BACKGROUND: The development of hip joint in children with developmental dislocation of the hip (DDH) has been evaluated by X-ray plain film, which mainly presents Shen Tong's line continuity and epiphyseal nucleus position. There is still a lack of quantitative and objective evaluation methods. OBJECTIVE: To evaluate the rotation center and dislocation degree in DDH children by using three-dimensional (3D) computed tomography (CT).METHODS: Preoperative 3D CT was performed for 16 unilateral DDH from December 2010 to December 2014 in Tongji Hospital of Huazhong University of Science and Technology, with 4 males and 12 females, at the mean age of (4.42±2.59) years. There were 10 cases on the left side and 6 cases on the right side. 3D digital models were constructed by analysis. The 3D coordinate system was established with reverse engineering software. In 3D coordinatesystem, using inverse solution method of sphere fitting engineering, the rotation center of the acetabulum, the rotationalcenter of the femoral head, and the radius of ossification were constructed. Ossific radius ratio and dislocation lengthwere calculated. RESULTS AND CONCLUSION: (1) The acetabulum has the same point as the rotation center with the head of femur,and no significant difference in X, Y, and Z coordinates was detected (Px > 0.05, Py > 0.05, Pz > 0.05). However, it is notthe same condition in ipsilateral acetabular rotation center and femoral head rotation center, showing significant differences (Px=0.052, Py < 0.05, Pz < 0.05). (2) There were no significant differences in ossific radius between the healthy and affected sides (P > 0.05). The ossific radius was (21.37±4.42) mm and (20.14±3.14) mm on the healthy and affected sides of the femoral head (P < 0.05). (3) There was no significant difference in ossific radius ratio between healthy and affected sides (0.544±0.069 and 0.522±0.088; P > 0.05). (4) The dislocation length was 8.64-35.28 mm, mean (19.47±7.84) mm. (5) These findings suggest that 3D CT reconstruction can construct 3D digital models of DDHchildren. Thus, the accurate rotation center of the hip can be identified so as to precisely measure the dislocation length.

BACKGROUND: Interleukin-1 receptor antagonist can relieve damage of neuron and protect nerve. Aminoglutaric acid can induce exitotoxicity through activating some kinds of aminoglutaric acid receptor, at the same time, can protect nerve through some receptors. But the relationship between them was unclear during the process of cerebral ischemia reperfusion.OBJECTIVE: To investigate the effect of neuroprotective actions of interleukin-1 receptor antagonist on hippocampal neurons, and the relationship between interleukin-1 receptor antagonist and metabotropic glutamate receptor 5 within the process of cerebral ischemic reperfusion injury.DESIGN: Completed randomized controlled study.SETTING: State Key Laboratory of Magnetic Resonance and Atomic and Molecular Physics, Wuhan Institute of Physics and Mathematics, Chinese Academy of Sciences; School of Medicine & Life, Jianghan University.MATERIALS: The experiment was performed at State Key Laboratory of Magnetic Resonance and Atomic and Molecular Physics, Wuhan Institute of Physics and Mathematics, Chinese Academy of Science from May 2004 to January 2005. Totally 32 well-being pure breed male Wistar rats were selected.METHODS: Totally 32 rats were divided into four groups by method of the simple random sampling: normal group (n=8) received no surgical treatment, sham operated group (n=8) subjected to only dorsal and ventral neck midline incisions and gently dissection of the bilateral common carotid arteries free of surrounding nerve fibers without occlusion of the both vertebral arteries and common carotid arteries, saline group (n=8) suffered from the permanently occlusion of the both vertebral arteries by electrocauterization and transient (20 minutes) occlusion of bilateral common carotid arteries respectively, and received the treatment of a 2 μL normal saline injection into right lateral ventricle at the rate of 0.4 μL/minute following a needle withdrawal within 5 minutes, and experiment group (n=8) offered the same procedure of the saline group but for that the equivalent amount of rhIL-1ra took the place of normal saline into the lateral ventricle. Hematein-eosin staining was applied to observe pathological changes and immunohistochemistry (ABC) was used to survey the IR of mGluR5 varieties of the hippocampal neurons.MAIN OUTCOME MEASURES: ① Basic pathological changes of hip pocampus and cerebral cortex; ② mGluR5 immunoreactivity (IR) of hippocampus, the sensitive area to cerebral ischemia.RESULTS: Two rats were excluded from the experiment on account of their convulsion during reperfusion (one of the experiment group, another of the saline group), data of 30 rats was entered final analysis. ①Basic pathological changes of hippocampus and cerebral cortex: The Hemateineosin (H.E) staining showed that there is little pathological discrepancy between the normal group and the sham operated group, apparent neuronal degeneration such as peripheral edema around neurons, pyknosis, karyorrhexis and so onin the hippocampus and cortex of the rats of the saline group compared with those of the previous groups, and also the pronounced lower degree of neuronal degenerationin the rats of the experiment group.② mGluR5 immunoreactivity (IR) of hippocampus, the sensitive area to cerebral ischemia (absorbency): The immunohistochemistry presented that the mGluR5 immunoreactivity (IR) of CA1, CA3 areas of the normal group and sham group rats was strong positive (CA1: 0.54±0.12, 0.54±0.05; CA3:0.57±0.02, 0.58±0.08;P ＞ 0.05) Compared with of the normal group and sham group, the mGluR5 IR of the saline and the experiment groups reduced apparently (CA1: 0.30±0.03, 0.40±0.04; CA3: 0.30±0.04, 0.42±0.06;P ＜ 0.01), but the mGluR5 IR of the experiment group was quite stronger than that of the saline one (P ＜ 0.05).CONCLUSION: IL-1ra, one member of the Interleukin-1 family (system)of the cytokines, and mGluR5, one subtype of the metabotropic glutamate receptors were both involved in the pathophysiological process of the global cerebral ischemia reperfusion injury of the rat. Also, as the antagonist of the proimflammatory medium intetleukin-1 receptor, IL-1ra may show neuroprotection by affecting the mGluR5 expression of the CA1 and CA3 areas of the rat hippocampus within the process of cerebral ischemic reperfusion injury. Furthermore, here it demonstrated that besides IL-1ra, other factors might regulate the expression of mGluR5.

AIM: To study whether there was a correlation between central foveal thickness (CFT) assessed with optical coherence tomography (OCT) and visual acuity of patient with high myopia after phacoemulsification and intraocular lens implantation.METHODS: Totally 67 patients with high myopia underwent phacoemulsification and intraocular lens implantation were enrolled in the study.Best corrected visual acuity (BCVA) was recorded and CFT was measured using OCT at 1wk,1 and 3mo after oerations.BCVA and CFT were compared before and after the operation.All patents were divided into two groups by the BCVA at 3mo after operation,BCVA>0.5 in Group A and BCVA≤0.5 in Group B.ANOVA,Spearman correlation analysis and independent t test were used for statistical analysis.RESULTS: There was a statistically significant difference between preoperative BCVA and postoperative BCVA (F=115.04,P<0.01).Preoperative CFT was different compared with that 1wk and 1mo after operation (P=0.04,0.02) and was not different with that 3mo after operation(P=0.52).There was a statistically significant difference in CFT of postoperative 3-month compared with that of postoperative 1-week(P<0.01) or that of postoperative 1-month (P<0.01).BCVA showed significant positive correlation with CFT without foveal lesion on postoperative 3mo (r=0.28,P=0.03).CFT of Group A and Group B was significantly different at 3mo after the operation (t=-2.24,P=0.03).There was no significant difference in age and intraocular lens of two groups.CONCLUSION: Optical coherence tomography allow for objective assessment of retinal construction changes in eyes with high myopia are correlated to visual acuity.

OBJECTIVE:To try to establish a combined serum-pharmacology and electrophysiology method for the study of mechanism of chuanxiong extract in dilatating coronary artery.METHODS:Chuanxiong extract was intragastrically given to rats and mice,then the serum contents of tetramethylpyrazine(TMP)were determined by HPLC,which provided data for electrophysiological study.The action of chuanxiong extract on Ca 2+ -activated K channel(Kca)of smooth muscle of coronary artery in pigs was studied by patch clamp technique.RESULTS:The calibration curve of TMP was linear in the range of0.216～54?g/ml(r=0.9999).The recovery was100.7%～102.4%.The serum concentrations of TMP in rats and mice were(3.56?3.01)and(8.19?6.57)?g/ml respectively.The chuanxiong extract could not markedly activate the Kca of smooth muscle of coronary artery in patch clamp study.CONCLUSION:The established method for TMP determination is feasible and relieable.In order to improve the combined electrophysiology and serum pharmacology technique,high quality medical materials should be adopted and the bioavailability improved.

Objective To evaluate the effect of beat to beat alterations in the cardiac cycle length on systolic flow velocity patterns of the pulmonary vein in patients with atrial fibrillation(AF).Methods Pulmonary vein flow was recorded in 20 control subjects and 74 patients with AF (16 with nonvalvular AF,22 with mild to middle mitral stenosis,and 36 with severe mitral stenosis) by transesophageal echocardiography.The peak velocities of the early systolic reversal wave (PVR) and the systolic forward wave (PVS) were measured.The relationships between the preceding R-R intervals and PVR,PVS were analyzed.Results The early systolic reversal wave was detected in all patients with AF.PVR was significantly lower in patients with severe mitral stenosis than that in patients with nonvalvular AF and mild to middle mitral stenosis.The preceding R-R interval had a significant negative correlation with PVR.PVS was significantly lower in patients with AF than that in controls.The preceding R-R interval had a significant positive correlation with PVS.Conclusions PVR and the systolic forward wave vary with disease conditions and preceding R-R intervals in atrial fibrillation.The evaluation of systolic pulmonary venous flow velocity patterns provides important information about left atrial hemodynamic abnormalities.

Objective Adult isolated ACTH deficiency ( IAD) is an uncommon and underestimated disorder with high rate of misdiagnosis.This paper aimed to analyze and summarize the clinical features of 6 patients with IAD to have deeper understanding of the disease. Methods Retrospective analysis was made on the data of 6 IAD cases enrolled in Nanjing Hospital of Nanjing Medical University from 2007 to 2015.Statistical analysis was made on the clinical manifestations, therapeutic schemes, laboratory and imaging results, along with outpatient follow-up(ranging from 0.5-10 years), in order to analyze clinical efficacy and prognosis result. Results Of 6 IAD patients, 4 patients showed main symptoms of long-term fatigue, anorexia, weight loss;5 patients were with differ-ent degrees of hypoglycemia (fasting blood glucose2.70 [1.2-3.0]mmol/L), among which 3 had hypoglycemic coma (fasting blood glucose <1.8mmol/L), 1 had chronic hypoglycemia and 1 had asymptomatic hypoglycemia( asymptomatic hypoglycemia by continu-ous glucose monitor system).4 of them had refractory hyponatremia (Serum Na+117 [110-120]mmol/L).ACTH values of all the patients were less than 0.01ng/L.After glucocorticoid replacement therapy, all the patients were followed up for six months after treat-ment and cortisol rhythm, plasma cortisol, urine cortisol, fasting blood glucose, serum sodium of the patients were in normal range, but still at a low level of ACTH. Conclusion The clinical manifestation of IAD is characterized as hypoglycemia, hyponatremia, low ACTH with other normal pituitary hormones.Long-term glucocor-ticosteroid therapy has favorable prognosis for patients with adult isola-ted ACTH deficiency.

Objective To observe the effect of acupuncture plus thunder fire moxibustion plus deglutition training plus VitalStim electrical stimulation on patients with deglutition disorder of early stroke.Methods 80 patients with deglutition disorder of early stroke were randomly divided into treatment group and control group,40 cases in each group.The treatment group was treated with acupuncture plus thunder fire moxibustion plus deglutition training plus VitalStim electrical stimulation,while the control group was only treated with deglutition training.The therapeutic effects of all patients were assessed by using drinking experiment before therapy and twenty times after therapy. Results The total effective rate of the treatment group was 97.5%,which was significantly higher than 82.5% of the control group,the difference was statistically significant(χ2 =12.50,P <0.05).Watian integration of the two groups were decreased after treatment,the difference was significant(t =5.606,9.056,all P <0.05),which of the treatment group was significantly lower than the control group,the difference was statistically significant(t =3.044,P <0.05). The lung infection rate and malnutrition rates in the control group were 10.0% and 20.0%,which were significantly higher than those in the treatment group(2.5% and 5.0%),the differences were statistically significance(χ2 =4.80, 10.29,all P <0.05).Conclusion Acupuncture plus thunder fire moxibustion plus deglutition training plus VitalS-tim electrical stimulation are beneficial to the recovery of swallowing functions to early swallowing disorder in patients and could avoid the incidence of aspiration pneumonia and malnutrition.

OBJECTIVE:To establish a HPLC method for the determination of both chloramphenicol and furacillin in compound chloramphenicol auristillae.METHODS:The determination was performed on Tianhe Kromasil C18 column,the mobile phase consisted of methanol-water(60∶40) with flow speed at 1.0ml/min,detection wavelength at 278nm,column temperature at 25℃,and sample size at 20?l.The dexamethasone was used as internal standard.RESULTS:The linear ranges for chloramphenicol and furacillin were 31.75～127?g/ml and 26.25～105?g/ml,respectively;The average recovery rates were 100.4%(RSD=0.89%) and 100.7%(RSD=1.20%),respectively.CONCLUSION:This method is simple in operation,accurate and reliable in determination results and it can be used for the quality control of compound chloramphenicol auristillae.

Objective To compare the primary clinical results of the anteromedial portal (AMP) and accessory anteromedial portal (AAMP) techniques for femoral tunnel drilling in single-bundle anterior cruciate ligament (ACL) reconstruction.Methods Data of isolated ACL rupture patients who had undergone single-bundle ACL reconstruction with autologous semitendinosus and gracilis tendons from March of 2012 to February of 2014 were retrospectively analyzed.The femoral tunnels were drilled with AMP techniques in 14 patients (group AMP) and with AAMP techniques in 23 patients (group AAMP).All the patients were followed up for 6 to 29 months.At the latest follow-up the Lysholm,Tegner and international knee documentation committee (IKDC) scores were used to estimate knee joint function,while the Lachman test and Pivot-shift test were used to estimate knee joint instability.Results The average follow-up time was 16.07±7.31 months in group AMP and 13.35±5.92 months in group AAMP.In group AMP,the Lysholm,Tegner and IKDC average scores were 89.86±7.90,8.64±1.65 and 89.31±8.16,respectively.While they were 92.17±6.72,8.91±1.16 and 90.89±7.80 in group AAMP,respectively.In group AMP the Lachman test was negative in 11 patients and positive in 3 patients.In group AAMP the Lachman test was negative in 20 patients and positive in 3 patients.The Pivotshift test was negative in 9 patients,positive in 5 patients and negative in 20 patients,positive in 3 patients in group AMP and AAMP,respectively.There were no significant differences in Lysholm,Tegner,IKDC scores,the negative rates of Lachman and Pivot-shift tests between two groups.Conclusion Single-bundle ACL reconstructions using AMP and AAMP techniques for femoral tunnel drilling have similar excellent primary clinical results.

BACKGROUND:Atlantal lateral mass screw fixation contains lateral mass screw fixation under the posterior arch of the atlas and lateral mass screw fixation via the posterior arch of atlas (also cal ed atlas pedicle screw fixation) according to different insertion points. The two methods have their advantages and disadvantages. There are lacks of the comparative studies on bony anatomy feasibility by two kinds of atlantal lateral mass screw fixation.
OBJECTIVE:To compare the feasibility associated with two kinds of atlantal lateral mass screw fixations taking Chinese data of atlantal bony anatomy as evidence.
METHODS:Data of CT scans in 30 adults with cervical spondylosis (60 sides) were col ected, and data were reconstructed using CT workstation. We measured key bone anatomy structure after atlantal lateral mass screw fixation. The atlantal lateral mass was suitable for lateral mass screw fixation via the posterior arch of atlas if its height and width of vertebral artery groove at the posterior arch ≥ 4 mm. It was suitable for lateral mass screw fixation under the posterior arch of the atlas if the height of posterior arch of atlas lateral mass ≥ 4 mm.
RESULTS AND CONCLUSION:The height of vertebral artery groove at the posterior arch was (4.54±1.17) mm. The width of vertebral artery groove at the posterior arch was (8.69±1.12) mm. The height of posterior arch of atlas lateral mass was (4.98±1.07) mm. There were 41 cases with the height of vertebral artery groove at the posterior arch>4 mm (suitable for lateral mass screw fixation via the posterior arch of atlas, occupying 68%. There were 52 cases with the height of posterior arch of atlas lateral mass>4 mm (suitable for lateral mass screw fixation under the posterior arch of the atlas), occupying 87%. There were significant differences in the differences between the two groups (P<0.05). These results indicated that lateral mass screw fixation under the posterior arch of the atlas was more feasible compared with lateral mass screw fixation via the posterior arch of atlas. Preoperative CT measure for key anatomic structure was significant for making personalized surgical plan.