[Objective]To investigate the clinical features,reasons of missed diagnosis and treatment for ipsilateral fractures of femoral neck and shaft.[Method]Twelve cases of ipsilateral fractures of femoral neck and shaft treated from 1999 to 2005 were retrospectively reviewed.Seven cases' neck fractures were diagnosed separately before operation,2 cases' were diagnosed during operation and 3 were diagnosed after operation.Among the 12 cases,3 cases were treated with reconstructive intramedullary nail to fix both shaft and neck fractures;2 cases were treated with DHS to fix both shaft and neck fractures;1 case was treated with retrograde interlocking intramedullary nail to fix shaft fracture and with canulated screws to fix neck fracture;2 cases were treated with interlocking intramedullary nails and canulated screws;1 case combined supracondylar fracture of femur,was treated with LISS-DF to fix shaft and supracondylar fracture,canulated screws to fix the neck fracture;the neck fractures were found in 3 cases after shaft fixation with plate,then fixed with canulated screws.[Result]All cases were followed up for 1~6 years,with an average of 3.4 years.All femoral shaft fractures were united and 11 neck fractures were united,1 neck fracture was malunion,1 case was osteonecrosis of femoral head.[Conclusion]The ipsilateral fracture of femoral neck and shaft is rare,and the neck fracture is easy to miss diagnosis.The orthopaedic surgeons should consider the femoral neck fractures by analyzing the mechanism of high energy injury patient with femoral shaft fracture.Pelvic X-ray should be taken conventionally or CT scan when necessary.The surgical treatment for ipsilateral fractures of femoral neck and shaft depends on the position of femoral shaft,and the situation of femoral neck.

Objective To investigate the trends of colorectal cancer incidence in Shanghai Xuhui District from 2001 to 2011.Methods Total 3042 cases of colon cancer and 1958 cases of rectal cancer were collected from the Shanghai Cancer Reporting System.The results were age-adjusted according the census data of 2000 as the standardized incidence.Results The standardized incidence rate of colorectal cancer in Xuhui District rose from the 21.83/100 000 in 2001 to 27.35/100 000 in 2006 and increased by 25.29％ ; from 2009 to 2011 the incidence rate was stabilized.The ratio of colon to rectal cancer was 1.55:1,and the incidence of colon cancer was significantly higher than rectal cancer.The incidence rate of male and feinale colorectal cancer increased with age,especially at ＞ 45 y group accounting for 98.70％ and 98.37％ of total incidence rate respectively.The ratio of male to female in colon cancer incidence rate was 0.98∶ 1,while that of rectal cancer was1.25∶ 1.Conclusion The incidence of colorectal cancer in Xuhui District from the last 11 years is significantly higher than of national level.More effective preventive measures should be taken.

Objective To study the relationships among postpartum depression,dysfunctional attitudes and automatic thoughts.Methods 274 cases of postpartum women were estimated at fifth or sixth week after delivery by Edinburgh Postnatal Depression Scale (EPDS),Dysfunctional Attitudes Scales (DAS),Automatic Thoughts Questionnaire(ATQ) and some other forms designed by ourselves.Results ①The prevalence of postpartum depression was 18.20％.②The impact of culture degree on postpartum depression was statistically significant(x2 =12.37,P ＜ 0.05).③Compared with normal subjects,the postpartum depression group had significantly higher total score of ATQ (48.98 ± 12.35 vs 79.29 ± 23.90),total scores of DAS (118.92 ± 20.03 vs 148.03 ± 28.47),attraction or repulsion (13.82 ± 4.33 vs 18.01 ± 6.38),perfection (14.53 ± 5.91 vs 19.21 ± 5.23),compulsion(13.09 ± 3.61 vs 19.36 ± 4.98),seeking applause (14.97 ± 4.06 vs 18.78 ± 5.59),dependence (14.30 ±4.12 vs 19.23 ± 5.43),autonomous attitude(16.54 ± 3.67 vs 21.51 ± 4.81),cognition philosophy (12.32 ± 3.79 vs 18.16 ± 3.43),the difference was all statistically significant (P ＜ 0.01).④There was a significant positive correlation in postpartum depression and total scores of ATQ,total scores of DAS,attraction or repulsion,perfection,compulsion,seeking applause,dependence,cognition philosophy (the Pearson correlation was respectively:0.658,0.432,0.187,0.432,0.481,0.304,0.458,0.459,P ＜ 0.01).⑤Through stepwise regression analysis,automatic thoughts,cognition philosophy,compulsion,perfection and dysfunctional attitudes might play considerable role to predict the occurrence of postpartum depression.Conclusion Automatic thoughts,dysfunctional attitudes can predict postpartum depression to some extent.

OBJECTIVE:To observe clinical effects and safety of small dose of octreotide for preventing hyperamylasemia and acute pancreatitis after endoscopic retrograde cholangiopancreatography (ERCP).METHODS:One hundred and twenty ERCP pa tients were selected from our hospital during Oct.2014-Jan.2015 and then divided in to observation group and control group in accordance with random number table,with 60 cases in each group.Both groups were given Diazepam tablet 10 mg+Meperidine hydrochloride tablet 100 mg+Phenobarbital scopolamine tablet 2 tablets 0.5 h before surgery for sedation and analgesia,and routine acid suppression and anti-infective therapy.Observation group was additionally given Octreotide acetate injection 0.1 mg hypodermically and then given Octreotide acetate injection 0.1 mg immediately after surgery,8 h after surgery.The levels of serum amylase and blood glucose were observed in 2 groups,and the occurrence of postoperative complication and ADR were recorded.RESULTS:Before operation,there was no statistical significance in the levels of serum amylase and blood glucose between 2 groups (P＞ 0.05).After operation,the level of serum amylase in control group was significantly higher than in observation group,with statistical significance (P＜0.05).There was no statistical significance in blood glucose level between 2 groups after operation (P＞0.05).The incidence of hyperamylasemia and ADR in observation group was significantly lower than in control group,with statistical significance (P＜0.05),and there was no statistical significance in the incidence of acute pancreatitis between 2 groups after operation (P＞0.05).CONCLUSIONS:Small dose of octreotide can effectively reduce the level of serum amylase and the incidence of hyperamylasemia after ERCP with good safety.

Objective · To evaluate the value of ultrasonic measurement of distance from skin to epiglottis (DSE) for predicting the difficult airway. Methods · 71 patients (20-80 year-old, ASA Ⅰ-Ⅲ ) undergoing endotracheal intubation and general anesthesia for an elective surgical procedure were enrolled. Conventional airway evaluation was performed. The distance from skin at thyroid cartilage upper edge to epiglottis was measured using ultrasound before anesthesia and compared between patients with difficult airway and normal airway. The effects of different methods for evaluating difficult airway were analyzed Results · The ultrasonic measurements of DSE on parasagittal view in patients with difficult airway and normal airway were (23.31±0.43) mm and (19.21±0.27) mm, respectively. The difference was statistically significant (P=0.003). The area under the ROC curve of ultrasonic measurement was 0.799 (95% CI:0.639-0.958) with the best cutoff point of 23.6 mm. The specificity of ultrasonic measurement was significantly increased as compared with Mallampati classification (96.43% vs 71.40%, P=0.004). The difference in sensitivity was not statistically significant (60.00% vs 73.33%, P=0.170). Conclusion · Ultrasonic measurement of DSE on parasagittal view can be used to predict the difficult airway.

OBJECTIVE: To study the expression of angiopoietin receptor Tie-2 in the renal tissue of diabetic rats and the effects of Astragalus. METHODS: SD rats were randomly divided into normal control group, diabetes group and Astragalus-treated group. The expression of receptor Tie-2 in the renal tissue was assessed by using real-time quantitative polymerase chain reaction and immunohistochemical method. RESULTS: Glomerule Tie-2 protein expression was significantly elevated in the diabetes group as compared with the normal control group (P<0.01). Glomerule Tie-2 protein expression in the Astragalus-treated group was decreased as compared with the diabetes group (P<0.01). CONCLUSION: Tie-2 may play an important role in the pathogenesis of the early stage diabetic renal injury. The reno-protection effect of Astragalus may be mediated by down-regulating the expression of Tie-2 in the kidney tissue of diabetic rats.

The development of a multi-functional tumor combined therapeutic instrument based on improved PID algorithm is introduced. It is based on the theory of 1 + 1 = 3 or 1 + 1 + 1 > 3 curative effect enhancement by tumor combined therapy, and it can be used solely, or with the combination of chemotherapy or actinotheraphy or both for tumor hyperthermia. By adopting improved PID temperature control algorithm, the problem of temperature control precision reduction due to process characteristics changing with different heaters was solved, thus ensuring homogeneous and smooth radio frequency heating by different heaters to intracavity tumor foci. These experiments demonstrated that the new algorithm has strong adaptability and anti-disturbance capability, the equipment works stably and reliably, and it can control therapeutic temperature precisely (+/- 0.1 degree C), which indicates a good value in clinical application.
Algorithms ; Combined Modality Therapy ; Equipment Design ; Hyperthermia, Induced ; instrumentation ; Neoplasms ; therapy ; Temperature

BACKGROUND:Studies have shown that vacuum sealing drainage can accelerate wound healing through increasing the wound blood flow, but its influence on activated gelatinases in human chronic wound stil lacks corresponding research. OBJECTIVE:To observe the effect of vacuum sealing drainage on the activity of gelatinase during the healing of chronic wounds. METHODS:Total y 96 trauma patients admitted at the People’s Hospital of Hubei University of Medicine from April 2013 to January 2014 were divided into two groups:52 patients in chronic wound group were treated with vacuum sealing drainage and 44 in control group treated with wound drainage at 3 days after removal of breast cancer. In the chronic wound group, exudates from pressure sores and skin necrosis after removal of breast cancer were col ected as samples A and B;exudates from two cases of venous stasis ulcer were col ected as samples C and D;exudates from traumatic skin wounds col ected as sample E. RESULTS AND CONCLUSION:TLC analyzer showed that:after 15-day negative pressure therapy, activities of matrix metal oproteinase 2 in sample A with low activity of gelatinase, matrix metal oproteinase 9 in sample B, matrix metal oproteinase 2 and 9 in samples C, D, E were al increased significantly (P<0.05);however, the activities of matrix metal oproteinase 9 in sample A with high activity of gelatinases and matrix metal oproteinase 2 in sample B were reduced significantly after treatment (P<0.05). In addition, no significant difference was found in the activity of matrix metal oproteinase 2, matrix metal oproteinase 9 and activated gelatinase betweenthe chronic wound group and control group (P>0.05). These findings indicate that the variation of activated gelatinases activity in human chronic wounds may be the reason why the chronic wounds cannot be healed for a long time, but vacuum sealing drainage can regulate the activity of activated gelatinases in chronic wounds.

Through several years of exploration in Shanghai Chongming region, the team from Chongming Branch of Xinhua Hospital has established the initial multidisciplinary diagnosis and treatment model of cancer pain, which includes the department of oncology, anesthesiology, pain, rehabilitation, psychology and so forth. By means of medical informationization, they take cancer pain management as the starting point and have initially real-ized a new model of the real-time assessment and treatment of cancer pain, which has helped patients effectively reduce the physical and psychological suffering, improved the quality of life, developed a healthy self-manage-ment of patients, and has reference significance to palliative care.

Objective The Da Vinci single－site surgical platform (DVSSP) is an intelligent operation platform widely used worldwide. It possesses 3D vision ,flexible operation and other advantages, so in the field of gastrointestinal surgery, it has been gradually applied to radical gastrectomy, radical gastrectomy, radical resection of colorectal cancer, gastric fundus folding, Heller myotomy, weight loss surgery and small bowel surgery, and the satisfactory clinical effect has been achieved. For gastric cancer surgery, compared with traditional laparoscopy and laparotomy, the robot operation is more accurate, flexible, and has obvious minimally invasive advantages. The intraoperative treatment and postoperative curative effect are better than the traditional laparoscopy. With the support of a large number of clinical cases, DVSSP has been proven to be a new platform for minimally invasive surgery and has considerable value in the field of gastric cancer surgery. However, there is still a long operation time and a high cost of operation. The long－term effect of gastric cancer surgery needs further observation.