" or "femoral head necrosis, quality of life". Manuscripts that address hip-preserving treatment of ONFH and related quality of life or manuscripts that were recently published or in the high-impact journals were included in this paper. Finally, 31 manuscripts were reviewed.RESULTS AND CONCLUSION: The current criteria for evaluating the curative effects of hip-preserving treatment focus on pain, function, and range of motion of hip joints, but do not lay emphasis on the local changes of hip joints or lower limbs, which can not sufficiently reflect the overall quality of life of patients. The SF-36 scale lack specificity to some extents and cannot be used to evaluate the curative effects of hip-preserving treatment systemically and specifically. Therefore, it is necessary to develop a specific quality of life scale for evaluating the curative effects of hip-preserving treatment of ONFH.

Ohjective To know the proper wraping method for postoperative patients with neurosurgical intervention treatment. Methods Divided 94 patients with neurosurgical intervention treatment into the ban-dage group and the gauze group randomly, there were 47 cases in the each group. Bandage and gauze was used in the two groups for punctured wound respectively, and then compared the condition of complications and puncture location between the two groups. Results The incidence rate of puncture-associated comphcations in the bandage group was sinificant lower than that of in the gauze group. Conclusions Wraping by bandage for postoperative patients with neurosurgical intervention treatment is more effective than gauze method.

BACKGROUND: Periprosthetic infection after total hip replacement usually results in surgery failure and needs a second operation.OBJECTIVE: To explore the pathogenesis, diagnosis and treatment of periprosthetic infection after total hip replacement by-reviewing and summarizing articles published in recent years.METHODS: A computed-based online search of Pubmed database was performed by using the key words of total hip arthroplasty, infection for manuscripts published from January 1990 to December 2010 and of those in SpringerLink database between January 1,1970 and December 31, 2010. A total of 2 109 manuscripts were retrieved. Moreover, related book or manuscripts that published by high-impact journals were included. Totally, 29 manuscripts were included. RESULTS AND CONCLUSION: The formation of biofilms on the surface of prosthesis is the main cause for hardly eradicated. Resistant bacteria and polymicrobial infection seems to be an increasing tendency. A correct diagnosis as soon as possible is very important to prognosis. However, without a gold-standard way, each mean has advantages and shortages, and comprehensive considerations are necessary. lnterleukin-6 seems a good choice for its inexpensive, non-invasive and a high sensitivity and specificity, which has aroused increasing attention. The antibiotics only, debridement with retention, one-stage replacement, two-stage replacement, joint arthrodesis, even amputation, are used to treat infection after total hip replacement. Prophylactic antibiotics are important to prevent infection. Antibiotic-loaded acrylic cement seems to be reliable and accept for more and more patients. However, each option must be selected according to the presence of infection individually.

BACKGROUND: It is difficult to revise replacement due to infection-induced osteodeficiency, osteoporosis, soft tissue lost orcicatrization.OBJECTIVE: To establish the standardized clinical prevention and treatment methods by summarizing the new progress to prevent, diagnosis of the infection, and its effective treatment, as well as rehabilitation evaluation after total Knee replacement. METHODS: A computer-based online search of CNKI and PUBMED database between January 1990 and December 2010 was performed to search related articles with the key words of total knee arthroplasty, infection. A total of 2 346 articles were retrieved. Moreover, related works were manually searched. Totally, 30 articles were included.RESULTS AND CONCLUSION: It is better to prevent infection rather than treatment after total knee replacement. Currently, there is lack of a clear diagnosis standard on the infection. In treatment aspect, debridement, revision surgery, and choosing effective antibiotics can effectively control the infection. Meantime, new methods are expected to improve the success rate of infection after total knee replacement. Exercise is a continuation of rehabilitation therapy and an important step in treatment. Therefore, on the basis of total knee replacement, it is important to establish the early prevention of postoperative infection, early diagnosis, effective treatment and rehabilitation evaluation system, in order to minimize the incidence of infection and treat infections timely and effectively.

This study was to compare 104 cases of malignant midline lymphoma with 69 cases of malignant granuloma in their clinical course, initial symptoms, location of lesion, extension of disease, treatment and prognosis. The two groups were similar in sex and median age. As regard to the initial symptoms such as nasal obstruction, epistaxis and nasal discharge, they were present in more than half of the patients in both groups. The primary location of lesions was in the nose (60% in both groups). As the Ann Arbor staging system is unsuitable for this disease, we compared the treatment results by area of involvement. Treatment: 74% of malignant midline lymphoma was treated by radiation and chemotherapy. 27% of malignant granuloma was treated by chemotherapy. The radiation of the two groups were 45～55Gy and 50～60Gy, respectively. The 5-year survival rates were over 90% in both groups, for those of lesion with one area involvement, 87.8% and 68% for lesions with two area involvement. 52.3% and 51.5% for three area involvement, 26.6% and 29% for four area involvement patients. Besides local uncontrol, the failure was extra-nodal invasion, such as subcutaneous nodules, pleura-peritoneal or bone marrow extensions. The authors believe that these two groups of lesions actually belong to one disease entity.

Objective To investigate the experiences of combined liver-kidney transplantation (CLKTx).Methods Six patients underwent CLKTx in our center. The primary diseases included chronic glomerulonephritis and post-hepatitis B cirrhosis in 4 patients, hepatitis B virus associated nephritis and primary hepatocellular carcinoma in 1 patient, and polycystic kidney and polycystic liver in 1 patient. Cyclosporine A (or tarcrolimus), mycophenolate mofetil and methylprednisolone were applied to prevent rejection. Four cases of post-hepatitis B cirrhosis received lamivudine. And hepatitis B immunogloblin was given to 4 patients for a short term.Results All 6 liver grafts had good primary function. Five renal grafts had good primary function within one week post-transplantation. One patient with delayed kidney graft function needed supportive hemodialysis. The serum creatinine was declined to normal level 52 days post-operation. Pleural effusion occurred in all 6 patients among which 2 patients needed surgical drainage. Two patients had to be treated for bacterial pneumonia and pneumocystis carinii pneumonia respectively. Three patients needed lipid-lowering therapy at early time post-operation. At the last follow-up, all 6 patients were alive with normal renal graft function and liver graft function. The panel reactive antibody (PRA) of one patient was 23 % before transplantation, and remained at about 8 % post-transplantation. The serum HBsAg and HBV DNA of all 4 post- hepatitis B cirrhosis patients became negative post-transplantation.Conclusion CLTx is a safe procedure for combined hepatic and renal end-stage disease with excellent short-term results.

OBJECTIVE:To study the hepatoprotective effect of the extract of Sabia parviflorawall(SPS) on mice with experimental liver injury.METHODS:The liver injury models were reproduced in mice with CCL4 and Paracetamol(AAP),respectively with the activities of serum ALT and AST measured.RESULTS:The activities of serum ALT and AST were all reduced to a certain degree in mice with liver injury induced by either CCL4 or Paracetamol(AAP).CONCLUSION: SPS exhibited certain hepatoprotective effect.

To investigate the effect of autoimmune regulator (AIRE) on phagocytic clearance of apoptotic cells, a recombinant expression vector containing full-length human AIRE cDNA was transfected into 16HBE cells. After incubation with transfected 16HBE cells, engulfment of apoptotic HL-60 cells induced by camptothecin was detected by myeloperoxidase (MPO) staining. The change in the expression of Rac 1 in transfected 16HBE cells was determined by RT-PCR and Western blotting. The results showed that the phagocytosis percentage of the experimental group, the mock transfection group and the negative control group (non-apoptotic cells) was (25.50+/-3.67)%, (6.25+/-1.58)% and (1.0+/-0.67)%, respectively. Moreover, the expressions of Rac 1 mRNA and protein were up-regulated in AIRE-transfected 16HBE cells, suggesting that AIRE may function as a regulator in the phagocytic clearance of apoptotic cells by promoting the expression of Rac 1.

Objective To investigate whether the mortality and death causes of renal transplant recipients have changed from 1985 to 2002 in our center.Methods 145 cases of renal transplant recipients who died during 1985 to 2002 were divided into 3 groups: 1985 to 1990,1991 to 1996,1997 to 2002. The death causes and the mortality on the 1st ,2nd,3rd,4th and 5th year post transplant of each group were reviewed.Results During the three periods,the 1st,2nd,and 3rd year mortality was decreased. Infection as a cause of death fell from 31.8 % to 29.2 % and 26.7 % . Whereas death from liver disease,cancer and cardiovasvular diseases was increased.Conclusions The mortality is decreased. Infection,cardiovascular diseases,liver diseases and cancer were the main causes of death after transplantation from 1985 to 2002. It is important to prevent these diseases and treat them effectively in order to improve the recipients' survival rate.