Objective　To investigate the relationship of proximal femur geometry and hip fracture in elderly women. 　Methods　 We compared proximal femur measurements made from the uninvolved hip of 48 plane anteroposterior pelvis radiographs of elderly women without fracture to those of the contralateral hip in a group of 43 cases with hip fracture. Measurements of Singh index, head diameter(HD), neck diameter(ND), femoral neck length(NL), neck shaft angle(NSA) and cortical thinckness of proximal femur were analyzed. 　Results　 The cortical thickness of proximal femur in hip fracture and without hip fracture groups was (10.9±3.1) mm and (13.2±2.9) mm, and the Singh index below Ⅲ° was 86.05% and 66.67%, respectively. No difference in HD,ND,NL and NSA could be demonstrated.　Conclusions　 Singh index and cortical thickness of proximal femur may be used to predict the occurrence of the hip fracture in elderly women.

Objective To explore the therapeutic effect of different postoperative chemotherapy and administration pathways in primary hepatocellular carcinoma (PHC) patients with portal vein tumor thrombus (PVTT). Methods 60 PHC patients with PVTT were divided into A, B, C and D groups. A group was treated by transcatheter arterial chemo-embolization (TACE); B group was treated by TACE and portal vein intubation(PVI) with quick intravenous injection; C group was treated by TACE and PVI with slow infusion controlled by computer; and D group was treated by hepatic arterial intubation chemo-embolization (HAI) and PVI with slow infusion controlled by computer. Results The survival rate among groups A, B and C had a significant difference (P0.05). Conclusion PHC patients with PVTT could be treated by both hepatic arterial chemotherapy and portal vein chemotherapy throug portal vein continuous infusion. TACE or HAI was suitable for postoperative chemotherapy.

Objective To investigate the relationship of proximal femur geometry and hip fracture in elderly women. Methods We compared proximal femur measurements made from the uninvolved hip of 48 plane anteroposterior pelvis radiographs of elderly women without fracture to those of the contralateral hip in a group of 43 cases with hip fracture. Measurements of Singh index, head diameter(HD), neck diameter(ND), femoral neck length(NL), neck shaft angle(NSA) and cortical thinckness of proximal femur were analyzed. Results The cortical thickness of proximal femur in hip fracture and without hip fracture groups was (10.9?3 1) mm and (13 2?2 9) mm, and the Singh index below Ⅲ? was 86 05% and 66 67%, respectively. No difference in HD,ND,NL and NSA could be demonstrated. Conclusions Singh index and cortical thickness of proximal femur may be used to predict the occurrence of the hip fracture in elderly women.

ObjectiveTo explore the therapeutic effects and value of endoscopic variceal ligation and tissue glue injection therapy in esophageal and gastric fundal varices.Methods184 patients with severe esophageal varices underwent endoscopic variceal ligation treatment,and 32 cases of those accompanied with gastric fundal varices were treated with tissue glue injection therapy.All patients were followed-up for 6-months to observe the therapeutic effects and complication of endoscopic variceal ligation and tissue glue injection therapy.ResultsThe effective rate of endoscopic variceal ligation in severe esophageal varices was 71.74 ％ ( 132/184 ),the rate of acute hemostasis was 95.00％(57/60)and the rate of complication was 2.17 ％ (4/184).The effective rate of tissue glue injection in gastric fundal varices was 100％ (32/32) and the rate of complication was 21.88％ (7/32) (7 cases with refractory ulcers in injection site,2 of refractory ulcers cases with bleeding).There was no perforation and severe infection complications.ConclusionEndoscopic variceal ligation and tissue glue injection therapy have good therapeutic effects in esophageal and gastric fundal varices.

BACKGROUND: The observation of vascular endothelial growth factor gene expression of cerebrovascular diseases and ultrastructure of cells may be helpful to understand angiogenesis and its relative cellular factors involved in the pathogenesis at cellular and molecular levels. OBJECTIVE: To investigate the method of culture of human cerebral cap illary endothelial cell by separation of capillary fragment in vitro, and to ob serve vascular endothelial growth factor gene expression and ultrastructure of cells. DESIGN: A randomized controlled research on technique and method. SETTING: The neurosurgery department of a general hospital of a military area command of Chinese PLA and the neurosurgery department of a college hospital. PARTICIPANTS: Eighteen patients with arteriovenous malformation of brain(Spetzler Ⅱ-Ⅲ grade), as confirmed by aortocranial angiography before operation, in the Department of Neurosurgery, General Hospital of Shenyang Military Area Command of Chinese PLA were included. The material was obtained from fresh integrated specimen of arteriovenous malfor mation of brain with surrounding fresh brain tissues during the opera tion. Capillary endothelial cell was separated by homogenate, filtration and enzymatic digestion techniques. Cells grew well in culture flask and were divided into 4 groups(hypoxia state for 2, 4, 8 hours groups and control group). Each group contained four flasks.METHODS: Simulation of anoxia condition: volume faction 0.95 N2 and volume fraction 0.05 CO2. Expression of factor Ⅷ related antigen in cells was detected by immunohistochemistry. mRNA expression of vascular endothelial growth factor on endothelial in every group was observed by RT-PCR, protein content of vascular endothelial growth factor in supernatant detected by enzyme-linked immunoadsordent assay, and cellular ultrastructural change observed by transmission electron microscopy.MAIN OUTCOME MEASURES: mRNA expression of vascular endothelial growth factor on endothelial cell and protein content of vascular endothelial growth factor in supernatant in control group and every hypoxia groups; cellular ultrastructural changes.RESULTS: Under phase contrast microscope, cultured living cells had mono-layer pebble-like typical character. More than 90% of were factor Ⅷrelated antigen(FⅧ-RA) staining positive. mRNA and protein expression of vascular endothelial growth factor in hypoxia 4 hours group was 0.98 ±0. 19,( 180. 77 ± 20. 15) ng/L, which was significantly higher than in control group [0, (26. 20 ± 6.33) ng/L, P ＜ 0.01 ]. Eight hours later, expression decreased [(0. 35 ±0.07), (31.68 ±8.34) ng/L]; swollen mitochondrion, dilated endoplasmic reticulum, and lysosome vesiculation were found.CONCLUSION: Humane cerebral capillary endothelial cell can be cultured by separation of capillary fragment, which is easy to operate and the cellular purity is reliable. In the early stage of ischemia and hypoxia, expression of vascular endothelial growth factor is not enough to maintain cellular ultrastructure integrity. Cells may be injured along with the prolong of hypoxia.Zhao MG, Tang T, Gao YZ, Pu PY, Wei XZ. Culture of human cerebral capillary endothelial by separation of capillary fragment and the observation of vascular endothelial growth factor gene expression and cell ultrastructure. Zhongguo Linchuang Kangfu 2005; 9(21):211-3 (China) [www. zglckf. com]

Objective To explore the application of 18F-FDG PET/CT combined with high-resolution CT (HRCT) in the same scanner on diagnosis of lung cancer, and its influencing factors. Methods 50 patients, in which some cannot supply HRCT raw date and under highly suspicion of being lung cancer, some were postoperative lung cancer and metastasis of lung cancer, were examined by 18F-FDG PET/CT combined with HRCT in the same scanner. Results 50 patients were all successful (100%) on PET/CT scans after preparation, injection, rest and breathing exercises;46 cases (92%) were successful on PET/CT combined with HRCT scans;4 cases (8%) failed on HRCT scans. Ma-lignant lesions were found in 35 cases, with the metastasis of 21 cases;4 in 6 cases of postoperative lung cancer were found metastasis;9 cases of benign pulmonary nodules need to be observed sequentially. Conclusion 18F-FDG PET/CT combined with HRCT in the same scan-ner is valuable on diagnosis of lung cancer. The diagnostic accuracy and sensitivity significantly increase. It is a non-invasive new imaging technology and systemic metastasis can be observed.

Objective To evaluate the efficacy and safety of minimally invasive percutaneous nephrolithotomy combined with negative pressure system in one-stage treatment of calculus pyonephrosis.Methods Eighty-three cases of calculus pyonephrosis,including 15 upper ureteral calculus cases,9 renal pelvis calculus cases,28 multiple calculus cases and 31 staghorn calculus cases,were retrospectively analysed.The diameter of the stone was from 1.2 to 6.3 cm.All the patients were punctured under X-ray or ultrasound guidance and established an access of 20 F.A 12 F nephroscope,combined with negative pressure system,was inserted to the collecting system to suck off the liquor pus.The stone was fragmented by pneumatic lithotripsy or holmium laser lithotripsy at one-stage.Negative pressure system was used to reduce the intrapelvic pressure during the operation.Results All the patients were treated successfully.The average operative time was 34 ± 19 min.The upper ureteral calculus and renal pelvis calculus cases were all stonefree at one-stage treatment.Of the other 59 cases,33 cases were stone-free and 26 cases need a secondlook.The total stone free rate was 68.7％(57/83)at one-stage and 91.6％(76/83)at second-look.Only 7 patients had fever after operation and no patient had sepsis or shock.Conclusion Combined with negative pressure system,minimally invasive percutaueous nephrolithotomy via a 20 F tract is safe and effective for one-stage treatment of calculus pyonephrosis.

Objective To investigate the efficacy of sequential ERCP and laparoscopy for acute biliary pancreatitis (ABP).Methods A total of 80 patients with ABP were randomly divided into 2 groups to receive sequential ERCP and laparoscopy (observation group,n=40) or traditional surgery (control group,n=40).Clinical data including abdominal pain relief time,recovery time of white blood cell,blood amylase and liver function,hospital stay,complication rate and mortality were analyzed.Results ERCP failed in 1 patient in observation group,and the remaining 39 patients (97.5％) were recruited into the study.There were significant differences between 2 groups in regarding of abdominal pain relief time (7.7±2.7 d vs.11.4±3.7 d),recovery time of white blood cell ( 9.7±2.6 d vs.13.3±3.9 d ),blood amylase ( 8.2±2.1 d vs.12.5±3.3 d ),liver function ( 12.5±5.1 d vs.21.3±6.5 d ),hospital stay ( 16.1±5.1 d vs.23.3±7.6 d ) and rate of complication ( 12.8％ vs.30.0％ ).There was no significant difference in morbidity between 2 groups (5.1％ vs.7.5％).Conclusion Sequential ERCP and laparoscopy is effective for ABP.

Objective To investigate the diagnostic values of (1,3)-β-D-glucan (G) and galactomannan (GM) for invasive fungal infection (IFI) in patients of acute radiation sickness (ARS).Methods Samples of periogeral blood,pharyngeal secretion,urine,and feces were collected from 316patients with ARS and suspected to suffer from IFI,192 males and 124 females,aged 60.50(1-96),with the underlying diseases of blood or respiration systems.Platelia Aspergillus EIA kit was used to detect the plasma BG (G test),and ELISA was used to detect the serum GM (GM test).Fungal culture and bacterial culture were performed.Results The positive rates of G test,GM test,and fungal culture were 36.33%,35.84% ,and 34.18% respectively,but the positive rate of fungal culture of blood sample was 1/316 only.Pearson correlation analysis showed that G test,GM test and fungal culture test were positively correlated with IFI clinical diagnosis respectively (x2 = 0.564,0.357,0.727,P ＜ 0.05).Conclusions Easy to operate,rapid,and highly sencitive,G test and GM test can be used as adjunctive methods for early IFI diagnosis in ARS patients.

Objective To compare the effect of difierent combinatio of mannitol, furesemide and albumin in reducing intracranial pressure in 451 patients with severe traumatic brain injury (sTBI). Methods A total of 451 patients with an admissiou Glasgow Coma Scale of or less from 5 medical centers were randomly divided into 5 groups, ie, Group A(250 ml 20% mannitol each time as control), Group B(125 ml 20% mannitol each time), Group C(alternate use of 250 ml 20% mannitol each time or 40 mg furosemide), Group D(alternate use of 125 ml 20% mannitol each time and 20 mg furosemide)and Group E(alternate use of 125 ml 20% mannitol and moderate or large dose of albumin). We monitored intracraniai pressure continuously and observed the changes of intracranial pressure, electrolytes, hemato-crit and renal function after use of 5 combinations of mannitol. Furosemide and albumin. Results Man-nitol and furosemide could independently reduce intracranial pressure after 1-3 hours (P<0. 05). Semis mannitol plus furosemide or albumin could more signifieantly reduce intracranial pressure, with statistical difference compared with full dose of mannitol. Semis mannitol and alternate use of mannitol and furose-mide in aspect of intracranial pressure reduction and persistence time(P<0. 05). Alternate use of man-nitol and furosemide begot higher incidence rate of electrolyte abnormality, compared with the other com-binations (P<0. 05). Rebound rate of intracranial pressure was higher in full dose of mannitol than other combinations (P<0. 05). Incidence of renal function abnormality was higher in combination involved al-bumin than alternative use of mannitol and furosemide as well as combination of semis mannitol and furo-semide (P<0. 05). Abnormality of electrolyte and renal function wag reversible. Conclusion The use of 125 ml 20% mannitol each time plus 20 mg furesemide is more reasonable than other combina-tions. Meanwhile, semis mannitol combined with moderate or large dose of albumin has certain advantages too.