BACKGROUND:Unstable intertrochanteric fracture is often treated with proximal femoral nail anti-rotation (PFNA), which has good repair effect, but there is the risk of varus deformity. Reverse less invasive stabilization system (LISS) is a new treatment, which can avoid varus deformity. However, little evidence has focused on the comparison of PFNA and LISS. OBJECTIVE:To compare the clinical efficacy, complications and joint function of reverse LISS and PFNA in treatment of unstable intertrochanteric fractures in the elderly patients. METHODS:A retrospective analysis was performed among 64 elderly patients with unstable intertrochanteric fractures. Among them, 28 cases were treated with reverse LISS and 36 cases were treated with PFNA. The healing time, loading time, complications and Harris score of hip joint function after internal fixation were compared in the two groups. RESULTS AND CONCLUSION:The loading time in the LISS group was earlier than the PFNA group. The healing time, incidence of complications and Harris score of hip joint function showed no significant differences between the two groups (P>0.05). Reverse LISS internal fixation has similar efficacy and complication with PFNA for the treatment of senile unstable intertrochanteric fractures, and it is a reliable method for internal fixation with few complications.Subject headings:Femoral Fractures;Clinical Healing;Internal Fixators;Bone Nails;Fol ow-Up Studies

OBJECTIVE:To observe analgesic efficacy of oxycodone acetaminophen after posterior lumbar fusion,and to opti-mize spinal postoperative analgesia plan. METHODS:In retrospective study,120 patients underwent posterior lumbar fusion were selected from the Affiliated People's Hospital of Hubei Medical College during Jun. 2013-Jun. 2014,and then divided into observa-tion group and control group according to therapy plan,with 60 cases in each group. Observation group was given oxycodone acet-aminophen 330 mg orally 6 h after surgery,and then 330 mg orally on 1st,2nd day after surgery,tid. Control group was given celecoxib 200 mg 6 h after surgery,and then 200 mg on 1st,2nd day after surgery,bid. Postoperative analgesic efficacy (VAS score) at resting state and active state,postoperative gastrointestinal motility recovery (the time to flatus) and the occurrence of ADR were observed in 2 groups after surgery. RESULTS:Whether at the resting state or the active state 24,48,72,120 h after surgery,VAS score of observation group was significantly lower than that of control group,with statistical significance(P<0.05). There was no statistical significance in the time to flatus and the incidence of ADR between 2 groups(P>0.05). CONCLUSIONS:Oral administration of oxycodone acetaminophen possesses good effect to relieve spinal postoperative pain,showing fast and safe analgesic efficacy.

Aim To study the effect of BNIP3 on hy-poxia-induced autophagic cell death in gastric carcino-ma.Methods The protein levels of BNIP3 and LC3-Ⅱ of 1 8 cases of gastric carcinoma were studied with immunocytochemistry and Western blot analysis be-tween normal and tumor tissues.The expression of LC3-Ⅱ in SGC-7901 cells was assessed while knock-down of BNIP3 by siRNA in CoCl2-induced hypoxia, and the effect of 3-MA was also studied.Cell viability in hypoxia treatment for 48 h was estimated with cell counting kit-8 (CCK8).Results Compared with nor-mal tissues,the protein levels of BNIP3 and LC3-Ⅱwere increased in tumor tissues.BNIP3 siRNA could decrease the expression of LC3-Ⅱ and enhance the cell viability,while inhibition of autophagy could also in-crease the cell viability in SGC-7901 cells.Conclu-sions BNIP3 may play a role in hypoxia-induced cell death in gastric carcinoma,and the possible mecha-nism may be related to the regulation of autophagy.

Objective Implementing the scientific research performance evaluation indicator system constructed to evaluate the situation of scientific research performance conducted by two basic Departments during the 12th Five-Year period in a general hospital.To understand the practical applicability of the scientific evaluation index system,and also propose comments and suggestions based on the comparison between assessment score and actual research situation in the departments.Methods Based on the database of scientific research management information platform,collect related research data from two basic departments of the hospital in latest five years.Using SPSS software to conduct statistical analysis on the total score of the first and two indicators,as well as the specific indicators of the three indicators,according to the performance evaluation index system and the weight built by the hospital.Results The index system can basically reflect the general information of scientific research input and output in the department,however,some indicators cannot truly reflect the index importance and the differences between the index weight is not significant,so it is necessary to make amendment based on demonstration.Conclusions Hospital should dynamically update the index system to make them match the developing strategy of the hospital,also important to combine them with research stimulation to guarantee more scientific management and better service to the research development of hospitals.

ObjectiveTo evaluate the methodology of percutaneous transluminal stenting for stenosis of internal carotid artery(ICA).Methods83 patients with ICA stenosis greater than 85% received antiplatelate therapy perioperatively, and underwent cerebral vascular angiography as well as cervical Doppler sonography. Four kinds of stents were used with or without predilation.ResultsThere were not procedure related morbidities. All procedures were successful based on angiography. Cerebral blood flow (CBF) restored to normal or significantly improved. Symptoms disappeared in 56 cases and ameliorated in 27 cases. Follow up by angiography and sonography at 3 to 24 months showed no distortion of stents and restenosis. ConclusionsPercutaneous transluminal stenting combined with perioperative medical therapy is a safe therapeutic method for stenosis of internal carotid artery.

Objective To investigate the protective effects of pretreatment with valsartan, an angiotensin Ⅱ type 1 receptor blocker, on the brain against ischemia-reperfusion (I/R) injury. Methods Thirty-six healthy male C57BL/6J mice aged 10-12 weeks weighing 20-25 g were randomly divided into 2 groups (n - 18 each): valsartan group (V) and control group (C). In group V valsartan 2 mg?kg-1 dissolved in 2.5% NaHCO3 100 ?l was given intraperitoneally (i.p. ) every day for 10 days before experiment while in group C 2.5% NaHCO3 100?l without valsartan was given. The animals were anesthetized with intraperitoneal pentobarbital 40 mg?kg-1. Middle cerebral artery occlusion (MCAO) was produced by inserting an 8-0 nylon thread with rounded end into the left internal carotid artery and advancing it cranially until resistance was felt. MCAO was maintained for 1 h. The nylon thread was then withdrawn for reperfusion. A laser doppler blood flow detector (Omegaflo FLO-C1, Omegawave Co, Netherlands) was used to detect local cerebral blood flow (LCBF) at central and marginal infarct area [LCBF (%) = LCBF during I/R / baseline LCBF ? 100% ]. The model of MCAO was considered established when LCBF at central infarct area was 20% lower than the baseline value. LCBF was measured 10 min before MCAO (T0, baseline), as soon as MCA was occluded (T1) at 10, 30, 50 min of ischemia (T2-4) and at 10, 30, 60 min of reperfusion (T5-7) . MAP was measured immediately before valsartan administration, at T0 and T5. Neurological function deficit (NFD) was evaluated and scored (0 = no deficit, 4 = worst result) at 23 h after reperfusion was started . After evaluation of NFD the animals were anesthetized again and killed. The brains were removed. Cerebral water content was measured [cerebral water content (%) = (wet weight - dry weight) / wet weight ? 100%]. Infarct area was measured. Mortality rate was recorded.Results Pretreatment with valsartan did not affect MAP significantly but significantly reduced infarct area, brain water content, NFD and mortality rate and improved focal cerebral blood flow after MCAO. Conclusion Valsartan pretreatment can decrease cerebral infarct area induced by MCAO through improvement of focal cerebral blood flow after MCAO.

Objective To investigate the relation between plasma macrophage migration inhibitory factor(MIF) concentration and the activity of activator protein-1(AP-1) in peripheral blood and coronary heart disease(CHD),and their relation with coronary arteriosclerosis plaques in patients with CHD.Methods One hundred and forty two patients were divided into coronary heart disease(CHD) group(n=107) and control group(n=35) according to coronary angiographic(CAG) result.The CHD group was further divided into stable angina pectoris(SAP) group(n=33) and acute coronary syndrome(ACS) group(n=75) according to clinical manifestations.In addition,according to the type of coronary lesions,the CHD group was further divided into the type A lesion(n=30) group,type B group(n=48) and type C group(n=29).According to the degree of coronary stenosis,the CHD group was also divided into mild stenosis group(n=21),moderate stenosis group(n=31) and severe stenosis group(n=55).The amount of Phospho-c-Jun in lysate and plasma MIF concentration were measured by enzyme-linked immunosorbent assay(ELISA).The results of Phospho-c-Jun was demonstrated with absorbance.Which reflect the amount of AP-1.Results The absorbance of Phospho-c-Jun in the CHD group was higher than that in the control(1.43?0.33 vs 0.71?0.13,P

Objective To understand the working pressure source of obstetric nurses in Kunming through a sample survey study, so as to provide a reference for obstetric nurses to adjust self-psychology and for clinical managers to relieve working pressure on obstetric nurses. Methods We gave a sampling survey on 249 obstetric nurses in provincial,municipal and private hospitals,and usedChinese nurse job stress scaleto collect the data for statistical analysis. Results Kunming obstetric nurses' working pressure mainly came from the workload and time allocation. The ten stressors with highest score of pressure were frequent highest score, too much work, low welfare benefits,too much useless paperwork, low social status,worry about mistakes at work, too high expectation of patients,too much non-nursing work, nursing work is not accepted by patients and their families, few nurses to work. Age,title and nature of the preparation had no effect on work stress. Public hospital nurses' working pressure was significantly greater than private hospitals. Conclusion Working pressure sources of obstetric nureses in Kuming are too much night shift,too much work,welfare berfits useless paperwork,social status,mistakes at work, patients expectation work is not accopted and staffing Hospital management and nuusing managers should doploy rationally human resoures on obstteic area,reasorabal scheduling.

Objective To analyze the implementation problems of hospital-level research after the reform at a tertiary referral hospital,and provide strategies for further management.Methods Using statistical analysis of the application,funding and implementation of hospital-level research,summarizing the problems in the process of research.Results 55.79％ of the issue can be completed on schedule,the main reason is that the research could not reach the subject mission.The subjects about the management and care progressing better than clinical and medical issues.Conclusions The hospital level research completion should to be increased,the main reasons including that papers published been delayed,the researchers invested too little in the implementation process and research funding could not be effectively use.Recommend hospital to strengthen the system construction of research input and use,not only promoting collaboration and communication between different disciplines,but also building a comprehensive research platform,and then improving the level of scientific research management.

The proportion of external research projects has constantly increasing in tertiary hospitals in recent years.However,compared with the government funded projects,the importance of those external research have not been recognized by both researchers and managers,and leading to various problems in project management.This article elucidates the problems and countermeasures of external research project management in tertiary hospital,with an attempt to further improve the management system and promote the overall development of the hospital scientific research.