Objective To explore and analyze the timing and postoperative effect of proximal femoral nail anti-rotation( PFNA) for the treatment of elderly femoral intertrochanteric fracture. Methods From September 2011 to March 2013, there were 36 elderly patients with femoral intertrochanteric fractures in our hospital, including 6 cases of type A1, 16 cases of type A2, and 14 cases of type A3. All the 36 pa-tients received PFNA and systematic rehabilitation exercise. Treat the underlying disease and strengthen the nursing to prevent thrombosis at the same time. Hip joint function was evaluated by the Harris score system. Results The average hospitalization of patients is 4 weeks. The wound healing was good in 30 cases and wound infection occured in 2 cases who recovered after subsequent treatment, and the other 4 pa-tients died due to complicated internal medicine diseases. 21 cases of patients were followed up,and their hip joint function recovered well according to the Harris score system, including 12 cases of excellent, 6 cases of good, and 3 cases of eligible, with an excellent and good rate of 85%. Conclusion The application of PFNA for the treatment of elderly femoral intertrochanteric fractures has the advantages of less damage to the local blood supply and better recovery of fracture healing and hip joint function, which is an ideal treatment for the elderly pa-tients with femoral intertrochanteric fractures.

Adult ; Elbow ; Giant Cell Tumors ; diagnosis ; pathology ; physiopathology ; surgery ; Humans ; Magnetic Resonance Imaging ; Male ; Tendons

Adult ; Bone Cysts ; diagnostic imaging ; Calcaneus ; Female ; Humans ; Tomography, X-Ray Computed

Objective To analyze the value of fine needle aspiration for male breast cancer and to investigate the clinical characteristics of male breast cancer.Methods The cell morphological characteristics of fine needle aspi-ration and clinical data were analyzed retrospectively within a total of 35 cases with male breast cancer of Affiliated Hospital of Luzhou Medical College,from 2000 January to 2014 December.Results During the 35 patients of male breast cancer with fine needle aspiration,from 35 to 82 years old,the median age was 64 years old and mean age was 61.6 years old.There were 23 cases of male breast cancer from 60~82 years old,suggesting that the relatively high incidence was after the age of 60 years.The diameter of male breast tumor was 0.8~8cm,while the average diameter was 3.5cm.In the clinical stage of TNM,14 cases were with stageⅠ,13 cases were with stageⅡ,7 cases were with stage Ⅲand 1 case wasⅣstage;that was to say,the cases of male breast cancer in the late was relatively more.The invasive ductal cancers were 16 cases (45.7%) of male breast cancer.The sensitivity was 94.3% of fine needle aspiration cytology before the operation.Conclusion The accuracy of fine needle aspiration cytology has important significance for the diagnosis of male breast cancer,can be used as a mean of detecting male breast tumor as benign or malignant.

Objective To analyze the population distribution and clinical characteristics of esophageal cancer in Luzhou prefecture of Sichuan. Methods The data of 690 cases of resected specimens with esophageal cancer from October 2010 to September 2014 were analyzed retrospectively, including 659 cases of esophageal squamous cell carcinoma, 10 cases of adenocarcinoma, 7 cases of adenosquamous carcinoma, 5 cases of sarcomatoid carcinoma, 2 cases of carcinoma in situ, 3 cases of leiomyosarcoma, 2 cases of small cell carcinoma, 1 case of undifferentiated carcinoma and 1 case of mixed carcinoma. Results The constituent ratio of 51-60 years old population of 690 cases with esophageal cancer was the highest for 40.00%(276/690). In≤60 years patients, the rate of esophageal cancer in male was higher than that in female: 56.15%(338/602) vs. 34.09%(30/88), χ2 = 15.005, P =0.000. Clinical pathological factors of lymph node metastasis showed that there were statistically significant differences between male and female: 45.68%(275/602) vs. 34.09%(30/88), χ2 = 4.182, P =0.041;the lower the position, the higher the lymph nodes metastasis rate:the lymph nodes metastasis rate in superior segment, middle segment, inferior segment was 32.00%(8/25), 41.22%(216/524) and 57.45%(81/141),χ2=13.425, P=0.001;the lower the differentiation, the higher the lymph nodes metastasis rate:the lymph nodes metastasis rate in high, middle and lower differentiation was 40.84%(165/404), 47.60%(109/229) and 75.76%(25/33), χ2 = 16.065, P = 0.000. The lymph nodes metastasis rate in different general types and histology types had no significant differences(P>0.05). Conclusions The incidence rate of esophageal cancer in male is significantly higher than that in female, the higher the lymph node metastasis rate, the lower the position and the differentiation of esophageal cancer in Luzhou prefecture of Sichuan.

Objective To analyze the clinical feature and prognostic predictors of disseminated herpes zoster.Methods A retrospective study was carried out on 76 patients with disseminated herpes zoster collected from 2005 to 2012 in the Department of Dermatology,Anhui Provincial Hospital.Statistical analysis and comparisons were done.Results The incidence rate of disseminated herpes zoster was highest in the three age groups:70-79 years,30-39 years,and 60-69 years.Of these patients,59.21％ suffered from complications,and 44.74％ from postherpetic neuralgia.Logistic regression analysis showed that the occurrence of complications was significantly associated with age and impaired cellular immune function,and the incidence of postherpetic neuralgia with age,impaired cellular immune function and presence of underlying diseases.Conclusions There is a high incidence of complications in patients with disseminated herpes zoster,and impaired cellular immune function may be an important factor affecting its prognosis.

Objective:With Diagnosis related groups(DRG)indicator introduced into the hospital efficiency evaluation, to analyze the adjustment effect of DRG on the efficiency value, and to compare the similarities and differences between the DEA efficiency value and the DRG efficiency indicator.Methods:The DRG pilot data in 2017 and 2018 of tertiary hospitals in Hubei province and related data from other reports were collected. Indicators including the actual number of beds, the number of employees, the actual total bed days occupied, and medical income were used as input indicators, and total admissions, number of discharges, weight of DRG and number of DRG groups were used as output indicators. 7 models were constructed using different indicator combinations. The efficiency of the hospital was calculated by the Bootstrap-DEA efficiency evaluation method. The relationship between hospital attributes and efficiency was analyzed by a generalized linear model.Results:There was an abnormal phenomenon that the higher the hospital level, the lower the efficiency in the efficiency value calculated by the traditional method. The efficiency values of county hospitals, city hospitals and provincial hospitals were 0.83, 0.74 and 0.71, respectively( P<0.01). DRG weight and group number were used as output for DEA analysis, and the efficiency values of county hospitals, city hospitals, and provincial hospitals were 0.95, 0.95 and 0.96( P=0.20)respectively. The DRG efficiency indications of county hospitals, city hospitals and provincial hospitals were 1.42, 1.11, 1.00 respectively( P<0.01). The higher the level, the lower the efficiency, while the efficiency values calculated by DEA were 0.84, 0.82, 0.86, respectively( P=0.58). Conclusions:The efficiency value calculated by the traditional method presents a systematic bias, which could be corrected effectively when DEA analysis using DRG weights is used as output indicator. The results developed new ideas of efficiency analysis for hospitals practicing DRG management.

Objective:To quantitatively measure the level of hospital human resources management of public hospitals in China with D-CHMS.Methods:From January through December of 2019, the Development Chinese Hospital Management Survey(D-CHMS)was used in field survey of relevant personnel of 36 tertiary general hospitals and 27 secondary general hospitals, with 10 persons chosen from each hospital. Survey data were subject to descriptive analysis and t test, for quantitative measurement of the human resources management level of these sample hospitals. Results:The level of human resources management in Chinese public hospitals was on the low side, as seven secondary dimensions scored 2.94 in average. To name a few, talents retention and talents recruitment scored the lowest, being (2.13±0.29) and (2.90±0.63) respectively. Tertiary hospitals presented an obviously better performance than secondary hospitals in incentives for best performers, talents retention and recruitment. Human resources management level of hospitals in China′s west regions scored the highest, followed by those in the east regions.Conclusions:Public hospitals in China, especially secondary hospitals were expected to enhance their human resources management. Approaches recommended include building a talent pool, developing a series of preferential policies, building development platforms, optimizing performance appraisal, motivating remuneration schemes, and offering unique employee value propositions, which serve to recruit and retain talents.

Objective: To elucidate the association between large conductance calcium-activated potassium channels (BK_Ca) in the paraventricular hypothalamic nucleus (PVN) and sympathetic outflow in rats with chronic heart failure (CHF) . Methods: Male Wistar rats (6-7 weeks old) were randomized to sham operated group and CHF group (coronary artery ligation) . Two weeks after operation, BK_Ca inhibitor Iberiotoxin (IBTX) was infused into PVN by osmotic minipumps, rats were divided into following groups: sham+aCSF, CHF+aCSF, sham+low dose IBTX (0.125 nmol/nl) , CHF+low dose IBTX, sham+moderate dose IBTX (1.25 nmol/nl) , CHF+moderate dose IBTX, sham+ high dose IBTX (12.5 nmol/nl) , and CHF+high dose IBTX (n=6 each) . Additional rats were grouped as follows: sham+vehicle, sham+KCNMB4 knockdown (by rAAV2-KCNMB4 shRNA virus injection in PVN) , CHF+vehicle, CHF+ KCNMB4 knockdown group (n=6 each) . The cardiac function was determined by echocardiography, left ventricular hemodynamics were measured invasively, renal sympathetic nerve activity (RSNA) was recorded at 6 weeks after coronary artery ligation or sham operation. The contents of norepinephrine (NE) and N-terminal pro-B-type natriuretic peptide (NT-proBNP) in plasma were determined by enzyme-linked immunosorbent assay. The protein and mRNA expression of KCNMB4 in PVN were measured by immunofluorescence staining, Western blot, and real-time PCR, mRNA expression of BK_Ca in PVN was detected by real-time PCR. Results: Compared with the sham operation group, the cardiac function of the heart failure group was significantly reduced (P<0.05) , and the plasma NE and the serum NT-proBNP were significantly elevated (P<0.05) . The protein and mRNA expression of KCNMB4 in PVN were obviously down-regulated in CHF rats (P<0.05) . After perfusion of IBTX or KCNMB4 knockdown by microinjection of rAAV2-KCNMB4 shRNA virus,right ventricular weight/body weight and lung weight/body weight ratio as well as left ventricular end-diastolic diameter were increased and left ventricular ejection fraction was decreased (all P<0.05) , the sympathetic driving indexes was increased in sham rats, changes of these parameters further aggravated in CHF rats (P<0.05) . KCNMB4 knockdown further downregulated protein expression in PVN of CHF rats. Conclusion Downregulation and blunted function of BK_Ca in PVN may contribute to sympathoexcitation and deterioration of cardiac function in rats with chronic heart failure.

Objective:To explore the feasibility of using ultrasound to evaluate the abdominal fat volume to predict bone quality.Methods:A total of 376 men, aged from 34 to 90 years, were recruited.The trabecular bone score(TBS)was measured by TBS iNsight ? software.Bone mineral density(BMD)of the femoral neck, total hip, and lumber spine, as well as android and gynoid fat mass were measured using dual-energy X-ray absorptiometry(DXA).Preperitoneal fat thickness and intraperitoneal visceral fat thickness were assessed by ultrasound. Results:BMD of the femoral neck, total hip, and lumber spine was significantly positively correlated with body mass index(BMI)( r=0.346, 0.378, 0.218, all P<0.001), while TBS was significantly negatively associated with BMI( r=-0.353, P<0.001); Femoral neck BMD, lumbar BMD and TBS were positively correlated with total lean mass( β=0.296, P<0.001; β=0.280, P<0.001; β=0.182, P=0.009; respectively), while femoral neck BMD, total hip BMD and TBS were negatively correlated with total fat mass( β=-0.161, P=0.036; β=-0.160, P=0.041; β=-0.354, P<0.001; respectively).Compared with fat mass, BMD was more closely correlated with BMI( P<0.001), while TBS was negatively correlated only with android fat mass( β=-0.297, P=0.017).TBS was inversely associated only with visceral fat thickness( β=-0.244, P=0.04), but not preperitoneal fat thickness( β=-0.119, P=0.256). Conclusions:Abdominal fat mass, especially intraperitoneal visceral fat mass, may have adverse effects on bone quality.Intraperitoneal visceral fat thickness measured by ultrasound is helpful for the prediction of bone quality.