Objective To explore the effect of Shexiang baoxin Pillls on super‐elder patients with myocardial infarction ,and observe and analyze its prognosis .Methods Two hundred super‐elder patients with myocardial infarction were selected in the hos‐pital from December 2013 to November 2014 ,they were randomly divided into control group(n=100) and observation group(n=100) .The control group used conventional drug treatment ,and the observation group treated with Shexiang baoxin pillls on the ba‐sis of the control group .Three months wasr a treatment period .To observe the clinical therapeutic effect ,echocardiography was used to detected the left ventricular wall thickness ,left ventricular end‐diastolic diameter (LVEDD) ,left ventricular ejection fraction (LVEF) before and after treatment .Observed 6 minutes walking distance .Total cholesterol (TC) ,blood lipid ,low density lipopro‐tein (LDL‐C) ,c‐reactive protein (CRP) ,and other indicators were detected .Results The total effective rate of the observation group was [72 .00% (72/100)] was higher than the control group [65 .00% (65/100)] ,P<0 .05 .The re‐hospitalization rate of the observation group was [23 .00% (23/100)] was lower than the control group [34 .00% (34/100)] ,P<0 .05 .The left ventricular posterior wall thickness and LVEDD of the observation group after treatment were(10 .12 ± 0 .40)mm and(49 .11 ± 1 .39)mm , which were lower than the control group after treatment [(11 .06 ± 0 .52)mm and (51 .36 ± 1 .46)mm] ,LVEF (% ) of the observa‐tion group after treatment was (0 .51 ± 0 .12)% ,which was higher than the control group after treatment (0 .47 ± 0 .11)% ,all P<0 .05 .TC ;LDL‐C and CRP of the observation group after treatment were (5 .19 ± 0 .32) mmol/L ,(2 .83 ± 0 .30) mmol/L and (54 . 11 ± 4 .83) mg/L ,they were lower than the control group after treatment [(5 .48 ± 0 .37) mmol/L ,(3 .10 ± 0 .33) mmol/L and (62 . 38 ± 4 .36) mg/L] ,all P<0 .05 .6 min walking distance of the observation group after treatment was (376 .38 ± 19 .41)m ,it was higher than the control group after treatment(331 .04 ± 22 .18)m ,P<0 .05 .The complications of the observing group[38 .00% (38/100)] was lower than the control group after treatment 47 .00% (47/100) ,P<0 .05 .Conclusion There is better clinical effect on super‐elder patients with myocardial infarction by Shexiang baoxin Pillls ,which can reduce hospitalization rates again ,improve left heart function and blood lipid levels ,reduce complications .

Objective To summarize and analyze the intraoperative and postoperative complications arising from the Anderson-Hynes transperitoneal laparoscopic pyeloplasty (LP) procedure in the treatment of patients with ureteropelvic junction obstruction (UPJO).Methods There were 154 consecutive patients who underwent transperitoneal LP between November 2011 and December 2015.These patients' data were retrospectively analyzed for intraoperative and postoperative complications.All the 154 patients were primary UPJO.Of the 154 patients,124 (80.7％) were males and 30 (19.3％) were females,114(74.0％) were found in the left side,32(21.0％)were found in the right side,while 8 (5.0％)were found in bilateral.The mean age was 3.9 years old(ranged 8-180 months).28 patients(18.2％) have the history of urological infection or flank pain.Results Mean operative time was 89 minutes (ranged 42-330 min).The mean blood loss was 7.5ml (ranged 2-50 ml),and no blood transfusions were necessary intra-and post-operatively.The mean postoperative hospital stay was 5.7 days (ranged 3-28 days).The mean follow-up duration was 28 months (ranged 6-54 months).2 laparoscopic surgeries were converted into open surgeries.One patient suffered with repeated infection after removing the double J stent two months postoperatively.The ultrasound and intravenous urography showed the more severe obstruction compared to that before surgery.The second operation was performed and resolved this problem.The overall success rate was 98％.All 28 patients,who has preoperative symptoms,reported a complete resolution of symptoms after the procedure.Intraoperative complication occurred in 11 (7.1％) patients,including injury of parapyelic vessel while in 3 (1.9％),the misplacement of the Double-J stent in 6 (3.8％),conversion to laparotomy in 2(1.3％).The postoperative complications occurred in 24(15.6％) patients,including urine leakage in 10(6.5％),infectious urinoma in 7 (4.5％),infection after removing the Double-J in 4 (2.6％),temporary intestinal obstruction,recurrent UPJO were in 1 (0.6％)respectively.Conclusions Our retrospective analysis confirmed that LP is an effective and safe procedure.The most common intraoperative complications are difficulty in double-J stent insertion.The most common postoperative complication is urine leakage.

BACKGROUND:Proximal femoral locking plate and proximal femoral nail anti-rotation are the two common methods for the treatment of femoral intertrochanteric fractures in clinic. However, there were few randomized control ed trials on the comparison of both methods. Most of them are retrospective case analysis, and short of systematic evaluation. OBJECTIVE:To systematical y evaluate the clinical outcomes and safety between locking compression plate and proximal femoral nail anti-rotation for the treatment of the femoral intertrochanteric fractures. METHODS:The Cochrane Library (No.2 in 2015), PubMed(1966-01/2015-06), MEDLINE (1966-01/2015-06), EMbase (1984-01/2015-06), CNKI (1979-01/2015-06), VIP(1989-01/2015-06)and WanFang Data(1990-2015)were searched by computer. Meanwhile, relevant literature from the relevant journals and references were searched by hand. Al the randomized control ed trials concerning locking compression plate and proximal femoral nail anti-rotation for the treatment of the femoral intertrochanteric fractures were col ected. The literature was strictly filtered out according to the inclusion criteria, and was strictly evaluated for the quality. Meta-analysis on the included results was performed with RevMan5.2 software from the Cochrane col aboration. RESULTS AND CONCLUSION:There were 54 potential y relevant papers, and final y, 11 randomized control ed trials were eligible for this investigation. A total of 917 patients were included containing locking compression plate group (464 cases), proximal femoral nail anti-rotation group (453 cases). The Meta-analysis results showed that there were no significant differences in Harris scores, excel ent rate, complications, fracture healing time and hospital stays after treatment between the locking compression plate and proximal femoral nail anti-rotation groups. However, there were significant differences in the time of operation [MD=15.80,95%CI(7.57-24.04), P=0.000 2], peri-operative blood loss [MD=98.01, 95%CI(58.57-137.44),P<0.01], ambulation loading time [MD=8.07,95%CI(3.02-13.12),P=0.002], the length of incision [MD=6.90,95%CI(1.07-12.73), P=0.02] and postoperative drainage volume [MD=41.85,95%CI(23.77-59.93),P<0.01]. These results suggest that the treatment of proximal femoral nail anti-rotation had shortened the length of incision and the time of operation. The treatment of locking compression plate took more time of ambulation loading time, more peri-operative blood loss and postoperative drainage volume. Because the number of cases which this study included are few, and the fol ow-up time was shorter, we should design stricter large sample randomized control ed studies in future increase the strength of the evidence by conducting medium and long-term fol ow-up.

OBJECTIVE:To explore the effects of dehydroepiandrosterone(DHEA)combined with Meloxicam tablets on thera-peutic efficacy of osteoarthritis and biochemical indicator. METHODS:104 patients with osteoarthritis were randomly divided into ex-perimental group and control group with 52 cases in each group. Control group only received Meloxicam tablets,7.5 mg/time,bid;ex-perimental group was additionally given DHEA,25 mg/time,qd,on the basis of control group. The treatment course of 2 groups was four weeks. The clinical efficacy,VAS score before and after treatment,joint function score,levels of IL-1β and TNF-α,cartilage thickness,synovial thickness and score of liquid aggregation of joint cavity were compared between 2 groups. RESULTS:The total ef-fective rate of experimental group(86.54%)was significantly higher than that of control group(69.23%),with statistical significance (P<0.05);compared with before treatment,VAS scores of 2 groups decreased significantly after treatment,while joint function scores increased significantly,with statistical significance(P<0.05). VAS score of experimental group was significantly lower than that of control group,while joint function score was significantly higher than control group,with statistical significance(P<0.05). Af-ter treatment,the serum levels of IL-1βand TNF-αin 2 groups significantly decreased,with statistical significance(P<0.05);those of experimental group were significantly lower than those of control group,with statistical significance(P<0.05);there was no statis-tical significance in the cartilage thickness between 2 groups before and after treatment(P>0.05). Compared with before treatment, the thickness of the synovial membrane and the score of liquid aggregation of joint cavity significantly decreased after treatment,with statistical significance(P<0.05);the thickness of synovial membrane and the score of liquid aggregation of joint cavity in experimen-tal group were significantly lower than in control group,with statistical significance(P<0.05). CONCLUSIONS:DHEA combined with Meloxicam tablets is significant in the treatment of osteoarthritis,can significantly relief the pain and decrease the levels of serum IL-1βand TNF-α.

BACKGROUND: With the continuous renewal and development of clinical repair techniques, the intraoperatie blood loss has been greatly reduced in the treatment of intertrochanteric fracture; however, no matter what kind of repair methods should be adopted, there are stil a large amount of perioperative hidden blood loss, however, there are few clinical reports for the reasons and related factors. OBJECTIVE: To study the correlation of perioperative hidden blood loss with gender and internal fixation methods in the surgery of elderly femoral intertrochanteric fractures.METHODS: Total y 121 patients with elderly femoral intertrochanteric fractures who received the treatment at Department of Orthopedics, Nanyang City Center Hospital from March 2010 to June 2013 were divided into two groups according to the condition and treatment wishes of patients, and were respectively treated with dynamic hip screw and proximal femoral anti-rotation intramedul ary nail internal fixation. The preoperative hidden blood loss, postoperative hidden blood loss, the total hidden blood loss, dominant blood loss and total blood loss of patients in these two groups were compared. The multiple linear regression analysis on the correlation of perioperative hidden blood loss with gender and internal fixation methods was conducted. RESULTS AND CONCLUSION: There was no significant difference in the preoperative hidden blood loss between these two groups (P > 0.05). The total blood loss, postoperative hidden blood loss and total hidden blood loss in the proximal femoral anti-rotation intramedul ary nail group were significantly higher than those in the dynamic hip screw group (P < 0.05), and the dominant blood loss was significantly lower than that in the dynamic hip screw group (P <0.05). There were significant differences in the preoperative, postoperative hidden blood loss and total hidden blood loss between males and females (P < 0.05), and above indexes in males were significantly lower than in females. The multiple linear regression analysis showed that gender and internal fixation methods were correlated with hidden blood loss (P < 0.05). These results suggest that the perioperative hidden blood loss in surgery for elderly femoral intertrochanteric fractures is closely related to gender and above indexes in internal fixation methods. The perioperative hidden blood loss of male patients is less than that of female patients, and the patients treated with proximal femoral anti-rotation intramedul ary nail fixation have more hidden blood loss than dynamic hip screw fixation.

Objective To explore the relationship between the somatosensory evoked potential (SEP) diversification during operation and the short term outcome of ossification of posterior longitudinal ligament (OPLL) of cervical spine. Methods 70 OPLL inpatients from February 2008 to February 2011were included in this study. All patients received anterior cervical operation. According to the diversification of the SEP during surgery, the patients were divided into 2 groups. The preoperative and postoperative JOA scores of the OPLL patients were collected. Results There were 35 patients in the SEP no change group and 30 in SEP improved group. There was no difference in the preoperative JOA scores between them (P>0.05), but was significantly different in the postoperative JOA scores (P>0.05). Conclusion There is some relationship between the SEP diversification during operation and the short term outcome of OPLL of cervical spine.

0.05). The mean ADC value obtained in poor group was significantly lower than that obtained in satisfactory group (t = 4.81,P

Objective To explore the characteristic clinical profiles and treatment modalities of Fetal rhabdomyomatous nephroblastoma(FRN).Methods A retrospective study was conducted for 14 FRN patients from Jan.2000 to Oct.2015.Their clinical data were collected including clinical presentations,pathology and treatment modalities.There were 8 males and 6 females with a mean age of 23 months.There were 3 cases at left side and right side 5 cases,bilateral 6 cases.2 patients were classified as stage Ⅰ,1 stage Ⅱ,5 stageⅢ and 6 stageⅤ.Abdominal mass was the main clinical presentation in 11 patients,and 1 case with hematuria,1 with abdominal pain,and 1 with vomit.Most tumors showed cysts or completely solid from the ultrasonography.Computed tomographic scan revealed a large inhomogeneous enhancement tumor from the kidney pole with necrotic,cystic,bleeding or calcification.Ultrasonography and Computed tomography (CT) had no different performance from Wilms' tumor.9 patients received preoperative chemotherapy,and the response was none in all of them.8 unilateral patients underwent tumor nephrectomy and another 4 had nephron-sparing surgery.Results Pathology showed that FRN contained more than 70％ of fetal rhabdomyomatous tissue.Immunohistochemistry had no specificity,most FRN shows Desmin (+) and Myogenin(+).Bilateral FRN tumors were seen in 2,one side with FRN and another side with nephroblastomatosis were seen in 3,one side with FRN and another side with Wilm's tumor was seen in 1 patient.Postoperative pathology confirmed FRN in all 14 cases.All patients received postoperative chemotheraphy:Act-D and VCR for 6 month(stage Ⅰ),Act-D and VCR for 15 month(stage Ⅱ),Act-D +VCR + ADR and radiotherapy for 15 month(stageⅢ).During follow-up of 6 months to 15 years,10 of them were alive without tumor and no evidence of recurrence.Conclusions FRN is a rare histologic variant of Wilm's tumor with less aggressive behavior.FRN usually has a huge volume and is bilateral with a poor responder to preoperative chemotherapy,but it is associated with a generally favorable outcome.Surgery and chemically treatment appears the effective measure.

Objective To treat femur fracture in neonates using a new homemade harness designed and observe the effec of this harness. Methods Designed a new harness used in femur fracture in neonates,and used this harness in 7(8 femur fracture)csses,including 6 boys(7 femur fracture)and 1 girl,the age from 1 day to 12 days(average 4.7 days).Those cases included proximal thirds(2 cases)and middle thirds(6 cases)of femur fracture.The angle of fracture was from 44°to 83°(average 62.4°)before treatment. Results The angle of fracture was from 0°to 22°(average 14.0°)after treatment using the harness.Hespitalization was from 2 to 3 days.There were no skin sloughing or harness breaking off.All cases were followed up 6 to 36 months(average 21.3 months).All femur fracture healed in good alignment with leg-length discrepancy＜1 cm.Movement of hip and knee was normal. Conclusions The harness is a better method to treat femur fracture of the proximal and middle thirds in neonates.Advantages of it include simply operation,minimal hospitalization,minimal cost,and easy nursing.

Objective To investigate the effect of different pore sized hydroxyapatite for promoting bone vascularization in tissue engineering.Methods Male Wistar rats were randomly divided into three groups,named group A,B and C,which were im-planted hydroxyapatite bioceramics compositing 4 μg bone morphogenetic protein with different aperture of 200 -300,350 -450, 500-600 μm in the back subcutaneously.The size of each block was 5 mm×5 mm×1 mm in a weight about of 40.0 mg.After im-plantation,the animals were killed and the implants and the surrounding tissue were taken out at the first,second,third and forth week respectively.HE staining of histological analysis was used to detect the situation of local neovascularization.Results There was significant difference between second and third week in group A.Comparing the area of vascularization at different time points in group B and group C,there were significant difference in the comparison of intragroup (P <0.05 ).During the first week after surgery,there was only group C that had the area of vascularization.During the second and forth week after operation,the area of vascularization in group B and group C were significant higher than group A (P <0.05).The C group showed a great deal of new-born blood vessels and clear formation of bone trabeculae.Conclusion The hydroxyapatite bioceramics of 500-600 μm could better promote vascalarization of tissue engineering in bone.