Objective To compare the clinical outcomes between proximal femoral nail antirotation (PFNA) combined with risedronate sodium and isolated PFNA for the treatment of intertrochanteric fractures in elderly patients.Methods Clinical data of 62 elderly patients with intertrochanteric fracture from January 2011 to April 2013 were prospectively studied.Patients were randomly divided into two treatment groups:risedronate sodium group (the combined PFNA and risedronate) and control group (isolated PFNA).According to AO classification,32 patients in risedronate sodium group (15 males and 17 females,with an average age of 78 years) were divided into type A1 (n=10),type A2 (n=18) and type A3 (n=4).30 patients in control group (13 males and 17 females,with an average age of 77.5 years) were divided into type A1 (n=9),type A2 (n=16) and type A3 (n=5).Bone mineral density (BMD) was measured by dual energy X-ray absorptiometry before and 1 year after operation.The hip joint function was assessed by Harris hip score.Complications and subsequent fragility fractures were evaluated postoperatively.Results 60 patients (30 patients in risedronate sodium group and 30 patients in control group) were followed up for at least one year.All fractures were healed at 6 months after surgery.No significant difference was found between the two groups in BMD in contra-lateral hip before treatment [(-2.58±0.41)kg/m2 vs.(-2.56±0.36)kg/m2,P＞0.05].BMD in contra-lateral hip had significant difference between the risedronate sodium and control groups one year after surgery [(-0.66±0.37)kg/m2 vs.(-1.13 ±0.28)kg/m2,P=0.000].There was no significant difference between the two groups in Harris hip score (P=0.238).During the follow-up,no patient in risedronate group suffered from subsequent fragility fracture after surgery,while lumbar compression fracture occurred in 1 case,distal radius fracture occurred in 1 case,the contralateral hip fractures occurred in 2 cases,postoperatively.Conclusions PFNA treatment combined with risedronate sodium can effectively improve BMD and reduce the risk for refracture,and has a good effect on intertrochanteric fracture in elderly patients.

Objective To evaluate the efficacy of intra-aortic balloon pump (IABP) on elderly patients with acute myocardial infarction (AMI) combined with cardiogenic shock (CS).Methods Among 62 elderly patients with AMI plus CS undergoing percutaneous coronary intervention (PCI),32 patients received IABP before PCI (IABP group) and 30 patients did not (control group).Diastolic blood press ure(DBP),mean arterial pressure (MAP),heart rate,cardiac index (CI),and ejective fraction before and 2 weeks after PCI in the two groups were observed.The short-and long-term therapeutic effects were compared between the two groups.Results The DBP,MAP and CI were higher and heart rate was lower in IABP group than in control group within 24 h after IABP [(64.4± 11.1) mmHg vs.(37.8±15.1) mmHg,(71.4±8.3) mmHg vs.(43.0±10.5) mmHg,(2.98± 0.33) L· min-1 · m-2 vs.(1.99±0.29) L· min-1 · m-2,(90.7±18.7) /min vs.(130.2±50.1)/min,t=7.97,11.83,12.51,4.16,all P=0.000].Two weeks after IABP,LVEF was significantly improved in IABP and control groups as compared with pre-IABP [(46.4±7.2)％ vs.(35.2± 7.2) ％,(39.1±6.8) ％ vs.(33.8±6.7) ％,both P＜0.01],and heart function was improved more significantly in IABP group than in the control group (t=3.91,P=0.000).Death tolls during hospitalization and after leaving hospital,and recurrence of AMI had no significant differences between the two groups (2 cases vs.4 cases,3 cases vs.8 cases,6 cases vs.10 cases,x2 =0.89,3.17,1.72,P=0.346,0.075,0.190).Conclusions IABP can improve the cardiac function in elderly AMI patients with CS after PCI.

Objective To study the distribution of brain dopamine transporter (DAT) in children with autism by single photon emission computed tomography (SPECT). Methods Brain SPECT imaging was performed in 10 autistic children and 10 normal children, and DAT distribution in different functional areas of brain were calculated and compared by semi-quantitative evaluation of tracer uptake. Results There were no differences in tracer uptake between left and right striatum either in autistic children or in normal children (P=0.556, 0.563), while the tracer uptake level in autistic children was significantly higher than that in normal children (P=0.018). Conclusions The striatum dopaminergic neurons are hyperactive in children with autism. SPECT is helpful for the diagnosis of autism.

Objective To investigate the treatment of proximal femoral nail antirotation (PFNA) in pertrochanteric hip fractures with unstable lateral-wall.Methods Thirty-two cases were included from the April 2009 to May 2011.Recorded operation period,blood loss volume,and complications and evaluated the effect of the methods.Arrange referral at 6 weeks,3 months,6 months,12 months respectively after operation,to check limb function and conventional camera hips,lateral X-ray film.Postoperative functional evaluation using the Harris hip score.Measure the last follow-up neck shaft angle and compare with postoperative's.Results The average operation period was (60-190) min,average was (80 ± 5) min ; blood loss volume was (90-250)ml,average was (120 ± 9) ml ; Average hospital periods was (15 ± 7) days; weight loading time was (6.3 ± 1.2)weeks after surgery and average time of union of fracture was 3.6 months.All patients obtained union of fracture without complications such as varus,internal fixation cutting out.Conclusion PFNA was proved to be an effective way for treating unstable lateral-wall of pertrochanteric hip fractures due to its advantages of stable fixation,minor trauma,less complications.

Objective To study the effect of the expansive open-door laminoplasty on the three-dimensional motion and stiffness of the cervical spine. Methods 55 cases after open-door laminoplasty of cervical spine due to myelopathy were follow-up for an average of 35.9 months. Cervical axial symptoms, neural functionality (JOA scoring system) and pre- and post-surgery dynamic cervical spine lateral X-ray films were evaluated. The Three-dimensional Motion and Stiffness of the Cervical Spine of Human Body Measuring Equipment was used in 12 post-operative open door laminoplasty cases and 10 pre-operative cases to measure the active and passive range of motion(ROM), load-displacement relationship, stiffness of cervical spine and torque caused by the isometric contraction of the extensors and flexors of the cervical spine. Results The average rate of improvement was 66. 2%. The excellent and good rate was 78.2%. The number of cases with distinct or severe cervical axial symptoms increased after the surgery ( P ＜ 0. O1 ) . The patients who have severe axial symptoms tend to have less curved cervical spine (P ＜ 0. 01 ) . There was no significant statistic difference between the severity of post-surgery cervical axial symptoms and JOA improvement level (P ＞ 0. 05). The active and passive ROM of extension, rotation and lateral bending of cervical spine were decreased after the surgery ( P ＜ 0. 05), and the main affection was on the middle and lower part of the cervical spine. The load-displacement figure of cervical spine can fit into an exponential equation T= b0eb1θ. In each direction, the lateral bending had the strongest stiffness, then the extension and flexion. The stiffness of rotation was the weakest. The stiffness of cervical spine of the post-surgery group was stronger than that of the contrast group. Conclusion The open-door laminoplasty of cervical spine damages the static mechanic balance on the sagittal plane and decreases the ROM and the flexibility of cervical spine. The curvature of the cervical spine is related to the severity of the axial symptoms and seems not to be related to the JOA score improvement.

Objective To seek the optimization hormone combination for the callus induction and differentiation from cotyledon and hypocotyl explants of Chrysanthemum morifolium through tissue culture. Methods Cotyledon and hypocotyl explants were cultured on various medium with different hormone combinations. Results Callus could be inducted on every media designed in this experiment,but the effects to the induction and differentiation culture of buds were different.The results showed that the medium MS+IAA 0.3 mg/L+6-BA 12 mg/L was suitable to the induction of callus from cotyledon and hypocotyl.The optimal hormone combination was MS+IAA 0.3 mg/L+6-BA 4 mg/L for the initiation of adventitious bud of cotyledon.The shoot regeneration percentage reached 67.5%.The optimal medium for the initiation of adventitious bud of hypocotyl was MS+KT 2 mg/L+NAA 0.2 mg/L.The shoot regeneration percentage reached 62.5%.Rooting was induced on 1/2 MS+NAA 0.1 mg/L,and the root inducting ratio reached 100% in 7 d. Conclusion A rapid plantlet regeneration system for C. morifolium is established from cotyledon and hypocotyl explants.Bud induction frequency is higher and the shoots in vitro grow vigorously.

Objective To investigate the situation of Pseudomonas aeruginosa strains carrying metallo-β-lactamases and inte-grases in the Second Affiliated Hospital of Harbin Medical University.Methods The phenotype of metallo-β-lactamases were detected by modified Hodge test,double-disc synergy and combination paper method,respectvily.PCR method was used to detecte metallo-β-lactamases genotypes and the integrationⅠ,Ⅱ and Ⅲ.The PCR products of the whole length bla-IMP gene were purified,sequenced and analyzed by Blast.Results Among 62 Pseudomonas aeruginosa strains,metallo-β-lactamases phenotype of 3 by modified hodge test,4 by double-disc synergy test,4 by combination paper method and were all positive 4 of IMP-1 type metallo-β-lactamases of Pseudomonasaeruginosa strains (10%,4/40)were positives by PCR.Inte-grase Ⅰ of 16(40 %,16/40)strains were positives by PCR method in IMP-resistant Pseudomonasaeruginosa,and integraseⅠ of 22.73 %(5/22)were positives in IMP-sensitive Pseudomonasaeruginosa.No other metallo-β-lactamases,integraseⅡandⅢ were detected in this study.Conclusion IMP-type metallo-β-lactamase existed in IMP-resistant Pseudomonasaerugi-nosa isolates of the Second Affiliated Hospital of Harbin Medical University.Most strains carried integraseⅠ,and other re-sistance mechanisms may be associated with multi-drug resistance,so it is important to prevent the Pseudomonasaeruginosa strains which carried metallo-β-lactamases and integrons widely spread in the hospital.

Objective To study clinical effect after laparoscopic abdominal preperitoneal inguinal hernia repair methodwithout stapler. Methods 80 cases of inguinal hernia(hospitalized from February 2015 to January 2017)were divided into two groups according to the random number table method ,with 40 patients in each group. Traditional laparoscopic peritoneal inguinal hernia repair method was applied in the control group. Free stapler group received free stapler laparoscopic preperitoneal inguinal hernia repair treatment method. Operation time , amount of bleeding during surgery , the average hospitalization time after operation , the total cost of hospitalization,postoperative pain score,postoperative recovery activities time,patients′satisfaction,operation effusion after operation occurred scrotal hematoma and other complications were comparedbetween the two groups of patients. Results In free stapler group,patients′ satisfaction rate was significantly higher than the control group (P < 0.05). Area of effusion,scrotal hematoma and other complications infree stapler group after surgery were significantly lower than the control group (P < 0.05). Total cost of hospitalization,postoperative pain score, postoperative recovery time activities in free stapler group were significantly better than those in the control group (P<0.05). Operation time,bleeding amount during the operation,average hospitalization time difference between the two groups were not statistically significant(P > 0.05). Conclusion Operation time and amount of bleeding were similar between traditional laparoscopic transabdominal preperitoneal inguinal hernia repair method and free stapler in laparoscopic transabdominal preperitoneal inguinal hernia repair.Clinical effect of free stapler in laparoscopic transabdominal preperitoneal inguinal hernia repair proves to be effective with less complications ,less pain, faster postoperative recovery, and can reduce the cost of treatment.Free stapler in laparoscopic transabdominal preperitoneal inguinal hernia repair has satisfactory cosmetic results and was well received by patients,worthy of promotion.

Objetive To study the effects of captopri on AT1 and AT2 receptors of load-pressured hypertrophied cardiac muscles of adult rats.Methods Using the methods of narrowing and contraction of the aorta of adult healthy rats to establish the model of animals with hypertrophied cardiac and to observe the changes of receptors AT1 and AT2 of hypertrophied cardiac muscles of AC rats by comprehensive applications of cardiac-tube,immunity tissue chemistry and the technique of image disjunction.Results Left ventricular and cardiac muscles of rats were increased remarkably as the pressure-loading time lasted.After using captopri,left ventricular hypertrophied one was decreased more significantly than that in control group.The expression of receptor AT 1 was increased remarkably as the pressure-loading time lasted.The expression of receptor AT2 was increased transiently,after that reached about as high as control group.AT1/AT2 was increased one week after operation,and then was progressively decreased.After AC,captopri prevented hypertrophied cardiac muscles and receptor AT1 in cardiac muscles.AT1/AT2 was remarkably decreased.Conclusion Load-pressured cardiac hypertrophy may increase the expression of AT1.The expression of receptor AT 2 was increased transiently.The main working mechanism of captopri's preventing and treating the load-pressured cardiac hypertrophy in adult rats may be lowering the expression of AT1 and may effectively block the cardiac hypertrophy regulation precess of Ang ll via AT1 preventing load-pressured cardiac hypertrophy in adult rats.

Objective To investigate the reliability of using inhibitors including Phenylboronic acid (PBA)and Fqucloxacillin(FCC)in detecting derepressed hyperproduction and plasmid-mediated AmpC B-lactamases.Methods PBA and FCC were chosen as inhibitors and double-disk potentiation method and double-disk synergy method were used to detect positive and negative control strains of AmpC β-lactamases and 107 clinical isolates for AmpC β-lactamases production.The positive control strains included E.cloacae (029M),plasmid-mediated ACT-1 type of E.coli DH5a2919,MOX-1 type of k pheumoniae,LAT-2 type of E.coil.The negative control strains included E.cloacae 029(wild-type),E.coli SHV-1,E.coli SHV-2, E.coil SHV-5,E.coli TEM-1,E.coli TEM-3,k peumoniae SHV-18 and E.coli ATCC25922.We compared the results above with the three dimensional test(3-DT)to observe the accuracy in detecting AmpC-BLA.Results 3-DT together with PBA and FCC based inhibition tests showed the 4 positive control strains and the 9 negative control strains were determined as expected.AmpC-BILA was detected in 107 clinical isolates ofEnterobacteriaceaes.The positive rate of3-DTmethod is24.3%.The positive rates ofPBA.FCC double-disk potentiation method and double-disk synergy method are 30.8%(33/107),26.2%(28/107) and 23.4%(25/107),respectively.The conjugate results in two strains of P mirabilis and one strain of K.peumoniae were positive.They were all plasmid-mediated AmpC-Bi.A.There Was a higher false positive when using PBA and FCC-based double-disk potentiation method to detect the induction type of AmpC-BLA, but the accuracy of double-disk synergy method was high.Compared with the 3-DT,the coincidence rate using PBA and FCC-based double-disk synergy method is 99.1%.Conclusions Using PBA and FCC as inhibitors in the double-disk synergy test is a accurate and reliable method to detect AmpC-BLA regardless of derepressed hyperproduction type or plasmid-mediated type.