Mandibular shape change caused by the decompression treatment of large unicystic ameloblastoma(UA) involving condylar process was observed in 2 cases and the reasons were analysed.

Objective To investigate distribution of Klebsiella pneumoniae infection and its drug resistance change in elderly pa‐tients during 2011 and 2013 .Methods API system was used to identify bacteria ,collected from clinical samples of elderly patients during 2011 and 2013 .Drug sensitivity was tested by using disk diffusion method .Results The isolation rate of Klebsiella pneu‐moniae from 2011 to 2013 was 9 .93% ,11 .56% and 13 .37% .During these three years ,the isolation rate of strains was the highest in Intensive Care Unit ,and the specimens mainly distributed in sputum .There was an increasing tendency of the resistance rates of Klebsiella pneumoniae to commonly used antibiotics ,though the resistant rate to piperacillin/tazobactam ,ceftazidime ,meropenem and amikacin was below 30% .Conclusion Observation on changes of drug resistance of Klebsiella pneumoniae and reduction of risk factors for bacteria infection ,might be important for prohibiting the increasing of drug resistance of Klebsiella pneumoniae .

Objective To analyze the postoperative complications of external fixator in treatment of elderly high-risk intertrochanteric fractures and its effect on length of hospital stay and on in-hospital fees.Methods The study involved 55 elderly patients with high-risk intertrochanteric fractures fixed with Orthofix external fixators from January 2009 to December 2011.There were 21 males and 34 females at age range of 70-79 years.All patients were associated with one underlying disease at least.Relationship of complications with patients' age,preoperative underlying diseases,surgery operation and postoperative care were analyzed.Results Common postoperative complications were lung infection (11％),screw channel exudation (25％),superficial pin tract infection (13％) and pain around the screws (22％).Factors for lung infection included the underlying lung disease and cerebral infarction before operation.Influential factor of screw channel exudation was the degree of damage to soft tissue intraoperatively.Influential factor of the superficial pin tract infection was postoperative care level.Average length of hospital stay was 5.17 days longer for patients who experienced complications after operation.Conclusions Common postoperative complications are influenced by preoperative occurrence of underlying lung disease as well as cerebral infarction,intraoperative damage to soft tissues and postoperative care level.Postoperative complications prolong the length of hospital stay and increase the treatment expense.

Objective To comparetheproximalfemoralnailantirotation(PFNA)anddynamichipscrew(DHS)treatmentonin-tertrochanteric femur fractures in the elderly .Methods Retrospective analysis was conducted on 60 patients with intertrochanteric femur fracture collected from December 2009 to December 2012 ,which underwent these two methods ,including 32 cases of PFNA group ,28 cases of DHS group .The 5 indicators including operation time ,intraoperative blood loss ,complications ,fracture healing time and hip function recovery were analyzed .Results Sixty cases were followed up for 10 to 25 months ,average 17 months ,com-pared with DHS group ,PFNA group was with short operation time ,less bleeding ,less complications ,short time of fracture healing , according to standard of Harris score ,the hip function recovered well .Conclusion PFNA treatment on intertrochanteric femur frac-tures is with little trauma ,reliable fixation ,fewer complications ,with which the hip function recovered well ,and it is the preferred method of operation in treatment of senile intertrochanteric femur fracture .

Objective To investigate the applicative effect of cardiopulmonary resuscitation in pre-hospital care of emergency pa-tients with cardiac arrest and provide the basis for pre-hospital care of cardiac arrest.Methods Selected 93 cases of cardiac arrest in January 2011 to May 2013 occurred out of Hainan Province Nongken Sanya Hospital,including 51 cases of cardiopulmonary resusci-tation of pre hospital rescue as the study group,42 cases of the application of artificial compression cardiopulmonary resuscitation as control group.Compared blood oxygen saturation,oxygen and carbon dioxide partial pressure and blood pressure changes,CPR time,spontaneous breathing recovery time and the recovery of the function of two groups.Used chemiluminescence method to detect NSE,NT-proBNP,cTnI and H-FABP.Results The two groups of patients with blood oxygen saturation,oxygen and carbon diox-ide partial pressure showed no statistical difference(P>0.05);the DBP and SBP levels of the study group were significantly higher than the control group(P<0.05);the study group CPR time and spontaneous circulationtime were significantly higher than that in control group(P<0.05).Two groups of intraoperative heart rate,respiration,blood pressure and oxygen saturation had no signifi-cant difference(P>0.05).Study group of patients with spontaneous breathing recovery,the restoration of spontaneous circulation, survival is greater than 24 h and rehabilitation discharge rates were significantly higher than the control group(P<0.05).There was no significant difference in the serum levels of NSE,NT-proBNP,cTnI immediately,H-FABP recovery in spontaneous circula-tion(P>0.05);after 24 h,NSE,NT-proBNP,cTnI,H-FABP levels in study group were significantly lower than those in the control group(P<0.01).Conclusion The application of cardiopulmonary resuscitation in patients with cardiac arrest before salvage can ef-fectively shorten the recovery time of CPR patients and spontaneous circulation time,reduce the damage to heart,brain,lung and other organs,improve the success rate of cardiopulmonary resuscitation,worthy of clinical application.

OBJECTIVE:To evaluate the long-term toxicity of Ginkgolide B injection on Beagle dogs,and to provide safety evidences for clinical experiment.METHODS: A total of 24 Beagle dogs were equally assigned to receive placebo(control group,n=6) or Ginkgolide B injection at high,medium,and low doses(80,20,and 5 mg?kg-1) by iv gtt for 6 consecutive days per week for up to 90 days.There were 6 Beagle dogs(male: female =1∶1) in each group.All the laboratory indicators were monitored and the recovery of the Beagle dogs was observed.RESULTS: During medication,vomiting was noted in one dog in high dose group,and the clotting time in high and medium dose groups was prolonged obviously.During the recovery stage,one dog in high dose group was strong positive in urinary protein test.No significant drug-associated toxic reactions were noted judging from Beagle dogs' body weight,appetite,temperature,ECG,hematology,blood biochemical analysis,ophthalmology test,marrow test,urine routine test,histopathologic examination etc.CONCLUSION: The non-toxic dose of Ginkgolide B injection for Beagle dogs was 20 mg?kg-1.

Objective To explore the curative effects of open reduction and internal fixation with Cable Pin or tension band wire for patellar transverse fractures.Methods Totally 28 cases and another 30 cases were enrolled in the Cable Pin group(8 months for average follow-up time) and the tension band wire group respectively(16 months for average follow-up time).The operative time,the average clinical healing time and the average range of the knee flexion between the 2 groups were compared.Results Obvious superiority was observed in the Cable Pin group over the tension band wire group concerning the average clinical healing time and the average range of the knee flexion 6 months postoperatively (P

Objective To evaluate the efficacy of transcatheter arterial chemoembolization(TACE) combined with radiofrequency ablation(RFA) in treating primary hepatocellular carcinoma(HCC).Methods From March 2004 to March 2006,137 patients with primary HCC underwent TACE alone(n=87) and TACE+RFA(n=50),respectively,after the interventional treatment,all patients periodically received CT reexaminations and alpha fetoprotein(AFP) measurement.The therapeutic efficacy,AFP level and survival rate between two groups were compared with each other.Results In TACE group the effective rate(CR+PR) was 34.5%,AFP decreasing amplitude was 54.2%,and 2 years survival rate was 43.7%.While in TACE+RFA group,the effective rate(CR+PR) was 70.0%,AFP decreasing amplitude was 78.0%,and 2 years survival rate was 62.0%,there were significant differences between two groups(P

Objective: To study an epidemiological methodology for domestic violence. Methods:A program was drawn,the epidemiological instruments were developed, investigators were trained, not only according to the principles of epidemiology but also being suited to Chinese condition. Then,We win over the support of government bodies, arouse the messes to action, and all clues from investigation were confirmed by interview with persons concerned.Spot check randomly was used for control of quality.Results:The reliability of the epidemiological instruments was 97%, the sensitivity was 95%, the specificity was 100%. The prevalence of domestic violence in life-time and past year was 16.2% and 11.6% respectively.Conclusion:This was a practical methodology in epidemiological survey for domestic violence in China.

BACKGROUND:The key of intertrochanteric fractures in elderly patients is to select the appropriate fixation, but few clinical studies concerned different fixation methods for blood volume of blood circulation system in elderly patients with intertrochanteric fractures. OBJECTIVE:To compare the effects of proximal femoral intramedul ary nail and dynamic hip screw on blood volume of blood circulation system in elderly patients with intertrochanteric fractures.
METHODS:A total of 48 elderly patients with intertrochanteric fractures, who were treated in the Jiangyin Hospital Affiliated to Nanjing University of Traditional Chinese Medicine from January 2012 to September 2014, were enrol ed in this study. These patients were assigned to two groups (n=24). Patients in the observation group received treatment with proximal femoral intramedul ary nail, and patients in the control group received treatment with dynamic hip screw. Postoperative blood loss, perioperative blood transfusion, preoperative and 3-day postoperative hemoglobin difference, incidence of postoperative complications, dominant blood loss, and hidden blood loss were compared between the two groups. Range of motion of the hip and Harris score of the hip were compared between the two groups at 4 and 12 months post surgery. RESULTS AND CONCLUSION:Intraoperative blood loss was less in the observation group than in the control group (P<0.05). No significant differences in perioperative blood transfusion and preoperative and 3-day postoperative hemoglobin were detected between the two groups (P>0.05). The operation time was significantly longer in the observation group than in the control group (P<0.05). The incidence of postoperative complications was significantly lower in the observation group than in the control group (P<0.05). No significant difference in length of hospital stay was detected between the two groups (P>0.05). Within the same time period, the range of motion of the hip and Harris score of the hip were better in the observation group than in the control group (P<0.05). The total amount of blood loss and dominant blood loss were less in the observation group than in the control group (P<0.05). These findings indicate that compared with the dynamic hip screw, proximal femoral nail fixation for intertrochanteric fracture has less intraoperative blood loss, lower incidence of postoperative complications, postoperative range of motion of the hip and better hip score. However, operation time of proximal femoral nail was long. There were no significant differences in hemoglobin difference and perioperative blood transfusion between the two fixation methods.