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.

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.

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.

[Objective]To investigate the effect and complications of treating radial neck fractures in children with elastic stable intramedullary nail(ESIN).[Method]A retrospective study was applied in 35 children(5~13 years) with displaced radial neck fractures,that were corrected with ESIN in our hospital from 2005 to 2008.[Result]All cases were successfully followed up,with an average time of 7.5 months.Ninteen cases were evaluated as excellent,6 cases were good,the excellent and good rate was 68%.Avascular necrosis was found in 9 cases,including 4 cases of radial head bulk formation,1 case showed ossification and delayed union was proved in 2 cases.[Conclusion]Treating the radial neck fracture with ESIN is a simple and minimally invasive method,the overall effect is good while the complications are limited.

Objective To compare the clinical effect of video-assisted thoracoscopic surgery (VATS) and chest tube drainage combined with urokinase for the treatment of empyema after fibropurulent pneumonia, and to determine the best therapy for patients. Methods Patients were randomly divided into two groups according to inclusion and exclusion crite?ria:55 patients were selected as group VATS performed VATS;46 patients were selected as drainage group performed 12F catheter chest closed drainage by Seldinger technique under B ultrasound guidance. The 100 000 unit urokinase was inject?ed into chest, and open after 4-hour closed, once a day for three days. Values of white blood cell (WBC), pH, glucose, lactate dehydrogenase (LDH) and C reactive protein (CRP) of pleural effusion before treatment were recorded, and the duration of fe?ver after treatment, duration of chest-tube placement, antibiotic use, hospital stay, cure rate, complication and hospitaliza?tion expenses were also recorded. Results The duration of fever after treatment,, duration of chest-tube placement, antibiot?ic use and hospital stay were significantly lower in VATS group than those in drainage group. The cure rate was significantly higher in VATS group than that of drainage group (P<0.05). There were no significant differences in complication rates and hospitalization expenses between two groups. There was no death in both two groups. Conclusion VATS is more suitable for the treatment of empyema after fibropurulent pneumonia than chest tube drainage combined with urokinase, and which is worthy of clinical promotion for not adding complication rates and hospitalization expenses.

Objective To study a new technique (lung cancer diagnossing system, LCDS) based on the computer imaging and artificial neural network for early diagnosis of lung cancer, and evaluate it's value in early cytopathological diagnosis of lung cancer. Methods The cytological smears from the specimens obtained by Percutaneous Aspiration Lung Biopsy (PALB) in 512 cases were synthetically analyzed by LCDS. Among them, 362 cases received operations. The diagnoses by LCDS were compared with postoperative histopathological diagnosis. Results In cytopathological diagnoses for the 512 specimens, LCDS can judge between cancer cells and non-cancer cells from lung lesions with its image analysis and expert system. Moreover, it can distinguish squamous carcinoma, adenocarcinoma and small cell carcinoma in cytopathological diagnosis with built-in neural network. The total coincident rate of LCDS diagnosis was 91.80% compared with the pathological diagnosis. In the 362 cases, the sensitivity of LCDS diagnosis was 94.79% (291/307), the specificity was 90.91%(50/55), and the consistent rate was 94.20%(341/362). Conclusion The diagnostic pattern of LCDS was practical and effective. It has applicable value in cytopathological diagnosis of lung cancer and may be an efficient means for early diagnosis of lung cancer.

BACKGROUND: Ligamentum flavum hypertrophy is one important cause of spinal stenosis. Ligamentum flavum thickness of more than 4 mm measured on computed tomography (CT) and magnetic resonance imaging is considered hypertrophy, but causes of hypertrophy and distribution characteristics remain poorly understood. Previous studies showed that the ligamentum flavum thickness at the segments L2/3, L3/4, L4/5 and L5/S1 was positively correlated with age.It remains unclear whether ligamentum flavum thickness is associated with nationality, sex and obesity. OBJECTIVE: To retrospectively analyze the risk factors for ligamentum flavum hypertrophy in lumbar spinal stenosis patients from the Xinjiang Uygur Autonomous Region, China.METHODS: We conducted a retrospective, single-center, case analysis at the Sixth Affiliated Hospital, Xinjiang Medical University, China. We collected lumbar CT imaging data of 104 patients diagnosed with lumbar spinal stenosis in the Sixth Affiliated Hospital, Xinjiang Medical University from May 2012 to May 2016. The primary outcome was the ligamentum flavum thickness of patients with different nationalities, sexes, heights, ages, and weights. The secondary outcomes were the morphology of lumbar vertebrae in patients with different nationalities, sexes, heights, ages, and weights; the correlation of nationality, sex, height, age, and weight with ligamentum flavum thickness; results of multiple linear regression analysis of relevant factors for ligamentum flavum hypertrophy. This trial has been registered at clinical Trials.gov (indentifier: NCT03057353). This protocol has been approved by the Medical Ethics Committee of Xinjiang Medical University and will be performed in accordance with the guidelines of the Declaration of Helsinki, formulated by the World Medical Association. Signed informed consent regarding trial procedure and treatment will be obtained from each participant.DISCUSSION: This study will determine the variations in the ligamentum flavum thickness of lumbar spinal stenosis patients of different nationalities, sexes, heights, ages, and weights in the Xinjiang Uygur Autonomous Region by measuring the ligamentum flavum thickness using CT, and analyzing risk factors for ligamentum flavum hypertrophy; the findings will provide quantitative reference data for preventing lumbar spinal stenosis induced by ligamentum flavum hypertrophy in the Xinjiang Uygur Autonomous Region.

Objective To investigate the results of non dissecting thoracic duct ligation cutting in treatment of recurrent chylothorax.Methods 22 patients suffered from recurrent chylothorax after original thoracic duct ligation surgery were enrolled and their clinical characteristics were collected,including previous thoracic surgical procedure, previous surgical approach,recurrent chylothorax side and postoperative complications.The probable causes of chylothorax recurrence were analyzed and targeted improvements were made,based on the traditional mass ligation procedure of the thoracic duct.Through the previous approach,non dissecting thoracic duct ligation combined with transection of the posterior mediastinal tissue,except esophagus and thoracic aorta,was applied during the reoperation for the recurrent chylothorax.Results All the patients were recovery form chylothorax after reoperations.There were no severe postoperative complications except one patient suffered from respiratory failure.All the patients discharged evenly without chylothorax recurrence during one-year follow-up period.Conclusion Recurrent chylothorax could be successfully and safely treated by non-anatomical mass ligation combined with transection of the thoracic duct,for the anatomical foundation of chylothorax recurrence had been eliminated.

The present experiment was to study the hematopoietic reconstruction effects of peripheral blood stem cell (PBSC) mobilized by anti-CD49d monoclonal antibody (McAb) and recombinant human granulocyte colony-stimulating factor(rhG-CSF) in mice. PBSCs from NS-treated mice (control group), rhG-CSF-mobilized mice (experimental group1), and anti-CD49d McAb-mobilized mice (experimental group 2), The changes in respectively, were transplanted to BALB/c mice pre-conditioned with high-dose chemotherapy and total body irradiation white blood cell (WBC) count, four-weeks survival rate, bone marrow nuclear cells (BMNC), granulocyte-macrophage colony-forming units (CFU-GM), and colony-forming unit-spleen (CFU-S) were observed. The results showed that survival rate, WBC, BMNC, CFU-GM, and CFU-S counts were significantly higher in experimental groups 1 and 2 than those of the control group(P

Objective To investigate the activation of mitogen-activated protein kinase (MAPK)/extracellular signal-regulated protein kinase (ERK) signaling pathway in the endometrium of women with polycystic ovary syndrome (PCOS) and its effect and significance in the cause of hyperplasia and carcinoma;and investigate the factors which affect the activation of the MAPK/ERK signaling pathway. Methods Collected 52 patients diagnosed as PCOS who were taken dilation and curettage of uterus as study, while 32 non-PCOS patients matched as control group. Serum hormonal parameters, fasting blood glucose and insulin were measured in all patients. The PCOS patients were sub-group as insulin resistance group and non-insulin resistance group; all the patients were carried out pathology inspection of endometria, and the PCOS patients were sub-group as endometrial hyperplasia and carcinoma group and normal endometrium group based on the outcome of pathology inspection. Western blot were performed to detect the expressions of ERK1/2 and phosphorylated ERK1/2 (p-ERK1/2), the activation of ERK1/2. Results (1)The expression of pERK1/2 [(61 ±13)%] in the endometrium in PCOS group was higher than that in the control [(44 ±10)%, P ＜0.01]. (2)The expression of p-ERK1/2 was significantly increased in group of endometrial hyperplasia and carcinoma [ ( 70 ± 11 )% ] compared to that in group of normal endometrium [ (55 ± 10)% ,P ＜ 0.01 ], while there were significant difference between group of insulin resistance [ (63 ± 13 )% ] and group of non-insulin resistance [ (55 ±7)%, P ＜0.01 ]. (3) Fasting insulin level, insulin area under the curve and body mass index were related to the expression of p-ERK1/2 in endometrium with PCOS, the correlation coefficient were 0.447, 0.456 and 0.381, respectively ( all P ＜ 0.01 ). Conclusions The MAPK/ERK signaling pathway in endometrium with PCOS was overactivation, which was related to the endometrial hyperplasia and carcinoma; while the activation of MAPK/ERK signaling pathway were effected by insulin resistance and hyperinsulinemia.