Objective:To analyze the clinical efficacy of arthroscopic transverse release of the iliotibial band through peritrochanteric space for the treatment of external snapping hip.Methods:A total of 30 patients (12 males and 18 females) with bilateral external snapping hip underwent arthroscopic transverse release of the iliotibial band through peritrochanteric space in Department of Sports Medicine, Senior Department of Orthopaedics, the Fourth Medical Center, Chinese PLA General Hospital were retrospectively analyzed from May 2021 and June 2022. The average age was 32.5±8.2 years (range, 17-51 years). At the same time, 30 patients who underwent arthroscopic external release of the iliotibial band through the external surface of the iliotibial band (external iliotibial band group) were selected as control group, including 13 males and 17 females, aged 29.5±6.8 years (range, 11-45 years). The visual analogue scale (VAS), modified Harris hip score (mHHS), and gluteal muscle contracture disability scale (GDS) were compared between the two groups at preoperative, 6 months postoperative, and final follow-up.Results:All patients successfully completed the operation and were followed up for 17.5±3.3 months (range, 12-25 months). The VAS scores of the two groups at the last follow-up were lower than those before operation ( P<0.05). The mHHS scores before operation, 6 months after operation and at the last follow-up in the peritrochanteric space group were 76.5 (67.0, 85.5), 98.5 (94.8, 100.0) and 100.0 (97.0, 100.0), respectively, and those in the external iliotibial band group were 80.5 (70.0, 86.0), 100.0 (96.0, 100.0) and 100.0 (99.5, 100.0). The differences in mHHS scores between the two groups were statistically significant for intragroup comparisons ( P<0.05); of these, 6 months postoperatively and at the last follow-up were greater than preoperatively, with statistically significant differences ( P<0.05); the differences at 6 months postoperatively and at the last follow-up were not statistically significant ( P>0.05). There was no significant difference in mHHS scores between groups at different time points ( P>0.05). The GDS before operation, at 6 months after operation and at the last follow-up were 47.0 (35.8, 64.5), 90.0 (81.0, 94.0) and 93.5 (89.8, 98.0) in the peritrochanteric space group, and 51.0 (38.0, 64.5), 50.0 (81.0, 94.0) and 93.5 (89.8, 98.0) in the external iliotibial band group, respectively. The differences in GDS between the two groups were statistically significant for intragroup comparisons ( P< 0.05); of these, 6 months postoperatively and at the last follow-up were greater than preoperatively, with statistically significant differences ( P<0.05); the differences at 6 months postoperatively and at the last follow-up were not statistically significant ( P>0.05). There was no significant difference in GDS between groups at different time points ( P>0.05). Conclusion:Arthroscopic transverse release of the iliotibial band through peritrochanteric space for the treatment of external snapping hip can effectively reduce hip pain and improve hip function, with satisfactory clinical results, and can be used as an alternative treatment to transverse release through the external surface of the iliotibial band.

Objective:To explore the effects of electroacupuncture combined with hyperbaric oxygen (HBO) therapy for the improvement of the neural function and cognitive ability in patients with hypertensive cerebral hemorrhage.Methods:A total of 180 patients with hypertensive cerebral hemorrhage admitted in Department of Neurology of the Sinopharm-Gezhouba Central Hospital of China Three Gorges University from the January of 2016 to the June of 2019 were selected and randomly divided into hyperbaric oxygen group (HBO group) ( n=60), electric acupuncture group (EA group) ( n=60), and EA combined HBO treatment group (EA+ HBO group) ( n=60) by random number table method. The clinical curative effect and the improvements of cerebral edema, neural function, and cognitive ability were compared in the three groups before and after treatment. Results:After 2 and 4 courses of the treatment, the absolute cerebral edema volume and relative cerebral edema volume of the patients were gradually decreased, and the absolute volumes in the EA+ HBO group were significantly decreased compared with those in the HBO group and the EA group with statistically significant differences ( P<0.05). After 4 courses of the treatment, the total effective rate of the EA+ HBO group was 91.67%, which was significantly higher than those of the HBO group (81.67%) and the EA group (76.67%) with statistically significant differences ( P<0.05). The serum neuron-specific enolase (NSE) and S100β levels of the three groups were significantly lower than those before the treatments, and the levels in the EA+ HBO group were lower than those in other two groups. The differences were statistically significant ( P<0.05). After treatment, the mini-mental state examination (MMSE) score and Barthel index score of the patients were significantly increased ( P<0.05), and the improvement of MMSE score in the EA+ HBO group was significantly better than those in the HBO group and the EA group with statistically significant differences ( P<0.05). Conclusion:Electroacupuncture combined with HBO can effectively reduce cerebral edema, repair cerebral nerve damage, and improve patients′ cognitive function through electrical stimulation and abatement of ischemia and hypoxia.

Objective:To explore the effects of electroacupuncture combined with hyperbaric oxygen (HBO) therapy for the improvement of the neural function and cognitive ability in patients with hypertensive cerebral hemorrhage.Methods:A total of 180 patients with hypertensive cerebral hemorrhage admitted in Department of Neurology of the Sinopharm-Gezhouba Central Hospital of China Three Gorges University from the January of 2016 to the June of 2019 were selected and randomly divided into hyperbaric oxygen group (HBO group) ( n=60), electric acupuncture group (EA group) ( n=60), and EA combined HBO treatment group (EA+ HBO group) ( n=60) by random number table method. The clinical curative effect and the improvements of cerebral edema, neural function, and cognitive ability were compared in the three groups before and after treatment. Results:After 2 and 4 courses of the treatment, the absolute cerebral edema volume and relative cerebral edema volume of the patients were gradually decreased, and the absolute volumes in the EA+ HBO group were significantly decreased compared with those in the HBO group and the EA group with statistically significant differences ( P<0.05). After 4 courses of the treatment, the total effective rate of the EA+ HBO group was 91.67%, which was significantly higher than those of the HBO group (81.67%) and the EA group (76.67%) with statistically significant differences ( P<0.05). The serum neuron-specific enolase (NSE) and S100β levels of the three groups were significantly lower than those before the treatments, and the levels in the EA+ HBO group were lower than those in other two groups. The differences were statistically significant ( P<0.05). After treatment, the mini-mental state examination (MMSE) score and Barthel index score of the patients were significantly increased ( P<0.05), and the improvement of MMSE score in the EA+ HBO group was significantly better than those in the HBO group and the EA group with statistically significant differences ( P<0.05). Conclusion:Electroacupuncture combined with HBO can effectively reduce cerebral edema, repair cerebral nerve damage, and improve patients′ cognitive function through electrical stimulation and abatement of ischemia and hypoxia.

OBJECTIVE: To investigate the protective effect of DSM17938 strain against oxidative stress in a neonatal mouse model of necrotizing enterocolitis (NEC) and explore the possible mechanism. METHODS: Ninety-six 10-day-old neonatal C57BL/6J mice were equally randomized into control group, NEC group, and NEC+ group. The pathological changes of the ileocecal intestinal tissue were evaluated with HE staining and double-blind pathological scoring. The mRNA and protein expressions of tumor necrosis factor-α (TNF-α) and interleukin-1β (IL-1β) in the intestinal tissues were detected using quantitative real-time PCR and ELISA, respectively. Colorimetric assays were used to determine the activity of superoxide dismutase (SOD) and its inhibition rate, malondialdehyde (MDA), glutathione (GSH), oxidized glutathione (GSSG), and GSSG/ GSH ratio. RESULTS: Compared with those in the control group, the neonatal mice in NEC group showed significant weight loss ( < 0.05), obvious intestinal injury, increased pathological scores ( < 0.05), increased expressions of TNF-α and IL-1β mRNA and proteins ( < 0.05), decreased SOD activity and inhibition rate, decreased GSH, and significantly increased MDA, GSSG, and GSSG/GSH ratios ( < 0.05). Treatment with obviously decreased the pathological scores, expressions of TNF-α and IL-1β ( < 0.05), MDA, GSSG, and GSSG/GSH ratio ( < 0.05), and significantly increased SOD activity, its inhibition rate, and GSH level in the mice with NEC, but the survival rate was not significantly different between NEC and -treated groups ( > 0.05). CONCLUSIONS DSM17938 can offer protection against NEC in mice by reducing oxidative stress and increasing antioxidant capacity of the intestinal tissue to suppress intestinal inflammations.

Objective To study the clinical characteristics of immune tolerance after liver transplantation in children and to identify possible predictors.Methods The clinical data of 37 pediatric patients who underwent liver transplantation between April 2006 and April 2014 at the Children's Hospital of Chongqing Medical University were retrospectively analyzed.The patients were divided into the no-drug (n =4),single-drug (n =16) and multi-drug (n =17) groups according to the status of their current immunosuppressant medications.The possible predictive factors were screened based on their clinical data,and statistical analysis was performed.Results The 37 liver transplantation recipients included 16 males (43.2％) and 21 females (56.8％).The factors that differed among the groups included age at transplantation and the levels of alanine aminotransferase (ALT) and aspartate aminotransferase (AST) of the transplant recipients.Age,ALT level,and AST level of the transplant recipients were significantly different between the single-drug group and the multi-drug group (all P ＜ 0.05).However,only the ALT Ievel was significantly different (P ＜ 0.05) between the no-drug group and the multi-drug group.No significant differences were found in the various other factors between the no-drug and single-drug groups.Conclusion The age of the recipient at transplantation was a predictive factor affecting clinical immune tolerance in pediatric liver transplantation,while ALT and AST levels were potential predictors of postoperative immune tolerance.

Objective To summarize the clinical experience of successful liver transplantation from infant donation after cardiac death (DCD) for infant with biliary astresia (BA).Methods The donor was a 16-months-old girl with a body weight of 10 kg,who died of irreversible anoxic cerebral damage after sudden asphyxiation.The recipient was a 24-months-old girl with a body weight of 12 kg,who suffered from icteric concurrent late biliary cirrhosis after the Porta-jejunum anastomosis because of congenital BA.The DCD liver was classically orthotopically transplanted into the infants recipient.The warm ischemia time was 7 min,the cold ischemia time was 360 min,and the graft volume to the standard liver volume (GV/SLV) was 1.02.After operation,the vital signs and transplanted liver function of the recipient were monitored,and the recipient was given treatments of anti-infection,anticoagulation,and improving the microcirculation.The recipient was treated with the triple immunosuppression protocol of tacrolimus,mycophenolate and prednisone to prevent rejection.Results The operating time of the recipient was 480 min,the non-liver stage was 65 min,and the blood loss was 230 mL.The endotracheal intubation was removed from the recipient at 12 h,and the recipient started to eat at 48 h aftcr operation.The recipient had a hepatic artery thrombus on the 3rd and 15th day after operation,and the hepatic artery had re-blood-supply after the hepatic artery catheterization and continuous perfusion with urokinase.The recipient was discharged on the 42nd day,and the recipient was in satisfactory condition to present.Conclusion The infant DCD liver is a better graft for infant liver transplantation for BA.The surgical complications can be reduced with matched volume of donor-recipient liver; and it can guarantee a successful operation with perfect operative technique and careful perioperative management.

Objective To investigate the cause of jejunum perforation after infantile livingrelated liver transplantation (ILRLT) and summarize the experience of treatment. Methods The clinical data of 28 infants with biliary atresia who underwent ILRLT were analyzed and 4 of 28 infantile recipients (14. 3%) developed jejunum perforation after ILDLT. Results Four patients had 7 episodes of jejunum perforation after transplantation among 28 infantile recipients who underwent ILRLT because of biliary atresia. The median time between transplantation and perforation was 11 days.Perforation occurred at the point of silk in jejunum stoma (n = 3) and the Roux-en-Y limb (n = 1 ).None had a history of prior operation including Kasai in 4 patients. Clinical manifestation included fever, increased heart rate, abdominal distention, leukocytosis, and no free air on abdominal roentgenograrns. A simple repair was performed in three infants with silk: two developed recurrent perforation (67%) and underwent a re-exploration,and another had a third perforation and underwent a third repair because of re-perforation. Another child underwent a simple repair with prolene, and there was no recurrence. None died from the perforation in our study. Conclusion The occurrence and location of jejunum perforation after ILDLT suggests that the cause of the perforation is related to the jejunal anastomosis with silk, and the jejunum perforation may be avoided in the jejunal anastomosis with prolene. Early diagnosis and exploration may ensure better survival.

Objective To summarize the clinical experience of segmental living related liver transplantation for very small infant with biliary atresia. Methods The recipient was a 145-day-old male with congenital biliary atresia. The infant was 66 cm in height and weighed 3.08 kg. The donor was his 36-year-old mother. Her segment Ⅱ of the liver was excised and orthotopically transplanted into the infant's body as the graft. The portal vein of the graft was end-to-end anastomosed to the portal vein of the recipient, the hepatic artery of the graft was end-to-end anastomosed to the proper hepatic artery of the recipient with lateral superficial vein of left great saphenous vein from donor as a bridge, and the hepatic vein was end-to-end anastomosed to the hepatic vein of the recipient whose hepatic vein was conformed from right, middle and left hepatic vein. Biliary tract was reconstructed via Roux-en-Y operation. Results Segment Ⅱ (160 g) of liver from donor was resected, and there was no blood infusion. The donor retained her liver function within 5 days and was discharged on the eighth day. The operating time of graft implantation was 451 min. The blood loss was 250 ml. Non-liver stage was 71 min. The cold ischemic time was 132 min. Cyclosporine, mycophenolate mofetil (MMF) and prednisone were used for postoperative immunosuppression. The bilirubin level of the infant was decreased to the normal level one week after operation, and the liver function became normal in 9 days. Jejuno-leakage on the 7th day after the transplantation was recovered by mend and drainage and discharged on the 35th day. The donor and recipient were in satisfactory condition to present. Conclusion The segmental living related liver transplantation is advisable for very small infant with biliary atresia. Perfect operative technique and postoperative intensive care are the keys to ensure the success of the procedure.

Objective To investigate the expressions of transforming growth factor-?1(TGF-?1)and ?-smooth muscle actin(?-SMA)in the lungs of mice with intra-amniotic endotoxin priming and exposed to 60% hyperoxia after born in order to elucidate the possible relationship with bronchopulmonary dysplasia(BPD).MethodsFifty C57 pregnant mice were divided into 2 groups:lipopolysaccharide(LPS,40 ?g/L)group and saline solution group,and then received an intra-amniotic injection of corresponding solution on E15.The neonatal mice of each group were randomized to be set in 60% oxygen exposure or in room air.So there were 4 subgroups,LPS+air,LPS+hyperoxia,saline+air and saline+hyperoxia groups.On days 1,3,7,10 and 14 after birth(8 rats each time point),the lung histological changes was assessed with hematoxylin and eosin(HE)staining for radial alveolar counting(RAC).The expressions of TGF-?1 and ?-SMA proteins were detected by immunohistochemical and immunofluorescence staining,and the expressions of TGF-?1 and ?-SMA mRNA by real-time polymerase chain reaction(RT-PCR).ResultsIn the LPS+hyperoxia group and saline+hyperoxia group,RAC began to decrease on day 3,and then further declined in a time-dependent manner.Compared with saline+hyperoxia group,LPS+hyperoxia group had significantly lower RAC(P

Objective:The study was to improve the protection of the bone marrow during the chemotherapy of late hepatocarcinoma balb/c mice and increase its survival rate. Methods:Cultivated H22 hepatocarcinoma cell was injected into the balb/c mouse to make the animal model. MDR1 gene was transferred into the hematopoietic cells of murine bone marrow by the mediation of retrovirus vecter and transplanted into the balb/c mouse with hepatocarcinoma exposure with 60 Co-? ray in advance.WBC were investigated 3 days after high-dose chemotherapy. The function and the expression of MDR1 gene were detected by PCR method and IC method in vitro and in vivo. Results:WBC of the different dose experiment group was higher than that of the control group obviously ( P 0.05) ,but in the second week WBC counting of the 0.8mg/kg group was lower than that of the other two groups( P