0.05).Spearman analysis revealed correlation between postoperative3 tibial plateau varus correction angle and functional recovery of knee joint(r=0.812,P

Objective To investigate the effects of intrathecal (IT) neostigmine on the excitatory amino-acid content in the L4-5 segment of spinal cord in a rat model of incisional pain. Methods Thirty-two male SD rats weighing 250-270 g were anesthetized with intraperitoneal pentobarbital 40 mg ? kg-1 . Intrathecal catheter was placed with the tip reaching the lumbar region according to the method of Yaksh. Five days later an 1 cm long incision was made in the plantar region of the right hind paw under isoflurane anesthesia according to the method of Brennan. Pain behavior was assessed at 1h after incision by cumulative pain score. The animals were randomly divided into four groups with 8 animals in each group: Ⅰsham operation group received IT artificial cerebro-spinal fluid (ACSF) 20 ?l but no incision was made in the hind paw; Ⅱ control group received ACSF 20 ?1 30 min before incision was made; Ⅲ postoperative neostigmine group received IT neostigmine 10 ?g 30 min after incision; Ⅳ preoperative neostigmine group received IT neostigmine 10 ?g before incision. 2h after incision the animals were decapitated and lumbar segment of spinal cord was removed for determination of aspartate and glutamate contents by high performance liquid chromatography (HPLC) with fluorescence detection. Results The cumulative pain scores in group Ⅱ were significantly higher than those in group Ⅰ (P 0.05) . Conclusion The decline in the increased excitatory amino-acid contents in spinal cord induced by incisional pain is involved in the mechanisms of analgesia provided by IT neostigmine.

[Objective]To evaluate the effect of bone cement oscillator on increasing bone cement-bone interface binding intensity.[Method]Sixty fresh femoral bones of adult pig were randomly divided into experiment group and control group under the 30%,50%,70% ultimate shear strengh of the cement/bone.There were 10 samples in each subgroup.Mechanics test was performed by MTS-810 material testing machine,and the binding intensity of bone cement-bone interface in oscillating cement-bone interface binding intensity in experiment group was compared with control group.[Result]Mechanics test showed bone cement group were significantly stronger than control group under the 30%,50% ultimate shear strengh of the cement-bone(P 0.05).[Conclusion]Bone cement oscillator can increase binding intensity of bone-cement interface,and effectively reduce long-term aseptic loosening of artificial prostheses.

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.

A GC method is described for measuring fentanyl in man plasma. Fentanyl was extracted at basic pH with cyclohexane-isobutyl alcohol (197:3) with Ro21-2212 added as internal standard and fentanyl derivative as earner. The drug was back-extracted in H2SO4, then the extract was made basic and recxtracted with ethyl ether-dichloromethane (9:1). The organic phase was evaporated at 40℃ under N2 and the residue was dissolved in ethanol. A. portion (2?l) was analyzed on a wide-bore capillary column (10 m ? 0.53 mm) of HP-1 (2.65 ?m), operated at 255℃ with N2 as carrier gas (8 ml/min) and N -P detector. The calibration graph was linear within the ranges of 0.25-100 ng/ml with a corelation coefficient of 0.9996 and the detected limit was 0.2 ng/ml. Mean recovery was 99.02% ? 6.81%. The coefficient of variation for the within- and between-run were all less than 8%. No interference was found from endogenous compounds, metabolites of parent drug or other commonly used drugs. The method was applied to therapeutic drug monitoring and pharmacokinetic studies.

Horseradish peroxidase (HRP) was injected unilaterally or bilaterally into the cerebellum of 11 rabbits in order to trace the distribution of labeled neurons in the whole length of the spinal cord. To investigate the ascending side of the axons, hemisections were made unilaterally in the lower thoracic cord of 4 rabbits before injection. The distribution of labeled spinocerebellar tract neurons was rather wide. Neurons in the cervical segments were located in (1) the central cervical nucleus (CCN) in Q_(1-4), (2) the medial part of lamina VI in C_2-T_1, (3) the central part of lamina VII in C_(4-8) and (4) lamina IV-V in C_(5-8). The labeled neurons located in segments caudal to thoracic cord could be divided into two groups. Neurons of the uncrossed tract were located in (1) Clarke's column in T_2-L_4, (2) laminae IV-VI in T_2-L_6. Neurons of the crossed tract were found in (1) the spinal border cells (SBC)in L_(3-6), (2) the medial part of the lamina VII in segments caudal to L_6, (3) lamina V in the sacrococcygeal cord and (4) laminae VII-VIII in the sacrococcygeal cord. The present study suggests that the location and fiber course of the spinocerebellar neurons in the rabbit are quite the same as those in the cat. These results should form a basis for further anatomical and physiological studies of spinocerebellar system in the rabbit.

Objective To explore the possibility of heterogenous gene to express in juvenile Schistosoma japonicum and the application of electroporation in transformation of schistosomulae. Methods The plasmids of pEGFP-C1 were introduced into mechanically transformed schsitosomula with electroporation. The presence, transcription and translation of the transgene in electroporated schistosomula were confirmed by PCR, RT-PCR and Western blotting analysis respectively using the genomic DNA, total RNA and protein extracted and isolated from schistosomula cultured in vitro for 48 hours. Meanwhile, localization of EGFP within electroporated schistosomula was performed with confocal laser scanning microscope. Results 760 bp and 276 bp amplified products by PCR and RT-PCR were found coincident with the expected size and expression of EGFP gene in elctroporated schistosomula was confirmed by Western blotting. Fluorescence of EGFP was localized in tegument and subtegument of the electroporated schistosomula with confocal microscopy, especially in the anterior part of the worm. Conclusion The heterogenous gene of EGFP has been successfully introduced into juvenile S. japonicum by electroporation and the expression of transgene was confirmed with molecular and microscopical methods.

Objective To investigate the diagnostic value of full-field digital mammography (FFDM) combined with three-dimentional digital breast tomosynthesis (3D-DBT) in the lesions of dense breast mass. Methods A total of 121 patients with breast mass (135 lesions) in Shanxi Provincial People's Hospital from January 2018 to May 2018 were retrospectively analyzed. The differences of FFDM combined with 3D-DBT technique and FFDM alone in the diagnosis of dense breast mass lesions were compared and analyzed by using American Radiological Society's Breast Imaging Reporting and Data System (BI-RADS) grading diagnosis, and then the pathological results were compared. Results The sensitivity, accuracy rate and specificity of FFDM combined with 3D-DBT in the diagnosis of breast cancer among 135 lesions was 97.3％ (36/37), 80.0％ (108/135) and 73.5％ (72/98), respectively. The sensitivity, accuracy rate and specificity of FFDM in the diagnosis of breast cancer was 86.5％ (32/37), 70.4％ (95/135) and 64.3％ (63/98), respectively. Area under the receiver operating characteristic curve of FFDM combined with 3D-DBT was higher than that of FFDM alone (0.854 vs. 0.754). Compared with FFDM, mass diameter measured by 3D-DBT was close to the pathological results. The detection rates of mass, burr features and suspected malignant aggregation calcification by using FFDM combined with 3D-DBT were superior than those by using FFDM [100.0％ (72/72) vs. 81.9％ (59/72), 52.8％ (19/36) vs. 41.7％ (15/36), 75.0％ (27/36) vs. 66.7％ (24/36), respectively]. Conclusions For the focal mass of compact glands, compared with FFDM alone, the accuracy rate of the mass measurement, the detection rate of the suspected mass, the malignant mass burr, and themicro-calcification of aggregation treated by FFDM combined with 3D-DBT have been increased in a varying degree.

BACKGROUND:The emergence of a large number of hidden blood loss during perioperative period of intertrochanteric fracture in the elderly not only increases the risk of perioperative period and complications, but also affects the postoperative recovery of joint function. At present, there is no relevant report about nutritional status and the hidden blood loss before surgery in and outside China.
OBJECTIVE:To identify the effect of nutritional status on preoperative hidden blood loss in elderly patients with intertrochanteric fracture.
METHODS:183 elderly patients with fresh and initial femoral intertrochanteric fracture were included. Laboratory serological examinations on admission and preoperation were completed. By mini nutritional assessment, patients were randomly divided into normal-nourishment group, malnourishment at risk group, and malnourishment group. The original blood volume and preoperative hidden blood loss were calculated depending on height, weight, hematocrit on admission and preoperation. According to the proportion of mean preoperative hidden blood loss on the original blood volume, patients were divided into low and high hidden blood loss groups. We compared preoperative hidden blood loss, and their proportion on the original blood volume and the preoperative incidence of high hidden blood loss, and analyzed the correlations between preoperative high hidden blood loss and preoperative nutritional status.
RESULTS AND CONCLUSION:(1) The nutritional status of elderly intertrochanteric fracture patients measured by mini nutritional assessment score was that the number of patients was 48 cases (26%) in normal-nourishment group, 64 cases (35%) in the malnourishment at risk group, and 71 cases (39%) in the malnourishment group. There were no obvious differences in the preoperative complications between any two groups (P>0.05). (2) Thirty-eight cases affected high hidden blood loss. The mean preoperative hidden blood loss was 260.43 mL. The proportion of preoperative hidden blood loss to the original blood volume was 6%. (3) The preoperative hidden blood loss, their proportion on the original blood volume and the incidence of high hidden blood loss were significantly higher in the malnourishment at risk group and malnourishment group than in the normal-nourishment group. Paired comparison showed significant differences (P<0.05). (4) Results confirmed that preoperative hidden blood loss, their proportion on the original blood volume and the incidence of high hidden blood loss gradual y increased with deterioration of nutritional status. The nutritional status is an important factor influencing the occurrence of preoperative hidden blood loss, and can be used as an important index for judging the high hidden blood loss and prognosis in elderly patients with intertrochanteric fracture.

Objective To study the distribution and related factors of curative care expenditure (CCE) of injury in Gansu Province in 2017. Methods Based on the "A System of Health Accounts 2011 (SHA 2011)", the curative care expenditure of injury in Gansu Province was calculated and analyzed. The five?stage stratified cluster sampling method was adopted to extract 149 medical and health institutions, 120 township hospitals (including community health service centers), 150 individual clinics and 600 village clinics (including community health service stations). The top?down allocation method was used to calculate the cost of injury treatment in Gansu Province, and the influencing factors were analyzed by multiple linear regression. Results In 2017, the CCE of injury in Gansu province was 3.831 billion yuan, and the expense in general hospitals was 2.708 billion yuan. Among them, the cost of lower limb injury and head injury were 1.090 and 0.847 billion yuan. People aged 40 to 69 years old spent 1.901 billion yuan on injury treatment, and the CCE of injury treatment for men and women were 2.422 and 1.409 billion yuan respectively. The results of multiple linear regression showed that hospitalization expenditure was significantly associated with length of stay, operation, hospital grade, age, payment method and gender (P<0.001). Conclusion The economic burden of injury in Gansu Province is relatively heavy, so it is necessary to focus on preventions for different groups and costly injury sites.