OBJECTIVETo compare the effect of three cannulated screws and dynamic hip screw (DHS) combined with antirotation screw in treating patients with comminuted fractures of femoral neck.

METHODSFrom January 2008 to December 2012,67 patients with comminuted fractures of femoral neck were treated with three cannulated screws or DHS combined with antirotation screw. Among them, 36 patients were treated with DHS combined with antirotation screw including 24 males and 12 females with an average of 43.7 years old ranging from 22 to 58 years old; 31 patients were treated with three cannulated screws including 22 males and 9 females with an average of 43.0 years old ranging from 24 to 56 years old. The incision size, operation time, blood loss, blood transfusion rate, postoperative hospital stay, walking time, weight-bearing time, union time, incidence of complication were recorded and compared between two groups, and functional outcomes were evaluated by Harris scoring.

RESULTSAll incision healed at stage I. The differences in operation time, blood loss, blood transfusion rate and postoperative hospital stay between two groups were not significant (P > 0.05). Incision size of DHS group (5.00 ± 0.86) cm was larger than that of cannulated screw group (3.30 ± 0.57) cm (P < 0.01). All patients were followed up more than one year, and the follow-up time showed no significant difference between two groups (P > 0.05). Walking time of DHS group (19.0 ± 3.5) d was less than that of cannulated screw group (37.0 ± 6.3) d (P < 0.01. Partial and full weight-bearing time of DHS group (23.0 ± 7.0) d and (138.0 ± 13.0) d was less than that of cannulated screw group (38.0 ± 5.7) d and (164.0 ± 12.0) d (P < 0.01). Union time of DHS group (151 ± 11) d was less than that of cannulated screw group (162 ± 11) d (P < 0.01). Harris hip score of DHS group (91.0 ± 5.7) was higher than that of cannulated screw group (85.0 ± 12.0) (P < 0.01). No significant differences were found in the incidence of postoperative complications between two groups (P > 0.05).

CONCLUSIONThe DHS combined with antirotation screw is superior to three cannulated screws for treatment of comminuted fractures of femoral neck due to earlier weight-bearing, faster fracture healing and better hip function

Adult ; Bone Screws ; Female ; Femoral Neck Fractures ; surgery ; Follow-Up Studies ; Fracture Fixation, Internal ; adverse effects ; methods ; Fractures, Comminuted ; surgery ; Humans ; Male ; Middle Aged

Chronic obstructive pulmonary disease is thought to arise from the interaction of environmental exposures and genet -ic susceptibility, and major research efforts are underwent to identify genetic determinants and single nucleotide polymorphisms (SNPs) of COPD susceptibility.The suspected COPD genes include tumor necrosis factor (TNF)-a, transforming growth factor-b1 (TGF-b1), SERPINA1, matrix metalloproteinase 9 (MMP-9), microsomal epoxide hydrolase (EPHX1) and superoxide dismutase 3 (SOD3).A lot of Genome-Wide Association Study in COPD have identified some novel genes influencing COPD , such as CHRNA3/5, IREB2, HHIP and FAM13A.This review detailedly describe the advances in this field .

Objective To compare the treatment accomplishmentsand adverse effects of the mixed- or single-application of etomidate and propofol during modified electroconvulsive therapy (MECT) in schizophrenics with hypertension. Methods Ninety hospitalized schizophrenics with hypertension undergoing MECT were ran-domly assigned to 3 groups: Group EP(etomidate = 0.3 mg/kg and propofol = 1.0 mg/kg), Group E (etomi-date = 0.7 mg/kg) and Group P (propofol = 2.0 mg/kg). Changes of SBP, DBP and HR were recorded before anesthesia, after induction, electrical stimulation instantly and 5 min after electrical stimulation. The average pe-riods of epileptic seizure (ESD), postictal suppression index (PSI) and the adverse reactions were also recorded. Results The ESD and PSI scores were significantly higher in Group EP and Group E than those in Group P (P < 0.05). SBP and DBP in Group E were significantly higher at the electrical stimulation instant than those af-ter induction (P < 0.05). SBP and DBP in Group P were significantly lower after induction than those before anesthesia(P < 0.05). The injection pain of Group EP and Group E were lower than that of Group P(P < 0.05). No significant differences were found among 3 groups in the adverse reactions such as nausea/vomiting anddys-phoria.Conclusion The mixed liquor of etomidate and propofol can extend the time of seizure, reduce the nega-tive reaction of cardiovascular system and adverse reactions during MECT in schizophrenics with hypertension.

A comprehensive overview of CR equipment in the system to use various types of image artifacts and accurate analysis of the reasons for the formation of artifacts; described in detail to avoid and eliminate the artifact method, and measures to solve the work encountered in the actual artifacts of the problem.

OBJECTIVETo evaluate the effect of Shexiang Baoxin Pill (SBP) on coronary vasodilation by analysis of coronary angiography (CAG).

METHODSA consecutive cohort of 300 patients who underwent CAG between January 2013 and July 2013 were recruited and randomly assigned to 2 groups before operation. Patients in the SBP group sublingually took SBP, while those in the control group sublingually took placebos. All patients repeatedly underwent CAG 5 min after administration. The vascular diameter was calculated by quantitative angiography analysis method. The diameter of the left anterior descending coronary artery was measured in patients whose coronary arteries had no stenosis. The narrowest vascular diameter was measured in patients whose coronary arteries had stenosis. The heart rate, blood pressure, and the vascular diameter were compared between before and after administration in the two groups.

RESULTSIn the two groups, there was no significant difference in changes of heart rate, systolic pressure, or diastolic pressure between before and after administration (all P > 0.05). There were 64 patients with normal CAG in the two groups, 30 in the control group and 34 in the SBP group. CAG showed there were 236 patients with stenotic coronary artery, 110 in the control group and 126 in the SBP group. The vascular diameter was obviously larger in patients in the SBP group with normal or abnormal CAG after administration (all P < 0.01). It was also obviously larger than that of the control group after administration (P < 0.05, P < 0.01).

CONCLUSIONSBP could dilate both normal coronary artery and lesioned coronary arteries, but did not lead to fastened heart rate and decreased blood pressure.

Blood Pressure ; Coronary Angiography ; Coronary Vessels ; drug effects ; Drugs, Chinese Herbal ; administration & dosage ; pharmacology ; therapeutic use ; Heart Rate ; Humans ; Tablets ; Vasodilation ; drug effects

Accidents, Occupational ; Humans ; Work Schedule Tolerance

Objective To investigate CT features of solitary fibrous tumor of the mediastinum(SFTM),and to analyze the causes of misdiagnosis of this disease.Methods CT features of 5 patients of SFTM confirmed operatively and pathologically were retrospec-tively analyzed.All patients underwent before operation but were misdiagnosed.Results 3 cases were located in right mediastinum with oval-shap,well-defined margin,and “pleural tail sign”,2 cases were located in right thoracis cavity with unwell-defined margin, and in the adjacent lung were oppressed.In all 5 patients,the mean median of tumors was 1 1.5 cm(8.6-1 5 cm),non-homogeneous density of tumors were seen on plain CT scans,and obvious non-homogeneous enhancement with“geographic pattern”on contrast-en-hanced CT.Conclusion CT can clearly reveal the size and the appearance of SFTM,adjacent architectures,the final diagnosis de-pends on histopathological and immunohistochemical findings of the tumors.To un-know is the main caused of misdiagnosis of medi-astinal SFT.

Objective To explore the expression change of death associated protein kinase(DAPK)and therapeutic time window for traumatic brain injury in rats.Method The traumatic brain injury models of rats were achieved by free drop impact model.The adult rats were randomly divided into normal control,sham-operation and TBI groups.Samples of"TBI group were acquired at the time point of2h,8h,24h,48h and 72h after brain injury.Pathological changes of injured neurons were demonstrated by H-E staining,the expression of DAPK mRNA W8.8 detected by RT-PCR,relative quantitation of neuron apoptosis Wa$detected by TUNEL.Results At the Sh after brain injury,the expression of DAPK increased evidently and neuron apeptosis Wag detected.The expression of DAPK and quantitation of neuron apeptosis reached peal[at the 24h after injury.Conclusion These obaervatiorm showed that the expression of DAPK in the cerebral tissues reached peak at the 24h after injury.The optimum therapeutic time window wag 24h after injury.

Objective:To investigate the most effective strategy for mature induction of dendritic cells.Methods:Human monocyte-derived dendritic cells were induced in the presence of cytokines GM-CSF and IL-4. On day 6, the immature DCs were pulsed with each of CD40L, LPS, TNF-? or a cocktail of cytokines(TNF-?, IL-6, IL-1?, PGE2). DCs were harvested after 24 h induction. The surface markers for maturation CD80,CD83,CD86 and HLA-DR were detected by FCM. FITC-Dextra endocytic activity was measured by FCM. IL-12 production was detected by ELISA. The capacity of DCs for T cell activation was detected by MTT assay.Results:CD40L,LPS,TNF-? and the cocktail of cytokines all could induce DCs’ maturation. The most effective scheme for induction of maturation was the cocktail of cytokines, and the expression rate of CD83 was up to 66.91%(P

Objective To evaluate the value of CT scan in diagnosis of the splenic lesions.Methods A retrospective analysis was made on the CT scans of 33 patients with surgically and pathologically proven splenic lesions,which included plain CT scan(n=33),biphasic contrast-enhanced CT scan(n=28)and contrast delay scanning(n=6).Results In 33 cases,non-neoplastic lesions were 6 cases,including tuberculosis(n=2),hematomas(n=3)and inflammatory pseudotumor associated with a cavernous hemangioma(n=1).Benign tumors were 13 cases,including cysts(n=5),hemangiomas(n=4),lymphanioma(n=1)and lymph-hemangiomas(n=3).Malignant tumors were 14 cases,including malignant lymphoma(n=8),metastases(n=4),malignant myofibroblastoma and hemangioendothelial sarcoma(n=1,respectively).Conclusion CT is of significant value in diagnosis of splenic lesions.