Now,too many times line up the patient in the outpatient service see a doctor the process demand.For resolving this problem,shorten a patient to wait for time,we design "line up to call the number system",making use of the WINDOWS.NET terrace,and conjoin with the HIS system of the hospital,will register,payment,take a medicine,analyze and line up to see a doctor knot to put together,carry out a multi-media management of seek medical advice the process.

Objective To summarize the cytological features of breast carcinoma by fine needle aspiration and differential diagonsis of breast hyperplasia and breast flbroadenoma. Methods Cytological features about 175 cases of breast cancer were analyzed,contrasted with 76 cases of breast hyperplasia and 93 eases of fibroadenoma. And 20 cases of low-diagnosis breast cancer were analyzed, compared with 13 cases of excessive diagnosis. Results The followings were found:disorderly arranged cells in 169 cases of breast cancer, about 96.9% in 175 cases,loose distance between the nucleus in 125 cases of all cases (about 71.4%). The percentage of small groups or scattered cells, medium size cells, round nucleus and irregular border nucleus was 34.3% (60/175) ,81.1% (142/175), 88.6% (155/175) and 28.6% (50/175) respectively. The nucleus/cytoplasm ratio was increased in 105 cases of all (about 60%). The nucleus/cytoplasm ratio was obviously reduced in 15 cases of all (about 8.6%). Big nucleolis were observed in 49 cases of all (about 28%). There was significant difference between nucleus size in 136 cases of all (about 77.7%). There was not myoepithelial cell in 168 cases of all (about 96%). The percentage of visible necrosis, scsttered round nucleus and integrity of cytoplasmic was 13.7% (24/175) ,89.7% (157/175), 66.9% (117/175) respectively. The cases of all above features were significantly more than those of breast hyperplasia and breast fibroadenoma (P <0.05). The percentage of large number of cells was 52.6% in 175 breast cancer cases,higher than 5.3% in 76 breast hyperplasia cases. There was a significant difference(P <0.05) between two groups. In 20 cases of low-diagnosis breast cancer the percentage of round nucleus with integrity of cytoplasmic, special arrangement cells was 70% (14 cases) ,35% (7 cases) ,higher than the cases in 13 excessive diagnosis cases. There was a significant difference(P < 0.05) between two groups. Conclusion The cell morphological characteristics of breast caner by fine needle aspiration are large number of cells, loose distance between the nucleus, disorderly arranged cells, small guoups or scattered cells, integrity of cytoplasmic, increased nuclear, round nuclear, irregular border nucleus,increased or decreased nucleus/cytoplasm ratio, big nucleoli, significant difference in nuclear size, no myoepithelial cell, visible necrosis. Most of breast cancer can be distinguished from breast hyperplasia and breast fibroadenoma by above characteristics. All those cytological characteristics are helpful to identify difficult case.

Objective To investigate the morphological changes and expression of nerve growth factor(NGF) in submandibular gland of C57BL/ksj\|db/db mutant diabetic mice. Methods Animals were C57BL/ksj\|db/+m mutant diabetic mice which were imported from Japan.The pure Zygote,that is db/db mouse,displays obesity and high blood glucose over 10mmol/L.The test groups were 3,4,6,8,10 month\|old db/db mice and the age\|matched db/+m mice as control.Immunohistochemistry technology was applied in this study. Results In db/db diabetic mice,submandibular gland atrophied and took on the significant morphological changes in acinar,duct and granular convoluted tubule.The NGF Immunopositive cells in submandibular gland were significantly less than the age\|matched control animals and showed a descend tendency with the progression of diabetes millitus.Conclusion\ The decreased expression of NGF demonstrates NGF synthesis and secretion in granular convoluted tubule of submandibular gland was decreased.The lower NGF levels may be associated with development of diabetic neuropathy.\;[

Objective:To analyze the epidemiological characteristics of geriatric hip fractures.Methods:This study retrospectively analyzed the clinical characteristics of 2 054 elderly patients with hip fracture aged 60 years and over who were admitted to Beijing Hospital from January 2011 to December 2020.The epidemiological characteristics of geriatric hip fractures were analyzed from the aspects of age, gender, fracture type, length of stay, surgical method and surgical complications.Results:The total number of hip fractures patients admitted from 2011 to 2020 showed a general upward trend in quantity.Among them, there were 1 177 femoral neck fractures(57.3%, 1 177/2 054), and 877 intertrochanteric femoral fractures(42.7%, 877/2 054)with statistical differences in the distribution of fracture types between patients at different ages( χ2=61.727, P<0.001). A total of 1 839 patients chose surgical treatment, accounting for 89.5% of the total number of patients.Artificial femoral head arthroplasty was the most common operation mode for patients with femoral neck fractures(783 cases, 75.4%).534 patients with intertrochanteric femoral fractures(66.8%)were treated with closed reduction and femoral intramedullary nailing.There was a statistically significant difference in operation modes among different fracture types( χ2=1 480.800, P<0.001). The length of hospital stay in patients with femoral neck fracture was(14.2±8.3)days, which was significantly longer than in patients with femoral neck fracture(13.2±10.9)days( t=2.417, P=0.016). There was no significant difference in the time from admission to operation between the two groups[(5.7±3.5)days vs.(5.4±3.3)days]( t=1.954, P=0.051). Among all the comorbidities of hip fracture patients, the top 5 diseases were cardiovascular system diseases(2 001 cases, 97.4%), nervous system diseases(1 105 cases, 53.8%), endocrine system diseases(814 cases, 39.6%), skeletal and muscular system diseases(623 cases, 30.3%), digestive system diseases(472 cases, 23.0%).1 485 patients(72.3%)had 3 or more comorbidities. Conclusions:Hip fractures in the elderly have some epidemiological distribution characteristics in terms of age, gender, length of hospitalization, injury mechanism and comorbidities, which is conducive to further improve the prevention and treatment strategies for hip fractures and promote the rational allocation of medical resources.

Objective:To explore our self-designed classification system of irreducible intertrochanteric fractures based on reduction stage and bone block position and to evaluate the reduction techniques guided by the classification system.Methods:A retrospective study was conducted to analyze the data of 115 patients with irreducible intertrochanteric fracture who had been admitted to Department of Orthopedics, Beijing Hospital from September 2014 to November 2022. There were 24 males and 91 females with a mean age of (80.9±11.0) years. The reduction for the fractures was divided into a diaphysis reduction stage (Phase Ⅰ) and a cortical reduction stage (Phase Ⅱ). Based on the relative positions of the intraoperative bone blocks, Phase Ⅰ was divided into an anterior and posterior interlocking type (Phase Ⅰa) and a distal bone block sinking displacement type (Phase Ⅰb) while Phase Ⅱ into a proximal lifting type (Phase Ⅱa), a posterior angulation type (Phase Ⅱb), a positive support type (Phase Ⅱc), and a negative support type (Phase Ⅱd). Depending on the difficulties encountered in different reduction stages, corresponding close reduction strategies (such as top rod support, percutaneous prying, and Joystick technique) were adopted to restore the proximal femoral neck shaft angle, anteversion angle, anterior medial cortex, and length of the affected limb before fixation with intramedullary nails. Recorded were the patient's surgical time, intraoperative bleeding, quality of postoperative reduction, fracture union time, and complications.Results:The surgical time for this group of patients was 70.0(60.0, 92.0) minutes, and the intraoperative blood loss 200.0 (170.0, 200.0) mL. According to the standards by Baumgaertner et al., the quality of postoperative reduction was evaluated as excellent in 103 cases and as good in 12 cases, with an excellent and good rate of 100.0% (115/115). Of the 115 patients, 86 were followed up for more than 6 months to reveal fracture union in all after a duration of 6.0 (4.0, 8.0) months. One patient died of an acute cardiovascular event in the hospital 5 days after surgery. Two patients lost their mobility within 3 months after surgery due to acute cerebral infarction. There was no internal fixation failure requiring secondary surgery or no incision infection.Conclusion:Guided by our self-designed classification system of irreducible intertrochanteric fractures based on the intraoperative reduction stage and the relative position of bone block, real time intraoperative fluoroscopy images can be used to effectively clarify the difficulty of fracture reduction in stages so that corresponding reduction strategies can be adopted, leading to fine clinical efficacy.

Objective:To evaluate our self-designed stick supporting reposition which was used to treat irreducible intertrochanteric fractures.Methods:A retrospective study was conducted of the 138 patients with irreducible intertrochanteric fracture (an observational group) who had been treated by stick supporting reposition followed by intramedullary nailing at Department of Orthopaedics, Beijing Hospital between April 2015 and December 2019. They were 45 males and 93 females with an age of (79.9±8.2) years; by AO classification, there were 25 cases of type 31-A1, 98 cases of type 31-A2 and 15 cases of type 31-A3. The other 142 patients with irreducible intertrochanteric fracture were included as a control group who had been treated by open or limited open reduction and intramedullary nailing between January 2010 and March 2015. The 2 groups were compared in terms of reduction time, operation time, intraoperative blood loss, reduction quality, fracture union time and complications.Results:The 2 groups were comparable because there was no significant difference between them in preoperative general data or follow-up time ( P>0.05). The reduction time [(12.0±3.4) min], operation time [(64.1±6.5) min], and intraoperative blood loss [(228.0±40.0) mL] in the observational group were significantly less than those in the control group [(18.3±8.9) min, (72.3±11.2) min and (319.1±95.0) mL] ( P<0.05). The reduction quality in the observational group (82 excellent and 56 acceptable cases) was significantly better than that in the control group (63 excellent, 65 acceptable and 14 poor cases) ( P<0.05). The fracture union time for the observational group [(3.8±0.9) months] was significantly shorter than that for the control group [(4.0±0.9) months] ( P>0.05). There were 6 cases of internal fixation failure and 8 cases of hip varus deformity in the control group, but no such complications occurred in the observational group. Conclusion:In the treatment of irreducible intertrochanteric fractures, compared with open or limited open reduction, our stick supporting reposition may shorten operation time, reduce intraoperative blood loss and improve quality of fracture reduction.

Objective:To investigate the clinical characteristics and prognosis of hip fractures in patients aged 90 and over.Methods:Clinical data of hip fracture patients aged 90 years and older admitted to Beijing Hospital from January 2016 to June 2020 were retrospectively analyzed.Patients were divided into a surgical treatment group and a conservative treatment group according to treatment received.Mortality and walking function 30 days and 1 year after injury were followed up.The mortality and walking function 1 year after injury in the two groups of patients were compared and analyzed, and related factors affecting the 1-year mortality rate of the surgical treatment group were analyzed.Results:Eventually 114 cases were included, with 18 in the conservative treatment group and 96 in the surgical treatment group.There were no significant differences in age, sex, American Society of Anesthesiologists(ASA)score, comorbidities, fracture type, hemoglobin, total protein, albumin and coagulation function at admission, walking ability before injury, and length of stay between the two groups(all P>0.05). Of the 18 conservatively treated patients, 9 died within 1 year(50.0%). Among 96 surgically treated patients, 20 died within 1 year(20.8%). The difference between the two groups was statistically significant( χ2=6.789, P=0.016). Among the 9 patients who survived 1 year after injury under conservative treatment, 1(11.1%)was able to walk independently, 2(22.2%)were able to walk with a walker, and 6(66.7%)were unable to walk; Among the 76 surviving patients 1 year after injury under surgical treatment, 16(21.1%)were able to walk independently, 50(65.8%)were able to walk with a walker, and 10(13.1%)were unable to walk.There was a statistically significant difference in walking ability between the two groups( χ2=20.030, P<0.001). Univariate analysis results showed that ASA score, walking ability before injury and total protein were correlated with 1-year mortality after injury( χ2 or t=5.803, -2.176, 29.400, all P<0.05). Multivariate logistic regression results showed that the inability to walk independently before injury was an independent risk factor for death within 1 year after injury[ HR(95% CI)=15.95(4.42-57.55), P<0.001]. Conclusions:The prognosis of surgical treatment of hip fractures in patients aged 90 and over is better than that of conservative treatment.The inability to walk independently before injury is an independent risk factor for death within 1 year after injury.

Objective:To analyze the risk factor of postoperative delirium in the elderly hip fracture patients.Methods:A total of 1051 patients with hip fracture aged 60 years and over, admitted to Beijing Hospital from January 2010 to December 2017 were retrospectively analyzed.They were divided into a postoperative delirium group(n=156)with 56 males and 100 females, 81 femoral neck fractures and 75 intertrochanteric fractures, and the control group(n=895)with no delirium, receiving the corresponding treatment in the same period.The complications, laboratory tests, fracture types, operation methods, the time from fracture to operation, operation time, intraoperative blood loss, intraoperative blood transfusion were compared between the two groups.Risk factors of postoperative delirium in the elderly hip fracture patients were screened using the binary multi-factor logistic regression analysis.Results:Of the 1 051 patients, 156 cases(14.8%)delirium occurred.There was no significant difference in fracture type and operation methods( P>0.05)between the 2 groups.The age was significantly older in the observation group(82.9±6.6)years than in the control group(79.9±7.2)years.The serum albumin before operation(37.1±2.9)g/L, creatinine clearance rate(52.4±22.2)ml·min -1·(1.73 m 2) -1in the observation group were significantly lower than in the control group[(37.8±3.8)g/L, (59.0±30.0)ml·min -1·(1.73 m 2) -1]( P<0.05). The past dementia rate was higher in delirium group[19.8%(31 cases)]than in control group[2.2%(20 cases)], with statistically significant difference( χ2=89.503, P<0.01). The proportion of patients with more than two medical diseases was higher in delirium group[51.9%(81 cases)]than in control group[40.3%(361)]( χ2=7.320, P<0.01). There were no significant differences(all P>0.05)between.the two groups in hemoglobin, white blood cell, serum K and Na, American Society of Anesthesiologists(ASA)grade, and the incidences of Parkinson's disease, pulmonary diseases and cardiovascular diseases(all P>0.05). The binary multi-factor Logistic regression analysis showed that the age, past dementia and kidney dysfunction were the risk factors for the postoperative delirium in the elderly hip fracture patients(all P>0.05). Conclusions:The incidence of postoperative delirium in the elderly hip fractures patients is high.Age, past dementia and kidney dysfunction are the risk factors for postoperative delirium in the elderly hip fracture patients, which should be prevented and improved preoperatively.

Objective: To explore the diagnosis, treatment and prognosis of synovial chondroma in the temporomandibular joint and to provide a reference for clinical diagnosis and treatment. Methods : A case of right temporomandibular joint synovial chondromatosis admitted to the Stomatological Hospital, Southern Medical University was reported, and the related literature was reviewed and analyzed. Results : During the movement of the mandibular opening, noise and obvious pain were found. The imaging features showed that several free calcification shadows of different sizes were seen around the condyle in the right articular fossa. The right temporomandibular joint mass resection and articular disc reduction were performed under general anesthesia, and the postoperative pathological results showed synovial chondromatosis. The patient′s symptoms were relieved 3 months after the surgery, and the imaging examination showed no residual lesions. A review of the literature shows that synovial chondromatosis usually occurs in large joints, such as the knee, hip, elbow, and shoulder joints, and rarely occurs in the temporomandibular joint. It occurs in middle-aged patients, manifesting as pain, swelling, and limited movement. Imaging studies play an important role in diagnosis, but the final diagnosis requires pathological diagnosis. Surgical treatment is effective, and synovial chondromatosis does not easily relapse. Conclusion The diagnosis of TMJ synovial chondroma should be combined with clinical manifestations, imaging features, and pathological examination. Surgery is an effective treatment. After completely removing the diseased and affected tissues, the disease has a good prognosis and does not easily relapse.