Objective To investigate the multiple factors correlated to femoral head necrosis in patients over 45 years old with femoral neck fractures after closed reduction and cannulated screws fixation.Methods Three hundred patients with femoral neck fracture were admitted from May 1999 to May 2004 and treated by closed reduction and internal fixation with cannulated screws.We analyzed the multiple factors:age,gender,Garden classification,follow-up time,procedure delay,quality of reduction,time of full-weight-loading,fixation removal, and preoperative traction.Multiple correlation factors were analyzed by SPSS10.0 statistic system.Results Complete case records were documented in 99 cases who were followed up for an average of 24.5 months(range,8 to 60 months).Femoral head necrosis occurred in 15 cases(15.2%).Time of femoral head necrosis was 8 to 50 months after operation.The combination of quality of reduction,preoperative traction,age,and age?fixation re- moval was found to have the most significant influence on femoral head necrosis after internal fixation for femoral neck fractures.Conclusions Good reduction is the most important factor correlated to the outcome of a femoral neck fracture.Age is linked to the risk of necrosis but it is relatively insignificant.Preoperative traction in wrong positions can increase the incidence of necrosis.Garden classification is important in predicting femoral head necrosis and is associated with quality of reduction,but it is not a risk one in the combination of multiple correlation factors that lead to the necrosis.

Objective To analyse 35 cases with failure and malfunction hemodialysis access managed by interventional radiology. Methods 35 cases with failure and malfunction hemodialysis access were examined by angiography and treated by interventional management subseqently. 26 cases of thrombosis occlusilon were treated with thrombolytic therapy and 15 cases of malfunctioning hemodialysis access were done with PTA. Results The initial angiogram showed 9 patients with simple stenosis while 26 patients with thrombosis occlusion, with concurrent stenosis in 13 patients. The rate of immediate recanalization of thrombolysis was 88.4% (23/26). The PTA was successful in 12 cases, 7 of the 13 cases concurrent with stenosis and 8 cases with simple stenosis while the other 3 cases of the 15 cases confronted failure. Follow up was made in 6 patients concurrent with stenosis without further management and 3 patients failure to conduct PTA after thrombolytic therapy. Recanalization occurred in 7 cases within 1 month and then did in all the cases in 3 month. Conclusions Angiography and subsequent interventional management play a critical role in the diagnosis and treatment of failure and malfunction hemodialysis access.

Objective To discuss the utility of lean management in the informationalization of health check-up.Methods A total of 2125 matched adults who received health check-up from April to July 2008 (n =1001) or 2012 (n =1124) were enrolled by using random sampling.Time of health check-up registration and laboratory sheet filling,preparation of final report,consumption of labor force,and integrity of data collection were compared before and after the conduction of lean management.Results Since lean management startup,time of registration was decreased from (250.0 ± 7.7) to (7.8 ± 0.9) min/100persons,time of sheet filling was reduced from (137.0 ± 10.6) to (26.0 ± 2.9) min/100 persons,preparation of final report was less time-consuming ((702.0 ± 11.7) vs.(300.0 ± 12.6) min/100persons).The integrity and accuracy of health check-up reports were significantly improved (67.0％ vs.99.2％).Newer health check-up receivers were increased from 17.8％ to 29.4％ (x2 =461.944,P ＜0.05).Conclusion Lean management may be feasible and effective in the informationalization of health check-up.

BACKGROUND: Microarc oxidation (MAO) is a break-through anodyzing technology for forming oxide films on valve metal.Use of this technology allows thick, porous oxide layers to be formed on the surface of pure titanium. Few biocompatibility reports using this treatment have been found.OBJECTIVE: The blood compatibility of a novel surface modified titanium substrata biomaterial using MAO was investigated.DESIGN: Positive and negative control, contrast observation and gold standard control.SETTING: Wuhan Union Hospital.MATERIALS: A healthy male adult New-Zealand rabbit, weighing 2.5 kg and ordinary grade, was selected in this study.Pure titanium sticks TA1 (Baoji Yingnaite Non-ferrous Metal Co., Ltd.), MAO-Ti and 20 g/L potassium oxalate were also selected in this study.METHODS: The study was carried out in the Laboratory of General Surgery, Union Hospital Affiliated to Tongji Medical College, Huazhong University of Science and Technology in May 2006. ① Materials: Titanium substrate of 10 mm in diameter and 2 mm in depth was put in an electrolyte which was quipped with deionized water, dibasic sodium phosphate, and ethanoic acid calcium for MAO treatment for 10 minutes. ② Groups: Three groups were analysed: test group, negative control group and positive control group. Test group: MAO-Ti was dipped in 10 mL saline; Positive control group: 10 mL deionized water was added in each tube; Negative control group: 10 mL saline was added in each tube. ③ Operation: Fresh whole blood was collected from rabbit and then mixed with the liquids in the three groups respectively after anti-coagulation. In addition, UV-Visible Spectrophotometer was used to evaluate the hemolytic ratio. A hemolytic ratio below or equal to 5% indicated that this novel material fitted the requirements. On the contrary, a hemolytic ratio higher than 5% proofed the existence of a hemolyzation.MAIN OUTCOME MEASURES: The hemolytic ratio of materials in three groups.RESULTS: The hemolytic ratio of the test group was 0.90%. The result indicated that this new material had no haemolysis effect.CONCLUSION: The material does not resolve red blood cells and is coincident with the international and governmental standard.

Objective To investigate the effeets of ulimstatin on expression of intestinal defemin-5 mRNAin the rat model of sepsis.Method The experiment was performed in pharmaco-laboratory of medical college,Sun Yat-Sen University.sixty Sprague-Dawley rals were randomly divided into control,sepsis,pretreated andtreated groups(n=15).Semis was induced in the mts of latter three groups by cecal lifo.and puncture(CLP).The rats of pretreated group received 25 000 U/kg ulinastatin 2 hours before operation and the rats of uli-nastatin treated groups received 50 000 U/kg ulinastatin 2 hours after operation.Some pieces of ileum mucosa weretaken 12 h after CLP.Tge pathological changes were observed and the expression of RD-5 mRNA was detectedwith RT-PCR.All data were managed by SPSS 13.0 software and arIaIyzed by using One-way ANOVA and LSD-ttest.Results The expression of RD-5 mRNA in the rats of sepsis group significantly decreased compared to col-trol(P<0.05).The expression of RD-5 mRNA of pretreated and treated groups sigificantly inereased comparedto sepsis group(P<0.05);pretreated groups had more increased expression of,RD-5 mRNA compared to treatedgroups(P<0.05).Conclusions The expression of intestinal RD-5 mRNA significantly decreases in sepsis,which could be improved by the treatment of ulinadtatin leading to intestinal mucosal protection of the siqnifleant.The pretreatment may be more effective than the theTapeatic treatment in the rat model of sepsis.

Objective To evaluate the role of Na+-K+-2Cl-cotransporter isoform 1 (NKCC1) in neurons in sevoflurane-induced epileptiform electroencephalogram (EEG) activity in the cortex of neonatal rats.Methods Twenty-four neonatal Sprague-Dawley rats,aged 4-6 days,weighing 8-15 g,were randomly divided into 3 groups (n =8 each) using a random number table:control group (group C),sevoflurane group (group S),and NKCC1 inhibitor bumetanide + sevoflurane group (group B).After electrodes were placed correctly,EEG was monitored continuously.At 30 min of monitoring,normal saline 3 μl/g was injected intraperitoneally in D and S groups,and bumetanide 10 μg/g was injected intraperitoneally in group B.At 60 min after the end of intraperitoneal administration,anesthesia was induced with inhalation of 6％ sevoflurane for 3 min and maintained with inhalation of 2.1％ sevoflurane for 1 h in group S and group B.The total duration of seizures,the duration of a single episode,the number of episodes of electroencephalographic seizures,and the amplitude and frequency of spike-and-wave were recorded.Results Seizures were not detected in group C,and no spike-and-wave was found in group B.Compared with group C,the incidence of seizures in S and B groups (75％ and 25％,respectively) and incidence of spike-and-wave in group S (100％) were significantly increased (P＜0.05).Compared with group S,the incidence of seizures and spike-and-wave was significantly decreased,the total duration of seizures,and duration of a single episode were significantly shortened,and the number of episodes of electroencephalographic seizures was significantly decreased in group B (P＜0.05).Conclusion NKCC1 in neurons may be involved in the formation of sevoflurane-induced epileptiform EEG activity in the cortex of neonatal rats.

Objective To examine the effect of berberine hydrochloride ( BER ) on the pharmacokinetic profiles of midazolam,a substrate of CYP3A,in rats. Methods The rats were intragastrically given different doses of BER (50,100, 200 mg?kg-1) or ketoconazole (75 mg?kg-1) for 10 days.Single-pass duodenum perfusion of 20 mg?kg-1 MDZ was performed and the inguinal artery was cannulated for blood sampling.Plasma concentrations of MDZ and 1'-OH-MDZ were analyzed by high performance liquid chromatography ( HPLC) with the CYP3A inhibitor ketoconazole serving as positive control. Results BER (50,100,200 mg?kg-1) and ketoconazole (75 mg?kg-1) could significantly increase the AUC(0-t),AUMC(0-t)and Cmax of MDZ in a dose-dependent manner ( P<0.05) ,and reduce the clearance rate ( CLz ) of MDA and its apparent volume of distribution in the body ( Vz ) ( P<0. 05). But they failed to dramatically affect the half-life ( t1/2z ) and the peak time ( tmax ) of MDZ. Additionally,BER ( 100,200 mg?kg-1 ) and ketoconazole ( 75 mg?kg-1 ) could significantly dose-dependently decrease the AUC(0-t),AUMC(0-t)and Cmaxof 1'-OH-MDZ,and profoundly increase the CLz,tmax and Vz of 1'-OH-MDZ (P<0.05),but they had no remarkable influences on the t1/2z.The ratio of AUC(1'-OH-MDZ)/AUC(MDZ) was decreased with the increase of BER concentration. Conclusion BER can inhibit the in vivo metabolism of MDZ in a dose-dependant manner, which is associated with the suppression of the activity of CYP3A.

Objective To investigate the clinical therapeutic effect of Chaishi fever particles on patients with epidemic encephalitis B and to study the machanism of anti-inflammatory.Methods One hundred and twenty one patients with epidemic encephalitis B admitted to the Second Clinical Medical College of Henan University of Chinese Medicine from January 2014 to May 2017 were enrolled, and they were divided into a routine treatment group (60 cases) and a traditional Chinese medicine (TCM) treatment group (61 cases) by random number table. The patients in routine treatment group were given symptomatic support and comprehensive treatment for 15 days, while those in the TCM treatment group were given as that of routine group with the addition of Chaishi fever particles 8 g, 4 times every day, orally taken for consecutive 15 days. The levels of tumor necrosis factor-α (TNF-α), interleukin (IL-1β, IL-10) in the serum of two groups were determined by enzyme-linked immunosorbent assay (ELISA), and the clinical therapeutic effect, complications and sequelae in two groups after treatment were observed.Results Compared with the routine treatment group, after treatment the time of body temperature recovering normal (days: 5.8±1.2 vs. 7.5±1.7), the coma time (days: 5.5±1.3 vs. 6.8±1.6), the remission time of convulsion (days: 5.2±1.4 vs. 6.5±1.5), and the length of stay in hospital (days: 22.6±1.9 vs. 25.2±1.8 ) were significantly shorter in TCM treatment group (P < 0.05). After treatment, the levels of serum tumor TNF-α and IL-1β were decreased, IL-10 was increased in both groups, moreover, compared with the routine treatment group, the changes were more obvious in TCM treatment group [TNF-α (μg/L): 11.4±3.6 vs. 14.6±3.5, IL-1β (μg/L): 22.3±6.2 vs. 26.2±5.6, IL-10 (μg/L): 225.2±19.2 vs. 186.2±21.5, allP < 0.05]. In addition, compared with the routine treatment group, the total effective rate was higher [98.3% (60/61) vs. 90.0% (54/60),P < 0.05], and the incidence of sequelae was lower [1.64% (1/61) vs. 13.3% (8/60),P < 0.05] in TCM treatment group.Conclusion The Chaishi fever particles can effectively treat the patients with epidemic encephalitis B and the action is related to the inhibition of inflammatory reaction.

Objective To evaluate the curative effect of interventional therapy in treating arteriosclerosis obliterans (ASO),and to discuss the related factors that may affect the postoperative recurrence.Methods The clinical data of 137 patients with lower extremity ASO (184 affected limbs in total),who were treated with interventional management during the period from January 2011 to October 2014,were retrospectively analyzed.After the treatment,the patients were followed up for 18 months.The arterial patency was checked up periodically,and the related factors that might induce recurrence were analyzed.Results The technical success rates for diseased iliac artery,femoral popliteal artery and infrapopliteal artery were 97.4％,92.5％ and 88.6％ respectively,while the technical success rates for TASC Ⅱ A,B,C and D type lesions were 97.4％,96.1％,89.7％ and 87.0％ respectively.Follow-up check-ups showed that the arterial patency rate of infrapopliteal artery was lower than that of iliac femoral artery and popliteal artery (P＜0.05),the restenosis rate of TASC Ⅱ C and D type lesions was higher than that of TASC Ⅱ A and B type lesions (P＜0.05).Multivariate Cox regression analysis indicated that diabetes mellitus,smoking and hyperlipidemia were the independent risk factors that could affect postoperative recurrence.Conclusion For the treatment of lower extremity ASO,interventional therapy is safe and effective.The postoperative restenosis rate is related to the location and type of the diseased arteries.Effective control of blood sugar level,smoking cessation and lipid-lowering measures can help reducc thc incidence of postoperative recurrence.

Objective To study the quality and effect of root cause analysis (RCA) on long-range video EEG monitoring on epilepsy patients.Methods The process of RCA long-range video EEG monitoring on patients with epilepsy was investigated to find out the root causes for quality of epilepsy capturing from pseudo differential of EEG and video effects.Then the measures were taken to improve the quality of monitoring.Result After the intervention,except canmera not clear enough,the incidences were significantly decreased compared with pre-intervention (all P ＜ 0.001).Conclusions Root cause analysis is effective in improving the quality of long-range video EEG monitoring on epilepsy patients.It is worth clinically promoting.