Adult ; Aged ; Altitude ; Echocardiography, Stress ; Female ; Heart Failure ; diagnostic imaging ; physiopathology ; Humans ; Male ; Middle Aged ; Young Adult

The paper introduced the hospital's attempt to build a scientific and practical set of performance evaluation system based on KPI.The system determines the quantitative indicators for the efficiency and performance of each department,and effectively helps accomplish common objectives of the hospital and its departments,playing a key role in the sustaimble development of the hospital.

OBJECTIVETo evaluate the early clinical and radiographic outcome of scaphoid non-unions treated with Acutrak headless compression screw.

METHODSFrom January 2008 to July 2011,21 patients with scaphoid non-union were treated in our department. There were 18 males and 3 females with a mean age of (23.6 +/- 4.6) years; 12 cases were on right hand and 9 were on left. According to Herbert-Fisher classification, there were 10 cases with type D1, 7 cases with type D2, 3 cases with type D3, and 1 case with type D4. The mean time from injury to operation was (12.4 +/- 2.7) months. All patients were treated with Acutrak headless compression screw fixation (6 cases received 2 screws fixation, 15 cases received 1 screw fixation, and Matti-Russe bone grafting was applied in 7 cases). The carpal height, the scaphoid index and changes of the scapholunate angle were assessed before and after the operation. Range of motion and grip strength were recorded and the wrist function was assessed according to the Patient-Rated Wrist Evaluation (PRWE).

RESULTSAverage duration of follow-up was (21.3 +/- 3.6) months. All the patients attained radiological union in a mean time of (13.3 +/- 2.4) weeks following the operation. No obvious complications were recorded. The surgical treatment allowed the preoperative mean scaphoid index of 0.61 +/- 0.13 and the preoperative mean scapholunate angle of (59.4 +/- 6.8) degree to be improved to 0.69 +/- 0.10 and (44.3 +/- 8.2)degree postoperatively, respectively. There was a substantial improvement in grip strength and pain amelioration after surgery. The preoperative mean PRWE score of 45.2 +/- 4.7 was improved to 76.1 +/- 5.2 postoperatively. All patients returned back to the original work,the average time from surgery to work was (6.0 +/- 1.1) months.

CONCLUSIONFor scaphoid non-unions, Acutrak headless compression screw fixation can provide anatomical reduction, provide satisfactory results with a high union rate, well return of function and minimal complications in the early stage.

Adolescent ; Adult ; Bone Screws ; Female ; Fracture Fixation, Internal ; Fractures, Ununited ; surgery ; Humans ; Male ; Range of Motion, Articular ; Scaphoid Bone ; injuries ; physiopathology ; surgery ; Treatment Outcome ; Wrist Injuries ; physiopathology ; surgery ; Wrist Joint ; physiopathology ; surgery ; Young Adult

OBJECTIVETo investigate the early clinical efficacy of induced membrane technique for reconstruction of large bone defects after debridement in adults with chronic osteomyelitis of limbs.

METHODSFrom March 2010 to March 2012,a total of 23 adult patients with chronic osteomyelitis of limbs were treated in our department. There were 15 males and 8 females, with a mean age 35.2 years old (ranged from 26 to 49 years old). Sixteen patients had open fracture history. According to the lesion site, there were 12 cases of tibia, 7 cases of femur, 3 cases of humerus, and 1 case of both radius and ulna. Among them, 19 patients had diseases in diaphysis and 4 patients in the metaphysis. The mean interval from infection to operation was 6.9 months (ranged from 4 to 13 months). All the patients were treated by using induced membrane technique. The follow-up evaluation included clinical complications, time of bone healing and limbs function. The Chinese version of SF-36 scores was used in the assessment of quality of life pre- and post-operation.

RESULTSThe average duration of follow-up was (27.6 ± 5.3) months (ranged from 18 to 43 months). Two patients had postoperative flap edge necrosis, 1 patient had superficial iliac incision infection, no obvious complications were recorded. Twenty patients obtained radiological union at a mean time of 4.6 months (ranged from 3 to 7 months). Among them, 16 patients treated with lower limbs surgery achieved full weight-bearing at about 5.2 months (ranged from 4 to 8 months) postoperatively. Four patients suffered from reinfection during follow-up, but 3 of them achieved complete bone healing after the second surgeries with induced membrane technique. At the final follow-up, there was a substantial improvement in each dimension scores and total scores of SF-36 as compared with those before surgery.

CONCLUSIONWhen treating with adult chronic osteomyelitis of limbs, the induced membrane technique can effectively reconstruct large bone defects after debridement, significantly shorten treatment cycle, provide satisfactory results with minimal complications, promote good recovery of limbs function and require relatively simple operation technique.

Adult ; Chronic Disease ; Extremities ; surgery ; Female ; Humans ; Male ; Middle Aged ; Osteomyelitis ; surgery ; Reconstructive Surgical Procedures ; methods

Objective To observe the efficacy and adverse reaction of ozone therapy combined with gemcitabine and cisplatin (GP) regimen in patients with advanced non-small cell lung cancer.Methods Fifty-five patients with advanced non-small cell lung cancer were enrolled and allocated to treatment group (28 cases) and control group (27 cases).The patients in treatment group received ozone therapy combined with GP regimen,and the patients in control group received GP regimen only.The efficacy,quality of life,adverse reaction and cellular immune function after treatment was compared between two groups.Results There was no significant difference in the efficacy between two groups (P ＞ 0.05).The quality of life after treatment in treatment group was better than that in control group (P ＜ 0.05).The liver function damage in treatment group was lower than that in control group (P ＜ 0.05).The cellular immune function in treatment group was stronger than that in control group (P ＜ 0.05).Conclusion Ozone therapy combined with GP regimen can effectively alleviate adverse induced by GP regimen chemotherapy and significantly improve the quality of life in patients with advanced non-small cell lung cancer.

Objective To evaluate the efficacy, advantages and shortcomings of micro-percutaneous nephrolithotomy in treatment of uncomplicated ureteral calculi.Methods Clinical data were collected from 126 patients with a failure treatment of history by ESWL (extracorporeal shock wave lithotripsy) and RIRS (retrograde intrarenal surgery) in treatment of upper ureteral calculi (< 3.0 cm) from June 2015 to May 2016. Antegrade percutaneous access was obtained by B-type ultrasound guidance. Micro-PCNL was done using YAG laser fiber or pneumatic through the ureteroscope (F4.5~F6.5、F6.0~F7.5, 315 mm) to disintegrate the stones. The calculi clearance rate, operation time, operative hemorrhage, length of hospital stay and complications of the patients were analyzed after operation.ResultsThe calculi clearance rate was 88.9%, the operation time was 15~75 min, the operative hemorrhage was 15~35 ml, the length of hospital stay was 5~10 d. Only one patient need the second stage surgery because of intraoperative hemorrhage affected the surgical ifeld. No patients occurred massive hemorrhage, pneumothorax, bowel and other complications such as organ damage.Conclusion Micro-PCNL had a good clinical curative effect and security in treatment of uncomplicated ureteral calculi, which was worthy of promoting clinically.

Objective:To evaluate the early clinical and radiographic outcome of scaphoid non unions treated with Acu-trak headless compression screw. Methods:From January 2008 to July 2011,21 patients with scaphoid non union were treated in our department. There were 18 males and 3 females with a mean age of (23.6±4.6) years;12 cases were on right hand and 9 were on left. According to Herbert-Fisher classification,there were 10 cases with type D1,7 cases with type D2,3 cases with type D3,and 1 case with type D4. The mean time from injury to operation was (12.4±2.7) months. All patients were treated with Acutrak headless compression screw fixation (6 cases received 2 screws fixation,15 cases received 1 screw fixation,and Matti-Russe bone grafting was applied in 7 cases). The carpal height,the scaphoid index and changes of the scapholunate an-gle were assessed before and after the operation. Range of motion and grip strength were recorded and the wrist function was assessed according to the Patient-Rated Wrist Evaluation (PRWE). Results:Average duration of follow up was (21.3±3.6) months. All the patients attained radiological union in a mean time of (13.3±2.4) weeks following the operation. No obvious complications were recorded. The surgical treatment allowed the preoperative mean scaphoid index of 0.61±0.13 and the pre-operative mean scapholunate angle of (59.4±6.8)° to be improved to 0.69±0.10 and(44.3±8.2)° postoperatively,respectively. There was a substantial improvement in grip strength and pain amelioration after surgery. The preoperative mean PRWE score of 45.2 ±4.7 was improved to 76.1 ±5.2 postoperatively. All patients returned back to the original work ,the average time from surgery to work was (6.0±1.1) months. Conclusion:For scaphoid non unions,Acutrak headless compression screw fixation can provide anatomical reduction,provide satisfactory results with a high union rate,well return of function and minimal complica-tions in the early stage.

OBJECTIVETo study the proliferation effect of the AM supernatant incubated activation of p38 mitogen activated protein kinases (p38MAPK) signal transduction pathway in human embryonic lung fibroblasts, and to participate in the development of fibrosis in silicosis.

METHODSThe silicotic alveolar macrophages were collected by bronchoalveolar lavage and incubated in vitro in the DMEM medium containing SiO₂ (50 µg/ml) and DMEM medium without SiO₂ for 18 h. Then the AM supernatant incubated for 18 h was collected. HELFs were isolated by organize paste block method, and incubated with AM supernatants. HELFs were divided into four groups: blank control groups, AM groups, SiO₂ + AM groups, SB203580 + SiO₂ + AM groups. The proliferation in the HELF was detected with MTT method and Flow cytometry.

RESULTSThe proliferation in the HELF acted with the conditioned AM supernatant fluid were more than blank control groups, AM groups and SB203580 + SiO₂ + AM groups [average optical density: (0.48 ± 0.03) vs (0.29 ± 0.01), (0.38 ± 0.02), (0.33 ± 0.03)], the values with MTT method were statistically different (P < 0.05); Proliferous index with flow cytometry in SiO₂ + AM groups (18.12 ± 0.82) was bigger than blank control groups (9.24 ± 0.48), AM groups (14.76 ± 0.43) and SB203580 + SiO₂ + AM groups (11.71 ± 0.70) and the values were statistically different(P < 0.05).

CONCLUSIONSThe AM supernatant stimulated by silicon dioxide can accelerate the proliferation in the HELF by activation of p38MAPK signal transduction pathway.

Adult ; Cell Proliferation ; Cells, Cultured ; Culture Media, Conditioned ; Fibroblasts ; cytology ; drug effects ; pathology ; Humans ; Lung ; cytology ; MAP Kinase Signaling System ; Macrophages, Alveolar ; cytology ; Male ; Signal Transduction ; Silicon Dioxide ; pharmacology ; Silicosis ; metabolism ; pathology ; p38 Mitogen-Activated Protein Kinases ; metabolism

Objective To investigate whether the gene polymorphisms of cytochrome P450(CYP) 2E1 are associated with the risk of anti-tuberculosis drug induced hepatotoxity (ADIH).Methods In this case control study, 339 patients who matched the diagnosis criteria of tuberculosis were included. The gcneral healthy status and liver biochemical parameters were checked in all these patients. Polymerase chain reaction-restriction fragment length polymorphism (PCR RFLP) technique was used to determine CYP 2Et polymorphisms. The statistic analysis were performed by using both univariate and multivariate Logistic regression analysis. Results The allele frequencies of CYP 2E1 7632T/A, 1019C/T and 1259G/C in 103 tuberculosis patients of ADIH group were 17.5%, 26.2%and 27.2 % respectively, while those in 236 tuberculosis patients of control group were 29.7 % ,39.4 %and 40.7%, respectively (x2 =5.539, P＜0.05; x2 =5.458, P＜0.05; x2 =5.628, P＜0.05). The results of univariate analysis demonstrated that the risk of concurrent ADIH was significantly higher in patients with wild genotypes of CYP 2E1-7632T/A, CYP 2E1-1259G/C, CYP 2E1-1019C/T than in patients with other genotypes. After adjusted for sex, occupation and alcohol consumption status, the results of multivariate Logistic regression analysis also showed that wild genotypes of CYP 2E1-7632T/A, CYP 2El-1259G/C, CYP 2E1-1019C/T were significantly associated with higher risk of ADIH. The results of interaction analysis indicated that the wild genotypes of CYP 2E1-7632T/A and CYP 2E1-1259G/C or CYP 2E1-1019C/T had synergetic effects on the development of ADIH.Conclusions The risk of concurrent ADIH is significantly higher in patients with wild genotypes of CYP 2E1-7632T/A, CYP 2E1-1259G/C, CYP 2E1-1019C/T compared to patients with othergenotypes. Wild genotypes of CYP 2E1-7632T/A and CYP 2E1-1259G/C or CYP 2El-1019C/T have synergetic effects on the development of ADIH.

In order to affirm the cardioactive components in Fuzi, we identified a group of aminoalcohol- diterpenoid alkaloids in Fuzi using ultra high-performance liquid chromatography coupled with electrospray ionization mass spectrometer (UPLC-ESI-MS) method. Among a total of forty-one isolated ingredients, thirteen major aminoalcohol-diterpenoid alkaloids were identified by comparing their retention times and MS spectra with those of the reference substances. Moreover, Fuzi samples from different places of origin and with different processing methods were examined and their components displayed a pattern of high similarity, though the relative abundance varies probably due to their different processing methods. Furthermore, the cardiac effect of each identified alkaloid was individually evaluated using the isolated bullfrog heart perfusion experiment. Among the thirteen aminoalcohol diterpenoid alkaloids tested, six of them significantly enhanced the amplitude rates. Taken together, we affirm that the cardioactive components in Fuzi are aminoalcohol-diterpenoid alkaloids, shedding light on future studies of the mechanisms and development of these cardioactive compounds.
Aconitum ; chemistry ; Alkaloids ; chemistry ; Amino Alcohols ; chemistry ; Animals ; Cardiotonic Agents ; chemistry ; Chromatography, High Pressure Liquid ; Drugs, Chinese Herbal ; chemistry ; Heart ; drug effects ; In Vitro Techniques ; Plant Extracts ; chemistry ; Rana catesbeiana ; Spectrometry, Mass, Electrospray Ionization