Objective To assess the interobserver reliability and intraobserver reproducibility of Neer classification system and its influencing factors.Methods The present study reviewed the series preoperative radiographs (including those of scapular anteroposterior view,scapular lateral view and modified Velpeau axillary view and an axial CT scan) of 40 patients who had been treated in our department from January 2010 to December 2010 for proximal humeral fractures.The radiographs were assessed by 12 individual observers on 2 separate occasions with an interval of 3 months at least Half of the observers (the professional group; n =6) had received a shoulder fellowship training and the other half (the control group; n =6) had not All the observers were asked to categorize the radiographs according to the Neer classification system of 16 types of fractures in a same process.The reliability and reproducibility of the system were assessed with the Kappa statistics.Comparisons of classification agreement were made between the professional group and the control group.We also evaluated the simplified Neer system of only 6 types of fractures with recombinant data.Results The interobserver reliability coefficients were 0.534 and 0.473 for the first and second assessments,with an intraobserver reproducibility coefficient of 0.669.The agreement level in the professional group was significantly higher than in the control group ( P ＜ 0.05).The interobserver reliability coefficients of the simplified Neer system were 0.581 and 0.502,with an intraobserver reproducibility coefficient of 0.680.Use of the modified Neer system did not elevate the agreement level beyond the moderate range.The classification was agreed on by all the observers in 17.5％ of the fractures during the first assessment and in 15.0％ during the second assessment.Conclusions Neer classification may have fair interobserver reliability and moderate intraobserver reproducibility.Experience of shoulder fellowship training is an important factor influencing the reliability of the Neer system.Simplification of the system may not help increase its reliability.

Objective To investigate the psychological state of high-risk pregnancy mothers af-ter being separated from their newborns and discuss the influencing factors of psychological state. Methods Nonexperimental descriptive study was used in this study. The investigation adopted state-trait anxiety inventory (STA-Ⅰ) and Edinburgh postnatal depression scale (EPDS). Results The moth-ers' anxiety score was significantly higher than normal women in China, and postnatal depression inci- dence rate was 57.9%. Mothers' psychological state was correlated with gestational age of new-borns, trait anxiety and pregnancy complications. Conclusions The psychological state of high- risk pregnancy mothers after being separated from their newborns should be paid more attention to, and cor-related nursing methods should be taken to improve their mental health.

Objective To observe the clinical effects of ximingting plan in treatment of osteoporesis result in hypofunction of ovary.Methods Sixty women with osteoporesis result in hypofunefion of ovary were divided into two groups by random digits table with 30 cases each.The investigated group received ximingting pian,the controlled group received hormone replacement therapy(HRT).The changes of bone density,bone gla protein(BGP),estradiol,follicle-stimulating hormone(FSH),the thickness of endometrium,blood routine,urine routine,liver function and kidney function before and after 6 months treatment were measured.Results Bone density and BGP after treatment wag higher than that before treatment in two (6.78±3.97)g/L;in controlled group:(0.617±0.065)g/cm2 vs.(0.552±0.073)g/cm2 and(8.92 4±4.43)g/L vs.(6.83±4.29)g/L](P<0.05).The levels of estradiol and FSH had no marked changes in investigated group(P>0.05);but not this in controlled group(P<0.01).The total effective rate of curative effect and presenting symptom was 93.3%(28/30),93.3%(28/30)in investigated group and 90.0%(27/30),86.7%(26/30)in controlled group,there was no significant difference between two groups(P>0.05).There was no significant difference in blood routine,urine routine,liver function and kidney function before and after treatment in two groups(P>0.05).Conclusion Ximingting pian is efficacious and safe in the treatment of osteoporosis result in hypofunction of ovary.

0.05). After experimental cerebral hemorrhage for 4 hours of model group, blood pressure and P O 2 were obvious increased( P 0.05), but they were lower than model group at the meantime ( P

Objective To investigate the clinical application of venturi oxygen therapy heated humidify system and closed endotracheal suctioning method for non-mechanical ventilation and tracheotomy patients with severe brain trauma.Methods The patients who met the experimental criterion were divided into the experimental group and the control group based on the admission date with 50 cases in each group.The experimental group was given venturi oxygen therapy heated humidify system and closed suction method,and the control group was treated with open endotracheal suctioning and continuous wet micro-injection pump method for artificial airway care.The humidification effect,sputum formation and the effect of oxygen therapy were compared between the two groups on the first day,third day and seventh day after the intervention.Results On the third and the seventh day,the humidifying effect and the effect of oxygen therapy in the experimental group were better than control group.The cases of sputum formation in the experimental group were less than the control group.They were statistically significant.Conclusions Combination of venturi oxygen therapy heated humidify system and closed endotracheal suctioning method can effectively reduce the sputum formation of non-mechanical ventilation and tracheotomy patients with severe brain trauma,it also can improve the effect of humidification and oxygen therapy,to improve ventilation,which is worthy of clinical promotion.

Objective To observe the effects of lysophosphatidic acid(LPA) on arrhythmia in acute myocardial infarction(AMI) rats.Methods AMI models were prepared by ligating the left coronary branch of rats.60 Wistar rats were divided into 5 groups:sham-operated(SO),AMI,AMI+LPA,AMI+pertussis toxin(PTX) and(AMI+)PTX+LPA.ECG were recorded,HR and VPBs were observed as important indexes.Results Incidence of tachycardia and VPBs of unit time in AMI group were increased compared with sham-operated group(P

Aim To investigate the effect of cisplatin(CDDP) on toxicity and apoptosis of human luteinized granulose cells.Method Human luteinized granulose cells were prepared from oocyte retrieval of fertilization procedure in vitro and treated with various concentrations of cisplatin(0,0.5,1.0,2.5,5.0 mg?L-1).The inhibitory rate of cells was examined by MTT assay.The change of nucleolus stained with Hochest 33258 was observed under fluorescent microscope,and bcl-2 and bax protein expressions were detected by flow cytometry(FCM).Results The results showed that CDDP inhibited the growth of ovarian granulose cells at the concentration of no less than 1 mg?L-1,in which Hochest 33258 staining demonstrated cell apoptosis.The expression of bax protein increased as compared with that of the control(P

Primary intraocular lymphoma (PIOL) is mostly composed by diffuse large B-cell lymphoma with a high degree of malignancy and often masquerades as uveitis.Moreover,it has a poor prognosis,therefore the early diagnosis and treatment are very important.Cytology,cytokine analysis,immunohistochemistry and genetic testing are often used in combination to improve the diagnosis rate of PIOL,however,eye tissue biopsy is the gold standard for diagnosis of PIOL.Currently,since there is no unified treatment program,the main treatment is given priority to local chemotherapy and orbital radiotherapy,and the use of multiple therapies can improve the efficacy of refractory PIOL.Base on these,this article reviews the current diagnosis and treatment for providing certain reference.

OBJECTIVE:To study the correlation between MTX concentration and hydration volume,alkalization volume,urine volume,body weight and biochemical indexes in Children with acute lymphoblastic leukemia(ALL).METHODS:The case histories of pediatric ALL patients hospitalized between 2003 and 2006 who were treated with MTX antitumor thrapy were reviewed retrospectively for a recording of MTX concentration,hydration volume,alkalization volume,urine volume,body weight and biochemical indexes etc.The data were analyzed with multiple linear regression method by SPSS(10.0)software.RESULTS:No significant correlation was noted between log MTX concentration and most of the biochemical indexes,hydration volume,alkalization volume and urine volume;however,log MTX concentration at 24 h was negatively correlated with body weight but positively correlated with TBIL(total bilirubin)(P

OBECTIVE:To establish a RP -HPLC method for the determination of plasma concentration of flurbiprofen. METHODS:By external standard method,the plasma sample after precipitation with acetonitrile was determined on Symmetry shield C_(18) chromatographic column with the mobile phase consisted of buffer phosphate(pH 7.0) - acetonitrile(75:25) at a flow rate of 1.0 mL?min~(-1).The detection wavelength was set at 247 nm.RESULTS:The linear range of flurbiprofen was 0.05～20?g?mL~(-1)(r=0.999 1) with the detection limit of flurbiprofen at 0.05?g?mL~(-1).The average recoveries at low,middle and high concentrations all ranged between 96.1%and 107.1%,and both the intra - day RSD and the inter-day RSD were less than 10%,meeting the standard required of the methodology.CONCLUSION:The method developed in this study was proved to be simple,accurate,rapid,and suitable for the monitoring of concentration and pharmacokinetic study of flurbiprofen.