Objective According to the assessment of the curative effect on different operation time of total hiparthroplasty for femoral neck fractures,to explore the effect of the different timing of surgery,itraoperative and postoperative blood loss,early postoperative complications and hip function recovery,and provide theoretical basis for selection of operation time of total hip arthroplasty for femoral neck fractures,to better guide clinical practice.Methods Retrospective analysis 90 femoral neck fracture patients with complete follow-up data for total hip arthroplasty,90 patients were divided into two groups,observation group was given the emergency surgery,the control group was given the delayed operation group.The differences of two groups about operation time,intraoperative blood loss,postoperative drainage,early postoperative complications and postoperative functional restoration of hip joint were compared.Results After 3 months follow-up,the comparison of operation time,intraoperative blood loss and postoperative drainage for the emergency operation group and the delayed operation group,the difference was statistically significant(t=2.37,15.38,22.73,all P＜0.05).The emergency operation group and the delayed operation group in the postoperative complications,P＞0.05,the difference was not statistically significant.After 1 month,the difference of the two groups of hip joint function by Harris score was statistically significant(t=2.76,P＜0.05);and after 3 months,the difference was not statistically significant(P＞0.05).Conclusion Emergency surgery can effectively shorten the operation time,reduce blood loss and postoperative drainage and conducive to the recovery of hip function in patients,reduce the pain caused by the disease,but the ultimate the hip function is not affected.

Aerobic glycolysis,which is also termed as Warburg effect,is one of the most common and profound biochemical phenotypes of tumor ceils.Several oncogenes and tumor suppressors genes have been implicated in aerobic glycolysis.MicroRNAs can control this metabolic switch by regulating oncogenes and tumor suppressors genes in a post-transcriptional way.A deeper understanding of the mechanisms and pathways by which miRNAs regulate the aerobic glycolysis will hopefully lead to a new therapeutic strategy for malignant cancer.

Objective To analyze the policy effect of first contact care options of residents under the essential medicine system.Methods The samples were divided into a treatment group and a control group depending whether the policy is implemented.Difference-in-differences model was used to estimate the changes in the First Contact Care choice of residents before and after the implementation.Results The net effect of policy is 6.15％,in which the resident category of the household head and per capita income were statistically significant.Conclusion Though the system promotes the first contact of residents for primary institutions,top-level design of the system calls for optimization,efficiency and equity of the health resource allocation of urban and rural health need to be improved,and the division of responsibilities of the two-level medical institutions needs to be clarified in first contact care system.

Introduced are the concept and connotation of the prospect theory in behavioral economics,and the theory is used to explore the psychological characteristics and irrational decision behaviors of both supply and demand sides of talents in human resource development of township hospitals.The study found that the limited rational decision of people influenced the policy effectiveness of human resource policy for such hospitals,and the certainty effect strengthened the demand for restoration of government accountability and the breaking of staffing quota limits.The change and difference of reference point resulted in the lack of incentives and turnover of posts in such hospitals.The presence and change of the mental account caused unscientific human resource development.Based on such findings,the prospect theory can provide good explanatory power and theoretical enlightenment for such development.

Objective To study and identify factors and evaluation criteria for optional health policy instruments for policy making reference.Methods A field survey was made to the10,000 primary care doctors to rural households campaign in Jining city,covering 453 doctors sent to villages,294 village doctors,and 572 rural residents,with the data obtained subject to descriptive analysis.Results In terms of equity of the campaign,97.8％ of the rural residents have entered into agreements,and 1.715 million of free visits have been provided by family doctors; in terms of economics,most of the superior doctors,rural doctors and rural residents believed that the policy could encourage high quality resources to sink to rural areas,and enhance the competence of public health services by rural doctors.In terms of the adaptability,60.4 ％ of the superior doctors and 92.7％ of the rural doctors hold that they are competent for health care role,but 51.8％ of the superior doctors were found not used to the current working mode.In terms of the enforceability,main complaints of superior doctors and rural doctors were excessive workload,overlong working hours,insufficient medical equipments,and reduced institutional revenue In terms of acceptability,90.4％ of the rural residents are supportive Conclusion The promotion of such a policy calls for a combination of compulsory,voluntary and mixed policy instruments in sinking the resources,with appropriate selection and optimization of such instruments,to ensure outcomes of the policy.

Objective To evaluate the efficacy and the toxicity of 89Strontium( 89 Sr) radionuclide therapy for the senile patients with bone metastatic cancer, and study the effects of 89 Sr on the image of bone metastasis, and to assess the utility of 89 Sr treatment for the senile patients in rehabilitation. Methods The effect on pain relief and the side effects of 27 senile patients with bone metastatic cancer were observed. The bone SPECT image was compared between those before and after the treatment, blood routine and blood biochemistry was tested. Results The total response rate was 70.4%, while the response rate of bone metastasis originated from prostatic cancer and breast cancer was 78.9%. A few metastasis sites in bone image disappeared or the concentration in the image became weak. A mild reversible harm to bone marrow function was the main side effect. 89 Sr had a little effect on blood biochemistry. Conclusion Radionuclide therapy with 89 Sr was an effective and well-tolerated method for the senile patients with bone metastatic cancer, which was a novel approach for pain-relief and rehabilitation of senile patients with bone metastatic cancer.

Objective To investigate the positive influence of telephone follow-up on primiparas′exclusive breastfeeding during puerperal period. Methods By using convenience sampling method, 90 primiparas were selected who had given birth in the integration ward of our hospital from October to December 2015 as the control group, and 60 primiparas were selected who had given birth in the integration ward of our hospital from December 2015 to January 2016 as the experimental group. For the experimental group, every 2 weeks, a telephone follow-up was executed according to primiparas′parturition time after leaving hospital. For the control group, telephone follow-up was not executed. The influence of periodic telephone follow-up on primiparas′ exclusive breastfeeding was observed. Results The exclusive breastfeeding rate of primiparas in the experimental group was increased as the telephone follow-up was executed. It was up to 91.7%(55/60) 6 weeks since parturition. The exclusive breastfeeding rate of primiparas in the control group was 71.1% (64/90). The difference was significant (χ2=9.28, P<0.01). Conclusions Periodic telephone follow- up according to necessity provides breastfeeding publicity and guidance after parturition, maintaining the continuous education and caring for the primiparas after leaving hospital which efficiently increased the pure breastfeeding rate of primiparas during puerperal period.

Acute traumatic coagulopathy (ATC) is one of coagulopathy induced by severe trauma in the early phase of trauma.It is always with high morbidity,mortality and multiple organ failure.Early diagnosis and treatment is the main content of trauma surgery in the department of emergency and the key to reduce mortality.Thrombelastography (TEG) can comprehensively assess the different stages of coagulation,early diagnose disturbance of blood coagulation and guide the goal-directed therapy with low complications,mortality and medical costs.TEG has been widely used in the operation of cardiac surgery,liver transplantation and trauma surgery to monitor coagulation and guide therapy.This paper mainly reviews the clinical value of thrombelastography in diagnosis and treatment of acute traumatic coagulopathy.

0. 05), respectively. Conclusion: Repeated +Gz stress may disorder the ratio of ET and NO. This imbalance may be one of the causes which lead to pathology changes in masseter musscles.

Objective To investigate the role of microglial activation in spinal cord in a rat model of persistent postoperative pain evoked by skin/muscle incision and retraction (SMIR) .Methods Seventy-two male SD rats weighing 200-250 g in which intrathecal (IT) catheter was successfully inserted were randomly divided into 3 groups ( n = 24 each) : group sham operation; group SMIR and group SMIR + FT minocycline (a specific microglia inhibitor) . The rat model of persistent postoperative pain evoked by SMIR was established according to the method described by Flatters. Pain behavior was assessed by paw mechanical withdrawal threshold ( MWT) to von Frey filament stimulation at 1 day before (T0,baseline) and 3, 7, 12, 22 and 32 days after operation (T1-5,) . Four animals were sacrificed at each time point in each group for detection of the expression of Iba-1 (a specific marker of microglia) in the spinal dorsal horn by immunofluorescence and the microglia was counted. Results MWT was significantly decreasedat T1-4, while the expression of Iba-1 and microglia counts in the spinal dorsal horn were significantly increased at T1, 2 by SMIR in group Ⅱ. IT minocycline significantly attenuated the hyperalgesia induced by SMIR at T1-4 and decreased Iba-1 expression and microglia counts at T1,2 in group Ⅲ. Conclusion Microglial activation in the spinal cord plays an important role in the development and maintenance of SMIR-evoked persistent postoperative pain in rats.