Objective To evaluate CT diagnostic value of blunt spenic trauma.Methods 36 cases with blunt spenic trauma underwent CT scan,their CT features were analysed restrospectively.Results Of 36 cases,there were 28 cases of true spenic rupture,5 cases of central spenic rupture,3 cases of subcapsular rupture.CT manifestations were heterogenceous hematomas,laceration of spleen,perisplenic hematoma,subcapsular hematoma and hemoperitoneum.CT also discovered other injuries including those of liver,stomach,duodenum,lumbar spine and ribs,31 patients were underwent an operation for the spenic injuries.Only 5 were treated conservatively.Conclusion CT can accurately display extent and degree of the blunt spenic trauma,and also guide the clinical management.

BACKGROUND: Studies have showed that Chengzai pill is of distinct significance in the treatment of steroid-induced osteonecrosis of femoral head through increasing bone mineral density, bone weight, bone strength and rigidity, it also reverses the low levels of estrogen. OBJECTIVE: To explore the effect of Chengzai pill on the genes of cell adhesion molecules on bone cells of steroid-induced ostaonecrotic rats, and to understand the role to resume normal blood transport in femoral head of steroid-induced osteonecrosis. DESIGN, TIME AND SETTING: Grouping controlled observation was performed in the Pharmacological Laboratory of Wangjing Hospital of China Academy of Chinese Medical Sciences and laboratory of CapitalBio Corporation between March and August in 2006. MATERIALS: Six male SD rats of 6 months old and weighing (280:1:20) g were used in this study. Chengzai pill was consisted of 22 Chinese medicines, such as Chinese Angelica, Eucommia Bark, Milkvetch Root, Barbary Wolfberry Fruit, Degelatined Deer-hom, Desertliving Cistanche, Eupolyphaga seu Steleophaga, Leech, Danshen Root and Himalayan Teasel Root, which were offered by Beijing Boran Pharmaceutical Co., Ltd. METHODS: The lipopolysaccharide and methylprednisolone were applied to prepare a rat model of steroid-induced osteonecrosis of femoral head. Six rats were divided into model group and Chengzai pill group at random with 3 rats in each group. The rats in the Chengzai pill group were administrated with methylprednisolone for the first time and then 1.5 g/kg Chengzai pill solution, once a day, totally for 6 weeks. The total RNA was extracted from femoral head in all rata 6 weeks later and then gene expression profiling was analyzed. MAIN OUTCOME MEASURES: Gene action pathway of cell adhesion molecules in gene expression profile. RESULTS: Compared with model rats, there were totally 8 downregulated genes of cell adhesion molecules which changed by a minimum of 1.5 folds in cell adhesion molecules pathway of Chengzai pill group, three rats were present with 633 genes (506 down-regulated and 127 up-regulated), 883 genes (640 down-regulated and 243 up-regulated) and 593 genes (408 down-regulated and 185 up-regulated), respectively. MAS software classification analysis showed 79 action pathways were involved in 297 genes.CONCLUSION: Following Chengzai pill administration, those downregulated genes recover the cognitive functions of macrophage and target cell in rats, also renew the normal survival condition of epithelial cells including vascular endothelial cells. Cell adhesion molecules action pathway returns to normal levels. This is the key to resume normal blood transport in femoral head of steroid-induced osteonecrosis.