Objective To investigate the therapy of DHS,PFNA and Intertan nail for the treatment in elderly patients with intertrochanteric femoral fractures.Methods One hundred and one elderly patients with intertrochanteric fractures were collected.Thirty-four cases of them were undertaken DHS (DHS group),33 cases for PFNA (PFNA group),and 34 cases for Intertan nail (INTERTAN group).Operative time,blood loss and complications were observed.Results The Operative time of patients in DHS,PFNA and Intertan groups were (85.1 ± 8.9) min,(63.1 ± 8.2) min,(57.9 ± 9.2) min respectively and the difference was significant (F=12.761,P＜0.001).The blood loss amount in DHS group were (350.1 ±80.2)ml,lower that those in PFNA and Intertan groups ((137.5 ± 35.4) ml and (125.2 ± 38.2) ml,F =20.462,P ＜ 0.001).Meanwhile,the postoperative drainage in DHS group was (125.3 ± 20.4) ml,significantly higher than PFNA group and INTERTAN group ((69.4 ± 9.2) ml and (74.6 ± 10.4) ml; F =15.871,P ＜0.001).Operative time,blood loss amount in INTERTAN group were less than that in PFNA group,but no significant difference (P ＞0.05).Nonunion in DHS group was significantly higher than the other two groups (8.82％ vs 0％ and 0％,x2 =6.092,P =0.047).Excellent rate in DHS group,PFNA group and Intertan group were 82.3％ (28/ 34),87.8％ (29/33),85.3％ (29/34) respectively,and there was no significant difference (x2 =0.591,P ＞ 0.05).Conclusion Compared with DHS,Intertan nail and PFNA have advantage of shorter operative time,stronger anti-rotation capability and less various postoperative complication rates,thus they are more suitable for elderly osteoporotic intertrochanteric fracture.

This paper is aimed to establish the method of fingerprint analysis of chemical constituents by reversed-phase ultra-performance liquid chromatography (UPLC) for the quality control of the roots and rhizomes of Panax ginseng (Ginseng Radix et Rhizoma). The method was performed on a ACQUITY UPLC BEH C18 (50 mm x 2.1 mm ID, 1.7 microm) with a mixed mobile phase of water and acetonitrile in a gradient mode. The flow rate was 0.3 mL x min(-1) and the wavelength of measurement was 203 nm. Eleven batches of the Ginseng Radix et Rhizoma were determined. The UPLC chromatographic fingerprints of chemical constituents were established from the eleven batches of the Ginseng Radix et Rhizoma and showed fifteen characteristic common peaks, among which fifteen peaks were recognized and nine compounds (ginsenosides Rg1, Re, Rf, Rg2, Rb1, Rc, Rb2, Rb3 and Rd) were determined by comparison with chromatographic behaviors and UV spectra of the authentic compounds. The eleven batches of samples were classified as two clusters by hierarchical clustering analysis (HCA) and principle component analysis (PCA), and six samples were confirmed to establish the mutual model. The quality was assessed by similarity evaluation system for chromatographic fingerprint of TCM (2004B Version). The convenient and high specific method can be used to identify and evaluate the quality of the Ginseng Radix et Rhizoma.

Objective To observe clinical effects of treating subarachnoid hemorrhage with intracranial aneurysm interventional embolization combined with Chinese herbs of removing blood stasis and hemostasis. Methods 45 cases with subarachnoid hemorrhage were randomly reeurited into a control group and a treatment group. The control group was treated with intracranial aneurysm interventional embolization, and the treatment group was treated with intracranial aneurysm interventional embolization combined with Chinese herbs with the functions of removing blood stasis and hemostasis. The clinical effect was observed between the groups. Results The clinical effect in the treatment group was significantly higher than that of the control group (P< 0.05 ). Conclusion The treatment of subarachnoid hemorrhage with intracranial aneurysm interventional embolization combined with Chinese herbs of removing blood stasis and hemostasis is better than intracranial aneurysm interventional embolization exclusively.

Objective To investigate the changes and clinical significances of the chemokines of interferon-?-inducible protein-10(IP-10),monocyte chemoattractant protein-1(MCP-1) and growth-related oncogene-?(Gro-?) involved in pathagenesis of Kawasaki disease(KD) and HenochSchonlein purpura(HSP).Methods The chemokines production of IP-10,MCP-1 and Gro-? were assayed by ELISA in 15 patients with KD,12 patients with HSP and 10 healthy children.Results The plasma levels of IP-10 and MCP-1 were markedly elevated in KD group [(394.2?176.4)and(420.5?163.4)ng?L-1]compared with HSP group[(94.8?66.4)and(109.2?76.6)ng?L-1] and the control group [(76.4?46.5)and(87.7?47.8)ng?L-1](all P0.05),as well as Gro-? between the three groups.Conclusion Monocyte may enhance the immune damage in KD pathogenesis,and the levels of IP-10,MCP-1 may be important indexes for KD.Neutrophil may be not involved in pathogenesis of HSP and KD.

Objective To investigate the correlation between vertebral artery dominance (VAD) and posterior circulation ischemic stroke (PCIS).Methods The consecutive patients with acute ischemic stroke hospitalized from November 2013 to October 2015 were collected.All patients underwent MRI and magnetic resonance angiography (MRA).The dominant vertebral artery was defined as having the larger diameter if left and right diameter difference ≥0.3 mm or the vertebral artery connected to the basilar artery in a more straight fashion if the diameter difference ＜ 0.3 mm.They were divided into either an anterior circulation ischemia stroke (ACIS) group or a PCIS group according to the classification criteria of Oxfordshire Community Stroke Project (OCSP).A multivariate logistic regression analysis was performed to investigate the correlation between VAD and PCIS.Results A total of 226 patients withacute ischemic stroke were enrolled,including 172 patients (76.1％) in the ACIS group and 54 (23.9％) in the PCIS group.Fifty-four patients (23.9％) had VAD,including 38 (70.3％) on the left and 16 (29.7％) on the right.The proportion of the patients with VAD in the PCIS group was significantly higher than that in the ACIS group (55.6％ vs.14.0％;x2 =39.115,P ＜ 0.001).Multivariate logistic regression analysis showed that VAD was an independent risk factor for patients occurring PCIS (odds ratio,13.60,95％ confidence interval 6.90-27.01;P＜0.001).Conclusions VAD is closely associated with the occurrence of PCIS,and it is an independent risk factor for PCIS.

Septic arthritis of the sternoclavicular joint(SCJ) is a rare condition and accounts for 0.5％-1.0％ of septic arthritis.SCJ infections often require surgical intervention.Diabetes mellitus,rheumatoid arthritis,intravenous drug use,intraarticular injection and immunosuppressive disorders are predisposing factors.Staphylococcus aureus and Pseudomonas aeruginosa are the most common bacteriologies.Early diagnosis of SCJ infection requires a high index of suspicion and a confirmatory CT or MRI scan.The characteristic imaging features include intramedullary and soft tissue gas,sequestra,soft tissue swelling and destruction or widening of joint space.Management strategies have ranged from conservative antibiotic therapy to en-bloc resection of the sternoclavicular joint with or without ipsilateral pectoralis major muscle transposition.The shoulder function in most patients were well preserved.

BACKGROUND:There were stil lacking related clinical researches in the aspects of whether the total blood loss and hidden blood loss were connected with pathogenesis, whether the total blood loss and hidden blood loss were different among the patients who conducted total hip arthroplasty under different pathogenesis, and whether the preoperative intervention should be conducted for a particular cause? OBJECTIVE:To compare and analyze the hidden blood loss of patients with hip osteoarthritis and femoral neck fracture after total hip replacement. METHODS:The clinical data of 150 patients who received the unilateral total hip arthroplasty treatment from June 2013 to January 2015 were colected and analyzed, including 54 patients with hip osteoarthritis (30 male cases and 24 female cases ), 96 patients with femoral neck fracture (41 male cases and 55 female cases). The pre-and post-operative blood routine and intro-and post-operative blood loss and transfusion were recorded, and hidden blood loss during pen-operation period was evaluated. RESULTS AND CONCLUSION:Total blood loss was (1 616±216) mL, hidden blood loss was (699±102) mL, and hidden blood loss accounted for 43.3% of the total blood loss. The total blood loss was (1 742±254) mL in the hip osteoarthritis group, hidden blood loss was (758±127) mL, hidden blood loss accounted for 44.6% of the total blood loss; The average total blood loss was (1 470±189) mL in the femoral neck fracture group, hidden blood loss was (625±98) mL, hidden blood loss accounts for 42.1% of the total blood loss. The total blood loss and hidden blood loss in hip osteoarthritis group were significantly higher than those in the femoral neck fracture group (P< 0.05). However, there was no significant difference on the hidden blood loss accounts for the proportion of the total blood loss between two groups (P=0.419 3). These results suggest that the total blood loss and hidden blood loss are different for the patients who underwent total hip arthroplasty in the premise of both pathogenesis. Therefore, before the total hip arthroplasty, we should fuly take into account the primary cause of patients and estimate the total blood loss and hidden blood loss, so as to take appropriate preventive measures in time to ensure the safety of the replacement process.

Objective To construct and implement theSTARnurse training model, and discuss its application effect and the problems that should be paid attention to, and to provide operational cases and practical basis for nursing clinical education. Methods Through literature review and expert consultation, the framework and content of STAR nurse training model were set up and implemented. The questionnaire survey and semi structured in-depth interviews were conducted among the nurses in the hospital to evaluate the effect of improving the nurses′self-directed learning ability. Results After the implementation of the project, the scores of the three dimensions of self-management, desire for study and self-control were (3.67±0.57), (4.05±0.54), (3.99±0.50) points, which were higher than (3.55±0.49), (3.71± 0.52), (3.53±0.42) points before implementation. The difference was statistically significant (P<0.05 or 0.01). The semi structured in-depth interviews showed that all the nurses believed that STAR nurse training model could promote independent learning and stimulate interest in learning. 14 nurses thought it was beneficial for the nurses to find the problems. Conclusions STAR nurse training model can create a favorable learning environment for nurses, and stimulate the learning motivation. It plays a positive role in improving nurses′ability of self-directed learning.

0.05).Conclusion:TH1 cell might not complicate in the pathogenesis of RSV bronchiolitis. The IL-2 levels showed a heterogenous behavior.

Objective To explore the effective method on the knee osteoarthritis (KOA) of stroke patients.Methods Twenty-four stroke patients with KOA were randomly divided into the treatment group and control group with 12 cases in each group. All patients received facilitation technique exercise, the patients in the treatment group were added with an extra complex therapy of electronic acupuncture, physical and exercise thepapies. All patients of two groups were assessed with visual analogous score (VAS) and Fugl-Meyer Motion Scale (FMMS) before treatment and one course after treatment.Results After treatment, the scores of VAS and FMMS of the patients in the treatment group were significantly better than that in the control group ( P<0.01).Conclusion Multidisciplinary rehabilitation including electronic acupuncture, physical, and exercise is efficiancy to KOA of stroke patients.