[Objective]To explore the technique of arthroscopy plus radiotherapy in the treatment of pigmented villonodular synovitis of the knee and to evaluate its clinical value.[Method]A total of 14 cases of pigmented villonodular synovitis of the knee were treated from January 2000 to July 2003.Intra-articular excision under arthroscope with a combined application of routine intrusments and Bipolar radiofrequency was performed on all these 14 cases,and postoperative radiotherapy for diffused pigmented villonodular synovitis of the knee,13 patients were followed up for 10~45 months,and were evaluated for range of motion,pain,swelling effusion.[Result]Thirteen cases according to the International Knee Documentation Committee(IKDC)criteria,subjective knee score was (58.7+6.4) and (86.5 ?5.7) respectively before surgery and at the last follow-up.[Conclusion]In case of pigmented villonodular synovitis of the knee joint,arthroscopical synovectomy can make good surgical results,and postoperative radiotherapy is an effective treatment for diffused pigmented vilionoclular synovitis of the knee.

Objective To investigate work stress state of nursing home staff and to analyze the influential factors affecting work stress.Methods Stratified random sampling method was adopted to investigate 180 nursing assistants by self-designed questionnaire,Work Stress Scale(WSS),Simplified Coping Style Questionnaire and internal-external locus of control scale investigation.Results Totally 174 valid questionnaires were collected.Variance analysis revealed there were significant differences of age and other factors.Stepwise multiple regression analysis showed five variables entered the equation,including workexpenence education level number of the cared ages work scheduline coping stule and explain 56.7％ of the total variable.Conclusion Nurse managers should pay attention to and improve achievement sense and mental adjustment ability of nursing assistants,to build a well-organized support system to reduce the workload.

Objective To evaluate the efficacy of automated medication management system in increasing clinical anesthesia management specification.Methods Sixty registered anesthesiologists of both sexes in our hospital,residents or attending physicians,with 1-10 yr of work experience,were divided into 2 groups (n =30 each) using a random number table:traditional medication management mode group (group T) and automated medication management system group (group A).In the clinical anesthesia work,traditional artificial management mode was used in group T,the mode of automated medication management system was used in group A,and 2 licensed pharmacists worked in the center pharmacy of our hospital were introduced for each group.Time of taking medicine was recorded by licensed pharmacists,and the error rates of taking medicine and recording were determined by licensed pharmacists.Results Compared with group T,the error rates of taking medicine and recording were significantly decreased (P＜0.01),and no significant change was found in the time of taking medicine in group A (P＞0.05).Medication errors including taking wrong anesthesia drug,wrong prescription recording,wrong names of the common drugs and drug omission were not detected in group A.Conclusion Application of automated medication management system can reduce the occurrence of errors made in taking medicine and recording,specify medication management and increase the quality of clinical anesthesia management.

Objective:To analyze the system of first contact in community health institutions for migrant workers in Shenzhen city with the stakeholder theory. Methods:The report forms of the Social Insurance Fund Administration Bureau and the health bureau of Shenzhen city were used to analyze. All stakeholders of this policy were interviewed. Results:The system of first contact in community health institutions was good for all stakeholders. The number of in-sured migrant workers grew steadily, the business volume of community health service centers increased significantly, and the fund ran smoothly. Conclusions:The effects of the system of first contact in community health institutions for migrant workers in Shenzhen city were obvious. All the stakeholders felt satisfied with the policy.

Objective To study the relationships between neutralizing antibody response against heterologous virus and disease progression in Chinese HIV-1 B'/C infected individuals. Methods Plasmas from HIV-1-infected individuals, grouped as HIV chronically infected or AIDS according to CD4+ count and clinical symptom, were tested for neutralizing activity against the three HIV-1 isolates with very low homology in vitro. Six two-fold dilutions of each plasma sample (from 1/10 to 1/320) were tested against each virus from the panel. Giving a 50% reduction in p24Ag compared with normal human plasma control wells was defined as positive. The breadth of the cross-neutralizing response was defined based on the number of viruses that were effectively neutralized by any given patient-derived plasma sample. The magnitude of the crossneutralizing response was defined based on the average neutralizing titer against all heterologous viruses. Resuits We found that there revealed a significant difference between HIV chronically infected and AIDS group in the breaths and magnitudes of neutralizing heterologous virus. There was higher prevalence for the frequency of neutralizing heterologous virus in HIV chronically infected than AIDS. The results showed that there was positive correlation between the breadths and magnitudes of neutralizing response against heterologous virus and the plasma HIV RNA level in HIV chronically infected group, while not in AIDS group. There was no association between the breadth of the neutralizing responses against heterologous virus and CD4 T cell counts. Conclusion The capacity of neutralizing antibodies against heterologous virus varied among different disease stage. There were higher titers of neutralizing antibodies in HIV chronically infected than AIDS group. The loss of neutralizing antibodies in plasma from AIDS group appears to be associated with a narrowing of the antibody response during disease progression. These suggest that the presence of neutralizing antibodies against hetreologous virus was associated with disease progression.

OBJECTIVE: To explore the effect of modified pedicled cranial periosteum compound flap in reconstructing the defect of anterior cranial fossa complicated with cerebrospinal fluid leakage. METHOD: Seven nasal and sinus tumor cases with defects and CSF were undertaken reconstructing surgery with the flap, of which 1 was benign and the others were malignancies. The transferred flap pedicled with the frontal branch of the superficial temporal artery and complemented with ipsilateral supraorbital and/or supratraochlear artery. RESULT: All cases healed without failure, one case with adjuvant radiotherapy experienced partial free frontal bone necrosis and healed by ways of drainage through temporal incision. The inner surface of the flap in the nasal cavity was smooth. CONCLUSION Frontal cranial periosteum compound flap have some advantages, such as adequate quantity, good blood supply and easily making,so it can be choose as an important method to reconstruct the defects of anterior cranial fossa and CSF leakage.
Adult ; Aged ; Cerebrospinal Fluid Rhinorrhea ; surgery ; Cranial Fossa, Anterior ; pathology ; Female ; Humans ; Male ; Middle Aged ; Periosteum ; transplantation ; Reconstructive Surgical Procedures ; methods ; Skull Base ; surgery ; Surgical Flaps ; Treatment Outcome

Objective To explore the effective nursing method of preventing the deep vein thrombosis according to D-Dimer and lower limb vein B ultrasonic examination.Methods The study investigated 120
patients with femoral neck fracture who were operated hip replacement in Wuxi No.2 People′s Hospital during September 2013 to June 2015. The participants were randomly divided into four groups with 30 cases in each group: basic care group, early path functional training group, SCD group, and early path functional training combined with SCD group. D-Dimer and thrombosis detection rate according to the lower limb vein B ultrasonic examination were observed and compared among the four groups.Results D-Dimer of the four groups had little differences before and after 24 hours of the operation ( P>0.05) , but had differences after 7 days and 14 days of the operation (P<0.05). Moreover, the early path functional training combined with SCD group had lower D-Dimer compared to the basic care group ( P<0.05) . Besides, no thrombosis occurred before and after one day of the operation among the four groups, however, the thrombosis detection rates had significant differences after 7 days and 14 days of the operation (P<0.01). After 7 days of operation, the thrombosis detection rate for the early path functional training combined with SCD group was already lower than the others (P<0.01). After 14 days of operation, the basic care group had the highest thrombosis detection rate while the early path functional training combined with SCD group had the lowest thrombosis detection rate ( P<0. 01 ) . Conclusions The method of SCD combined with early path functional training can effectively prevent the deep vein thrombosis after hip arthroplasty surgery.

Objective To analyze the value of high-frequency color Doppler ultrasonography in the diagnosis of children with intussusception.Methods A total of 60 children with intussusception all received high-frequency color Doppler ultrasound and abdominal X-ray examination.Sensitivity and specificity of high-frequency color Doppler ultrasound and abdominal X test were compared,and check time and expense of patients were analyzed.Results The coincidence rate of high frequency color Doppler ultrasound examination in intussusception was higher than that in abdomen X-ray examination,and the difference was statistically significant (P ＜ 0.05).The sensitivity and specificity of color Doppler ultrasound in intussusception were 96.67％ and 96.67％,respectively,which were significantly higher than 73.33％,70.00％ in abdominal X-ray examination (P ＜ 0.05).Color Doppler ultrasound required more time in examination than abdominal X-ray examination (P ＜ 0.05).But there was no significant difference in the two examination methods (P ＞0.05).Conclusion High-frequency color Doppler uhrasonography in children with intussusception can improve diagnostic accuracy,facilitate the early symptomatic treatment,prevent disease deterioration,and improve prognosis.

Objective To analyze the value of high-frequency color Doppler ultrasonography in the diagnosis of children with intussusception.Methods A total of 60 children with intussusception all received high-frequency color Doppler ultrasound and abdominal X-ray examination.Sensitivity and specificity of high-frequency color Doppler ultrasound and abdominal X test were compared,and check time and expense of patients were analyzed.Results The coincidence rate of high frequency color Doppler ultrasound examination in intussusception was higher than that in abdomen X-ray examination,and the difference was statistically significant (P ＜ 0.05).The sensitivity and specificity of color Doppler ultrasound in intussusception were 96.67％ and 96.67％,respectively,which were significantly higher than 73.33％,70.00％ in abdominal X-ray examination (P ＜ 0.05).Color Doppler ultrasound required more time in examination than abdominal X-ray examination (P ＜ 0.05).But there was no significant difference in the two examination methods (P ＞0.05).Conclusion High-frequency color Doppler uhrasonography in children with intussusception can improve diagnostic accuracy,facilitate the early symptomatic treatment,prevent disease deterioration,and improve prognosis.

Common complications related to nutritional metabolism and somatic function in chronic kidney disease patients include protein-energy wasting, sarcopenia, and frailty. These three complications are different and closely related. This article reviews recent research progress on the definitions, epidemiology, diagnosis and evaluation, underlying causes, intervention measures and their differences and connections of chronic kidney disease in conjunction with protein-energy wasting, sarcopenia and frailty, to help clinicians identify them and personalize interventions.