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 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 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 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 .

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.

BACKGROUND:The most important influence caused by patel ar fracture is the breakage of knee extension apparatus continuity and potential uncoordination of patel ofemoral joint. The aim of patel ar fracture surgery is to restore the smoothness of patel ar articular surface and to maintain the continuity of knee extension apparatus, to provide stable effective fixation, so as to do early functional exercises. OBJECTIVE:To evaluate the clinical effectiveness of a fixation technique for patel ar fractures using QWIX combined with Kirschner wire and wire. METHODS:From September 2011 to September 2012, 30 patients with patel ar fractures were treated using QWIX screws combined with Kirschner wire and wire in the First Affiliated Hospital of Chongqing Medical University, China. There were 17 males and 13 females, at the age of 47.7 years on average. In accordance with the situation of comminuted fracture and the degree of displacement, QWIX screws or QWIX screws+tension band wire or QWIX screws+Kirschner wire+tension band wire were used for fixation. Active and passive knee motion exercises began at 1 day after surgery, without any external fixation. At 6 weeks, 3, 6, 12 months, and 1 year after surgery, the patients were fol owed up in out-patient clinic to identify fracture healing and to make sure whether complications appeared or not. The range of flexion and extension of bilateral knee was measured. The knee function of the affected side was evaluated using Bostman score at 1 year postoperatively. RESULTS AND CONCLUSION:Al patients were fol owed up for 12 to 24 months. 24 cases were healed within 3 months after surgery, and 6 cases were healed within 4 months after surgery, with an average healing time of 3.2 months. With time prolonged, the range of flexion and extension of bilateral knee gradual y increased. The knee function of patients recovered to the level before injury at 1 year after surgery. During fol ow-up, one patient experienced knee pain due to Kirschner wire loosening. No infection, knee pain, fixation failure, or flexion dysfunction occurred in the remaining patients. In accordance with Bostman score, there were excellent in 27 cases, good in 3 cases, and poor in 0 case, with an excellent and good rate of 100%at 1 year fol owing surgery. Results data suggested that QWIX screws combined with Kirschner wire and wire fixation in repair of patel ar fracture have some advantages such as continuous dynamic and static pressure at the broken ends of the bones, early flexion and extension exercises, and reducing the fixation-related complications. It is an effective method to repair patel ar fracture.

Objective By testing the particle removal efficiency of LG Electronics Company's two types of plasma air cleaners,to explore more scientific and reasonable methods for evaluating the purifying effectiveness of indoor air cleaners so as to obtain scientific and contrastable experimental data and calculating results. Methods This evaluating method referred to Standard Examination Method of Portable Household Electric Cord-Connected Room Air Cleaners of America (ANSI/AHAM AC-1-2000) and used one of indexes regu lated in standard Clean Air Delivery Rate (CADR) as the main evaluating index of the effectiveness of indoor air cleaners,meantime several kinds of domestic and international current evaluating indexes were adopted to synthetically evaluate decontaminating function of the air cleaners. Results The index of CADR could accurately and objectively manifest the true decontaminating function of indoor air cleaner. But if using the index of purifying efficiency to reflect the purifying effectiveness of air cleaners,pollutant's natural decay rate and initial concentration should be considered and at the same time other experimental conditions should be given out. Conclusion The establishments of accurate testing methods and accurate expressions of testing results were the sufficient and essential conditions for accurate evaluation on testing objectives.

Objective: To study the group consultation in preventing psychological disorders causing by retirement. Methods: Implement group consultation to 23 elderly staff members from a government organization. Both the self-designed health knowledge and SCL-90 questionnaires were used before and after he/she participated the group consultation. Comparisons were conducted of the results getting from 18 old people who had never had the consultation. Results: There was significant difference in two groups. Experiments show that group consultation can impressively held to improve the psychological and behavior disroders. Conclusion: Group consultation is an effective way to prevent psychological problems causing by retirement.

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 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