Objective To observe and analyze the outcome of artificial femoral head replacement in the treatment of senile femoral neck fracture. Methods Artificial femoral head replacement was performed on 67 patients over 70 years. Results All cases were followed up for 22 months.Clinical evaluation was made from four aspects(including pain,function,joint activity and deformation)according to Harris criteria,excellent in 23 cases,good in 28 cases,fair in 13 cases and poor in 3 cases,with 76.1%excellent and good results.Conclusion Artificial femoral head replacement is an effective method for treatment of patients in the old-aged with femoral neck fracture.

With the development of radiologic intervention, the treatments of aortic dissection are getting more and more diversified. In recent years, Debakey Ill and Debakey I aortic dissection has been usually treated with endovascular graft exclusion, or combined surgical and endovascular treatment. It is therefore more important to evaluate the aorta and its complications after interventional treatments. Because multidetector-row computed tomography (MDCT) has advantages, such as short examination time, high spatial resolution, and simple operation, this modality has become a first choice of non-invasive methods for the follow-up of aortic diseases after the intervention. Now the MDCT presentations and their anatomic-pathologic features of aortic dissection after endovascular graft exclusion or combined surgical and endovascular treatment are reviewed in this article.
Aneurysm, Dissecting ; surgery ; Aortic Aneurysm ; pathology ; Blood Vessel Prosthesis Implantation ; Humans ; Multidetector Computed Tomography ; Stents

Objective To explore the early diagnostic and treatment value of combined detection of direct antiglobulin test ,free antibody and antibody releasing test ( hemolysis three tests ) and measurement of serum total bili-rubin for hemolytic disease of newborn ( HDN) .Methods Hemolysis three tests were carried out with micro column gel technology in 212 blood samples from neonatal jaundice ( derived from the O type mothers ) and positive rate differ-ences in hemolysis three tests were compared .Patients were divided into 4 groups by the antibody results in hemolysis three tests:group 1[direct antiglobulin test ( +),free antibody test ( +) and antibody releasing test ( +)],group 2[(direct antiglobulin test(+),free antibody test(-) and antibody releasing test(+)],group 3[direct antiglobu-lin test(-),free antibody test(+) and antibody releasing test(+),and group 4[direct antiglobulin test( -),free antibody test (-) and antibody releasing test (+) ] .Constituent ratio was compared .The total bilirubin in serum from four groups were determined by automatic biochemical analyzer and compared .Results The positive rates of direct antiglobulin test,free antibody test and antibody release test were 18.4%(39/212),33.5%(71/212) and 39.6%(84/212) respectively.The positive rate had no significant difference between antibody release test and free antibody test(χ2 =1.70,P>0.05),but compared with direct antiglobulin test ,the differences were significant (χ2 =23.18, 12.58,all P<0.05).Serum total bilirubin levels in four groups were significantly increased ,but had no significant differences(F=1.369,P>0.05).Conclusion Combined detection of serum total bilirubin and serum hemolysis three tests can be used as the early diagnosis and patients condition of HDN ,and contribute to the early control of neo-natal hemolytic increase ,reduce complications and sequelae .

Objective To study the DNA damage induced by dichloroacetic acid(DCA) and trichloroacetic acid(TCA) which are from drinking water disinfection by-products. Methods V79 cells and hepatocytes of mice were treated with DCA and TCA for 1 hour and then were tested by comet assay. After stained by EB, tail length of the cells were observed and counted under the fluorescence microscope. Results Both DCA and TCA could result in the increasing of average tail length of the treated cells whether they were V79 cells or hepatocytes of mice and the dose-response relationships were seen. Conclusion Both DCA and TCA can cause DNA damage of mammalian cells and this may be related to the carcinogenic mechanism. DCA and TCA belong to genetic carcinogens.

To survey the time management disposition of the medical postgraduates,the Time Management Disposition Scale were used on 774 medical postgraduates for investigation in 2009. The difference of medical postgraduate from the countryside,towns and cities on time management disposition is not significant ( P＞0.05 ) ; Students of different gender have significant difference ( P＜0.05 ). The female postgraduates cultivation on time management disposition needs to be strengthened.

OBJECTIVETo explore the correlation between signs of living body in abdominal and pelvic cavities and syndrome typing of Chinese medicine (CM) in colorectal cancer patients.

METHODSTotally 112 colorectal cancer patients undergoing open abdominal surgery or laporoscopic surgery were syndrome typed as five types, i.e., inner-accumulation of damp and heat, blockage of stasis and toxin, Pi-Shen yang deficiency, blood-qi deficiency, Gan-Shen yin deficiency. Signs of living body in abdominal and pelvic cavities were collected. The correlation between signs of living body in abdominal and pelvic cavities and syndrome typing of CM were analyzed.

RESULTSRed colorectal canals or mass were dominated in colorectal cancer patients with inner-accumulation of damp and heat syndrome. Dark purple colorectal canals or mass were dominated in colorectal cancer patients with blockage of stasis and toxin syndrome. Reddish colorectal canals or mass were dominated in colorectal cancer patients with blood-qi deficiency syndrome. Pale colorectal canals or mass were dominated in colorectal cancer patients with Pi-Shen yang deficiency syndrome. Whitish or red-white stripes were dominated in colorectal cancer patients with Gan-Shen yin deficiency syndrome. Dropsy colorectal canal was associated with Pi-Shen yang deficiency syndrome. Intracavitary effusion was often seen in colorectal cancer patients with inner-accumulation of damp and heat syndrome. The effusion was yellowish in less amount. Intracavitary adhesion was often seen in colorectal cancer patients with blockage of stasis and toxin syndrome. There was no correlation between the maximum diameter of mass or each syndrome type of CM.

CONCLUSIONThere existed correlation between signs of living body in abdominal and pelvic cavities and syndrome typing of CM, which could be taken as one of references for syndrome typing of colorectal cancer patients.

Abdominal Cavity ; pathology ; Colorectal Neoplasms ; diagnosis ; surgery ; Humans ; Medicine, Chinese Traditional ; Pelvis ; pathology ; Yang Deficiency ; diagnosis ; Yin Deficiency ; diagnosis

Objective:To observe the acoustic characteristics of glottal stops produced by patients with cleft palate.Methods:Twenty boys with cleft palate who were judged to be glottal-stop-producers and 20 normal peers were included. In their own way, all the children were asked to produce following sounds: /iu/ /pai/ /t′u/, /s/ /k′/ /p′u/ /t′u/, /tA/ /ku/ and /i/ /k′u/ /ti/ /suan/. Then the speech spectroanalysis and the comparison were performed by one investigator.Results:The acoustic characteristics of glottal stops changed a lot when they substitute or accompany with different oral stops, which included the emergence of spikes, changes of voice onset time, the formant transitions and spetroanalysis of spikes. Conclusion:The acoustic changes of glottal stops are complicated. Every single aspects of acoustic analysis should be considered in the identification of the acoustic characteristics.

Objective To evaluate the effect of continuous spinal anesthesia with a "catheter-over-needle" system which diminished the leakage of CSF through the hole in the dura alongside the inserted catheter and minimizes the risk of post-dura-puncture headache. Methods Sixty ASA Ⅰ - Ⅱ patients aged over 60 yr, scheduled for transurethral prostatectomy, were randomly divided into two groups of 30 patients in each group: group I continuous spinal anesthesia (CSA); group Ⅱ continuous epidural anesthesia(CEA) . Catheter was placed at L2-3 or L3-4. Both groups received 0.5% bupivacaine for surgery. A loading dose of 1.5-2.5 ml (groupⅠ ) or 8-13 ml (group Ⅱ) was given. If the surgery exceeded 2 h a third of the loading dose was injected. For postoperative analgesia a mixture of 0.125% bupivacaine + 0.0006% fentanyl was used. In group I the PCA setting was loading dose 0.5ml, background infusion at 0.5 ml/h, bolus dose 0.5 ml and lock-out interval 8 min. In group Ⅱ the loading dose was 2 ml followed by background infusion at 2 ml/h and bolus dose was 2 ml with lock-out interval of 15 min. Onset time and level of analgesia were recorded during surgery and VAS pain score and movement of lower extremities (modified Bromage score) were assessed. Postoperative PCA was maintained for 50 h. Results The demographic data including age, height and body weight were comparable between the two groups. There was no significant difference in the duration of surgery between the two groups. The onset of block was significantly faster in group I (3.5 ?2.3) min than that in the group Ⅱ (9.5 ?3.4) min. Motor blockade was less intense in group Ⅱ as assessed by modified Bromage score. Analgesia was more satisfactory in group I as less patients received fentanyl and droperidol iv during surgery in group I . Thetotal amount of bupivacaine used during postoperative analgesia was significantly less in group I , only about one-fifth of the total amount used in group Ⅱ. Two patients complained of headache in group I but in group Ⅱ there was also one patient complaining of headache. Conclusion Continuous spinal anesthesia has the advantage of faster onset of block, better analgesia, more intense motor block with less local anesthetic.

Objective: To investigate the safety, feasibility, and efficacy of full repair strategy under small incision in the treatment of closed Lauge-Hansen pronation-external rotation type Ⅳ ankle fracture. Methods: The clinical data of 57 patients with closed Lauge-Hansen pronation-external rotation type Ⅳ ankle fracture treated by full repair strategy (fracture, ligament, and cartilage repair) under small incision between January 2012 and January 2017 were retrospectively analyzed. There were 31 males and 26 females, with an average age of 41.1 years (range, 21-65 years). The causes of injury included traffic accident injury in 33 cases and falling injury in 24 cases. All of them were closed fractures, including 20 cases of medial malleolus fracture, 37 cases of complete medial malleolus but deep and shallow rupture of deltoid ligament. The average time from injury to admission was 9.6 hours (range, 3-34 hours). The quality of reduction of distal tibial articular surface (based on Ketz-Sanders standard), the reduction of tibiofibular syndesmosis (the anterior and posterior distances of distal tibiofibular syndesmosis and the lateral ankle twist angle measured by CT scan at 10 mm above the ankle joint line), and the fracture healing were evaluated. The medial clear space (MCS), tibiofibular clear space (TFCS), and distal fibular tip to lateral process of talus (DFTL) were measured on the X-ray films of ankle points. Before and after operation, the pain and functional improvement of ankle joint were evaluated by visual analogue scale (VAS) score and American Orthopedic Foot and Ankle Association (AOFAS) score, and the activities of ankle dorsiflexion and plantar flexion were measured. Results: Three cases with osteochondral lesions of the talus were found during operation and all were treated with microfracture techniques. Tournament paralysis occurred in 2 cases after anesthesia. The surgical incisions healed by first intention in all patients. All the 57 patients were followed up 24-84 months, with an average of 38.6 months. All patients achieved bone healing without bone nonunion and malunion at 12 months after operation. The reduction quality of distal tibial articular surface was excellent in 56 cases and good in 1 case at 3 months after operation, the excellent and good rate was 100%. There was no significant difference in the MCS, TFCS, DFTL, anterior distance of distal tibiofibular syndesmosis, posterior distance of distal tibiofibular syndesmosis, and lateral ankle twist angle between the affected and healthy sides at 12 months after operation ( P>0.05). At last follow-up, the VAS score, AOFAS score, ankle dorsiflexion and plantar flexion activities of the affected side were significantly improved when compared with preoperative ones ( P<0.05). Compared with the healthy side, there was no significant difference in ankle dorsiflexion and plantar flexion activities ( P>0.05). Conclusion: Full-repair strategy under small incisions for the treatment of Lauge-Hansen pronation-external rotation type Ⅳ ankle fracture is effective and safe. It can not only reduce wound complications, but also improve the quality of joint reduction of the ankle joint and distal tibiofibular syndesmosis. Full repair of ligaments and cartilage can improve the internal fixation strength and joint stability of the ankle joint.

AIM: To set up a fingerprint analysis of Xintongning Capsules (Radix Notogenseng......) by TLC. METHODS: Silica gel G plate was adopted with developing underlayer of chloroform ethylacetate methanol water (15:40:22:10) under 10℃ resting overnight, 10% solution of H 2SO 4 in ethanol sprayed with and ginsenosides Rb 3 was used as standard substance. RESULTS: The result had 5 common spots. CONCLUSION: This method is accurate, reliable and provides a means for controlling the qualities of Xintongning Capsules.