[Objective] To discuss the therapeutic effect of different methods in the treatment of intertrochanteric femur fracture. [Methods]Totally 118 middle aged or old patients with intertrochanteric femur fracture were fixed with dynamic hip screw (DHS), Gamma nail or PFNA.[Results]Totally 112 cases were followed up, and the average time was 16 months, in those 45 patients were fixed with DHS: 29 were excellent, 11 cases were good, and 5 were poor, and the excellent to good rate was 88.9%; 36 patients were treated with Gamma nail, and the excellent, good, poor results were 28, 2, 1, respectively, and the excellent to good rate was 96.8%; 36 patients were fixed with PFNA, and the excellent, good, poor results were 29, 6, 1, respectively. The differences were significant (P=0.02, analyzed by Logistic regression with SPSS software). The excellent and good superiority of Gamma nail and PFNA were 5.1552 and 2.3726 times compared to DHS, and there was significant differences between the groups.[Conclusion]Surgical treatment of intertrochanteric femur fracture can improve the functional recovery and reduce the complication incidence, and PFNA fixing method can shorten the operative time, reduce the bleeding and the therapeutic effect is reliable, and suitable for old patients combined with osteoporosis.

The humanistic thinking of life philosophy of traditional Chinese medicine (TCM) observed inlife activities is different from western theories and methods,which is more about life experience and feeling and rich in practical significance.The life philosophy of TCM is also different from traditional Chinese culture.The intuitive feeling of life is one of the main characteristics of life philosophy of TCM.Students of TCM soak in traditional Chinese medicine culture and are influenced by the thinking of real life caused by the care of realbody in TCM.Chinese medicine education should fully mobilize the tacit knowledge of life education in TCM,play excellent tradition of Chinese traditional life philosophy,and cultivate the life moral quality in students of TCM.

Objective To conduct the performance verification of the Stago STA-R automatic blood coagulation analysis system once every year to evaluate the analysis system for ensuring its accuracy and reliability .Methods According to the related docu-ments of the Clinical and Laboratory Standards Institute (CLSI) ,5 items of prothrombin time (PT ) ,activated partial clotting en-zyme live time (APTT) ,thrombin time (TT) ,fibrinogen (Fib) and antithrombin Ⅲ (ATⅢ) were selected to conduct the verifica-tion and preliminary evaluation on the accuracy ,imprecision ,carry-over rate ,linearity range and reference interval of the instrument analysis system .Results The relative bias(SE% ) of accuracy in each item was less than 5% .The intra-batch and inter-batch im-precisions (CV) were less than 3% and 5% respectively .The carry-over rates were within 4% .The linearity of Fib and AT Ⅲ was very well ,r2 were 0 .9980 and 0 .9979 respectively .Validated reference interval was consistent with quotative reference range . Conclusion The Stago STA-R automatic blood coagulation analysis system has good analytical performance ,can provide accurate and reliable test results for clinical doctors .

Objective It has been shown that ketamine and magnesium used in combination provide more effective analgesia than either drug alone. The purpose of this study was to investigate the effects and interaction of the two drugs on recombinantly expressed NMDA receptors. Methods Xenopus oocytes expressing NR1/NR2A or NR1/NR2B glutamate receptors were stimulated with glutamate/glycine and studied at a holding potential of -70mV using two electrode voltage clamp. The effects of magnesium and s ( + )-ketamine alone or in combination on NMDA signaling were determined. Results Magnesium and s( + )-ketamine alone inhibited NMDA receptors non-competitively. IC50s of magnesium were (4.2 ± 1.2)×10-4mol/L and (6.3 ± 2.4) × 10-4 mol/L on NR1/NR2A and NR1/NR2B, while IC50s of s( + )-ketamine on NR1/NR2A and NR1/NR2B were (4.1 ± 2.5) × 10-6 mol/L and (3.0 ± 0.3 ) × 10-6 mol/Lrespectively. Magnesium and s( + )-ketamine used in combination decreased IC50s more than 90% at both receptors. Isobolographic analysis demonstrated superadditive interactions. Conclusions s( + )-ketarnine and magnesium inhibit responses of recombinantly expressed NMDA recptors non-competitively, and the combinations of the two drugs produces a synergistic effect.

Objective To introduce a new CT classification system we designed for Hoffa fractures and compare the interrater reliability between the CT and X-ray classification systems.Methods A total of 20 isolated Hoffa fractures from January 2008 to December 2011 were randomly selected for the present analysis of their imaging data (anteroposterior and lateral X-ray films of the knee joint and three-dimensional CT reconstruction of the femoral condyle).At the same time,a total of 20 independent observers (clinicians with junior,intermediate and senior professional qualifications) were selected for classification of the Hoffa fractures in the same manner respectively according to the Letenneur's X-ray system and our self-designed CT system.We used Kappa statistics to evaluate the interrater reliability among the clinicians between the 2 classification systems for Hoffa fractures.Results According to the CT classification of the 20 Hoffa fractures by the 20 clinicians,type Ⅰ,Ⅱ and Ⅲ fractures accounted for 66.0％,30.5％ and 3.5％ respectively.In type Ⅰ fractures,type Ⅰb involving zone b accounted for the most (50.0％),next by type Ⅰc(31.0％) and type Ⅰa (19.0％).In type Ⅱ comminuted fractures,fracture fragments were mostly seen in zone b.The overall incidence of fractures involving zone b by CT classification was 67％.According to the X-ray classification,type Ⅰ,Ⅱ,Ⅲ and Ⅳ fractures accounted for 31.4％,14.3％,28.0％ and 26.3％,respectively.The interrater reliability for CT classification agreement (Kappa =0.681) among clinicians was higher than that for X-ray agreement (Kappa =0.261).Conclusion For Hoffa fractures,communicated ones in particular,our CT classification system may be better than the X-ray classification system.

Objective To investigate the application effect of flexible management in nursing of general surgery department. Methods 21 nursing staff and 836 patients from January to October, 2007 were selected as research object, and were given flexible management. 21 nursing staff and 797 patients from January to December were selected as the control. The influence of flexible management on nurses and patients and satisfaction degree with nursing work before and after application of flexible management were compared. Results Working and learning enthusiasm greatly improved,educational background and professional titles of nurses increased after application of flexible management. The average hospitalization time was 28 days,the per capita cost was 12 131 yuan,satisfaction degree with nursing was 87.0% before application of flexible management, but the average hospital stay of patients decreased to 20 days, the per capita cost decreased to 8764 yuan and satisfaction degree with nursing increased to 97.0% after application of flexible management. Conclusions Application of flexible management in nursing care of general surgery department showed significant effect,it is suitable for more application in practice.

Objective To observe the dyskinesias and motor fluctuation in patients with Parkin-son’s disease, and investigate their influential factors. Methods The detail information of dyskinesias and motor fluctuation of 63 patients with Parkinson’s disease were recorded and followed up when the of L-Dopa therapy was carried out, and all patients were assessed by using UPDRS at “on” and “off” stage, Hoehn and Yahr scale, Schwab and England living scale.The data were calculated with SPSS 10.0 statistic software. Results All patients received alone or combined L-Dopa therapy.Among the 63 patients, 11 (17.5%) were experienced dyskinesias, in which 10 show dystonia; and 36 were (57.1%) experienced motor fluctuation, in which 28 developed wearing-off.The mean daily dose of L-dopa and score of UPDRS in “off” stage were positively correlated with dyskinesias.The duration of therapy with L-dopa was positively correlated with motor fluctuation.The controlled release cabidopa/levodopa was in negative correlation. Conclusions The rate of motor fluctuation was approximately equal to the results reported in other countries.The dyskinesias was lower in occurrence and the mean daily dose of L-dopa and the disease severity should be the main influencing factors to the dyskinesias.The duration of therapy with L-dopa should be influencing factor to motor fluctuation.The main subtype of motor complications should be dystonia and wearing-off.

Objective: To evaluate the depression and anxiety in patients with sleep apnea-hypopnea syndrome (SAHS). Methods: Fifty patients with SAHS were diagnosed with polysomnography (PSG) and 30 healthy controls underwent whole-night PSG monitory and evaluated by Zung Self-rating Depression Scale (SDS) and Zung Self-rating Anxiety Scale (SAS). Results: The total scores of SAS and SDS in SAHS group were significantly higher than those in control group ( P

Objective To evaluate the efficacy of telephone follow-up on glycemic control in patients with diabetes mellitus. Methods Randomized clinical trials that assessed the effectiveness of telephone follow-up in patients with diabetes mellitus were selected in the databases of Cochrane library, JBI, PubMed, Medline, EMBASE, EBSCO, OVID, Springer, China National Knowledge Infrastructure, China Biomedical Literature Database, VIP , Wangfang Data. At the same time manual retrieval of relevant professional information to collect randomized clinical trials that met the inclusion criteria. The searching time was from database establishment to June 2016. RevMan5.2 software was used to analyze the data after quality assessment. Results A total of 12 randomized controlled trials were included in a total of 1905 patients. Meta-analyses showed that, compared with the conventional nursing group, the telephone follow-up could significantly reduce the level of glycosylated hemoglobin (weighted mean difference was-0.49, 95% confidence interval was-0.52--0.46, P<0.01), the level of fasting blood glucose (weighted mean difference was-0.99, 95% confidence interval was-1.16--0.83, P<0.01). Conclusions Telephone follow-up can improve blood glucose control in patients with diabetes, it is worth to be popularized in clinical practice.

Objective To analyze the CT, especially HRCT appearance of localized organizing pneumonia. Methods The CT scans of nine patients with histologically proved localized organizing pneumonia were studied retrospectively. Results The size of the lesions in nine cases varied from 2 to 4 cm( average 2.5 cm). Eight lesions were located in the peripheral lung parenchyma near the pleural surface. The lesions were detected as round in four, anomaly in five. The margin of six lesions had inward bow indentation. Infiltrating lesions in surrounding structures were found in four cases. Conclusion The CT, especially HRCT appearance of localized organizing pneumonia shows some features that can make most of them to be differentiated from other lesions.