Objective To compare the treatment effects of senile intertrochanteric fracture with the dynamic hip screw(DHS),proximal femur locking compression plate (LCP),anti-spin femur proximal femoral nail(PFNA).Methods Ninety cases of femoral rotor fracture patients were treat in our hospital from September 2010 to March 2012 by DHS(n =30),LCP(n =30) and PFNA(n =30) treatment of femoral intertrochanteric fractures.We compared the surgical time,blood loss,fracture healing time,postoperative complications and hip function scores.Results In DHS,LCP and PFNA group,the blood loss ((287.1 ± 72.0) ml,(214.9 ± 65.8)ml,(85.0 ± 33.6) ml,F =88.7,P ＜ 0.05),the operative time ((1.51 ± 0.07) h,(1.49 ± 0.04) h,(0.70 ±0.10) h,F =445.8,P ＜ 0.05),and both were significant difference.But the fracture healing time ((15.2 ±1.7) weeks,(17.0 ± 1.4) weeks,(15.9 ± 1.8) weeks,F =1.4,P ＞ 0.05),there was no significant difference.The PFNA group had a good hip Sander' score of 96.7％,better than other two groups (87.5％、96.8％) (x2 =39.06,P ＜0.05).The weight-beating time of PFNA group is earlier than the other two groups ((1.00±0.36) cm,(0.80±0.12) cm,(0.60±0.19) cm,F=30.4,P＜0.05).Conclusion PFNAinthe treatment of femoral intertrochanteric fracture has advantages in minimally invasive,less blood loss,and help patients go through the perioperative period.

Objective To observe the effect of alpha lipoic acid on quality of life in patients with type 2 diabetic peripheral neuropathy.Methods 76 cases diagnosed with type 2 diabetic peripheral neuropathy,in accordance with the random number table,were divided into the control group (37cases)and treatment group (39cases).All the patients received diabetic diet,exercise guidance and blood glucose control.The control group was treated with methy-cobal 500μg muscle injection once a day for 2 weeks.The treatment group was treated besides above treatment with intravenous drip alpha lipoic acid 600mg once a day was added for 2 weeks.Then,the changes of motor nerve conduc-tion velocity,sensory nerve conduction velocity and quality of life (QoL)score (somatic symptoms,cognitive func-tion,health happy feeling,social participation,emotional state,work performance,life satisfaction and total score)of the two groups after treatment were observed.Results After treatment,the motor nerve conduction velocity of the control group were as follows:median nerve (40.7 ±4.5)cm/s,common peroneal nerves (41.3 ±4.9)cm/s,The sensory nerve conduction velocity of the control group were as follows:median nerve (38.6 ±4.3)cm/s,common per-oneal nerves (38.3 ±4.5)cm/s.After treatment,the motor nerve conduction velocity of the treatment group were as follows:Median nerve (45.4 ±5.7)cm/s,common peroneal nerves (44.9 ±6.4)cm/s,The sensory nerve conduction velocity of the treatment group were as follows:Median nerve (45.0 ±2.0)cm/s,common peroneal nerves (43.6 ± 3.2)cm/s.Both the two groups′motor nerve conduction velocity and sensory nerve conduction velocity were significantly increased after treatment (P <0.05).Compared with control group,the motor nerve conduction velocity and sensory nerve conduction velocity in the treatment group were significantly improved after treatment,which had statistically significance,(t =2.63,2.51,2.85,2.79,all P <0.05).After treatment,the somatic symptoms,cognitive function,health happy feeling,job performance,social participation,emotional state,life satisfaction and the total score of control group were (52.4 ±9.6)points,(27.0 ±7.8)points,(35.7 ±10.3)points,(19.6 ±7.3)points,(17.4 ± 3.1)points,(16.5 ±3.9)points,(185.4 ±40.7)points,respectively.After treatment,the somatic symptoms,cogni-tive function,health happy feeling,job performance,social participation,emotional state,life satisfaction and total score of treatment group were (41.9 ±7.4)points,(24.1 ±8.6)points,(28.3 ±9.2)points,(14.5 ±5.5)points, (12.6 ±5.6)points,(11.9 ±4.7)points,(135.0 ±38.7)points,respectively.The quality of life score of the treat-ment group was obviously lower than the control group,which had statistically significance,(t =5.14,2.54,2.96, 2.87,2.69,3.05,6.25,all P <0.05).Conclusion Alpha lipoic acid can improve the nerve conduction function of patients with type 2 diabetes peripheral neuropathy,and improve the quality of life.

Objective To evaluate the feasibility and safety of establishing benign proliferative esophageal stenosis model by using stent implantation in experimental rats.Methods A customized self-expanding,metallic and straight tubular stent was used in this experiment (5 mm in diameter and 15 mm in length),on both sides at the stent's middle part there was a protruding barb that was used as a fixation device.Twelve healthy Sprague Dawley (SD) rats were randomized divided into group A (blank control group) and group B (stent implantation group),with 6 rats in each group.Esophageal stent implantation was employed in the rats of group B,and esophageal radiography was separately performed immediately,one and 4 weeks after stent implantation.All the experimental rats were sacrificed 4 weeks after stent implantation.The normal esophageal tissue of the rats in group A and the esophageal tissue at stent site of the rats in group B were collected and sent for pathological examinations,including gross morphology,light microscopy,etc.Results Successful stent implantation was achieved in all rats of group B,and the esophageal radiography performed immediately,one and 4 weeks after stent implantation showed no esophageal stent displacement;no severe complications occurred during the operation or follow-up period.Compared with group A,esophageal radiography reexamination performed 4 weeks after stent implantation in group B revealed that esophageal stricture at stent segment,caused by benign tissue hyperplasia,could be observed.The esophageal stent segment was taken out,its lumen was obviously narrowed under gross observation,and typical benign hyperplasia could be seen under optical microscope examination.Conclusion Using esophageal stent implantation to establish esophageal stenosis model is safe and feasible in experimental rats.The use of esophageal stent with barbs can significantly reduce the incidence of stent displacement.

Objective To study the photodynamic therapy (PDT) mediated by a novel porphyrin-typed photosensitizer on human hepatic carcinoma HepG2 cell and the mechanisms.Methods Experiments were derided into four groups:control group,PDT group,photosensitizer group and photosensitizer+PDT group.The photostability of novel photosensitizer upon repetitive illumination was evaluated by bleaching method,and cell survival rate was determined by MTT assay.Cellular uptake of novel photosensitizer was measured with luminescence spectrometer,and cellular localization ofphotosensitizer was observed by laser scanning confocal microscopy (LSCM).Furthermore,apoptotic cell was detected with Hoechst 333342 staining.Results Novel photosensitizer was stable after repetitive light irradiation,and PDT or photosensitizer alone showed no dark cytotoxicity toward HepG2 cell (P＞0.05),but intense killing was observed in photosensitizer+PDT group (P＜0.05).The IC50 is 1.21 μmol/L.Cellular uptake of novel photosensitizer was concentration-dependent and the highest uptake is at concentration of 12.5 μmol/L.Novel photosensitizer localizes in lysosomes of HepG2 cell,and the death mode of HepG2 cell was mainly apoptosis.Conclusions Novel photosensitizer exerts profound cytotoxic effects on HepG2 cell mainly through the initiation of secondary cell apoptosis by lysosome destruction.

AIM: To establish the method for quality control of Yijingbushen Granules(Herba Epimedii, Semen Cuscutae, Radix Paeoniae Alba, Rhizoma Curcumae, etc.). METHODS:Semen Cuscutae, Radix Paeoniae Alba and Rhizoma Curcumae in this medicine were identified by TLC; The content of icarrin in this medicine was determined by HPLC;The acetonitrile-2%acetum(30∶70) solution was used as the mobile phase. The flow rate was 1.0mL?min -1. The detection wavelength was set at 270nm. RESULTS:Semen Cuscutae, Radix Paeoniae Alba and Rhizoma Curcumae, could be identified by TLC on lichrospherC 18 column. For Icarrin, the linear range was from 4.32 to 21.60?g, and the average recovery was 98.69% with RSD of 1.13%. CONCLUSION:The method is simple, reliable, accurate and can be applied to the quality control of the preparation.

Objective To observe late effect of 60Co radiation accident on eye lens in the victims.Methods Medical observations of eye lens were performed on ten victims accidentally exposed to 60Co sources in four radiation accidents that have occurred from 1986 to 2000 in Henan Province.Pathological changes of the eye lenses were examined by using slit lamp microscopy after mydriasis with compound tropicamide.Results Of these ten victims, Liang in a radiation accident in Kaifeng (in 1986), Mei in Xinxiang (in 1999) and Xu in Xuchang (in 2000) all had typical radiation-induced cataract 2, 3 and 6 years after irradiation, respectively.Follow-up observation of the lens showed the punctate and/or granular opacities present in the eye posterior subcapsular of Yan in Kaifeng accident, Jie in Zhengzhou (1987), and Tian, Yong and Yi in Xinxiang accident, featuring the early changes of radiation-induced cataract, but the posterior subcapsular opacities were not observed in Wang and Min in Xinxiang accident.Conclusions Focus should be on the eye lens as the target organ of radiation exposure in long-term follow-up of victims accidentally exposed to radiation source.Severity of the lens opacity induced by ionizing radiation is closely associated with radiation doses.

Objective To analyze the causes of misdiagnosis and mistreatment of Dravet syndrome. Methods Patients with Dravet syndrome diagnosed according to clinical features and SCN1A gene mutation detection were recruited within recent 3 years. The patients were grouped into correct diagnosis-treatment group and misdiagnosis-mistreatment group according to whether the patients had ever been misdiagnosed and mistreated by sodium channel blockers. The clinical features were compared between two groups. Results Thirty-five cases with Dravet syndrome were collected and the rate of misdiagnosis reached 40%, Nine cases were misdiagnosed as symptomatic focal epilepsy, 4 as Lennox-Gastaut syndrome and 1 as Doose syndrome. The average age of onset in misdiagnosis-mistreatment group was (5.50 ± 3.56) months,and the age of confirmed diagnosis was (83.57 ± 105.62) months. The percentage of abnormal EEG, onset seizure with partial seizure, the seizure frequency within the first year from onset, onset with afebrile seizure, patients with status epilepticus or cluster seizures was higher in misdiagnosis-mistreatment group but it showed no significant statistical significance when compared with that of correct diagnosis-treatment group. The percentage of patients with mental retardation and focal neurological signs was significantly higher in misdiagnosis-mistreatment group (P=0.005 and 0.002, respectively). Conclusions Dravet syndrome is frequently misdiagnosed as symptomatic focal epilepsy. The appearance of focal neurological signs and mental retardation before confirmed diagnosis are important factors for misdiagnosis. Gene mutation screening will be helpful for differential diagnosis of Dravet syndrome.

Objective To assess the safety and efficacy of percutaneous nephrolithotripsy withpneumatic and ultrasonic power in pediatric renal calculi. Methods The clinical data of 44 patientstreated with combination of pneumatic and ultrasonic power during pereutaneous nephrolithotripsywere retrospectively analyzed. The 44 patients had 49 renal calculi. The patients were all under 14years old. The average age was 11 years (range 7-14 years). There were 39 unilateral and 5 bilateralcalculi. Among the 44 patients,metabolic disturbance occurred in 19 cases (43.2%),anatomical dys function occurred in 15 cases (34.1%),urinary tract infection occurred in 14 cases (31.8%). Ante grade percutaneous access was established under ultrasound guidance,a combination of pneumatic andultrasonic lithotripsy were used. The effect was evaluated by postoperative KUB and ultrasonic. Re suits The access was successfully established in all patients. Complete stone clearance was achievedin 36 kidneys in phase Ⅰ,stones from 9 kidneys were completely removed with second lithotripsy.Leftover stone in 2 kidneys were treated by ESWL. Open surgery was performed in 2 kidneys due toexcessive bleeding. The operative time ranged from 52 132 min,average time was 79 min. Two pa tients needed blood transfusion. No severe complications occurred in all patients. Thirty seven pa tients were followed up for 3 18 months. The renal function was not worsened and hydronephrosiswas not aggravated in these patients. Conclusion The percutaneous nephrolithotripsy with pneumatic and ultrasonic power is a safe,effective treatment for pediatric renal calculi.

Objective To analyze the risk factors of nosocomial infection in Department of Neurosurgery and to provide evidence for the prevention and treatment of infection.Methods A total of 931 patients with neurosurgery operation in our hospital from January 2012-January 2016 were collected medical history data immediately after admission,including age,gender,underlying diseases,and primary diseases.Surgical records include preoperative white blood cell count,blood glucose level before operation,duration of operation,and reoperation.Hospitalization records include hospitalization time,without the use of corticosteroids,with or without the use of proton there is no pump inhibitor,and tracheal intubation / incision.Patients were divided into infection group and non infection group according to whether the hospital infection occurred during hospitalization.The difference of two groups of clinical data with statistically significant variables was Logistic multivariate regression analysis.Results There were 112 patients with nosocomial infection,the infection rate was 12.03％,and the infection occurred in the postoperative 3-25 d.The main infection site was postoperative wound,accounting for 35.7％;respiratory tract,accounting for 34.8％.There were 64 strains of pathogenic bacteria,81 strains of Gram-negative bacteria,accounting for 64.1％,21 strains of gram positive bacteria,accounting for 32.8％,2 strains of fungi,accounting for 3.1％.There were significant difference between infection group and non infection group in ≥ 60 years,with basic diseases,reoperation,combined with other injuries,white blood cells,abnormal preoperative hyperglycemia,glucocorticoid use,proton pump inhibitors use,tracheotomy,hospitalization time,operation time (P ＜ 0.05).Further Logisitc regression analysis showed that age,reoperation,hospitalization time,preoperative high blood sugar and tracheotomy were the risk factors of nosocomial infection in Department of neurosurgery.Conclusions For the older,reoperation,longer hospitalization time,preoperative hyperglycemia and tracheotomy patients can take specific measures to improve the immunity of the patients,the rational use of antimicrobial drugs to avoid the occurrence of postoperative infection.

OBJECTIVE: To investigate the clinical manifestations and diagnostic method of hyperparathyroidism due to parathyroid tumors and to evaluate the intra-operative detection of parathyroid hormone in surgical treatment. METHOD: Thirty-seven cases with functional parathyroid tumors from January 2003 to October 2012 were retrospectively analyzed. The clinical manifestation, examination and operation method, changes of parathyroid hormone before and after operation were collected. RESULT: All cases were definitely diagnosed before operation. The sensitivity and the positively predictive values of neck ultrasonography were 86.5% and 97.6% respectively, and the same data of Tc-99m-MIBI was 97.2% and 100.0%. The PTH levels declined by 84.9% ten minutes after tumor resecting compared with the level before operation. The serum calcium and PTH returned to normal levels and symptomatic relief occurred after operation. CONCLUSION Recurrent bone disease, long-term urinary calculus and obscure gastrointestinal symptoms were common symptoms of hyperparathyroidism due to parathyroid tumors. The neck ultrasonography and Tc-99m-MIBI were suitable for location of parathyroid tumors. Surgical operation was an effective treatment for parathyroid tumor. Intra-operative PTH assay would be able to ensure the radical excision and the operative safety for functional parathyroid tumors.
Adult ; Aged ; Female ; Humans ; Hyperparathyroidism ; etiology ; surgery ; Male ; Middle Aged ; Monitoring, Intraoperative ; Parathyroid Hormone ; blood ; Parathyroid Neoplasms ; complications ; surgery ; Retrospective Studies