OBJECTIVE:To investigate the influence factors of plasma concentration of digoxin(SDC)and application of it in our hospital in order to promote rational use of digoxin. METHODS:445 cases treated with digoxin were collected from our hospital and plasma concentration of digoxin was detected. Multiple stepwise regressions were used to analyze current application of digoxin,relationship between SDC and factors including age,gender(Gen),departments(Dept),drug combination(Drug),serum creatinine concentration(SCR),dose. RESULTS:SDC was relation with age,gender(Gen),departments(Dept),drug combination(Drug),serum creatinine concentration(SCR),dose. CONCLUSION:There are many influence factors of SDC which are different among individual patients. In our survey,16.2% patients taking digoxin occurs adverse reactions. The most common adverse reaction is nausea and poor appetite. We should pay attention to arrhythmia caused by digoxin. The SDC of surgical inpatients were higher than that of medical inpatients(P

BACKGROUND:There are objections to the efficacy and safety of total hip arthroplasty and artificial femoral head arthroplasty in the treatment of femoral neck fracture.
OBJECTIVE:To assess the efficacy and safety of one-stage total hip arthroplasty and femoral head arthroplasty for > 60-year-old patients with femoral neck fractures.
METHODS:According to the search strategy of Cochrane colaboration network, we searched PubMed (1966 to December 2014), EMbase (1974 to December 2014), Cochrane Library (Issue 3, 2011), China Biology Medicine database(1978 to December 2014), China National Knowledge Infrastructure (1994 to December 2014), VIP database (1989 to December 2014), and Wanfang Database (1979 to December 2014). Twenty-one articles on total hip arthroplasty and hemiarthroplasty for elderly femoral neck fractures were included. Two reviewers independently evaluated the quality of the included studies and extracted the data. In case of disagreement, settlement was made by negotiation. Meta-analysis was performed by RevMan 5.0 software in the included studies.
RESULTS AND CONCLUSION:(1) Literature analysis: five randomized controled studies, three quasi-randomized controled studies, and thirteen retrospective cohort studies were included, containing 2 250 patients. (2) Meta-analysis: No significant differencein rate of dislocation, deep infection rate and mortality rate in 1 year after replacement was detected between total hip arthroplasty and hemiarthroplasty for elderly femoral neck fractures (dislocation rate:RR=1.38, 95%CI: 0.81-2.34; deep infection rate RR=1.12, 95%CI: 0.60-2.11; mortality rateRR=0.90, 95%CI: 0.69-1.18). Reoperation rate was higher in the hemiarthroplasty group than in the total hip arthroplasty group (RR=0.46, 95%CI: 0.32-0.66). Harris score on the affected side between1 and 4 years was significantly higher in the total hip arthroplasty group than in the hemiarthroplasty group (MD=5.64, 95%CI: 2.82-8.46). (3) Results suggested that if physical conditions permit, compared with hemiarthroplasty group, femoral neck fractures patients aged > 60 years old in the total hip arthroplasty group had better hip function, but no significant difference was found in dislocation, deep infection and mortality between both groups.

Objective To investigate the effect of rehabilitation on cervical fracture-dislocation following spinal cord injury.Methods126 patients with cervical fracture-dislocation following spinal cord injury from August, 2002 to March, 2009 in our hospital had undergone cervical anterior surgical treatment. 22 cases were picked up as control group, who missed rehabilitation after surgery. 22 cases were chosen randomly from the rest of 104 cases as rehabilitation group, who had undergone rehabilitation. Prognosis was evaluated by Japanese Orthopaedic Association Scores score(JOA).ResultsFollow-up time was 8-32 months，mean time 18 months. The limb function of rehabilitation group improved significantly. JOA score and quality of life were much higher in rehabilitation group than in control group.ConclusionRehabilitation is very beneficial to improve the quality of life and prognosis, and reduce complications of patients with cervical fracture-dislocation following spinal cord injury at the early stage.

To explore the diagnostic values of real-time elastosonography quantitative parameters in uterine fibroids and adenomyoma.The clinical data of 175 cases were analyzed retrospectively.Strain ratios (B/A) of lesion and normal adjacent myometrium were measured and mean B/A was calculated.The average B/A of uterine fibroids and adenomyoma was 3.81 ±0.52 and 1.39 ±0.46 respectively.And there was significant statistic difference (t =2.563,P ＜ 0.05).the accuracy rates of real-time elastosonography in the diagnosis of uterine fibroids and adenomyoma were high at 97.4％ (148/152) and 95.3％ (122/128) respectively.Real-time elastosonography has high diagnostic values for uterine fibroids and adenomyoma.

A total of 104 patients with polycystic ovarian changes on ultrasound were divided into polycystic ovary syndrome (PCOS) and polycystic ovaries (PCO) groups according to their clinical symptoms and endocrine examinations.And 40 women with normal ovulation served as the controls.Ovarian volume (OV),ovarian stroma area (SA),ovarian total area (TA) and SA/TA ratio were measured by transvaginal uhrasonography.Their endocrine hormone levels were determined.Patients with PCOS showed significantly higher OV,SA,TA and SA/TA than those of PCO and control groups.SA/TA was positively correlated with testosterone.The median serum levels of anti-Mullerian hormone (AMH) and inhibit B in the PCO group were intermediate between those in control and PCOS groups.AMH and inhibin B of PCOS were higher than the PCO and control groups.It indicated that the levels of AMH and inhibit B were associated with the degree of polycystic ovaries and they could be used to differentiate PCOS and PCO.SA/TA is associated with the elevated serum testosterone of PCO.And SA/TA is an important ultrasonic parameter for diagnosing PCOS.

Objective To observe the effect of perioperative rehabilitation on anterior spinal cord syndrome caused by cervical hyper-flexion injury. Methods Sixty-nine inpatients with anterior spinal cord syndrome after cervical hyperflexion injury from January, 2012 to De-cember, 2014 were reviewed. 32 cases (group A) accepted systematic rehabilitations and other 37 cases (group B) did not. They were as-sessed with Japanese Orthopaedic Association (JOA) scores preoperatively and 1-year follow-up. Results All the patients succeeded in the operation. The JOA score improved more 1 year follow-up in group A than group B (t=2.538, P=0.044). Conclusion Systematic rehabilita-tion may work in the management of anterior spinal cord syndrome after cervical hyperflexion injury.

Objective To explore the efficacy of multiple interventional models combined through anterior tibial veins approach in treatment of acute deep venous thrombosis (DVT).Methods The clinical data and the imaging materials of 10 patients with acute DVT were analyzed retrospectively,and the interventional treatment strategies were discussed.Results The percutaneous mechanical thrombectomy (PMT) was performed after a temporary inferior vena cava filter implanted in all patients,and thrombus clearance rate of grade Ⅲ was obtained in 7 patients while 3 patients reached grade Ⅱ criteria.There were 7 patients underwent angioplasty,then the inferior vena cava filter was retrieved during the same procedure in 5 patients while 4 patients in the second stage and 1 patient rejected to retrieve the filter.All swelling limbs alleviated significantly after those procedures.There was no critical complications occured.The total hospital stay ranged from 4 to 7 days,with a mean time of (6.00±0.94) days.All patients were followed up with a mean time of (3.60± 1.84) months (ranged from 1 to 6 months).No thrombus recurrences of the previously affected vessels were reported.Conclusion The multiple interventional models combined via anterior tibial veins for acute DVT is simple,safe and effective,combined with mechanical thrombectomy device can reduce thrombus burden quickly,and combined with angioplasty can consolidate the therapeutic effect,all those methods combined can shorten the overall hospitalization time.

BACKGROUND: Aseptic loosening occurs after long-term total hip replacement, which directly affects the service life and prospective efficacy of artificial joints. The particles produced by artificial joint wear lead to the surrounding bone dissolved, further cause loosening, among which, polyethylene particles because of acetabular liner wear stand out. OBJECTIVE: To systematically assess the acetabular liner wear, loosening and osteolysis caused by cross-linked polyethylene or conventional polyethylene after total hip arthroplasty. METHODS: A computer-based research of Medline, EMbase, CBM, CNKI, CqVip, WanFang databases before December 2015 and Cochrane (3rd issue, 2011) was performed in accordance with the retrieval strategy made by Cochrane collaboration. A manual retrieval of related bone journals and conference papers was conducted. Eleven randomized controlled trials about the wear caused by cross-linked polyethylene or conventional polyethylene after total hip arthroplasty were enrolled based on inclusion criteria, followed by a Meta-analysis using RevMan 5.0 software. RESULTS AND CONCLUSION: (1) Eleven randomized controlled trials involving 952 patients were included. (2) Meta-analysis showed that the acetabular liner wear rate of cross-linked polyethylene was significantly lower than that of conventional polyethylene at 5 years postoperatively [MD=-0.07, CI(-0.09, -0.05), I2=93%, P < 0.00001]; the large heterogeneity was decreased [MD=-0.06, 95%CI (-0.07, -0.04), I2=39%, P < 0.00001] after three research removed through sensitivity analysis. (3) The osteolysis rate in the cross-linked polyethylene group was significantly lower than that in the conventional polyethylene group [RR=0.39, 95%CI (0.27, 0.57), I2=0%, P < 0.00001]. (4) These results suggest that the cross-linked polyethylene liners exhibit reduced radiological wear and osteolysis, but the mean follow-up of 5 years (1.8 to 8.0) cannot meet the long-term requirements. Therefore, multi-central, large sample size and high-quality randomized controlled trials are needed to testify the efficacy and safety of cross-linked polyethylene.BACKGROUND: Aseptic loosening occurs after long-term total hip replacement, which directly affects the service life and prospective efficacy of artificial joints. The particles produced by artificial joint wear lead to the surrounding bone dissolved, further cause loosening, among which, polyethylene particles because of acetabular liner wear stand out. OBJECTIVE: To systematically assess the acetabular liner wear, loosening and osteolysis caused by cross-linked polyethylene or conventional polyethylene after total hip arthroplasty. METHODS: A computer-based research of Medline, EMbase, CBM, CNKI, CqVip, WanFang databases before December 2015 and Cochrane (3rd issue, 2011) was performed in accordance with the retrieval strategy made by Cochrane collaboration. A manual retrieval of related bone journals and conference papers was conducted. Eleven randomized controlled trials about the wear caused by cross-linked polyethylene or conventional polyethylene after total hip arthroplasty were enrolled based on inclusion criteria, followed by a Meta-analysis using RevMan 5.0 software. RESULTS AND CONCLUSION: (1) Eleven randomized controlled trials involving 952 patients were included. (2) Meta-analysis showed that the acetabular liner wear rate of cross-linked polyethylene was significantly lower than that of conventional polyethylene at 5 years postoperatively [MD=-0.07, CI(-0.09, -0.05), I2=93%, P < 0.00001]; the large heterogeneity was decreased [MD=-0.06, 95%CI (-0.07, -0.04), I2=39%, P < 0.00001] after three research removed through sensitivity analysis. (3) The osteolysis rate in the cross-linked polyethylene group was significantly lower than that in the conventional polyethylene group [RR=0.39, 95%CI (0.27, 0.57), I2=0%, P < 0.00001]. (4) These results suggest that the cross-linked polyethylene liners exhibit reduced radiological wear and osteolysis, but the mean follow-up of 5 years (1.8 to 8.0) cannot meet the long-term requirements. Therefore, multi-central, large sample size and high-quality randomized controlled trials are needed to testify the efficacy and safety of cross-linked polyethylene.

Objective To explore the mechanism of Niaochangshu capsule in the treatment of postmenopausal overactive bladder, through observing its influence on bladder weight and the expression of eNOS and AQP1 of ovariectomized female rats. Methods Female SD rats were divided into blank group, model group, Nilestriol group and Niaochangshu group. Rats were removed ovaries except the blank group. The treatment groups were given corresponding drugs, blank group and model group were given normal saline by gavage. After 4 weeks, the bladders' weight and thickness were detected, the expressions of eNOS and AQP1 in serum and bladder tissue were determined by ELISA, and NO by spectrophotometry. Results Ovariectomy resulted in decreased bladder weight, bladder mucosal and muscular atrophy, and opposite changes showed after given Niaochangshu. The expressions of eNOS and NO in bladder and serum were decreased significantly after ovariectomy, while increased by given Niaochangshu capsule or nylestriol (P<0.05), and there was significant difference between Niaochangshu group and Nilestriol group (P<0.05). The expression of AQP1 was decreased in the model group, and increased after given nylestriol or Niaochangshu capsule. While the expression of AQP1 in bladder had no significant difference among the four groups. Conclusion Niaochangshu capsule can reverse bladder mucosal and muscular atrophy caused by estrogen deficiency, and increase the content of eNOS in serum and bladder, thus play the role in the treatment of postmenopausal overactive bladder.

Objective To investigate the causes and factors of hemoglobinuria in patients with thrombosis after AngioJet mechanical thrombectomy.Methods The clinical data of 16 patients with thrombosis treated by AngioJet thrombectomy system were retrospectively analyzed.Nine patients with hemoglobinuria during the procedure were included in group A,while 7 patients without hemoglobinuria in group B.The type of surgical procedure,time of intraoperative aspiration and the thrombus volume were compared between both groups.Results Nine (9/16,56.23 ％) of 16 patients were found hemoglobinuria during and after AngioJet mechanical thrombectomy.There were no statistically significant differences in surgical approaches (x2 =1.667,P=0.197),the time of intraoperative aspiration ([320.11±108.80]s vs [265.29±31.46]s,t=0.741,P=0.457),the thrombus volume (x2=0.442,P=0.506) between both groups.No renal function failure were noted directly relating to the use of the AngioJet thrombectomy device.Condusion There are many factors influenced the occurrence of hemoglobinuria in the patients after AngioJet thrombectomy.It can be reduced by using reasonable type of intraoperative aspiration,controled time of aspiration and active perioperative symptomatic treatment.