Radiological study on the cup abduction angle during total hip arthroplasty / 中国骨伤

OBJECTIVE@#To analyze the relationship among the parameters by measuring the relevant parameters of the anteroposterior X-ray of both hips in patients after total hip arthroplasty, to discuss the reliable anatomical markers and reference standards of acetabulum placement in total hip arthroplasty, and finally to accurately control the abduction angle of acetabulum.@*METHODS@#From January 2016 to June 2017, 282 patients (235 hips) underwent total hip arthroplasty and 128 patients(157 hips) met the inclusion criteria. There were 91 males and 37 females, 82 cases of the left hip and 75 cases of the right hip; ranging in age from 22 to 78 years old, with a mean of 55.1 years old. The abduction angle(β), ilium thickness (a), acetabular cup insertion depth (b), ischial thickness (c), acetabular cup insertion depth(d), acetabular abrasion and contusion depth(e) were measured on the postoperative AP X-ray of both hips, and the data were compared.@*RESULTS@#There was a positive correlation between β and b (=0.424, =0.000), a negative correlation between β and d (=-0.407, =0.000), a positive correlation between β and b/a (=0.419, =0.000), a negative correlation between β and d/c (=-0.472, =0.000). There was a linear relationship between β and b/a (5.753, =0.000) and a linear relationship between β and d/c (-6.671, =0.000).@*CONCLUSIONS@#The outreach angle is mainly controlled by the distance between the outer edge of the cup and the outer edge of the cup in the inferior portion(d) during the operation. The distance b from the outer edge of the cup can be used as a reference.

Massive Lower Gastrointestinal Bleeding from the Appendix

Massive rectal bleeding from the appendix, considered a rare case of lower gastrointestinal bleeding, is not easily recognized by various diagnostic modalities. A multidisciplinary approach for both a diagnosis and a differential diagnosis is important because the identification of the bleeding site is crucial to proceed to a proper intervention and there are various causes of appendiceal bleeding. Because early colonoscopy plays an important role in the diagnosis and management of lower gastrointestinal hemorrhage, we report a case of a life threatening massive rectal bleeding from the appendix diagnosed by colonoscopy. We also present a review of the literature.

Effects of experimental liver injury on the intestinal barrier in rats / 中华肝脏病杂志

<p><b>OBJECTIVE</b>To study the effects of experimental liver injury on the intestinal barrier, and to evaluate the significance of plasma D(-)-lactate, diamine oxidase (DAO) and endotoxin in live injury.</p><p><b>METHODS</b>Fifty-five rats were randomized into the acute liver failure group (group C, n = 25), acute liver injury group (group B, n = 15), and control group (group A, n = 15). The concentrations of D(-)-lactate, DAO and endotoxin in plasma were detected by spectrophotograph. The morphology and subcellular structure were observed under optical microscope and transmission electron microscope.</p><p><b>RESULTS</b>Acute liver failure and acute liver injury models were established successfully. The concentrations of D(-)-lactate and DAO in the plasma of experimental groups (group B and C) were significantly higher than those in the control group (P less than 0.05); the concentration of intestinal DAO in experimental groups were significantly lower than that in the control group (P less than 0.05); the level of endotoxin in C group was significantly higher than that in group A and group B (P less than 0.05).</p><p><b>CONCLUSION</b>Liver injury induces hyperpermeability of the rat intestinal mucosal barrier, plasma D(-)-lactate and DAO are sensitive markers for early diagnosis of liver injury, plasma endotoxin may accelerate deterioration of liver function.</p>

Liver histopathology, clinical features and prognostic factors of primary biliary cirrhosis: an analysis of 60 cases / 中华肝脏病杂志

<p><b>OBJECTIVE</b>Clinical and liver pathological features of 60 primary biliary cirrhosis (PBC) patients were reviewed to identify prognostic factors in order to improve the diagnosis and treatment of the disease.</p><p><b>METHODS</b>The general conditions, clinical manifestations, serum biochemical and immunological changes, and liver pathological findings were assessed in 60 PBC patients. All cases were followed up and 5 variables were studied by univariate analysis; the variables linked with survival were included in a Cox model.</p><p><b>RESULTS</b>Forty-eight patients were females (80%), 12 were males (20%), and the mean age at their diagnoses was (52.5+/-9.4). The symptoms most frequently complained about were jaundice (61.6%), fatigue (51.6%), anorexia (43.3%) and pruritus (25%). Serum alkaline phosphatase (ALP) and glutamyl transpeptidase (GGT) levels were markedly elevated in the majority of the patients [(242.3+/-137.1) U/L and (250.6+/-216.1) U/L, respectively], whereas ALT and AST levels were mildly to moderately elevated [(185.8+/-269.1) U/L and (172.5+/-163.6) U/L, respectively]. Thirty-two patients (53.3%) had a total bilirubin level of > or = 34.2 micromol/L. Twenty-eight patients (59.5%) had elevated serum IgM and 41 patients (68.3%) were anti-mitochondrial antibody AMA/AMA-M2 positive. Forty-two of the 60 patients had liver biopsies. The liver pathological changes: 33.3% of the cases were in I or II stage and 66.6% in III or IV stage. The follow up results: Five patients died of liver failure or massive upper gastrointestinal bleeding; 45 were still alive; the average survival period was 3.92 years; 10 patients were lost in the follow-up. With multivariate analysis (Cox model), age, level of total bilirubin and the stage of the liver pathological changes were found to be independent factors linked to the survival of the patients.</p><p><b>CONCLUSION</b>PBC may not be a rare liver disease in China. The awareness to recognize PBC is important in making an early diagnosis and treatment.</p>