Objective To explore the clinical curative effects of hip replacement in the treatment of femoral neck fracture and femoral head necrosis in elderly patients and the existing problems.Methods A total of seventy-five aged patients with femoral neck fracture or femoral head necrosis who were treated by hip replacement were selected as study objects.They were divided into fracture group and femoral head necrosis group according to disease type,all the patients were treated with hip replacement.The surgical time,intraoperative blood transfusion volume,length of hospital stay,in-bed time,perioperative complications and postoperative complications were observed and recorded.The Harris score was used to evaluate hip function of preoperation and postoperation.Results All patients were followed up for 6 ～ 24 months,no incision infection and severe perioperative complications.The volume of intraoperative blood loss,operation time,hospitalization time,in-bed time of the fracture group were (334.9 ± 90.4) mL,(91.7 ± 14.3) min,(19.5 ± 7.5) d,(5.9 ± 1.6) d,respectvely,which of the femoral head necrosis group were (362.9 ± 71.5) mL,(93.5 ± 7.8) min,(20.5 ± 4.2) d,(6.3 ± 1.4) d,respectvely,the differences between the two groups were not statistically significant (all P ＞ 0.05).At the end of the follow-up,the Harris scores of the two groups were higher than before operation,and the score of the fracture group (89.0 ± 7.4) points was significantly higher than (84.0 ± 9.2) points of the femoral head necrosis group (t =19.639,P ＜ 0.05).In the fracture group,1 year after surgery,1 patient appeared delayed fracture healing,2 cases with postoperative pain when walking the affected area.In the femoral head necrosis group,1 case with femoral nerve injury,1 case of death due to its original diseases,1 case of postoperative sore pain when walking,the two groups had no prosthesis loosening or dislocation phenomenon.Conclusion Hip replacement in the treatment of femoral neck fracture and femoral head necrosis in elderly patients can be used as a clinical treatment option with short in-bed time,less intraoperative blood loss,short operation time,less perioperative complication and good treatment effect,and it is worth to be promoted.

Objective To discuss the clinical value of procalcitonin (PCT) in guiding antibiotics use in children with severe diseases. Methods The clinical data of patients admitted to intensive care unit from January 2012 to July 2012 were retrospectively analyzed. The patients without antibiotics use before admission and with procalcitonin level less than 0.5 ng/ml on admission were selected. The body temperature, infection indicators and prognosis were compared between patients with and without antibiotics use during hospitalization. Results There was no difference in body temperature, PCT, C-reactive pro-tein (CRP), erythrocyte sedimentation rate (ESR) and white blood cell count (WBC) on admission between patients with and without antibiotics use during hospitalization. The PCT level was increased signiifcantly (P<0.05) on the day of starting the an-tibiotics when compared with that on admission in 60 patients while there was no change in the levels of WBC and CRP. Com-pared with the day of starting the antibiotics, body temperature declined (P<0.05) and PCT level in 56 patients reexamined was decreased (P<0.05) at 3 days after antibiotics use. Two hundred and eleven patients (98.14%) had favorable prognosis. Conclu-sions Monitoring PCT can guiding the clinical use of antibiotics.

Child ; Cochlear Implantation ; adverse effects ; Hematoma, Epidural, Cranial ; etiology ; Humans ; Male

Objective To evaluate the effect of comprehensive control of schistosomiasis along the Xinglong River in Qianji?ang City so as to provide the evidence for improving schistosomiasis control. Methods The comprehensive control measures including infection source control and Oncomelania hupensis snail eradication were surveyed along the Xinglong River in Qianji?ang City. Results The prevalence of schistosomiasis was under control that was the human and cattle infection rates decreased by 53.77%and 100%respectively the snail area decreased by 26.9% the mean density of living snails decreased by 25.5%and no infected snails was found. Conclusions The comprehensive control measures along the Xinglong River are effective and the management and surveillance of snail environments still should be strengthened.

Objective To id scuss the role and safety of fiberoptic bronchoscopy for diagnosing and treating respiratory dsi ease in PICU.Methods A total of 95 eil gible children with respri atory diseases admi-tted ni PICU of Hu′nan Prvo inec Children′s Hospital were enroll ed in this retrospectvi e study from January 2013t o December 2013, and the efficacy and complications of fiberoptic bronchoscopy were assessed.Results A total of 95 children underwented bronchoscopy 112 timest, he most common of microscopic examination resutl s was tracheal bronchitis ( 62.1%) , followed by congenital airway abnormality ( 21.1%); 58 times (56.9%) showed becteria positive in 102 times lavage and sputum culture results, including 16 times (27.6%) of Klebsiella pneumoniae bacteria,12 times(20.7%) of Acinetobacter baumannii.After under-wenting bronchoscopy and lavage wash,blood gas analysis of pH value,PaO2 ,PaCO2 ,SaO2 had significant improvement than before( P<0.05 ) , respiratory rate had improved than before ( P<0.05 ) , little effect in heart rate(P>0.05).The inrt aopear tive and postoperative transient comlp ications were obserev d in 38 times (33.9%).Conclusion The appil cation of fiberoptic bronchoscopy for diagnosing and ter ating disease in PICU has a cetr ia n value, its vo erall safety is reliable.

Objective: To investigate the therapeutic effects of compound Kushen Tang and its relevant mechanism in TNBS-in-duced ulcerative colitis ( UC) rats. Methods:UC was induced by TNBS in rats. After compound Kushen Tang was given orally, the levels of MDA, iNOS, and NO and the activity of MPO, SOD, and GSH-Px were measured. The general condition of rats and colon tissue morphology were observed. Results:The levels of MDA (P<0. 05), iNOS (P<0. 01) and NO (P<0. 01) and the activity of MPO (P<0. 01) in tissues of UC rats were significantly higher than the control group. The activity of SOD (P<0. 01) and GSH-Px (P<0. 05) were significantly lower than those in the control group. After the treatment with high doses of compound Kushen Tang, the levels of MPO (P<0. 01), MDA (P<0. 05), iNOS (P<0. 05) and NO (P<0. 01) were significantly decreased, and the activity of SOD (P<0. 01) and GSH-Px (P<0. 05) significantly increased. The therapeutic effect was dose-dependent and the general con-dition of rats and colon tissue morphology were also significantly improved. Conclusion:Compound Kushen Tang is considered as a no-vel therapeutic alternatives for the treatment of UC, which can reduce coloni inflammatory injury and ameliorate the colitis.

The gentamicin sulfate carried calcium sulfate (GSCS) implants were fabricated by the coagulating method, and the release rate of the gentamicin tested by UV-spectrometer and the absorbing rate of the calcium sulfate carrier in vitro were studied. The release patterns of two types of GSCS were compared. The trend of daily weight loss of GSCS was found being similar to that of pure calcium sulfate, which suggested that the gentamicin part has little effect on the absorbing pattern of calcium sulfate. The release rate of gentamicin is controlled by the erosion rate of calcium sulfate, so GSCS with different amount of gentamicin has the same release patterns. The DRP value of ED is higher than that of CO during the early stage, while the DRP value of ED is lower than that of CO during the late stage. The GSCS samples were implanted into the defect mold on the radii of the rabbits to investigate the potential for the use of GSCS implants as bone fillers, and the results revealed that new bone had been induced in a great part of the defect at 14 weeks after operation.
Animals ; Anti-Bacterial Agents ; administration & dosage ; pharmacokinetics ; Bone Regeneration ; drug effects ; Calcium Sulfate ; administration & dosage ; Gentamicins ; administration & dosage ; pharmacokinetics ; Implants, Experimental ; Rabbits ; Radius Fractures ; therapy

Objective To investigate the prevalence of pulmonary fungal infection and drug resist-ance of the pathogenic fungi among children with severe diseases in pediatric intensive care unit(PICU). Methods From July 2013 to June 2017,the complete clinical data,results of fungal culture and drug sensi-tivity of bronchoalveolar lavage fluid in 112 critically ill children with pulmonary fungus infection of PICU hospitalization in our hospital were collected. Samples of peripheral venous blood were collected meantime, including blood routine examination,C reactive protein,G test and GM test. Results One hundred and twen-ty-six fungi were isolated from sputum samples in 112 critically ill children. Severe pulmonary infection (30. 36%,34/112) was the most common form of the primary diseases, the next were severe sepsis (16. 07%,18/112)and severe malnutrition(15. 18%,17/112). Classified based on age difference,the first one was ＜1 year old (43. 75%,49/112),the second one was 1 to 3 years old(29. 46%,33/112). The fun-gal strains were predominantly Candida albicans (61. 90%) and Candida tropicalis (16. 67%),among the infectious cases 14 were diagnosed as mixed infection. Two cases of 3 cryptococcal infectious children were HIV infection,another one was malignant tumor,Cryptococcus was cultured in both sputum,pleural effusion and cerebrospinal fluid. The drug resistance rate of fluconazol in 126 strains of fungi was 12. 70%,the rate of itraconazole was 7. 14%. Generally,the fungi cultured were with very low resistance to 5-fluorocytosine,vori-conazole and amphotericin B. However,the strains of Aspergillus fumigates,Candida kruse,Candida parapsi-losis and Cryptococcus were highly resistant to fluconazol and itraconazole,but with very low resistance to 5-fluorocytosine and amphotericin B. Conclusion Candida albicans is the main pathogenic fungus of pulmo-nary fungal infection among children in PICU,and we could choose voriconazole and amphotericin B as treat-ment of critically ill children with pulmonaty fungal infection.

Primary angle-closure glaucoma (PACG) is a common subtype of glaucoma and one of the leading causes of blindness in Asia.Trabeculectomy has been recognized as an effective filtering surgery for PACG and is widely used in clinical practice, but its high risk of postoperative complications, especially bleb scarring over time can not be ignored.Nowadays, non-bleb-based minimally invasive glaucoma surgeries (MIGS) have attracted much attention.Surgeries opening, restoring, or expanding Schlemm canal to reconstruct aqueous humor outflow pathway is one of the MIGS and able to achieve moderate intraocular pressure (IOP) reduction, which has been widely used in the treatment of primary open-angle glaucoma (POAG) for a long time.However, based on the pathogenesis of PACG and its similar pathological changes in Schlemm canal to POAG, some retrospective studies and prospective single-arm studies discovered that Schlemm canal surgery combined with phacoemulsification and/or goniosynechialysis appears to lower IOP well and safe in PACG eyes in recent years.Whether Schlemm canal surgery is also suitable or effective for PACG is getting some attention and is still controversial up to now, mostly due to some differences in pathogenesis between PACG and POAG, it is necessary to perform randomized controlled trials to confirm the efficacy of Schlemm canal surgery for PACG and upgrade the therapeutic strategy of PACG.

Objective:To explore the clinical value of serum insulin combined with cardiac-related markers in evaluating the severity of sepsis associated encephalopathy (SAE).Methods:The clinical data of 130 children with sepsis who admitted to the Pediatric Intensive Care Unit of Hunan Children's Hospital from January 2018 to December 2021 were analyzed retrospectively, and the differences of serum insulin and cardiac-related markers in children with sepsis and SAE were compared.Results:The levels of serum insulin, creatine kinase isoenzyme, hypersensitive troponin T, and N-terminal cerebral urine peptide in the SAE group were significantly higher than those in the non-SAE group ( P<0.05), but there was no significant difference in heart rate and lactic acid ( P>0.05). The levels of serum insulin, creatine kinase isoenzyme, hypersensitive troponin T, N-terminal cerebral urine peptide and lactic acid in the death group were significantly higher than those in the survival group ( P<0.05), while the heart rate was not significantly different ( P>0.05). The area under ROC curve of serum insulin, creatine kinase isoenzyme, hypersensitive troponin T, and N-terminal cerebral urine peptide in predicting SAE were 0.841, 0.599, 0.700, and 0.667, respectively; in terms of judging the prognosis of sepsis, the area under ROC curve were 0.647, 0.669, 0.645, and 0.683, respectively; and in terms of judging the prognosis of children with SAE, the areas under the ROC curve were 0.509, 0.682, 0.666 and 0.555, respectively. Binary logistic regression equation was established with serum insulin, creatine kinase isoenzyme, hypersensitive troponin T, and N-terminal cerebral urine peptide: Y=8.153×NT-proBNP+1.704×CTnT-hs+27.121×insulin+0.946×CK-MB+1.573. The area under the ROC curve of the new variable Y in predicting sepsis SAE, evaluating the prognosis of sepsis, and predicting the prognosis of children with sepsis and SAE was 0.890, 0.756, and 0.729, respectively. Conclusions:Serum insulin, creatine kinase isoenzyme, hypersensitive troponin T, and N-terminal cerebral urine peptide can be used alone to determine the severity of sepsis and sepsis in children with SAE. The combined value of the four indicators is obviously better than that of the single indicator. The combined application of the four indicators may better evaluate the severity of sepsis and SAE.