Objective To evaluate the effect of proximal femoral nail antirotation (PFNA) with autogenous bone grafting for salvage of failed internal fixation of intertrochanteric hip fracture.Methods Between January 2007 and June 2012,21 cases of intertrochanteric fractures who had failed internal fixation initially were treated with revision open reduction and PFNA internal fixation and autogenous bone grafting.There were 9 men and 12 women with the mean age of 54 years (range,27-76 years).In the initially failed internal fixation,dynamic hip screw (DHS) was used in 7 cases,locking proximal femoral plate (LPFP) in 8 cases,Gamma nail in 2 cases,proximal femoral nail (PFN) in 2 cases and home-made reconstruction nail in 2 cases.Results Mean operation time was 150 minutes (range,100-240 minutes) and mean blood loss was 800 ml (range,400-2,000 ml).There were no serious complications during operation.Mean follow-up was 26 months (range,6-66 months).Bone healing was achieved at mean 4 months (range,3-8 months) in all cases.Harris hip score was (42.1 ±3.2) points (range,36-48 points) before operation and (87.2 ± 3.8) points (range,62-94 points) at the final follow-up,with significant improvement in hip function (P ＜ 0.05).At the final follow-up,no avascular necrosis of the femoral head or hip degeneration occurred and mean neck-shaft angle was 130° (range,110°-142°).Conclusions Once the fracture patients with strong ability of action,massive proximal femoral residuals,and non-serious hip injury,revision PFNA internal fixation with autogenous bone grafting is effective.Complete preoperative evaluation and attention to specific technical details may improve success rate and reduce complications.

0.05). Cross-reactivity was seen in 1 case of clonorchiasis sinensis by both the methods. Conclusion Microwave ELISA has the advantages of high sensitivity, specificity and rapidity.

A HPLC-QTOF MS method was established for analysis of components in Ophiocordyceps sinensis . The HPLC analysis was performed on an Agilent Zorbax SB Aq (150 mmí4.6 mm, 5 μm) with gr adient elution (5 mmol·L-1 ammonium acetate aqueous solution-acetonitrile), flow rate was 0.8 mL·min-1 and detection wave-length was 260 nm. The developed method was successfully applied in analysis of three different samples in-cluding O. sinensis, Hirsutella sinensis ( anamorph of O.sinensis) and Cordyceps militaris. Nine compounds were i-dentified in both O.sinensis and H.sinensis, which eight compounds were identified in C.militaris.

Objective To explore the application value of 64-slice spiral CT cardiac enhancement scanning in the morphological as-sessment of left atrial appendage(LAA).Methods Patients were selected retrospectively between April 16,2013 and May 1,2013, including 142 patients with sinus rhythms underwent MDCT coronary angiography,25 patients with atrial fibrillation underwent MDCT pulmonary vein-left atrial angiography.All images were post-processed,datas were measured and the morphology of left at-rial appendage were classified into different types.Results 167 patients were enrolled,including 88 males and 79 femals,age 53.7± 8.9 years.Anatomical relationship of the orifice of left atrial appendage to left superior pulmonary vein(LSPV)were classified as high type (superior to LSPV,2.4%),middle type(parallel to LSPV,86.2%),low type(inferior to LSPV,11.4%).LAA orifice could be classified into three types including oval(162,97%),round-like(3,1.8%)and drop-like(2,1.2%).LAA morphology could be classified in four types including Cauliflower(35,21%),Windsock(41,24.6%),Cactus(7,4.2%),Chicken-wing(84, 50.3%).Patients with atrial fibrillation have a larger LAA volume than who with sinus rhythm.Conclusion 64-slice spiral CT car-diac enhancement scanning can provide a vivid and intuitive reference to the anatomy of LAA and its adjacent structures,and it can also provide quantitative evaluation of LAA anatomical parameters,so it may have a nice significance in the direction of LAA occlu-sion.

Objective: To determine the protective effect of zero-balanced ultraifltration and modiifed ultraifltration on infants’ pulmonary function atfer cardiac surgery. Methods: Sixty infants with congenital heart diseases were randomly divided into 3 groups: a zero-balanced ultraifltration group (Z group), a modiifed ultraifltration group (M group) and a zero-balanced ultraifltrationwith modified ultrafiltration group (Z+M group). Oxygenation index (OI), difference of alveoli-arterial oxygen pressure (P(A-α)O2), static lung compliance (Cstat), and airway resistance (Raw) were measured before caridopulmonary bypass (CPB, T1), 20 minutes atfer the CPB (T2), 2 h atfer the operation (T3), 6 h atfer the operation (T4) and 12 h atfer the operation (T5). hTe time of mechanical ventilation was also monitored. Results:Atfer the CPB, OI and Cstat in all groups decreased signiifcantly, while Raw and P(A-α)O2 increased signiifcantly. At T3, T4 and T5, OI and Cstat in the Z+M group were signiifcantly higher than those in the Z group and the M group (P<0.05), Raw andP(A-α)O2 in the Z+M group were signiifcantly lower than those in the Z group and the M group (P<0.05). hTe ventilation time in the Z+M group was signiifcantly shorter than that in the Z group and the M group (P<0.05). Conclusion:Zero-balanced ultrafiltration and modified ultrafiltration can effectively promote the pulmonary function atfer cardiac surgery in infants.

OBJECTIVE To investigate the effect and related mechanism of all￣trans retinoic acid (atRA) exposure on osteogenic differentiation of mouse embryonic palate masenchymal cells MEPM. METHODS MEPM were cultured in osteogenic medium (OM) with atRA 0.1 and 1.0 μmol??L-1 for 1, 3,5, 7 and 9 d. MTT assay was performed to measure the cell viability. The alkaline phosphatase (ALP) activity was measured by chemical colorimetry. The cells were stained using the Von￣Kossa technique to detect the formation of mineralization nodules after 21 d of culture. RT￣PCR was performed to determine expression Runx2, osteopontin, bone morphogenetic protein receptor ( Bmpr) 1b, Bmpr2 and Smad5 mRNA. RESULTS The result of MTT on 9 d showed that, compared with normal control group, the cell viability of OM, OM+atRA 0.1 and 1.0 μmol??L-1 groups decreased significantly(P<0.01). Compared with normal control group, ALP activity of OM group increased significantly(P<0.05), while the ALP activity of OM+atRA 0.1 and 1.0 μmol??L-1 groups was lower than OM group(P<0.05). On 21 d, the Von￣Kossa stai￣ning results showed that the percentage of mineralization nodules formation of OM+atRA 1.0 μmol??L-1 group was (3.65±1.24)%, which was significantly lower than that of OM group(10.33±2.29)%(P<0. 05). On 9 d, the relative Run expression of OM group was the highest one in the four groups, while at￣RA 1.0 μmol??L-1 treatment negatively regulated 20% in comparsion with OM group(P<0.05). Compared with normal control group, the mRNA expression of osteopontin of OM, OM+atRA 0.1 and 1.0 μmol??L-1 groups increased significantly(P<0.05); BDNF mRNA expression of OM group was 2.6￣fold to normal control group, while that of OM+atRA 1.0 μmol??L-1 group was 33% to OM group(P<0.05) . The level of Smad5 mRNA of OM+atRA 1.0 μmol??L-1 group was significantly lower than that of OM group(P<0.05). CONCLUSION atRA Might inhibit osteogenic differentiation of MEPM by down￣regulated the expression of Bmpr1b.

Objective To understand the dynamic changes of snail situation and wild faeces pollution in marshlands in the pilot areas after leveling embankment for flood running and moving people from outside embankment to town for providing the scientific basis of schistosomiasis control in the same type areas. Methods Shishou City,Jiangxia District,Tuanfeng County and Huangzhou District were selected as the pilot areas. Snails were surveyed by the systematic and environmental sampling. Wild faeces were also investigated. The data were processed by Excel. Results Snail areas in Huangzhou Yeluzhou increased by 12.71%,in the others it did not change. For the snail density,there was a decline trend in Jiangxia Sanjiaozhou from 1999 to 2001,but it increased in 2002 obviously;in Huangzhou Yeluzhou it decreased in 2000,but increased again from 2001 to 2002;in Tuanfeng Luohuozhou it was fluctuation;it did not change in Shishou Fuxingzhou. Except Shishou City,the other three sites had infected snails distribution. The densities of wild faeces in the pilot areas were 1.14～15.60/hm~2. The positive rates of wild faeces were 1.35%～37.21%. Conclusion The marshlands in pilot areas were seriously polluted by wild faeces. There seemed to be an increase trend in the snail density. Snail areas did not change significantly in the last few years. However,the high transmission areas will expand. So the snail survey and snail control should be strengthened.

Objective To investigate the effect of different etiology on the serum level of carbohydrate antigen 125 (CA125) in elderly patients with chronic congestive heart failure (CHF), and to assess any correlation of CA125 with serum level of B-type natriuretic peptide (BNP). Methods The 155 aged patients with New York Heart Association (NYHA) class Ⅲ or Ⅳ were enrolled and grouped into four reasons of hypertension, coronary heart disease (CHD), cardiomyopathy and other reasons, and 25 healthy old persons as control.CA125 and BNP levels were measured by automatic chemiluminescent immunoassay and enzyme immunoradiometric assay, respectively. Results CA125 level in patients with CHF was (83.4±6.6)U/L for hypertension, (36.8±1.4)U/L for CHD, (38.1±1.6)U/L for cardiomyopathy and (38.4±1.4)U/L for other reasons, which significantly higher than for healthy controls [(14.3±1.15) U/L, P＜0.05].Especially, CA125 level in hypertension group was notable higher than in other reasons of group (P＜0.05), and was positively related to BNP level (r=0.67,P＜0.05). Conclusions Serum CA125 level is a predictor for clinical pathogen of CHF.Therefore, it may be a useful additional marker for the evaluation of clinical treatment of these patients

Objective To explore the prognosis and management of atrial fibrillation (AF) in patients with atrial septal defect(ASD) accompanied by AF after transcatheter closure of ASD. Methods During the period from July 2010 to May 2013, a total of 24 patients with ASD accompanied by AF were admitted to authors’ hospital to receive transcatheter closure of ASD. Electrocardiogram (ECG), chest X-ray film and transthoracic echocardiography (TTE) were performed before and one day after the operation. Follow-up information was obtained through telephone or at out-patient clinic interview. Results Successful occlusion of ASD was obtained in all patients, and in no patient the AF rhythm turned to sinus rhythm after the procedure. In one patient preoperative AF turned to postoperative atrial flutter, and AF recurred in one case who had received transcatheter ablation of AF before the procedure. One female patient developed gastric bleeding during the course of orally taking warfarin, and she died of cerebral infarction at three days after ceasing the use of warfarin. Of the 24 patients, no anticoagulant drug was used in 5 (20.8%), oral administration of aspirin was given in 7 (29.2%), and oral medication of warfarin was employed only in 11 (45.8%). Conclusion The spontaneous conversion rate of AF is very low in patients with ASD complicated by AF after transcatheter closure of ASD. Postoperative medication of anticoagulation should be strictly standardized and carefully managed.

Objective To assess the feasibility,safety and efficacy of primary PCI in elderly patients with AMI.Methods Three hundred and sixty-four AMI patients were divided into ≥75 years old group (n=90) and ＜75 years old group (n=274).The successful operation rate,preoperative complication rate,mortality and incidence of major adverse cardiovascular events (MACE) were recorded during their hospital stay time.Results The successful operation rate was 94.4％,the postoperative TIMI 3 blood flow rate was 87.8％,and the preoperative complication rate was 10.0 ％ in ≥75 years old group.The mortality and incidence of MACE were significantly higher in ≥75 years old group than in＜75 years old group during the hospital stay time (12.2％ vs 2.9％,P =0.001;16.7 ％ vs 5.1％,P =0.000).Conclusion Transradial primary PCI is a safe,feasible and effective therapy for ≥75 years old AMI patients.