38 cases of Vesicovaginal fistula were repaired. Among them 11 cases were Complicated V. V. F. Three operative methods were reported: Using musculus bulbocavenosus island flap, the huge Vesico-vaginal fistulae were successfully repaired. Using anastomosis of artificial fistula on the bladder with remnant urethra, the huge V. V. F with urethral trauma were repaired. Extraperitoneal and intracesical repairing cured high position and huge V. V. F. The report put forward the principlle the the simpler the method the better the result when repairing complicated V. V. F. V. V. F. could only be cured by surgical operation.

BACKGROUND:The etiological factor of pediatric avascular necrosis of the femoral head(Legg-Calv?-Perthe disease) is unclear right now,and the disease typing,treatment and prognosis outcome are also different.Thus a simple,practical and reliable clinical classification is necessary to guide treatment and estimate result.OBJECTIVE:To summarize and analyze the criteria commonly used for Legg-Calv?-Perthe disease in clinical typing as well as their advantage and shortcoming,which provides evidences for the treatment and instruction.RETRIEVAL STRATEGY:A computer-based search of Medline database was undertaken to identify the articles regarding the classification criteria for Perthes disease,published between January 1970 and September 2007,with the key items of "Perthes,classification" in English.After the primary check,the full-texts of the remained articles were looked for.Inclusion criteria:①X-ray,bone scanning and MRI classification criteria for Perthes disease.②the study of the correlation between the classification reliability and the prosthesis.Exclusion criteria:repeated researches.Totally 76 articles about the classification criteria for Perthes disease were retrieved,and 32 of them were in accordance with the inclusion criteria.LITERATURE EVALUATION:Among 32 included articles,24 ones concerned with X-ray examination,4 with bone scanning image,and 4 with MRI image.DATA SYNTHESIS:There were many related researches to the clinical classification of Legg-Calv?-Perthe disease,but uniform conclusion is absent.A reliable and unified clinical classification is beneficial for the orthopaedic physicians to find out the risk factors at early stage,and take therapeutic measures as soon as possible,so as to prevent the malformation of the femoral head.Ideal classification criteria with good reliability and consistency,are closely related to the disease prosthesis,and should be used at early stage.CONCLUSION:X-ray typing is commonly used in the clinical classification for Legg-Calv?-Perthe disease,but it is difficult to apply at early stage.Bone scanning can forecast results,and also induce irradiation.Due to good sensitivity and high resolution,MRI has an earlier effect on detecting necrosis and collapse,and is potential for further development and application,however,it also calls on a long-term clinical follow-ups.

Background and purpose:Nipple secretion is one of the frequent symptoms in mammary gland disease.Clinically,about 1% breast cancer patients demonstrate with nipple secretion as initial symptom.It could be used as a screening tool for the patients with nipple secretion but no palpated mass and increase the possibility of early diagnosis for breast cancer.In 1997,our country developed a new technique——breast fiberoptic ductoscopy(FDS). It uses a ?(0.7) millimeter optic scope to insert into the nipple discharge canal orifice,and depends on introscope technology to observe and record the normal or abnormal changes in mammary gland ductus.Its advantages are not only in highly diagnostic sensitivity(above 90%),but also in accurate location of tumor,so it can be used to diagnose early breast cancer and mammary gland ductal diseases.This study evaluated the clinical effect of breast FDS in diagnosis and treatment of abnormal nipple secretion.Methods:1 000 patients had been under examination by FDS.Results:Of the 1 000 cases,there were 33 cases((3.3%)) of early breast cancer;412 cases(41.2%) of papilloma and papillomatosis;and 480 cases(48%) of either ductal ectasia and or chronic inflammation.Duct endoscoptic biopsy was successfully performed on 30 cases,220 cases(55%) with chromic inflammation were cured by perfusion.453 cases were received operation.The accordance rate with pathologic eiagnosis was 90.7%.Conclusions:FDS is a very important and new method to diagnose breast.FDS could be inserted into 5th ducta lumen of breast and significantly increase the positive detection of breast cancer.Because the position and nature of the lesions can be determined accurately by FDS,tt is used as intervening treatment for some intraductal papilloma and chronic inflammatory disease.FDS will be of great influence on early diagnoses and treatment of the breast cancer.

Objective To investigate the effects of hyaluronan(HA) on phagocytosis of macrophages and to explore the mechanism.Methods CD44 of macrophages was labeled with immunochemical method.In phagokinetic track assay,the areas without gold particles around the cells were measured with an image analyzer,shape of the cells was viewed under a scanning electron microscope.In fluorescent bead phagocytosis assay,the phagocytosed beads were conunted,the distribution of intracellular F-actin was viewed.In HA-coated bead phagocytosis assay,the phagocytosed beads were counted,shape of the cells was viewed with scanning electron microscope,the level of the intracellular Ca~(2+) was analyzed with confocal laser scanning microscope when the beads were phagocytosed.After treatment with anti-CD44 antibody,the changes of phagocytosis of the cells were examined.Results CD44 expressed on macrophages.The phagocytosing cells were round,their lamellipodia and filopodia were short.The membrane of the cells formed cup-like invagination when they engulfed particles and beads.In HA group,the phagocytosed gold particles and fluorescent beads increased.There was rich F-actin in the area where the fluorescent bead was engulfed.In HA-coated group,number of the phagocytosed HA-coated beads was great,the level of the intracellular Ca~(2+) in the area where the bead was engulfed increased significantly.After treatment with anti-CD44 antibody,the phagocytosed gold particles,fluorescent beads and HA-coated beads decreased.Conclusion HA promotes phagocytosis of macrophages,CD44 mediates effects of HA on phagocytosis of the cells.

Objective To investigate the therapeutic effect of a new surgical procudure for intractable pnumothorax.Methods Subaxillary mini-incision and folding ligation of bullae of lung were conducted without suture if possible.Parietal pleura was rubbed with a dry gauze roll and irrigated with hydrogen peroxide solution.The corresponding pulmonary segments were suspended on the parietal pleura to keep the lung tissues in inflation state and to avoid over compression of the lungs.Pleural cavity was irrigated with 5-10 ml lidocaine for 3 days after the surgery.Results The operation was successfully conducted in 21 cases(including 1 case of bilateral surgery).The average operation time was 45 min(range:30-60 min);and the average blood loss was 70 ml(range:50-100 ml).No complications occurred.The follow-up time was 6-72 months,25 months in average,and no recurrence of pneumothorax occurred.Conclusions This therapeutic method combining subaxillary mini-incision,suspension of pulmonary lobe,folding ligation and general adhesion is effective,minimally invasive,safe and inexpensive for treating intractable pnumothorax.

Diagnosis of early Alzheimer's disease (AD) is still a clinical challenge,growing evidence indicated radionu-elide neuroimaging, especially positron emission computed tomography (PET), would be promising for the diagnosis of early AD. Studies showed reduction of cerebral blood flow and glucose metabolism occurring at the parietotemporal lobes of AD patients at the early stage. A study showed that PET detected AD with an accuracy greater than 90% 2. 5 years earlier than clinical diagnostic methods using electroencephalography, structural imaging studies and so on. Recent investigation aimed at senile plaques (SPs) and neurofibrillary tangles (NFTs) that were hallmark pathologies accompanying the neurodegeneration involved in AD. Some researchers used 2-(l-(6-[(2-18F]fluoroethyl) (methyl)amino]-2-naphthyl)ethylidene) malononitrile (C18F]FDDNP) , in conjunction with PET to determine the localization and load of NFTs and SPs in the brains of living AD patients. Monitoring SPs and NFTs development is expected to facilitate diagnostic of AD patients and assist in response-monitoring during experimental treatments.

Objective To establish a method for HPLC to determine content of acetyl tyrosine in pediatric compound amino acid injection (19AA-Ⅰ).Methods The chromatographic separation was achieved on a Agilent Hypersil ODS column (250 mm ×4.0 mm,5 μm) with Agilent 1200 liquid chromatography system.The mobile phases consisted of 20 mmol/L sodium dihydrogen phosphate solution ( adjusting pH to 2.5 with phosphoric acid)-acetonitrile (90:10) at a flow rate of 1.0 mL/min, the detection wavelength was 210 nm, the column temperature was 25℃.Results Acetyl tyrosine was completely separated from other amino acids.The calibration curves for acetyl tyrosine revealed good linearity in the range of 12.062-120.62μg/mL (r=0.9999).The average recoveries (n=9) of acetyl tyrosine was 100.0%, RSD% (n=9) was 0.9.The limits of quantification (S/N=10) was 0.15μg/mL.Conclusion The methodological validation results indicate that the established method can be applied to quality control of acetyl tyrosine in pediatric compound amino acid injection (19AA-Ⅰ).

This paper introduces the platform and mode of military medical equipment E-procurement. Composed of the service system in the procurement center, the network system and the client-side, the platform can be applied to on-line bidding, tendering, evaluating, opening bid and so on. The organizational configuration, technical measures and supporting mechanism of the platform are studied. The platform is characterized by low expense, high efficiency, high security, and easy to monitor and expand.

OBJECTIVEThe purpose of this study is to investigate the influence of cryogenic treatment and age-hardening heat treatment on the corrosion behavior of a dental casting Ag-Pd alloy.

METHODSA low gold content dental casting alloy composed of Ag-Pd-Cu-Au was prepared for this study. Corrosion test was performed according to ISO 10271:2001 dental metallie-corrosion test methods. Experimental specimens were casted according to a standard dental lost-wax casting procedure, treated with solution by heating the specimens to 900 degrees C, and immediately quenched in ice water. The specimens were then divided into four groups and subjected to heat treatment, cryogenic treatment, and heat treatment combined with cryogenic treatment. The specimens after the solution treatment were taken as control. The metallographic structures of the specimens were observed. The electrochemical parameters and the quantity of non-precious metallic ions released were evaluated via electrochemical and static immersion tests.

RESULTSMetallographic observation revealed that all the treatments resulted in a change in the microstructure of the alloy. The treatments were effective in improving the electrochemical parameters, such as an increase in Eocp and Ecorr and a decrease in Icorr (P < 0.05). The amount of non-noble metal ions released showed no difference compared with the control group (P > 0.05).

CONCLUSIONAfter different treatments, the antierosion properties of the alloy satisfied the ISO requirements. Age-hardening heat treatment and cryogenic treatment improved the corrosion resistance of the alloy.

Clinical pharmacological study of cefuroxime was carried out in 8 normal volunteers. The drug obeyed two-compartment model kinetics in serum. The mean peak serum concentrations were 32.14, 89.06 and 63.11 (.is/ml respectively after IM, IV injection and IV infusion of 0.75g cefuroxime. Serum concentrations after IV administration dec re- ased rapidly, the elimination half lives ranged from 1.05-1.48 hours Absorption after IM injection was rapid and complete, the bioava-ilability being 98.89%,The apparent volume of distribution. ranged from 0.34 L/kg to 0.37 L/kg after IM and IV administration which showed that cefuroxime distributed mainly in extracellular fluid.The mean urinary recovery of cefuroxime was more than 90% within 24 hours after the administration of the drug.Based on its pha.rmacokinetic characteristics and antimicrobial activity, a therapeutic regimen is suggested for use in the treatment of various infections.