Femoral Fractures ; surgery ; Fracture Fixation ; Humans ; Minimally Invasive Surgical Procedures

Purpose　To evaluate the therapeutic effect of laser-induced chorioretinal venous anastomosis for retinal vein occlusion　(RVO)．　Methods　The investigation included 28 consecutive patients　(28 eyes) with RVO．The non-ischemic group 18　cases　(18 eyes) were treated with the krypton red laser to induce chorioretinal venous anastomosis， the ischemic group underwent the same therapy and the grid or scatter-type photocoagulation at the same time． All of the eyes were followed up for more than 5 months， and with an average period of 6．6 months．　Results　Seven cases　(7 eyes， 38．9%) of the non-ischemic group created successful chorioretinal venous anastomosis， with mean improvement of 4．43±0．78　standard deviation　（±s） lines of best-corrected visual acuity compared to　0．19±0．67　（±s） lines for 11 eyes with unsuccessful anastomosis　(P<0．001)． None of the seven eyes developed to ischemic state． Four of the 11 eyes with unsuccessful anastomosis converted to ischemic type (36．4%)． Two cases of the ischemic group created successful anastomosis with improvement in visual acuity． The other cases had no change in visual acuity．　Conclusion　Laser-induced chorioretinal venous anastomosis is a new therapeutic method for RVO， especially for nonischemic type　and successful anastomosis can decrease the conversion rate of the vein occlusion to an ischemic state．

By analyzing the current situation of the application of clinical pathways in China, the paper reviews the achievements that have been made via the application of clinical pathways to the domestic management of patient care, nursing, pharmacy and operation and discusses the problems existing in such application. It argues that there are sound prospects for the application of clinical pathways to hospital management.

CTGF, a member of the CCN family of immediate early genes, is a recently discovered profibrotic growth factor, which is involved in many pathophysiologic procedures. CTGF acts as a downstream effector of TGF-? acting on interstitial cells to enhance the progression of fibrotic renal diseases. It has been shown that CTGF gene expression can be induced or blocked by some kinds of cytokine and drugs. It is an interesting candidate target for future intervention strategies of renal interstitial fibrosis. [

A method for simultaneous isolation and clean-up pyrethroid insecticides (methothrin, fenpropathrin,cyhalothrin, permethrin, cypermethrin, fenvalerate and deltamethrin)with a solid phase extractionmethod (Sep-Pak C18 cartridge) from biological samples (human plasma and urine) is presented.The systematic separation of the insecticides was excellently performed by wide-bore capillary gaschromatography with flame ionization detection and temperature programming. The recoveries werebetween 81% and 93% for plasma, and 90% and 102% for urine. Mixing the samples with 70%methanol and eluting with chloroform demonstrated excellent adsorption on C18 and the best recoveries,respectively.

Objective To evaluate the application value of serum endotoxin combined with integrated model for end-stage liver disease (iMELD) in evaluating the short and medium term prognosis of patients with decompensated liver cirrhosis.Methods The clinical data of 68 patients with decompensated liver cirrhosis were retrospectively analyzed.The patients were divided into survival group and death group according to the result of follow-up at the 3,6 and 12 months.The iMELD score and Child-Turcotte-Pugh (CTP) score were calculated according to relevant indicators,and the serum endotoxin level was detected.The correlation between serum endotoxin and iMELD score was analyzed in the short and medium term prognosis in patients with decompensated liver cirrhosis.Results After 3 months' follow-up,5 patients died.The iMELD scores in survival group and death group were (39.26 ± 7.29) and (49.29 ± 8.63) scores,CTP scores were (9.32 ± 2.12) and (12.03 ± 2.75) scores,serum endotoxin levels were (9.21 ± 2.24) and (15.39 ± 5.12) ng/L,and there were statistical differences (P ＜ 0.05).After 6 months'follow-up,12 patients died.The iMELD scores in survival group and death group were (41.35 ± 8.03) and (52.18 ± 10.37) scores,CTP scores were (9.78 ± 2.05) and (12.93 ± 1.99) scores,serum endotoxin levels were (8.96 ± 2.41) and (16.43 ±6.03) ng/L,and there were statistical differences (P ＜0.05).After 12 months' follow-up,19 patients died.The iMELD scores in survival group and death group were (40.74 ± 6.38) and (52.29 ± 8.53) scores,CTP scores were (10.01 ± 2.23) and (13.27 ± 1.69) scores,serum endotoxin levels were (8.53 ± 2.34) and (16.52 ± 6.08) ng/L,and there were statistical differences (P ＜ 0.05).The area under curve of receiver operating characteristic (ROC) was 0.952,standard error was 0.048,and 95％ confidence interval was 0.790-1.022.The best critical value of iMELD score to predict death was ≥48.00 scores,and the risk of death would rise if iMELD score was increased.The best critical value of serum endotoxin to predict death was ≥ 11.00 ng/L.Conclusion iMELD score and serum endotoxin have important value in predicting prognosis in patients with decompensated liver cirrhosis.

Small cell lung cancer (SCLC) is an aggressive malignancy with fairly poor prognosis. Innovative treatment based on improved understanding of the genetic alterations of SCLC is awaited. Recently, a number of potential targets or important oncogenic pathways have been identified by the next generation sequencing or other systematic genomic analysis in SCLC. In this review, we summarised the new ifndings of genetic characteristics in SCLC.

Objective To translate the English version of the Medication Adherence Self-efficacy Scale (MASES) into Chinese and to test the reliability and validity of the Chinese version of MASES in patients with hypertension.Methods Totally 285 patients with hypertension were recruited and were investigated by the Chinese version of MASES.The results underwent analysis for reliability and validity.Results The retest reliability of MASES was 0.843.The Cronbach α of the Chinese version of MASES was 0.876.The Cronbach α of the four dimensions ranged from 0.794 to 0.905.The average content vality index (CVI) of the scale was 0.946.Factor analysis got four factors,which explained 68.683％ of the total variance.The factor loading of each item on its common factor was ＞0.4.Conclusions The Chinese version of MASES has been proved to be reliable and valid.It can be used as a valid tool for the measurement of the patient compliance in patients with hypertension.

Objective To translate the English version of the Oncology Patients' Perceptions of the Quality of Nursing Care Scale (OPPQNCS) into Chinese and to test the reliability and validity of the Chinese version of OPPQNCS in oncology patients.Methods The English version of OPPQNCS was translated by Brislin translation mode.Totally 320 oncology patients were recruited and were investigated by the Chinese version of OPPQNCS.Results The internal consistency coefficient of the Chinese version of OPPQNCS was more than 0.70,ranged from 0.804 to 0.964;the test-retest was 0.826.The content validity index(CVI) was 0.845-1.000,the average CVI was 0.925.Factor analysis got four factors,which explained 78.548％ of the total variance.And every objective factor loading were greater than 0.4.Conclusions The Chinese version of OPPQNCS has been proved to be reliable and valid.It can be used as a valid tool for the oncology patients to measure their perceptions of the quality of nursing care they got.

Objective To investigate the association between serum uric acid (SUA)levels and outcome in acute ischemic stroke.Methods A total of 388 acute ischemic stroke patients were included in the prospective case study.Data on demographic characteristics, risk factors for life style, history of disease, the admission SUA and outcome at discharge were collected for all participants.Results Mean serum uric acid levels were (284.5±83.6) μmol/L in the normal uric acid? group, and(455.3±78.1)μmol/L in the high uric acid group(P＜0.01).There were significant differences in National Institutes of Health Stroke Scale (NIHSS) score at two weeks between the high UA group and the normal UA group [(11.0±6.0) vs.(11.0±5.3),P=0.048], and also in early neurological improvement (P=0.048).A significant difference was found in serum uric acid level between patients with good versus poor neurological function outcome (P =0.045).Conclusions There is the association between admission serum uric acid levels and outcome in acute ischemic stroke.Elevated serum uric acid level predicts a lower chance of a poor outcome in acute ischemic stroke.