BACKGROUND:Internal fixation has become the first choice for the treatment of intertrochanteric fractures. However, the methods and materials for internal fixation are various. Which one has the best clinical efficacy?
OBJECTIVE:To compare the effects of proximal femoral nail and total hip arthroplasty for the treatment of intertrochanteric fractures.
METHODS:A total of 46 patients with intertrochanteric fractures were voluntarily divided into two groups:proximal femoral nail and total hip arthroplasty. Operation time, intraoperative blood loss, and Harris scores were compared between the two groups, and X-ray examination was used for assessment of clinical efficacy in the two groups.
RESULTS AND CONCLUSION:Total y 46 patients were fol owed-up for 3 to 12 months. Fractures in al the patients were healed. As compared with the total hip arthroplasty group, in the proximal femoral nail group, approach incision was smal er, blood loss was higher, operation time and fracture healing time were longer, and Harris score was lower (P<0.05). These findings indicate that the total hip arthroplasty is better than proximal femoral nail for intertrochanteric fractures, with less invasion and blood loss. However, the long-term effects need further studies.

Objective To analyze the prevalence of lower urinary tract dysfunction in stroke patients in the convalescent stage,its risk factors and the characteristics of urodynamics.Methods One hundred and thirty-one stroke patients in the convalescent stage were included in this study.Their general information,neurological system reviewing and past history were obtained,especially detailed micturitional histories.In patients with urinary symptoms,diagnosis and classification were made and relevant analysis and urodynamic study were performed.Results The prevalence of lower urinary tract dysfunction is 44.3%.The most common symptom was urinary incontinence(frequency,urgency and nocturia)followed by hesitancy,straining and urinary retention.The incidence of micturitional disturbance is higher 1.8 times in cognitive disfunction group than normal cognitive function group(χ~2=18.683,P=0.000);it was higher 1.2 times in patients with modified Bathel index scale≤20 than those with≥25(χ~2=16.832,P=0.000).Logistic multivariate analyses suggested that age(OR=1.622,95%CI 1.183-2.224),the during of urethral catheterization(OR=3.236,95%CI 1.335-7.840)and single or multiple lesions (OR=1.296.95%CI 1.083-1.550)to be the risk factors of lower urinary tract dysfunction at the convalescent stage in stroke patients.The urodynamics study found detrusor over activity in 78.5% patients,normal in 10.5%and detrusor areflexia in 10.5% patients.There was no detrusor-sphincter dyssynergia.Conclusions Lower urinary tract dysfunction is common after stroke with the storage symptoms to be the most common.Patients with lower urinary tract dysfunction show impaired cognitive function and poor ability in daily life.Age,during of urethral catheterization and single or multiple lesions are among risk factors of lower urinary tract dysfunction.Detruser overactivity is the most common finding in urodynamic study.Because the clinic symptoms are not often in accordance with the findings in urodynamics study,further urodynamics study are needed to benefit the treatment.

Objective To observe the effect of laparoscopic operation( LPS) for the treatment of endometrio-sis(EMS) infertile serum matrix metalloproteinase in patients of matrix metalloproteinases-9(MMP-9),tissue inhibi-tors of metalloproteinase-1(TIMP-1) and interleukin-2 (IL-2),interleukin-10(IL-10) .Methods 80 patients with EMS in 2012 August to 2013 August to accept the choice of operation cases,according to the different operation modes for the observation group(received LPS operation therapy) and control group(received open operation treatment), 40 cases in each group.The changes of serum MMP9, TIMP-1, MMP-9/TIMP-1 and IL-2, IL-10, IL-2/IL-10 and 6 months after operation in the two groups were observed before and after treatment,the pregnancy situation were ob-served.Results The MMP-9 levels of the patients in the observation group[(51.21 ±24.01)μg/L] than before treatment[(261.88 ±190.11)μg/L] decreased significantly,and the observation group decreased more obviously than that in the control group;the observation group the level of TIMP-1[ (45.88 ±11.02)μg/L] than in the control group[(25.32 ±6.67)μg/L]increased significantly (t =4.846,P <0.05);observation group MMP-9/TIMP-1 decreased significantly compared with the control group,the difference was statistically significant ( t=3.636,P<0.05);the two group after treatment,IL-2,IL-10,IL-2/IL-10,the difference was statistically significant ( t=4.228, 4.415,3.396,all P<0.05);the observation group the pregnancy rate was 65%,the abortion rate 7.7%,30.0%and the 33.3%was better than that of the control group (χ2 =9.825,4.060,all P<0.05).Conclusion LPS is an effective method in treating EMS,which can increase the serum TIMP-1 and IL-2 levels,reduce MMP9 and IL-10 level;improve the immune index,improve the patient's fertility.

In the teaching process of nursing ethics,there are two issues arousing teachers' attention and worth discussing.The first issue is to lead the students to discuss the identity status of nurse,define a proper orientation of this specific occupation in order to help the nursing students themselves to have a comprehensive knowledge and cognition of the profession they are going to engage in.The second one is to emphasize understanding of the definition of "respect".

As a kind of abnormal phenomena,mirror movement occurred after both stroke and Parkinson's disease,and influence the rehabilitation prognosis was uncertain.Recently,bilateral training has been used in the stroke patients and showed some effect.

Abstract: Objective To summary and analyze the epidemic situation of imported malaria and the prevention and control measures implemented during the new crown pneumonia epidemic in Shenzhen, so as to provide reference for the prevention and control of imported malaria under COVID-19 epidemic. Methods　The data on the prevention and control of malaria epidemic in Shenzhen from 2017 to 2021 were collected for analyzing the epidemic situation of malaria, measures taken and the effect of prevention and control with descriptive epidemiological methods. Results　From 2017 to 2021, a total of 104 confirmed malaria cases were reported in Shenzhen, all of which were imported from abroad. 97.1% were imported from Africa, mainly falciparum malaria, accounting for 80.8%. The age of onset was mainly young adults, the age group 20-49 years accounted for 81.7%, and most of the patients were overseas migrant workers, accounting for 59.6%. Imported malaria cases were reported in each month, the most was 13 cases in July, then 12 cases in September. From 2017 to 2021, 709 mosquito trap lamps were placed, and 3 523 mosquitoes were captured, with an average mosquito density of 2.60 per lamp and night. Anopheles were not found, and the dominant species were Culex quinquefasciatus. During the outbreak of COVID-19, Shenzhen has implemented a series of measures in terms of improving the working mechanism of multi-departmental cooperation and joint defense, strengthening screening and monitoring, personnel training, mosquito vector control, and material security, so as to achieve early detection, early transfer, early isolation and early treatment. Conclusions　A series of measures have been comprehensively implemented to prevent and control imported malaria in Shenzhen while preventing and controlling imported new coronary pneumonia, and achieved positive results. It has realized the timely identification of cases and effective treatment, and prevented the occurrence of severe and fatal malaria cases, as well as halting the spread and spread of malaria outbreaks.

Objective To explore the clinical effect of detection of serum procalcitonin (PCT), C-reactive protein (CRP)and white blood cell (wBC)on diagnosis and treatment of severe pneumonia in children.Methods A total of 189 cases of pediatric patients with pneumonia including 51 severe pneumonia cases (severe pneumonia group)and 138 common pneumonia cases (common pneumonia group)treated from Mar 2014 to Dec 2014 and 30 healthy cases (control group)were enrolled,and the level of PCT,CRP and wBC of all cases were detected.Results The levels of PCT before treatment in severe pneumonia group,common pneumonia group,and control group were 1.12(0.44 ~3.07)ng /ml,0.14 (0.09 ~0.26) ng /ml and 0.03(0.01 ~0.06)ng /ml respectively,and there were significant differences among three groups (P ﹤0.05,respectively).The levels of CRP before treatment in severe pneumonia group,common pneumonia group,and control group were 82.2(25.9 ~120.3 )mg /L,10.8 (5.3 ~23.9)mg /L and 3.2 (2.1 ~6.9) mg /L respectively,and there were significant differences among three groups (P ﹤0.05,respectively).The counts of wBC before treatment in severe pneumonia group,common pneumonia group,and control group were 10.1 (9.1 ~14.1 )×109 /L,8.8(6.8 ~1 1.7)×109 /L and 6.2(4.8 ~7.9)×109 /L respectively,and there was significant difference only between severe pneumonia group and control group (P ﹤0.05 ).The level of PCT and CRP significantly decreased in severe pneumonia group after one week of treatment[PCT:0.15(0.09 ~0.24)ng /ml,CRP:9.9(3.6 ~19.0)mg /L](P ﹤0.05),but there was no significant differ-ence of wBC counts in severe pneumonia group between after and before treatment[8.5(6.3 ~9.8)×109 /L vs.10.1 (9.1 ~14.1 )×109 /L](t =1.312,P =0.205 ).After two days of anti-inflammatory treatment in severe pneumonia group,serum PCT dropped to 44% of the level before treatment,and smoothly dropped to nearly 10% of the basic value every two days.Serum PCT was correlated with serum CRP in children with pneumonia(R2 =0.550 4,P ﹤0.05).Conclusion The combined detection of PCT and CRP could provide important guidance for the differential diagnosis,treatment and prognosis for severe pneumonia in children.

AIM: To demonstrate the susceptibility of cell apoptosis varies during the progress of cell malig- nant transformation from human being in vitro. METHODS: A SV40T - transfected human bronchial epithelial im- mortalized cell line (called M) was selected in this work, which has acquired some characteristics of malignant trans- formation at the later passage. The alterations of apoptosis and bcl- 2, P53 genes between early and later passage of M cells were investigated by means of TDT labeling in situ, chromosome FISH, RNA and protein testing, etc. RE- SULTS: Incidence of apoptosis induced by cis - platin was significantly lower in later than in early passages of M. Levels of bcl - 2 mRNA and protein in later passages were higher than early passages of M, and overxpression of bcl -2 was accumulated following the development of cellular malignancy. P53 protein level was as high in early as in later passages. CONCLUSION: Overexpression of bcl - 2 decreases the cellular sensitivity to apoptotic inductors plays an important role during progress of carcinogenesis in human bronchial epithelial cancers. The inactivation of P53 protein in the SV40 - T transfected M cell line may be one of reasons of bcl - 2 overexpression, but not associated with the accumulation of bcl - 2 expressed level during cell transformation.

Dust ; Female ; Humans ; Male ; Occupational Exposure ; adverse effects ; Pneumoconiosis ; diagnostic imaging ; etiology ; Poaceae ; Radiography, Thoracic ; Silicates ; adverse effects