[Objective]To investigate the method and efficiency of operative femoral supracondylar varus osteotomy combined with new blade plate on treatment of valgus deformity of knees.[Method]Thirty-seven patients with 43 knees with valgus deformity were treated with femoral supercondylar varus osteotomy with Giebel blade plate(Link company/Germany)from Oct.2000 to Oct.2005.The study group consisted of seven men with 8 knees and thirty women with 35 knees,the average age of the patients was 31.2 years(range,fifteen to seventy years).Eleven patients with 13 knees had lateralcompartment osteoarthritis,Ahlback stage Ⅰ eight patients with 10 knees and stage Ⅱ three patients 3 knees.The full-length Ap view of the lower extremity and the weightbearing AP view of the knee were obtained before and after operation,as well as the femoral angle and femoral-tibial angle were evaluated.The Giebel blade plates were taken out average 1.5 year after operation and the patients were followed-up,bone union and the change of the correction angles and the pain of the knees were evaluated.[Result]All deformity of the knees were well corrected,the femoral angle were corrected from 71.7?(62?～75?) to 82.1?(78?～85?),the average correction angle was 10.4?(8?～21?).With average 1.5 year follow-up thirty four patients with 40 knees got good bone union,two knees had non-union and we changed the internal fixationwith bone autc-grafting and got good results,as well as lost follow-up for one knee.The pain relieved in 10 knees with lateral osteoarthritis and disappeared in 3 knees after operation.[Conclusion]Femoral supracondylar varus deformity of the knee,the technique is simple and damage is slight,fixation is safety and effective.

[Objective]To investigate the method and effeciency of management massive acetabular bone defect with impaction bone grafting plus mesh in revision total hip arthroplasty[Method]Twenty-one patients 21 hips with massive acetabular bone defect were treated with impaction bone grafting plus mesh during Dec 2001 to Jan 2006,including 6 men and 15 women,the average age were 51.9 years at the revision operation(range,38~77 years).The acetabular defects of the patients in this study group were type III(combined defect)according to the American Academy of Orthopaedic Surgeons(AAOS)classification scheme.At first the combined defect was transformed into cavitary defect with metal mesh,then the contained acetabulum was tightly packed with deep-frozen morselized cancellous allograft chips(size 7~10mm),the anatomy of the hip was reconstructed and the cup was inserted after pressurizing the cement directly onto the graft.The AP view of the hip at 3 days,3 months,1 year and yearly after the operation were obtained,cup migration according to the teardrop and radiolucent line were evaluated,at the same time the Harris hip score were also evaluated.[Result]The mean follow-up time was 2.8 years,the mean Harris hip score improved from 46.4 points preoperatively to 81.3 points at the final evaluation,no cup migration were found,except for one dislocation and one sciatic nerve injury,as well as lost follow-up for one hip.[Conclusion]Impaction bone grafting plus mesh is an effective approach to treat massive acetabular bone defect in revision total hip arthroplasty,it can restore bone stock and help the cup to be placed to the anatomic position,as well as provide execellent prothesis stability.

[Objective]To investigate the method and efficiency of operative modified rotational acetabular osteotomy for treatment of adult acetabular dysplasia. [Methods]Twenty-seven patients with 30 hips with acetabular dysplasia were treated with modified rotational acetabular osteotomy. The study group consisted of three men with 3 hips and twenty-four women with 27 hips,the average age of the patients was 29.4 years(range,fifteen to forty-two years ).The anteroposterior plevis view,lateral and abduction view of bilateral hip were taken,CE angle(center-edge angle) and AC angle(acetabular roof obliquity) were measured,the changes of the rotational center of the hip ,Shenton's line and the degree of osteoarthritis were recorded ,the Harris score was obtained before and after operation.[Results]The femoral head coverage was improved in all patients. On average ,the CE angle was improved from 3.2 (-15?～15?)to 28.5?(20?～40?),the AC angle was declined from 26.6?(15?～38?)to 3.9?(0?～12?). The rotational center of the hip was medialized in 19 hips(63.3%),the discontinuity rate of Shenton's line was declined from 67% to 23%. On average 4.2 years follow-up ,1 case lost follow-up,the degree of osteoarthritis in 28 hips was not aggravated,pain was aggravated in 1 hip ,the Harris score was improved from 82.7(67～96) to 97.8(87～100).Two patients have had Fibre-union of pubic and one patient has had stress fracture of the inferior pubic ramus postoperatively,non-union of iliac and posterior column of the osteotomy or the greater trochanter was not found.[Conclusion]The method of modified rotational acetabular osteotomy for treatment of adult acetabular dysplasia is effective and safety.

Objective To evaluated the result of modified Mitchell operation for treatment of hallux valgus. Methods From March 1998 to October 2001, 39 feet of 20 patients were treated with modified Mitchell procedure. Before operation, HVA averaged 29.5? and IMA averaged 12.5? were measured on standing AP radiographs. The lateral displacement of the capital fragment was depended on the amount of IMA and the capital fragment shifted plantarly 2-3 mm. Fixation was achieved with an absorbable screw. The lateral spike on the distal fragment was not preserved in this operation. Results After follow-up of 11-38 months, patients rated as excellent or good in 97.4%. The average postoperative HVA was 14.5? and IMA was 8.5?, the average HAV correction was 15? and 4? for the IMA. Conclusion The modified Mitchell procedure provides satisfactory deformity correction. The transverse arch of metatarsals is reconstructed since distal part of the first metatarsal is shifted plantarly in this operation.

Objective To evaluate the effect of chest backplate in treating multiple rib fractures in patients with focal abnormal breathing.Methods The clinical data of 36 patients with multiple rib fractures and focal abnormal breathing who were treated by Chrisofix chest backplate were analyzed.Results Thirtyfour patients were cured by chest backplate and other conservative treatments,and 2 patients underwent rib internal fixation surgery.The numeric rating scales scores before and after the application of the chest backplate were (8.1 ± 0.7) scores and (5.2 ± 0.5) scores respectively(P ＜ 0.01).Seven patients had skin blisters forming around the shield,which were cured by liquid extraction with a syringe and gauze covered with povidone iodine.No patients stopped treatment because of allergy.Conclusions Chest backplate is an effective,easy and inexpensive method for patient with multiple rib fractures and focal abnormal breathing who doesn't need exploratory thoracotomy.It is worthy to spread in clinical treatment.

Objective To investigate the value of ionic-contrast esophagogram in diagnosis of intrathoracic anastomotic leakage after oesophagectomy.Methods The data of 728 patients suffered esophagectomy were retrospectively collected.723 patients without clinical manifestations of anastomotic leakage were divided into group A(esophagogram before eating,n=465) and group B(non-esophagogram before eating,n=258).The incidence of anastomotic leakage was compared between the two groups.Results The discovery rates of anastomotic leakage in group A and B were 0.43%(2/465) and 0.78%(2/258),respectively,the difference was no statistically significant between the two group(P=0.55).The total incidence rates of anastomotic leakage in group A and B were 0.65%(3/465) and 0.78%(2/258),respectively,the difference was no statistically significant between the two groups(P=0.84).5 patients with clinically suspected anastomotic leakage,all had loculated pleural effusion,4 cases had fever,and 2 cases had abnormal chest drainage.Finally,4 cases(80%) were confirmed to be anastomotic leak by esophagogram.Conclusion Routine ionic-contrast esophagogram before eating do not improve intrathoracic anastomotic leakage detection rate after esophagectomy,but when patients have fever,loculated pleural effusion and abnormal chest drainage,esophagogram is necessary and can improve the detection rate of esophageal anastomotic leak.CT radiography may detect smaller anastomotic leakage than conventional esophagogram.

Objective:To investigate frequencies and polymorphism of HLA-DRB1 and DQB1 allele in the Hans of Zunyi area.Methods:Polymerase chain reaction-sequence specific primers(PCR-SSP) were used to type HLA-DRB1 and DQB1 genes of 200 unrelated healthy Han individuals in Zunyi area.Results:13 HLA-DRB1 and 7 HLA-DQB1 alleles were obtained at low resolution level in all subjects.The allele DRB1*09,DRB1*08 and DQB1*05 were showed high distributing frequencies;The allele DRB1*10 and DQB1*04 were scarcely found with low distributing frequencies.Comparied with Northern and Southern Han people,it would seem that Han people in Zunyi are more closely related to the Southern ones.The allele B*07 was scarcely found in the Southern Han with a high distributing frequency(GF=2.0%).Conclusion:HLA-DRB1 and DQB1 of Han people in Zunyi have plenty of polymorphisms.They seem to distribute in line with the Southern Han's characteristics but have their own territory feature with a high B*07 frequency.

Objective:To explore the association between HLA-DR,DQ allele polymorphisms and onset of epidemic hemorrhagic fever(EHF)among Han Nationality in Zunyi area.Methods:Using group study,HLA-DR and DQ genotyping was conducted in 100 EHF cases and 100 controls among Han Nationality in Zunyi area with polymerase chain reaction-sequence specific primer(PCR-SSP),GF(gene frequency)and RR(relative risk)were calculated and compared.Results:The frequency of HLA-DRB1 16 in patients with EHF was higher than in the control group(RR=3.58,?2=4.916,P=0.0266

Objective To explore the correlation between HLA-A, B alleles polymorphism and hemorrhagic fever with renal syndrome (HFRS) among Han nationality in Zunyi area. Methods Using group study, HLA-A, B genotypes were conducted in 100 HFRS cases and 100 controls among Han nationality in Zunyi area with polymerase chain reaction-sequence specific primer (PCR-SSP), gene frequency (GF) and relative risk (RR) were compared and calculated. Results The frequencies of HLA-A * 31 and HLA-B * 58 alleles in HFRS cases (GF=4%,12.5%) were strikingly higher than that in the healthy controls (X2=6.380, 7.792, P<0.05;RR=18.47,2.91). The frequencies of HLA-B * 40 alleles in HFRS cases (GF=11%) were strikingly higher than that in the healthy controls (X2=6.095,P<0.01, RR=O.47). Conclusion HLA-A * 31, B * 58 genes are positively related to HFRS of Han nationality in Zunyi area, HLA-B * 40 gene is negatively related to HFRS of Han nationality in Zunyi area.

Objective To investigate the nutritional status of vitamin D in preterm infants after birth and further explore its possible influencing factors, so as to guide clinical vitamin D therapy and to screen the preterm infants who are at high risk of vitamin D deficiency.Methods Retrospective analysis was conducted in the neonatal department of our hospital from April 21st, 2014 to February 5th, 2016.The serum 25(OH)D level in preterm infants were measured 2 weeks after birth.Data including gender, season of birth, time to initiation of breastfeeding were collected.According to the 25(OH)D levels[25(OH)D≤37.5 nmol/L, 37.5 nmol/L≤50.0 nmol/L, and 25(OH)D>50.0 nmol/L], all the preterm infants were divided into three groups: vitamin D deficiency, insufficiency, and sufficiency groups.The influencing factors of vitamin D in preterm infants were screened by using statistical method.Results The mean 25(OH)D level of 172 preterm infants was (43.1±16.7)nmol/L.In vitamin D deficient, insufficient, and sufficient groups, there were 68 (40％), 50 (29％) and 54(31％) cases of preterm babies, respectively.The mean values of 25(OH)D in these three groups were (27.8±16.7)nmol/L, (42.4±3.4)nmol/L, and (63.0±11.7)nmol/L, respectively.Only the season of birth had significant difference among three groups (P=0.013): 44.2％ of the preterm infants born in winter had vitamin D deficiency, which was higher than those in spring (41.7％), summer(33.3％), and autumn (38.1％);44.2％ of the preterm infants born in winter had vitamin D insufficiency, which was much higher than those in spring (30.6％), summer (25.1％), and autumn (19.0％);furthermore, only 11.6％ of the preterm infants born in the winter had vitamin D sufficiency, which was much lower than those in spring (27.8％), summer (41.2％), and autumn (42.9％) (OR=4.655, 95％ CI=1.716-12.627, P=0.003).Conclusion Vitamin D deficiency in preterm infants 2 weeks after birth is prevalent, and winter birth is a risk factor of vitamin D deficiency and insufficiency in preterm infants.