Objective To provide sectional anatomic data for the coronal imaging diagnosis and surgical treatment of the diseases of the liver.Methods The course,distribution of left,middle,and right hepatic veins and their important tributaries as well as the relationship with the hepatic portal veins were investigated using serial coronal sections of the trunk of 30 adult cadavers,coronal MR images of abdomen of 10 adult healthy volunteers and three-dimensional MSCT image of intrahepatic ducts of 5 healthy adults.Results The draining form of left hepatic vein can be divided into 4 types according to the external shape character of left lateral lobe.All veins of the ventral area of segment Ⅷ opened into the middle hepatic vein.All veins of the dorsal area of segment Ⅷ joined the right hepatic vein.However,the veins(V8i) situated between the ventral and dorsal areas of segment Ⅷ can be divided into 3 types on the draining form.Right hepatic vein usually appears on the section through or behind the inferior vena cava with 4 types on the coronal plane.Conclusions Coronal section has obvious advantage to show the course of hepatic veins in the longitudinal direction.Segment Ⅷ can be divided into dorsal and ventral subsegments according to V8i,This method of subsegmental division may contribute to the development of new and safer surgical procedures of the liver.

OBJECTIVE:To explore the reasons for leg length discrepancy following total hip arthroplasty,and to summarize the prevention and treatment of leg length discrepancy after total hip arthroplasty.DATA SOURCES:A computer-based online search was conducted in PubMed (www.ncbi.nlm.nih.gov/pubmed) for the English articles published between 2001 and 2008 with keywords "Leg length discrepancy,hip arthroplasty" and Wanfang database (http://www.wanfangdata.com.cn) for the Chinese articles published between 2004 and 2009.DATA SELECTION:Totally 154 literatures were retrieved by computer,including 116 English articles and 38 Chinese articles,through reading title and abstract,112 independent and 51 repeated papers were excluded.The remained 29 literatures were performed further analysis.MAIN OUTCOME MEASURES:Reasons for leg length discrepancy and the prevention and treatment of leg length discrepancy following total hip arthroplasty.RESULTS:The main cause of leg length discrepancy after total hip arthroplasty included redundant neck of femur stump,used longer prothesis neck,diminished femur eccentricity,selected longer neck of femur prothesis,as well as larger movement of cotyloid cavity rotation center.The effective approaches of leg length discrepancy after total hip arthroplasty included careful preoperative planning,intraoperative measurement digital templating and image-guided surgery.It could be the adjusted with heel and shaped bottom for the limbs length which was more than 15 mm after operation,and revision operation maybe applied to patients who had more than 20 mm limbs length or combined with complications.CONCLUSIONS:Leg length discrepancy is one of the common complications following total hip arthroplasty.Along with the development of science and technology,to design individual prothesis and computer-assisted navigation joint can be recover farthest joint function.

Objective To investigate the levels of CD4 + CD25 + regulatory T cells and the Foxp3 in the peripheral blood of patients with ulcerative colitis ( UC), and analyze its role in the pathogenesis of UC. Methods From February 2007 to December 2008, 40 UC patients (23 active and 17 remissive), 33 irritable bowel syndrome (IBS) patients, and 32 normal controls entered our study. CD4 + CD25 + T cells were detected with flow cytometric assay. The expression of Foxp3 mRNA in peripheral blood mononuclear cell (PBMC) was detected by RTPCR. Interleukin-10 (IL-10) and transforming growth factor-β (TGF-β) in the serum from the peripheral blood of UC patients, IBS patients, and normal controls were determined with ELISA. Results There were no significant differences of the peripheral CD4 +T cell numbers among the active, remissive UC and IBS patients, and normal control groups (P=0. 126). The positive rate of CD4+ CD25+ T cells in patients with active and remissive UC were significantly lower than those in IBS patients and normal controls ( both P ＜ 0. 01 ) it was more lower in the active UC patients than the remissive UC patients ( P ＜ 0. 001 ). However, the positive rate of CD4 + CD25 + T cells showed no significant difference between IBS patients and normal control groups ( P = 0. 343 ). The percentage of CD4 + CD25 + T cells was negatively correlated with UC disease activity index ( r = - 0. 660, P ＜ 0. 001 ) and with erythrocyte sedimentation rate (r = -0. 572, P =0. 001 ). The expressions of Foxp3 mRNA in PBMC from active and remissive UC patients were significantly lower than those in both IBS patients and normal controls ( both P ＜0. 001 ). There was no significant difference of the plasma levels of IL-10 or TGF-β among the active/remissive UC patients, IBS patients, and normal controls ( all P ＞ 0. 05 ). Conclusions CD4+ CD25 + regulatory T cells remarkably decline in the active UC and show certain increase in remissive UC, indicating that these cells may be involved in the pathogenesis of UC. The decreased expression of Foxp3 mRNA may be an important factor of the aberrant developmental disorder of CD4 + CD25 + regulatory T cells.

Objective To investigate the relationship between the TRAb-producing cell precursors and different clinical stages of Graves' disease.Methods Peripheral lymphocytes were infected with Epstein-Barr virus,a kind of lymphocyte precursor stimulator,and were stimulated to produce TRAb.Results Of the total wells containing Ig-producing B cell precursors,there were 34.6% and 29.1% from 2 untreated patients,30% from 1 relapsing patient and only 1.3% and 3.8% from 2 healthy controls that secreted TRAb,respectively.As for the wells containing B cell precursors from 2 remission patients with undetectable TRAb in circulation,the percentage (10.7%) of TRAb-containing wells from one was higher than that from the other (5.3%).And the latter had similar percentage of TRAb-positive wells with the controls.The isotype of TRAb in supernatants of our EBV-transformed B lymphocytes was predominantly IgM.Conclusion The frequencies of TRAb-specific precursors were different at three distinct clinical stages of the disease.

Objective To evaluate the diagnosis of ureteral stone by helical CT. Methods 25 patients with acute flank pain. hematuria and suspected of ureteral stone on B ultrasonography yet with negative,KUB and IVU underwent helical CT scanning. Results 24 cases were found to have ureteral stone by helical CT,the accurate rate being 96%.Three cases were fond to have Hydronephrosis,Ureteral dilation,Edema periureteric and secondary signs of ureteral obstraction. Conclusions Helical CT is safe,quick and accurate in diagnosing ureteral stone.

Objective To discuss the uterus artery embolization of uterine flesh tumour clinical curative effect and influence of ovarian function.Methods Participants included 52 routine uterine artery embolization of uterine flesh tumour patients,all patients were followed up for one year,observed the curative effects of all subjects and the influence of the rightness of ovarian function.Results After treatment,the results showed that the curative effects,after 3 months,6 months,12 months compared with the preoperative,uterine tumor size,volume were significantly smaller,menstrual cycle extended,menstrual quantity increased,uterine fibroids oppression,anemia patients were significantly reduced,the difference was statistically significant (t =3.23,3.18,x2 =2.98,4.57,4.42,2.18,respectively,P ＜ 0.05) ; And after treatment with the extension of time,the symptoms and signs of patients were distinct improvement,the difference was statistically significant (t =2.66,2.57,x2 =3.45,5.12,6.54,3.67,respectively,P ＜ 0.05).After treatment of ovarian function results showed that the effects,after 3 months,6 months,12 months compared with the preoperative,serum levels of estradiol (E2),progesterone (P),follicle-stimulating hormone (FSH),corpus luteum erythropoietin (LH),prolactin (PRL) level had no change,there were no statistically significant differences (P ＞ 0.05).Conclusion Uterine artery embolization for treatment in patients with uterine fibroids has obvious curative effect,and the influence of ovarian function is not obvious.

OBJECTIVE To discuss the application of tachypleus amebocyte lysate test in transfusion reaction. METHODS Based on agglutination when tachypleus amebocyte lysate test encountered bacterial endotoxin, the quantity of the bacterial endotoxin was tested. RESULTS Twenty-three cases were analyzed with tachypleus amebocyte lysate test, the main reasons were excessive pyrogen, improper combined drug compatibility, excessive agents or unqualified pyrogen of the agent added, pollutions on transfusion devices and air in the treatment room, disobeying axenic operation rules, overlong drug dispensing, too fast transfusion speed, etc. CONCLUSIONS On prevention of transfusion reaction, all the axenic operation rules should be strictly followed, single dose transfusion, to reduce transfusion reaction.

BACKGROUND:Pedicle screw fixation has been used in children with thoracic injury. Conventional method is screw implantation by hand. This method can meet the needs of surgery, but its accuracy was low, and incidence of complications was high. The application of digital image navigation aid module is possible. OBJECTIVE:To study accuracy and safety of digital image navigation aid module in thoracic pedicle screw placement. METHODS:Eight thoracic vertebral bodies were equal y and randomly assigned to the manual insertion group and the digital image navigation aid module group. Manual insertion group received manual screw insertion. In the digital image navigation aid module group, navigation aid module was made according to CT scan results combined with principle of reverse engineering and rapid prototyping. Pedicle screw was placed using the digital image navigation aid module. RESULTS AND CONCLUSION:(1) Success rate of once screw set was significantly higher in the digital imaging navigation aid module group than in the manual insertion group (P<0.05). (2) Twenty-eight screws were implanted in the digital image navigation aid module group and manual insertion group separately. The excellent and good rate of screw placement was 96%in the digital image navigation aid module group and 75%in the manual insertion group (P<0.05). (3) These findings suggested that digital image navigation aid module can effectively improve the success rate of pedicle screw insertion. Moreover, this method is simple, easy to operate, and can make a personalized nail placement program for each child.