Objective To study the method of surgical correction for pelvic obliquity secondary to leg length inequality. Methods Pelvic equilibrium operation is designed to correct the fixed pelvic obliquity, equilibrate the two lower limbs by bilateral iliac osteotomies with transfer of a block of iliac bone from the normal ilium into the abnormal ilium of the contralateral side. This procedure also corrects the associated acetabular dysplasia. Results In this series of 32 patients, none was lost to follow-up. Thirty-two patients, 19 males and 13 females, whose ages ranged from 14 to 34 years with a mean of 22 years, underwent surgery; twenty-four cases had fixed pelvic obliquity and acetabular dysplasia secondary to a short limb following anterior poliomyelitis. The deformities in seven cases were due to severe tuberculous infection in childhood which had resulted in a fixed adducted ankylosed hip. The pelvic equilibrium was caused by trauma in one case. During the review, the minimum time from surgery was 2 years and 6 months, and the maximum 13 years and 6 months with a mean of 6 years and 8 months. The results were excellent. Preoperatively, 29 patients walked on crutches, and postoperatively, 25 patients could walk unaided, one with a stick and three on single crutch. In this paper, we also presented the associated experiment research of pelvic equilibrium operation. Conclusion Pelvic equilibrium operation has been proved to be a new effective surgical correction method of pelvic obliquity secondary to leg length inequality.

Objective To determine the potential impact of superantigens produced by skin-colonizing Staphyiococcus aureus in patients with atopic dermatitis and eczema. Methods Of 117 patients with atopic dermatitis and 199 with eczema, 140 Staphyiococcus aureus strains were isolated from the skin specimens. Superantigens were detected with reverse passive latex agglutination. Results Among 140 Staphyiococcus aureus strains, 60 (42.9%) produced superantigens, among which 43 produced one kind of superantigens only and 17 produced at least two kinds. Of strains isolated from atopic dermatitis, 51.5% produced superantigens and no significant difference was seen in superantigen production between lesional and non-lesional strains in atopic dermatitis. Of strains isolated from eczema patients, 34.7% (all were lesional strains) produced superantigens. The positive rates of total superantigens, lesional superantigens and toxic shock syndrome toxin-1 production were all higher in the strains from atopic dermatitis than in those from eczema. Conclusions Superantigen production by skin-colonizing Staphyiococcus aureus probably plays a more important role in atopic dermatitis than that in eczema. However, further studies are necessary to validate its importance.

Objective To investigate the causes,diagnosis,treatment of the difficult postoperative decannulation resulting from tracheotomy between children and adults and the method of improving the rate of successful decannulation.Methods Clinical data of 56 cases with difficult decannulation after tracheotomy were analysed retrospectively,all the patients were admitted in our hospital between Jan 1990 and Oct 2006.All the patients were separated into two groups,children group including 24 cases of 14 months ～ 14 years old,adult group including 32 cases of age ranging 15 ～ 48 years old.The postoperative time after tracheotomy were 6 month ～ 1.5 year and 6 month ～ 2 year respectively.Results There were differences of the etiology,diagnostic choice and the clinical manifestation in the treatment of the diffficult decannulation after tracheotomy between children and adults.Children with difficult decannulation after tracheotomy occurred mainly in laryngitis and airway foreign body airway caused by obstruction retrieved after tracheotomy (14/24,58.33 ％),followed by the emergency tracheotomy,such as head and neck trauma (7/24,29.17％).Adults with difficult decannulation after tracheotomy mainly occurred in the throat caused by traumatic lesions of the larynx (including malformations,subglottic stenosis of larynx or vocal cord paralysis) (23/32,71.88％).The average block time in children with anti-inflammatory treatment was significantly lower than that in without anti-inflammatory therapy (6.2 d vs 10.1 d,t =4.26,P ＜ 0.01).However,there was no significant difference in the average block time in adults with anti-inflammatory and without anti-inflammatory treatment (t =1.63,P ＞ 0.05).In the course of treatment,rates of children consciously breathing difficulties (21/21,100％) was also significantly higher than the adult group (13/28,46.43％).Conclusion Children less than 3 years old should avoid tracheotomy.There is no definite relation between the successful treatment in the difficult decannulation and the age of the patients over 3 years old.The first failure treatment in children may be related with the local inflammation.When in treatment,doctors should observe the characteristics of respiratory difficulties,take attention to the influence of children psychological factors to the treatment.Children should be treated in the non-traumatic examination methods.

Objective To investigate the expression and significance of bone sialoprotein and matrix metalloproteinase-9 in calcified mitral valves in patients with rheumatic heart disease.Methods A total of 150 mitral valves were divided into the rheumatic group (n =120) and the non-rheumatic group (n =30 ).Expressions of bone sialoprotein and matrix metalloproteinase-9 were determined by immunohistochemistry.Results Expressions of bone sialoprotein ( 91.6％,x2 =56.6354 ) and matrix metalloproteinase-9 ( 90.8％,x2 =59.4272) in the rheumatic group increased significantly than in the non-rheumatic group (P ＜ 0.01).Conclusion Both bone sialoprotein and matrix metalloproteinase-9 are highly expressed in the calcified rheumatic group.This suggests that caficify of rheumatic mitral valves is related with the degradation and remodeling of extra cellular matricx by matrix metalloproteinase-9,as well as osteoblastlike bone formation by bone sialoprotein.

ObjectiveTo observe the expression of bone sialoprotein(BSP) and matrix metalloproteinase-9 (MMP-9) in calcified valves of patients with rheumatic heart disease.MethodsA total of 150 mitral valves which were resected by surgery were divided into rheumatic group ( 120 valves) and nonrheumatic group (30 valves).Immunohistochemical staining was taken by SP method and the expressions of BSP and MMP-9 in two groups were observed and compared.ResultsThe positive expressions of BSP and MMP-9 in rheumatic group were 91.7％(110/120) and 90.8％(109/120),respectively,which were significantly higher than those in non-rheumatic group [23.3％(7/30) and 20.0％(6/30) ](P＜ 0.01 ).Conclusions The expressions of both BSP and MMP-9 are higher in the valves of patients with rheumatic heart disease.The calcification of rheumatic mitral valves is closely related with the degradation and remodeling of extracellular matrix caused by MMP-9,and osteoblast-like bone formation induced by BSP.

Objective To evaluate the cumulative irritative effect of topical retinoic acid preparations on normal skin.Methods A randomlized,doubled blind,placebo-controlled clinical trial was carried out with7groups for6tested preparations.All subjects were patch tested with each preparation for24hours on Monday to Thursday,and for72hours on Friday.The patch tests were performed for3consecutive weeks.Results The minimal cumulative irritative effects were found in Group G treated with0.1%adapalene gel,with a cumulative irritative index of0.09?0.11in20days.The cumulative irritative index was significantly lower in Group G than that in Group B treated with0.1%retinoic acid(Diweishuang誖)(0.59?0.24),or in0.025%retinoic acid(Diweishuang誖)(0.41?0.22),or in0.05%retinoic acid(VITAMIN誖Cream)(0.25?0.22).Conclusion Adapalene,the third generation of retinoic acid,is characterized by lower irritative ef-fects in comparison to the first generation of topical retinoic acid agents.

Objective To investigate the colonization features of Staphylococcus aureus (S. aureus) in the skin lesions of eczema and atopic dermatitis (AD), and to evaluate the therapeutic effect of combination topical treatment with mupirocin and hydrocortisone butyrate. Methods A multicentre, double-blind randomi-zed trial was conducted. The SCORAD was evaluated on day 1, 7, 14 and 28. Swabs for bacterial isolation were taken from the lesional skin and non-lesional skin. A combination topical therapy with mupirocin ointment and hydrocortisone butyrate ointment was used in treatment group, with vehicle ointment and hydrocortisone butyrate ointment as a control. Results Three hundred and twenty seven patients were enrolled in the study, including 208 patients with eczema and 119 patients with atopic dermatitis. Bacteria were isolated from 70.19% of lesional skin and 32.69% of non-lesional skin of patients with eczema, in which S. aureus accounted for 47.26% and 27.94% respectively. Bacteria were isolated from 74.79% of the lesional skin and 34.45% of non-lesional skin of patients with atopic dermatitis, in which S. aureus accounted and 79.78% or 80.49% respectively. The amount of S. aureus colonized was markedly higher in the lesional skin than that in non-lesional skin, either in eczema patients or in atopic dermatitis (P 0.05). Conclusions The bacterial colonization, especially S. aureus, is more frequently dectected in the lesional skin of eczema patients and AD patients than that in the non-lesional skin, which may be related in the pathogenesis of eczema and AD. And, early application of combination therapy with topical antibiotics and corticosteroids is beneficial to the patients.

Objective To study the bacteriological characteristics and the pathogenesis of Staphylococcus aureus (S. aureus) on eczema and atopic dermatitis (AD). Methods A multi-center randomized, double blind bacteriological study on the lesions and non-lesional skin of patients with eczema (207) and AD (119) were carried out. The antibiotic sensitivity and the bacteriophage typing were performed on all the S. aureus isolated from the patients. Results There were statistical differences in the positive rate of the culture, the ratio and the colonization of S. aureus between the lesion and the non-lesional skin in eczema (P

Objectives To study the role of interleukin-4 (IL-4) and interferon-gamma (IFN-?) in the pathogenesis of atopic dermatitis and eczema,and the changes of serum levels of IL-4 and INF-? with topical treatment of co rticosteroid plus antibiotic cream or corticosteroid cream alone.Methods Seru m levels of IL-4 and IFN-? were detected by enzyme-linked immunosorbent assa y(ELISA).Results Serum levels of IL-4 and INF-? were significantly higher in the patients with atopic dermatitis and eczema than those in the normal control s,respectively(both P

0.05).Conclusions The higher level of SEB-specific IgM and IgE in AD and eczema indi cates the colonization of Staphylococcus aureus,which participates in the exace rbation of allergic inflammation,is involved in the pathogenesis of AD and ecz ema.