Cardiomyopathies ; chemically induced ; Chlorine Compounds ; poisoning ; Female ; Humans ; Middle Aged ; Oxides ; poisoning

BACKGROUND: Tension band suture fixation is always used in treating patellar fracture, and its modified method of Kirschner wire plus tension band steel-wire is also widely applied. But because the traditional surgery always causes massive incision and scar formation, it affects the appearance and function of knee joint.OBJECTIVE: To investigate the clinical curative effect of percutaneous puncture plus tension zone steel-wire fixation for the treatment of patella closed transverse fracture.DESIGN: Retrospective analysis:SETTING: Second Hospital of Medical College, Xi'an Jiaotong University.PARTICIPANTS: Twenty-nine patients with closed patellar transverse fracture admitted by Department of Orthopedics,Medical College of Xi'an Jiaotong University were selected from an average age of 36 years old. Only people that were diagnosed by X-ray as closed patellar transverse fracture were enrolled, and the informed consent was obtained from them.jostled until resetting, and then the fractured pieces were clamped by a clavical clamp to fix. Two incisions were made at the upper and lower ends of patella, and two were penetrated from the incision until its tip out of the lower hole of the same Kirschner wire under skin. The soft steel wire was drawn tightly and bended along the tip of Kirschner wire. The three-grading method, and the recovery of patients in 4 years after operation was evaluated according to the composite evaluation means about the knee joint established by Xu et al (pain, movement range of knee joint and reset of the fracture in patellar face. Meanwhile, the postoperative complications were observed.MAIN OUTCOME MEASURES: Wound healing, postoperative functional recovery and complications of patients.cases scored in grade 1, accounted for 93%, 2 cases in grade 2, accounted for 7%, who were recovered after change of means about the knee joint established by Xu, 26 cases were excellent, and 3 were good; in the movement range of knee joint, 27 cases were excellent and 2 were good; in the resetting of fracture, 26 cases were excellent and 3 were infection, traumatic arthritis, or other complications were found in patients.CONCLUSION: Percutaneous internal fixation with Kirchner needles combined with tension band wires for treatment of closed patella transverse fractures is featured by minimal trauma, fast recovery and beautiful outlook in the operative area. Moreover, it permits early movement in the knee joints. This method has a satisfied clinical curative effect.

Objective To investigate the value of myocardial enzymes and cerebrospinal fluid examination in diagnosis of hand , foot and mouth disease(HFMD) complicated with systemic inflammatory response syndrome (SIRS) and multi-organ dysfunction syndrome(MODS) .Methods During April 2010 to January 2013 ,204 cases were retrospectively analyzed and checked myocardial enzymes and cerebrospinal fluid examination of the children to analyze the correlation between inspection results and incidence of SIRS and MODS .Results The incidence of SIRS and MODS and mortality rate of severe and critical group was significantly higher than ordinary group(P<0 .05) .CSF protein ,CK-MB ,LDH and cTnT content of SIRS group were significantly higher than non-SIRS group(P<0 .05) .CSF protein ,CK-MB ,LDH and cTnT content of MODS group were significantly higher than non-MODS group(P<0 .05) .Spearman rank correlation analysis showed that CSF protein ,CK-MB and cTnT was positively correlated to inci-dence of SIRS and MODS(P<0 .05 ,P<0 .05) .Conclusion Myocardial enzymes and cerebrospinal fluid examination have a higher value in diagnosis of HFMD complicated with SIRS and MODS .

In recent years,many breast cancer therapeutic vaccines have been entered several clinical trials,which bring a new promising treatment for breast cancer.These trials reveal the advantages and characteristics of tumor-associated antigens,and put forward the questions waiting to be solved.

Objective To investigate the effect of bundle strategy of diagnosis and treatment on preventing hospital acquired pneumonia in intensive cancer patients.Methods Two hundred and sixty-five patients as control group were treated by regular preventive measures,and 292 cases as intervention group were treated by bundle strategy including the control application of antibiotics,hand hygiene,oral care,isolation of multi-drug resistant,elevation of bedside,management of respiratory tract and appropriate sedation and analgesia et al.Compare the hospital acquired pneumonia incidence,attribution mortality,duration of mechanical ventilation,stay-time in ICU,hospital acquired pneumonia antibiotics defined daily doses system and positive rate of multi-drug resistant infection between two groups.Results With the bundle treatment,the decreases of the hospital acquired pneumonia Incidence,duration of mechanical ventilation,stay-time in ICU and hospital acquired pneumonia Antibiotics daily doses system were significant(P＜ 0.01),and the positive rate of hospital acquired pneumonia attribution mortality and MDR infection were no statistical significance (P ＞ 0.05).Conclusion The bundle strategy of diagnosis and treatment could reduce the hospital acquired pneumonia incidence and the length-time in hospital.

Objective To determine the value of 18F-FDG PET-CT in detecting the primary origin of cancer of unknown primary (CUP).Methods A total of 48 patients (age range 41-82 years,mean age of 57±16 years, 20 females) were retrospectively selected. All patients were diagnosed as CUP and were examined by 18F-FDG PET-CT scan.The patients were divided into cervical lymph node metastasis group (28 cases) and extra-cervical lymph node metastasis group (20 cases) according to different metastasis site.Sensitivity of 18F-FDG PET-CT to detect primary tumor site was compared between these two groups.Results 18F-FDG PET-CT detected primary tumors in 32 of 48 patients (66.7 ％), the cervical lymph node metastasis tumors in 22 of 28 patients (78.6 ％), and extra-cervical lymph node metastasis tumors in 10 of 20 patients (50.0 ％).There was significant difference between cervical lymph node metastasis group and extra-cervical lymph node metastasis group (x2 =4.286,P ＜ 0.05).Conclusion 18F-FDG PET-CT has a high sensitivity to detect primary origin of CUP,especially for patients with cervical lymph node metastasis.

Objective To explore the rising degree of hemodiastase,lipase and the relationship with acute pancreatitis with diabetic ketoacidosis(DKA).Methods 36 diabetic ketoacidosis patients with increased trypsin were divided into non pancreatitis group(20 cases)and pancreatitis group(16 cases)based on the results of abdominal CT.And the blood amylase,urine amylase,blood fat enzyme levels of the two groups were measured and compard.Results The blood amylase of the pancreatitis group was(275.0±10.5)U/L,and that of pancreatitis group was(615.4±17.8)U/L,the difference between two groups was obvious(P＜0.01);The blood lipase of pancreatitis group was(2125.0±50.4)U/L,and that of pancreatitis group was(2021.0±19.8)U/L,there was no significant difference between the two groups(P＞0.05).The blood amylase and abdominal CT results compliance high.Conclusion Pure DKA can cause diabetes pancreatic enzyme increases,and in the diagnosis of acute pancreatitis,the specificity of blood amylase is high.

Objective To evaluate and compare the clinical effects of forward and reverse anterior cruciate ligament (ACL) reconstruction through the arthroscopy. Methods From April 2008 to August 2009,97 cases with simple ACL injures were treated with eight strands of hamstring tendons in way of two-bundle and four-tunnel reconstruction. The patients were randomly divided into two groups according to the number of hospital admissions: odd numbers (A group, 47 cases) were treated with forward double-bundle reconstruction and even (B group,50 cases) were treated with reverse. The grafts were fixed with a suspension technique by mini-plates and mini-buttons. Mean follow-up exceeded one year. The function of knee joint were assessed by the IKDC, Lysholm and Tegner rating scale. Results Mean follow-up was 13.71 months.At the last follow-up, 2 patients in A group had a 10°extension deformity and 5 had a less than 15° flexion limitation. All patients in B group showed normal knee extension, and 4 had a 5° flexion limitation. According to Lachman test, there were one case with one plus positive and one with two plus positive in A group,and one with two plus in B. KT-1000 examination (30° flexion and 30 N) showed the side to side mean difference of anterior knee laxity was (1.04±1.11) mm in A group and (0.86±1.12)mm in B. According to objective IKDC evaluation, the results were graded as normal or nearly normal in 46 patients in A group and 48in B. There were no statistical differences in the IKDC, Lysholm, and Teguer scores between two groups.Conclusion Forward or reverse ACL double-bundle reconstruction with eight strands of hamstring tendons can both restore knee stability, and there is no significant deviation between the two techniques.

Objective To investigate the effect of autologous serum therapy in the treatment of three cases of exposure keratitis after general anesthesia.Method Autologous serum therapy was used to treat 3 cases of exposure keratitis,the curative effects assessed by the patients’complaints and observation of the ocular symptoms.Result All the patients reported eliminations of exposure keratitis and symptomatic relief.Conclusions The autologous serum therapy is effective for the treatment of exposure keratitis.The nursing strategies of keeping cornea moist,preventing infections,performing mental nursing and storing serum properly are critical for the enhanced curative effect.

Objective To investigate the effect of different frequencies of pudendal electrical nerve stimulation on female stress urinary incontinence.Methods 60 SUI female patients from Shanghai Research Institute of Acupuncture and Meridian affiliated Yue Yang Hospital were enrolled in a three-times-per-week treatment group (30 paients) and a twice-per-week treatment group (30 patients).Both groups were treated by pudendal nerve electrical stimulation for twelve times.The change of therapeutic effect,symptoms index were observed in both groups before and after the treatment.Results ① Comparison of clinical efficacy:The therapeutic rate of three-times-per-week treatment group was 63.3％ (19/30),the total effective rate was 90.0％ (27/30); the therapeutic rate of twice-per-week treatment group was 36.7％ (11/30),the total effective rate was 76.7％ (23/30).The therapeutic rate showed significant differences between the two groups (x2=4.267,P＜ 0.05); The total effective rate showed no differences between the two groups (x2 =l.920,P＞0.05).② Comparison of clinical symptom score and life quality score:the post-treatment clinical symptom scores of the both groups improved significantly compared with the pre-treatment (tthee-times-prt-week=7.972,ttwice-per-week=9.520,both P＜0.01).Clinical symptom score of three-times-per-week treatment group improved better than twice-per-week treatment group (P＜0.01).Conclusion Three-times-per-week of pudendal nerve electrical stimulation has a better effect on treating female SUI patients.