OBJECTIVE To investigate clinical status,distribution of the genera,and risk factors of pneumonia caused by fungi in hospitalized senile patients.METHODS The notices of hospitalized senile patients from Jan 2000 to Apr 2003 were analyzed according to Diagnosis Standard of Nosocomial Infection published by National Ministry of Health.RESULTS Totally 135 cases were collected.The isolating ratio of Candida albicans ranked first(54.8%),followed by C.tropicalis(20.0%).The risk factors included underlying diseases,invasive surgical procedure,and prolonged hormones and antibiotics therapy.CONCLUSIONS To prevent and control pneumonia caused by fungi in hospitalized senile patients,the measures such as curing the underlying diseases,reducing invasive surgical procedures,and using antibiotics reasonably should be adopted.

Objective To evaluate the accuracy of Doppler ultrasound (BUS), computer tomography (CT) and magnetic resonance imaging (MRI) in the diagnosis of hepatocellular carcinoma. Methods A total of 74 patients with hepatocellular carcinoma and cirrhosis who received a liver transplantation was included in this study. We compared the postoperative pathological results with preoperative imaging findings (BUS, CT, and MRI). An assessment was made in respect of the accuracy in tumor size (a diagnostic accordance was defined as

Objective To investigate the effect of the locking plate fixation with anti-osteoporosis drug in the treatment of older patients with proximal humeral fractures. Methods Sixty-two patients with proximal humeral fractures who were treated in Yuzhou Mining Company Hospital of Kailuan Group of Hebei Province from Feb. 2011 to Oct. 2013 were divided into observation group(n=30)and control group(n=32). Patients in both groups were given locking plate fixation,and patients in the observer group were also received anti-osteoporosis treatment. The information including hospitalization periods,efficacy and bone mineral density of the two groups was recorded. Results The hospitalization periods of the observation group and control group were (6. 9 ± 1. 0)d,(9. 5 ± 1. 1)d,and the difference was statistically significant(t=8. 426,P﹤0. 05). The efficacy in observer group was excellent in 17 cases,good in 10 cases,fair in 2 cases and poor in 1 case,and the efficacy of the control group was excellent in 14 cases,good in 10 cases,fair in 5 cases and poor in 3 cases. The difference was statistically significant(χ2 =4. 617,P ﹤0. 05 ). After the anti-osteoporosis treatment,the bone mineral density of the observer group and control group were( 0. 79 ± 0. 13)g/cm2 and(0. 66 ± 0. 05)g/cm, the difference was statistically significant( t =10. 251,P ﹤0. 05 ). Conclusion The effect of locking plate fixation with anti-osteoporosis drug is better with shorter hospital stay,safe and reliable,and it is worthy of clinical application.

Objective To investigate the clinical effects of open decompression drainage on acute pulpitis.Methods Totally 180 acute pulpitis patients hospitalized during January 2012 to September 2014 in our department were selected and randomly divided into control group and observation group (n=80 each).The control group was treated with pulp inactivating agent and the observation group was given open decompression drainage.The clinical effects,analgesia efficiencies at 7d after treatment,treatment course and the complications were compared between the 2 groups.Results There was significant difference in the effective rate between control and observation groups after treatment [61.3％ (49/80 cases) vs.86.3％ (69/80 cases),P＜0.05].The analgesia efficiencies at 7d after treatment was 46.3％ (37/80 cases) in control group and 73.8％ (59/80 cases)in observation group (P＜0.05).There was no significant difference in treatment course between two groups [(7.7±1.4) times vvs.(6.1± 1.2) times,P＞0.05]].6 patients developed periapical periodontitis in control group,and only 4 cases in the observation group (P＞0.05).Conclusions Early open decompression drainage has good clinical effects and analgesia efficiencies in treatment of acute pulpitis,which is worthy of clinical application.

Multiple organ dysfunction syndrome(MODS),a hot topic worldwide,has made rapid progress with nigh mortality.MODS in pediatrics versus MODS in adults are similar but different.Due to special age-related physiological characteristics.It is difficult to carry out randomized controlled clinical study compared with adults.Diagnosis and treatment of pediatric MODS can only be obtained with reference to adult MODS.This study reviews on the epidemiology,clinical scoring system,pathogenesis,clinical features and treatment of MODS in pediatrics.

Objective To explore the temporal expressions of interleukin-10(IL-10)and interleukin-4(IL-4)and their relationship with the wound age during skin incised wound healing in mice.Methods Immunohistochemical and image-analysis techniques were employed in vital skin wounds 0.5h～168h after incision and postmortem incision 0.5h～6h after death.Results Weak expression of IL-10 was detected at 0.5h after incision,which increased subsequently,and peaked at 3h post-injury.Then decreased to the pre-incision level at 24h,but peaked again at 72h after injury.Immunostaining revealed that epidermal cells and infiltrating mononuclear cells were the major source of IL-10.IL-4-positive cells were observed in the dermis at 24h,and reached the maximum level at 96h,which maintained until 168h post-injury.IL-4 was mainly expressed in the fibroblast-like cells of the granulation tissue and dermis.In addition,faint IL-10-positive cells were merely identified in the epidermal cells in the postmortem incision skin within 1～3h after incision.No IL-4-postitive cells were found in the postmortem incision skin.Conclusion The time-dependent expressions of IL-10 and IL-4 during cutaneous wound healing may be used for the estimation of wound age.

Objective To investigate the clinical effect of small incision for total hip arthroplasty on osteoporosis treatment of elder patients with fracture of the femoral neck.Methods Fifty-six elder patients with femoral neck methods were selected as our subjects,who were hospitalize from Jan.2011 to Dec.2013 in Xiahuayuan Meikuang Hospital,Zhangjiakou Company Limited.They were randomly divided into the observation group (26 cases) and control group (30 cases).All patients were treated with small incision total hip arthroplasty.The patients in the observation group were given the alendronate sodium.The curative effect,hospitalization time,bone mineral density were recorded.Results The long-term efficacy of the excellent and good rate of the observation group was 96.2％ (25/26),higher than that in control group(86.6％ (26/30)),and the difference was statistically significant(x2 =4.125,P ＜ 0.05).The length of hospitalized time in observation group was (26 ± 4) d,shorter than that in the control group (35 ± 3) d,and the difference was statistically significant(t =9.102,P ＜ 0.05).The bone density of patients in the observation group was (0.64 ± 0.03) g/cm2,higher than that in control((0.61 ± 0.05) g/cm2),and there was significant difference between two groups (t =8.461,P ＜ 0.05).Conclusion The effect of small incision total hip arthroplasty combined with anti osteoporosis drugs for the treatment of femoral neck fractures in the elderly is good and worthy of clinical usage.

BACKGROUND:Studies have shown that placement, needling point, angle and length of pedicle screws for thoracic vertebral fractures have been unified. Many studies concerned axial pul-out force and biomechanical behavior of a single screw, but few reports addressed the biomechanical behavior after the replacement with three kinds of screw connecting to rods. OBJECTIVE:To further observe and compare biomechanical behavior after three kinds of thoracic screw placement connecting rod using biomechanical testing, to understand the strength of thoracic pedicle screw replacement connecting rods, and the effects of its puling out on the stress of the bone surrounding the placement site. METHODS:The fresh frozen specimens of thoracic vertebra were divided into three groups at random: the pedicle fixation group, the transverse process-vertebral body fixation group, and modified rib transverse process fixation group. Thoracic pedicle screw system was inserted by the standard placement method in each group. The experiment was measured on the mechanical equipment. During puling out, the strength that bone bore was described with dynamic curve, folowed by statistical analysis. The difference in the gripping force on the thoracic vertebra among three kinds of screw placement method was compared. RESULTS AND CONCLUSION: Among three kinds of screw placement methods and among three kinds of screw placement methods on the injured vertebral body, the gripping force was significantly bigger in the pedicle fixation group than in the transverse process-vertebral body fixation group and modified rib transverse process fixation group (P < 0.01). No significant difference in the gripping force was detected between the transverse process-vertebral body fixation group and modified rib transverse process fixation group. Results verified that the stability of loading ability was apparently better in the pedicle fixation group compared with the transverse process-vertebral body fixation group and modified rib transverse process fixation group.

Objective To comprehensively grasp the grassroots medical institutions blood transfusion(blood) management present situation,put forward improvement strategy for the universality of existence weak link,the stand-ardized management of clinical blood transfusion to strengthen grass -roots medical institutions to provide necessary theoretical support.Methods 62 grassroots medical institutions blood transfusion(blood)in Yantai district were selected as the research subjects,to set the planning,layout,basic construction standards,related technology and equipment application aspects of quantitative evaluation,preliminary conclusions.Results By examination of 62 grassroots medical institutions transfusion quality management level both in terms of hardware and software facilities, emergency plan formulation,system file support informatization construction,staff education training,etc,found many problems,there was a certain gap between the existing department of blood transfusion standards.Conclusion The current grassroots medical institutions transfusion management is conditioned by the objective conditions,there are many problems,such as not improved,will cause a certain hidden trouble on the safety of clinical blood transfusion. Therefore,should combine their own reality,strengthen the quality of blood transfusion management system construc-tion,and give full play to the supervision and management of the hospital transfusion quality management committee. At the same time,the local administrative department of health also should formulate corresponding policies,ensure transfusion management level significantly increased.

The understanding of anatomical structures and their adjacent relationship is the founda-tion and key to the development of surgical skills and clinical thinking. In clinical teaching for residents and graduate students , we took the advantage of donor operations in organ transplantation and showed abdominal anal operations anatomical features and relationships through different view angles and compre-hensive ways. This new teaching approach was designed in accordance with processes of organ donation, procurement and back-table operation. The main contents included anatomy of abdominal wall layers, rela-tionships among abdominal organs, locations and courses of important structure, as well as medical human-istic education. In the context of organ donation becoming more and more popular and standardized after the cardiac death of Chinese citizens, this teaching approach is worth exploring.