Objective To explore the clinical value via comparison of umbilical incision and traditional right upper quadrant abdominal transverse incision of congenital hypertrophic pyloric stenosis.Methods According to the digital table,38 children with congenital hypertrophic pyloric stenosis were divided into two groups,the study group (n=19)was given umbilical transverse incision,the control group(n=19)was given right upper quadrant abdominal transverse incision.The effect of the two groups were compared.Results In the study group,the operate time was (20.4 ±1.47)min,incision scar healing time was (5.53 ±0.51)d,which were significantly lower than (24.00 ± 1.36)min and (7.26 ±0.45)d of the control group(t=7.835,11.090,all P<0.05).The length of incision scar [(0.53 ±0.015)cm]was obvious shorter than that of the control group[(2.03 ±0.12)cm](t=54.070,P<0.05). The postoperative eating time[(23.84 ±0.96)h]and hospitalization time[(9.37 ±0.83)d]of the study group had no difference with the control group of[(24.11 ±0.81)h and (9.42 ±0.84)d](t=0.936,0.184,all P>0.05). Followed up for 6-8 months,all children had good growth and development,but abdominal scar was obvious in the control group,and the study group had no obvious scar.Conclusion Umbilical incision for the treatment of congenital hypertrophic pyloric stenosis does not prolong the operation time,and has rapid postoperative recovery and better beau-ty effective than the traditional operation,.It is suitable for primary hospitals with no condition to carry out laparoscop-ic operation.

Objective To evaluate the results of gluteal muscle contracture released by radiofrequency vaporization (RF) under arthroscopic guidance. Methods Eighteen cases of bilateral gluteal muscle contracture were treated with radiofrequency vaporization. The patients consisted of 7 males and 11 females, aging from 8 to 40 years. The patients were lying in lateral recumbent position under epidural anesthesia. The outline of the gluteal contracture, the incision line and the sciatic nerve were marked preoperatively on the skin. The entrance for the vaporization was 2 cm superior and 5 cm lateral to the top of the greater trochanter. The portal for the arthroscope was 3 cm inferior to the antero-superior iliac spine. A space was made between constricted fibrous band and overlying subcutaneous tissue with an elevator, and then saline was filled into the space, the constricted fibrous band from the tip of the greater trochanter was removed. The contracture was released, bleedings were controlled, and the range of motion of the hip was evaluated, it was guaranteed that the motions like snapping and impingement were eliminated completely. The patients were allowed to walk about 24 hours following operation in order to prevent adhesions. Results All of the cases of bilateral gluteus contracture treated with RF vaporization were followed up for average 7 months (range, 6 to 13 months). Two cases of hematoma were noted, there was no infection, no limitation in squatting, no snapping, and no difficulty in crossing the legs. Ober sign was negative in the treated patients. The gait and function recovered to normal. Conclusion Gluteus contracture can be effectively released with RF vaporization under arthroscopic guidance. The advantages of this procedure are mild tissue damage and reaction, and less blood loss. The tissue damage is very limited. The rehabilitation can be started soon postoperatively, and functional recovery is better.

Objective To evaluate the clinical outcomes of arthroscopically assisted combined anterior and posterior cruciate ligament reconstruction, with an implant fixation of combined press-fit technique of hamstrings tendon knot and bone bolt. Methods 15 cases of combined injury of anterior and posterior cruciate ligament were reconstructed under arthroscopy. There were 10 males and 5 females, and the average age of patients was 23 years ranging from 19 to 31 years. 9 left knees and 6 right knees were involved. A hamstring was taken by standard procedure with a stripper, and pretension was performed on the harvested tendons; a bone bolt was inserted into the tendon to form a tendon knot. The bottle-neck shaped tunnel was prepared by stepping drill at the femoral side, the tendon knot and bone bolt was pulled inside of femoral tunnel, and then out of the tibial tunnel. Repeating the full extension and flexion of the knee joint for 20 times, and then the weaving suture of tendons was brought to pass underneath of tibial bridge and tightened together. Results The patients were evaluated by Lysholm knee functional scales, the average knee score were 61.5?4.6 and 92.5?3.7 respectively before and after operation, and the difference was of statistical significance(P

Objective To investigate the value of TAP in the early prediction of severe acute pancreatitis (SAP) and to compare it with acute physiology and chronic health evalutionⅡ (APACHEⅡ).Methods We observed the association between TAP concentration and the severity of acute pancreatitis with competitive enzyme-linked immunosorbent assay(ELISA). Urine samples were collected for the measurement of TAP concentration at admission, 24,48,and 72*!h after from 41 patients with acute pancreatitis (AP) (12 severe cases, and 29 mild) who presented within 48*!h of the onset of symptoms and from 11 control patients, while APACHEⅡ scores were recorded at 48*!h after admission. Results The TAP at admission of SAP (95*!nmol/L) was signficantly higher than that of mild (20*!nmol/L; P

[Objective]To sturdy the biological responses of osteoblast-like cells in different maturation stages under shear flow.[Method]Flow chamber system was used to apply shear flow stimulation of 4.62dyn?s/cm~2 for 2 hours on osteoblast-like cell MC3T3-E1 of different maturation stage induced by osteogenic media,and then samples for dsDNA content and ALP activity analysis were collected.[Result]On 24 hours after simulation,there was not obvious change of ALP activity with non-osteogenic inducing group,an increase was observed in the group of 4 days of differentiation,while an decrease in the group of 8 days of differentiation.[Conclusion]Biological responses of osteoblast-like cells in different maturation stages under shear flow is quite different,and this may be an important role in bone growth and reconstruction.

The effect of the selective debridement with the aid of the arthroscope performed under local anesthesia for osfeoarthritis of 296 knees in 260 patients was studied. The pathological changes of osteoarthritis under the arthroscopy include hyperplasia of synovial membrane, degeneration of cartilage or exposure of subchondral bone on the stress areas of the femur condyles and patella , wear and tear of meniscus, formation of osteophyte and loose body. The debridement included the removal of the loose body, hyperplasia of synovial membrane, degenerated cartilage, and the torn meniscus. Many factors,including age of the patients, selection of the indication, stress of the knee joint, and the degeneration of cartilage,may influence the curative effect. After selecfive debridement and lavage for osteoarthritis of the knee joint, the majority of patients were released from pain, with restoration of function and range of motion, and the development of pathological process was retarded. Good and excellent results constitute 74.7% of the patients.

Bi-polar,bi-pedicled separation delayed flaps were designed on the backs of New Zealand rabbits with the application of a medical silicon membrane as the separation material. Values of glucose and lactic acid, PtcO 2 were measured separately at proximal,middle and distal areas of the flaps after the distal pedice was cut at 0,1,4,7,14,21 days,respectively, after the formation of flaps. After flap delaying,PtcO 2 in separated flap was always lower than that of the mormal control,accompanied with glucose decrease and lactic acid increase, although there were significant differences in different areas of the flap. The survived area of the flap increased after 7 days. Furthermore,all the length of the flap survived after 21 days,although the level of glucose in the flap was still lower and lactic acid was still higher.The results suggested that by separation and delaying the flap may adapt gradually to hypoxia via lowered metabolism.For flap survival,the threshold value of glucose in flap is 0 01mmol/L , lactic acid is 0 47mmol/L,and PtcO 2 is 3mmHg .

Relation between change of capillary pressure, survival length in bi pedicled separation delay flap was observed. Bi polar, bi pedicled separation delay flaps were designed on the backs of New Zealand rabbits. Medical silicon membrane was used as separative material. Values of capillary pressure were measured at proximal, middle and distal points. Survival length increased with delayed time, capillary pressure at middle was lower in the bi pedicled separation delay flap. It is concluded that capillary pressure is increased greatly by separation delay, and there is a linear relation between capillary pressure and survival length of flaps.

Objective To investigate a new method for reconstruction of posterior cruciate ligament(PCL)using hamstrings tendons knot and bone lock-bolt under arthroscopy.Methods Ten cases of PCL lesion were treated arthroscopically. Hamstrings were harvested with a stripper following standard procedure. The hamstring tendons tied a knot at the inter-media part of the tendons and insert a bone lock-bolt on the knot. The tunnel of femur and tibia were prepared. Tunnel diameter of the tibia and the infra 1/3 of femur was 5-7mm and the superior 2/3 of the femur side was 11-12mm,Pulling in the tendon from the lateral side of femur tunnel to the tibia.A hole of 4 5mm was drilled 1cm distal of tibia tunnel exit. Create a bone bridge using curved clamps,passing a tendon under the bone bridge and tying the tendon over the bone bridge in extension.Results All the patients were follow-up.Function and stability of knee during walking and activities improved apparently. All patients were evaluated with the knee functional scales.Patients were clinically rated as excellent in 6,good in 3,and fair in 1. There were no poor results.Conclusion The result of using semitendinosus and gracilis tendons tied a knot and implant a bone lock-bolt to reconstruct PCL is satisfactory. The advantages of the technique included well biological match, exemption from costly materials, promotion of healing of tendons and bone tunnel, decrease in medical cost.

Objective To study the effect of arthroscopic plasty of discoid meniscus with local anaesthesia and radiofrequency. Methods From Aug. 2000 to Aug.2002, arthroscopic plasty of discoid lateral meniscus with local anaesthesia and radiofrequency was performed on twenty-six joints in twenty-three patients including 12 male and 11 female, their average age was 25 years(13～14 yrs). The procedure of discoid meniscus reshaping in 23 cases was to produce the similar appearance to the normal lateral meniscus. Unstable leaf of the horizontally torn meniscus was removed, while the stable one was preserved. In 6 cases,the tear of edge rim was not only reshaped but also insider-out sutured. Results 21 cases were followed-up for average 11 months (from 5 months to 2 5 years).There was no pain snap and lock, the joint function is normal in 21 cases and 23 knees. Based on Ikeuch knee functional scales,16 cases were rated as excellent, 3 good and 2 fair. Conclusion Arthroscopic radiofrequency meniscus plasty is of importance in avoiding total meniscectomy. The procedures were safety and less traumatic.