Objectives To evaluate plain radiographs and computed tomography (CT) scans in respect of assessment of articular fragment displacements (step and gap) in displaced acetabular fractures. Methods A retrospective evaluation was done to analyze the CT scans and plain radiographs of 64 patients who had been treated for displaced acetabular fractures in our hospital from January 1998 to May 2003. Of them, 20 met the inclusion criteria. In a blind method, 3 independent reviewers measured step and gap deformities on plain radiographs and CT scans utilizing a standardized measurement technique. The sensitivity and specificity of plain radiographs in detecting step and gap displacements (2 mm and 4 mm) in comparison of those of CT scans were determined. Moreover, intraclass correlation coefficient and intraobserver reliability were also calculated. Results Compared with CT, plain radiographs showed poor sensitivity in detecting step deformity (sensitivity = 44.3%). As far as fracture type was concerned, plain radiographs were particularly poor at detecting step deformity in fractures involving a single column of the acetabulum (sensitivity = 0%). Excellent intraobserver and intraclass reliability existed among the 3 reviewers. Conclusions Compared with CT scans, plain radiographs are poorly sensitive in detection of step and gap deformities in patients with acetabular fractures, and particularly poor at detecting step deformities. Therefore, in treatment of displaced acetabular fractures, CT scans are essential and should not only be used together with plain radiographs in the preoperative evaluation but also be considered in the postoperative assessment of fracture reduction and predicting future outcomes.

2 weeks ) were screened by BAEP. Results Hearing-ability of 11 children(11/23,47.8%) was abnormal,one month later hearing-ability of 2 children was abnormal, and there months later hearing-ability of only 1 child was abnormal. Conclusion Hyperbilirubinemia may cause hearing-ability damage in neonates and BAEP is one of effective audiometric means.

With the method of bibliometric analysis, we analyzed the scientific papers on health pol-icy research embodied by CBMdisc from 1978 to 2007. It was found that the status quo of studies on health policy research in China developed rapidly. And the core journals has preliminarily formed , there were a number of highly productivity authors, besides the Ministry of Health and universities were the main units of output of health policy research papers although core authors not yet appeared.

OBJECTIVE To find out about the transverse section use rate of antimicrobials in our hospital. METHODS A transverse section survey was made from midnight on June 24,2004 to midnight on June 25,2004 within all the inpatients. RESULTS Among 1132 inpatients,the transverse section use rate of antimicrobials was 58.83%,the combined medication ratio being 34.08%.Of all antimicrobial takers 65.92% were given single drug,31.68% double,and 2.40% were given triple.Among all departments of the hospital,the universal ICU had the highest use rate which was 100.00%,next to which were those in the departments of nephrology and gynecology,being respectively 90.00% and 87.23%.The antimicrobial use rate in surgical department(69.68%) was remarkably higher than that in medical department(43.08%).The departments of ophthalmology and otorhinolaryngology had the highest prophylactic use rate which was 83.64%.Rate of etiological examination for therapeutic medication in the whole hospital was 35.97%. CONCLUSIONS The transverse section use rate of antimicrobial in our hospital is slightly higher than the national average use rate.The constituent ratio of prophylactic medication is on the high side and the rate of etiological examination for therapeutic medication is on the low side.Management should be further strengthened for rational use of antimicrobials.

Starting from the clinical practice,this paper considers the common used syndrome typing in current of zang-fu differentiation are basic syndromes. It is too general,weak in pertinency and inconvenient for the clinical application. Therefore,we provide the new assumption about the detailed typing of zang-fu differentiation,and expatiate its concept,principle,basis and significance. Through these,TCM syndrome differentiation system can be expanded in some sense. The paper also provides a new way for building an objective and standard TCM system.

ObjectiveTo investigate the efficacy of laparoscopic spleen-preserving hilar lymph nodes dissection based on splenic hilar vascular anatomy.MethodsFrom July 2010 to March 2011,the clinical data of 39 patients with advanced proximal gastric cancer who underwent laparoscopic spleen-preserving hilar lymph nodes dissection at the Union Hospital of Fujian Medical University were retrospectively analyzed.Different types of vascular anatomy were analyzed,and different methods of lymph node dissection in the splenic hilus were adopted accordingly.ResultsThe operation was successfully performed on all the patients,with no conversion to open surgery or splenectomy due to splenic vascular or parenchyma injury.There were 4 types of splenic artery running,including type Ⅰ (25 patients),type Ⅱ (8 patients),type Ⅲ (4 patients) and type Ⅳ (2 patients).There were 2 types of the end branches of splenic artery,including concentrated type (28 patients) and dispersion type (11 patients).The splenic lobial vessels of all the patients were anatomically classified and divided into 4 types,including a single branch of splenic lobial vessels in 3 patients,2 branches in 24 patients,3 branches in 11 patients and multibranches in 1 patient.The mean number of short gastric vessels was 3.2 ± 1.4 (range,2-6).The time for dissection of the lymph nodes in the splenic hilum,number of lymph nodes dissected in the splenic hilum,volume of operative blood loss,duration of hospital stay and incidence of complications were ( 30 ±7)minutes,2.8 ±2.1,(20 ±7)ml (range,0-55 ml),(10 ± 1) days and 10％ (4/39).All patients were followed up until March,2012. One patient had hepatic metastasis,and no patient died postoperatively.ConclusionFamiliar with the variation of splenic hllar vascular anatomy is helpful in mastering and promoting laparoscopic spleen-preserving hilar lymph nodes dissection.

Objective To explore the efficacy and feasibility of laparoscopy-assisted radical total gastrectomy in the treatment of cancer of the cardia and fundus. Methods The clinical data of 176 patients with cancer of the cardia and fundus who received total gastrectomy at the Union Hospital of Fujian Medical University from April 2007 to April 2009 were retrospectively analysed. Among the patients, 81 received laparoscopic total gastrectomy ( LATG group) and 95 received open total gastrectomy ( OTG group). The patients' intra- and postoperative conditions, clearance of lymph nodes, morbidity and mortality were analysed using the chi-square test and t test. Results All the operations were successfully carried out. The intraoperative blood loss was (98 ± 84) ml in the LATG group and (339±245) ml in the OTG group. Three patients in the LATG group and 19 in the OTG group received blood transfusion. The time to first flatus and postoperative hospital stay were (3.9 ± 1.1) days and (13 ± 5) days in the LATG group, and (5.0 ± 1.6) days and (15 ± 5) days in the OTG group, respectively.There were significant differences in the time to first flatus and postoperative hospital stay between the LATG group and OTG group (t = 4.16, x2 = 6.82, t = 4. 57, 2. 83, P ＜ 0. 05). The mean number of lymph nodes dissected was 28 ± 12 in the LATG group and 29 ± 11 in the OTG group, with no significant differences between the two groups (t = 0. 42, P ＞0.05). The number of lymph nodes dissected in patients with T1, T2 and T3 stages were 21 ±8, 25 ±7 and 29 ± 11 in the LATG group, and 29 ± 12, 31 ±9 and 28 ± 11 in the OTG group, respectively,with no significant differences between the two groups (t = 1.53, 1.90, 0. 65, P ＞ 0.05). The morbidity and mortality rates of the LATG group were 11%( 9/81 ) and 0, and 19% ( 18/95 ) and 1% ( 1/95 ) in the OTG group, with no significant differences between the two groups (x2 = 2.07, 1.18, P ＞ 0.05). Conclusion The efficacy of laparoscopy-assisted radical total gastrectomy is similar to that of open gastrectomy. Laparoscopy-assisted radical total gastrectomy is a safe and feasible procedure that leads to quick postoperative recovery.

Objective To explore the surgical treatment of Crohn's disease(CD).Methods Clinical data of 11 patients with Crohn's disease undergoing surgery were retrospectively analyzed.Results 9 cases were diagnosed before operation,with symptoms including abdomen pain,diarrhea or constipation,weight loss,and segmental lesions.Abdominal mass was the most common cause,accounting for 54.5%(6/11)in surgery,and intestinal obstruction was secondary.accounting for 36.4%(4/11),and perianal abscess,9.1%(1/11).Partial enterectomy and anastomosis was the main procedure.3 cases were suspected malignance and underging radical cure.The pathology results showed there was moderate atypical hyperplasia in 2 of 3.Most of the patients had a good recovery and their nutritional conditions were improved obviously(P＜0.05).Conclusion Abdominal mass and intestinal obstruction are the main causes of surgical management in patients with Crohn's disease.The possibility of cancerization is higher in patients with longer medical history.The length of intestine reseeted would be enough with visitable lesions resected,and the operative effects are as good as those underwent radical cure.

Objective To investigate Fascin expression in human lung cancer tissues and its clinical significance.Methods Immunohistochemistry was performed in 62 patients with different histological types and clinical stages of lung cancer and 92 cases with other malignant tumors.Fascin positive rate in each group was calculated and the differences of pathological characters between the two groups were analyzed.Results Fascin expression in lung cancer tissues was significantly higher than that in normal lung tissues(P ＜ 0.05),its expression varied by different clinical stage of lung cancer tissue differentiation.As differentiation degree decreased,Fascin positive rate increased.Fascin expression was independent with age,sex,smoking history(P ＞ 0.05).Fascin expression had no significant difference between lung cancer group and other tumor group(P ＞ 0.05).Conclusions Fascin expression raising might be common in malignant tumors.Fascin expression in lung tissues indicated the possibility of lung cancer.In lung tissue,high expression of Fasein was a sign of poor differentiation and malignant status of lung cancer.

Objective To investigate the impact of preoperative comorbidities on the abdominal complications after laparoscope-assisted total gastrectomy (LATG) for gastric cancer.Methods The retrospective casecontrol study was conducted.The clinical data of 1 657 gastric cancer patients who underwent LATG at the Fujian Medical University Union Hospital between January 2008 and December 2015 were collected.There were 175 patients with postoperative abdominal complications,including 78 without preoperative comorbidities and 97 with preoperative comorbidities (52 with 1 comorbidity,30 with 2 comorbidities and 15 with more than 3 comorbidities).Analysis method and observation indicators:(1) risk factors analysis of abdominal complications after LATG;(2) risk assessment of abdominal complications after LATG:independent influencing factors of risk factors analysis were expressed as dependent variables,alignment diagram was built and then consistency index was calculated;(3) comparisons of abdominal complications among the patients with different kinds of comorbidities after LATG;(4) multivariate analysis of abdominal complications in patients with comorbidities after LATG;(5)follow-up situations.Follow-up using outpatient examination and telephone interview was performed to detect postoperative survival of patients up to May 2016.The univariate analysis and multivariate analysis were respectively done using the chi-square test and Logistic regression model.The survival rate was calculated by the Kaplan-Meier method.Results (1) Risk factors analysis of abdominal complications after LATG:results of univariate analysis showed that age,body mass index (BMI),number of preoperative comorbidities,operation time and estimated volume of intraoperative blood loss were related factors affecting abdominal complications of patients after LATG (X2 =4.487,16.602,10.361,4.567,7.482,P＜0.05).Results of multivariate analysis showed that BMI,number of preoperative comorbidities and estimated volume of intraoperative blood loss were independent factors affecting abdominal complications of patients after LATG [OR =1.966,1.204,1.423,95％confidence interval (CI):1.355-2.851,1.014-1.431,1.013-1.999,P＜0.05].(2) Risk assessment of abdominal complications after LATG:BMI,number of preoperative comorbidities and estimated volume of intraoperative blood loss were expressed as dependent variables,and the alignment diagram on risk prediction of abdominal complications after LATG was built,with a consistency index of 0.703.(3) Comparisons of abdominal complications among the patients with different kinds of comorbidities after LATG:numbers of patients without comorbidity,with 1 comorbidity,2 comorbidities and ≥3 comorbidities were detected in 21,8,13,3 patients with intra-abdominal infection and 13,10,9,5 patients with anastomotic leakage and 6,3,6,2 patients with intra-abdominal bleeding,respectively,with statistically significant differences (X2 =10.677,10.436,9.245,P＜0.05).(4) Multivariate analysis of abdominal complications in patients with comorbidities after LATG:BMI ≥25 kg/m2 and estimated volume of intraoperative blood loss ＞ 82 mL were independent risk factors affecting abdominal complications of patients with preoperative comorbidities after LATG (OR =2.104,1.771,95％ CI:1.307-3.387,1.146-2.738,P＜0.05).(5) Follow-up situations:of 1 657 patients,1 568 were followed up for 4-99 months,with a median time of 47 months.Ninety-seven patients with preoperative comorbidities undergoing LATG had postoperative abdominal complications and were followed up.During follow-up,5-year survival rate of patients was 58.1％,and 5-year survival rate of 97 patients with preoperative comorbidities undergoing LATG and with postoperative abdominal complications was 57.4％.Conclusion Preoperative comorbidities are independent factors affecting abdominal complications of patients after LATG.