Objective To compare the clinical effects of hemiarthroplasty and dynamic hip screw (DHS) in treatment of unstable femoral intertrechanterie fractures in the elderly. Methods A total of 62 elderly patients with unstable femoral intertrochanteric fractures treated from January 2004 to April 2007 were randomly divided into DHS group and hemiarthroplasty group, with 31 patients in each group. The patients were foLlowed up to compare the clinical effects between two groups. Results Of all, 58 patients ( including 28 patients in the hemiarthroplasty group and 30 in DHS group) were followed up for 13-49 months. The mean operation time was ( 76.07 ± 6.29 ) minutes in hemiarthroplasty group and ( 117.50 ± 8.88 ) minutes in DHS group ( P < 0.05 ). The mean blood loss during operation was (305.36±34.26) ml in hemiarthroplasty group and (431.67±53.31) ml in DSH group (P<0.05). The postoperative complications occurred in three patients in hemiarthroplasty group and 10 in DHS group, with statistical difference ( P < 0. 05 ). The Harris score for hip function was ( 85.46 ± 3.05 ) points in hemiarthroplnsty group and ( 79.73 ± 2.57 ) points in DHS group, with no statistical difference between two groups ( P > 0.05 ). Conclusions DSH is still one of effective methods for patients with unstable femoral intertrochanterie fractures. Hemiarthroplasty can diminish bleeding during operation, help walk earlier and reduce complications and is a better selection for the elderly patients with osteoporosis and unstable femoral intertrochanteric fractures. However, hemiarthroplasty can not replace DHS.

Objective: To understand the longitudinal changes of refractive errors in adolescent myopia screening in the suburb of Shanghai, and to provide reference for targeted measures of myopia prevention and intervention. Methods: By using the cluster sampling method, 1 346 students were selected from two primary schools in a town in the suburb of Shanghai. Physical development indicators and refractive examination parameters of non ciliary muscle paralysis, and uncorrected visual acuity in 2017 and 2020 were collected from the Shanghai adolescent refractive development file. Longitudinal change of spherical equivalent (SE) refractive were assessed. A linear regression model was used to examine the relationship between the rate of SE change with characteristics of the students. Results: The average annual incidence of myopia was 16.36%, and the SE degrees of the left and right eyes of myopia students decreased by 225 degrees for three years. Girls (right eye Z=-4.33; left eye Z=-3.75, P<0.01), newly-onset myopia and persistent myopia (right eye Z=634.45; left eye Z=638.85, P<0.01) was a key for the rapid progress of refractive power. Conclusion The proportion of students with severe low vision is relatively high, and the apparent shifts toward more hyperopia in myopia students call for effective prevention and control programs based on changes in refractive to slow the progression of adolescent myopia.

Objective To evaluate the cognition, attitude, and barriers of family doctor team members in chongming district of Shanghai to pharmacists joining the team and providing community pharmaceutical care. To provide the reference resources for the establishment of community pharmaceutical care management mode with appropriate suburban characteristics. Methods In a cross-section study conducted in 2020, an online questionnaire was provided to family doctor teams in 18 townships in Chongming District through group WeChat. Descriptive statistical data were used to analyze the cognition, attitude and barrier of family physician team members to community pharmaceutical care. Results Among the 555 participants in the study, 351 (63.24%) were female, 187 general practitioners (33.69%), 226 nurses (40.72%), and 142 public health physicians (25.59%). There were statistically significant differences in CPC cognition among the three classes of family doctor team members (P<0.05). 126 nurses (51.22%) and 84 public health physicians (68.85%) claimed never heard of CPC. 11.48% public health physicians and 23.58% nurses were familiar with the work content and responsibilities of community clinical pharmacists. General practitioners showed relatively high proportion of 34.76%. 34.22% of general practitioners held a "disagree attitude" against that "community pharmaceutical care can improve the medication efficacy for patients". "Insufficient investment in the health sector" and "insufficient community pharmacists" were the main obstacles to the development of community pharmaceutical care. Conclusion The attitude of family doctors in Chongming area to community pharmaceutical care was conservative. Public healthcare persons and nurses had a low awareness to community pharmaceutical care. The development of community pharmaceutical care was limited by the lack of financial investment and manpower.

The health of the human body is the result of the dynamic interplay between immunity and various microorganisms. Furthermore, the health of the mitochondrial grid determines the strength of immunity. Mitochondrial imbalance leads to the metabolic remodeling of intracellular nutrients, which accelerates the occurrence and development of tumors. The theory of yin and yang and the theory of visceral outward manifestation are the foundation and core of traditional Chinese medicine (TCM) theory, which guides the clinical diagnosis and treatment of TCM. Yang Qi is the driving force behind the metabolism and physiological functions of the human body; it is also the adenine nucleoside triphosphate produced efficiently by mitochondrial aerobic respiration. The main transport of spleen refers to the biological oxidation process of food in the mitochondria, and its normal function is closely related to the integrity of the mitochondrial structure and function of the cell. Therefore, warming yang and strengthening the spleen essentially means restoring the high production capacity of the mitochondria. Rebuilding damaged mitochondrial function, improving efficiency, and boosting the energy level of the neuro-endocrine-immune network are the key factors contributing to the body’s ability to resist disease and return to health.

Background and objective With the extensively application of HRCT (high resolution CT) and the popularization of early lung cancer screening, the proportion of small nodullar lung cancer to be operated increases rapidly. Identifying the focus lesions quickly and accurately in operation has shown to be a challenge. We carried out this research try-ing to make use of and evaluate a new method that localizaes and extracts small peripheral pulmonary nodules by way of simu-lating radiaotherapy combining methylene blue staining.Methods From February 2012 to January 2015, 97 patients with 100 peripheral pulmonary nodules ≤10 mm in size were simulated puncturing using a radiotherapy planning. When the anaesthesia came into use, methylene blue dye was injected to the virtually identiifed point corresponding to the surface point, according to the angle and depth previously computed by the radiotherapy planning. hTe video-assisted thoracoscopic surgery (VATS) wedge resections of the marked lesions were undertaken and the specimens were sent for frozen pathologic examination. hTe interval time from anesthesia-completing to puncture and injection, hTe interval time from methylene blue injection to iden-tifying the stained area and the distances between the centre point of the stains and edge of coloured lesion were recorded. Results Our preoperative localization procedure was successful in 96 of 100 (96%) nodules. hTe interval time from anesthesia-completing to puncture and injection of methylene blue were (4.85±1.25) min. hTe interval time from methylene blue injec-tion to identifying the stained area was (16.36±2.36) min. hTe distances between the centre point of the stains and edge of coloured lesion were (4.78±2.51) mm. No complication was observed in all participants.Conclusion hTe new method of locating peripheral pulmonary nodules by simulating simulating radiaotherapy combining methylene blue staining has a high success rate and no complication for localizing small peripheral pulmonary lesions, avoiding the fear and pain of the patients untaken puncture without anaesthesia reducing radial damage.

ObjectiveTo explore the mechanism of Tibetan medicine Ershiwuwei Guijiuwan against osteoporosis in ovariectomized rats through the classical Wnt/β-catenin signaling pathway. MethodForty-eight 3-month-old SD female rats were randomized into model group （equivalent volume of normal saline）， sham operation group （equivalent volume of normal saline）， estradiol group （0.1 mg·kg^-1 estradiol valerate）， and high-， medium-， low-dose Ershiwuwei Guijiuwan groups （800， 400， 200 mg·kg^-1， respectively）. For the modeling， some adipose tissue near the ovaries was removed in the sham operation group， and ovaries were excised in other groups. Administration （ig， once a day） started two weeks after the operation and lasted 12 weeks. After sampling， based on hematoxylin and eosin （HE） staining， the morphological changes of the right femur and lumbar spine of the rats were observed. The enzyme-linked immunosorbent assay （ELISA） was performed to detect the serum levels of rat tartrate-resistant acid phosphatase 5b （TRAP5b）， collagen type Ⅰ C-terminal peptide （CTX-Ⅰ）， bone alkaline phosphatase （BALP）， amino-terminal propeptide of type Ⅰ procollagen （PINP）， and bone Gla-protein （BGP）. Real-time fluorescence quantitative polymerase chain reaction （Real-time PCR） was performed to examine the mRNA expression of β-catenin and Runt-related transcription factor 2 （Runx2） in femur， and Western blot to detect the protein expression of β-catenin， Runx2， and low-density lipoprotein receptor-related protein-5 （Lrp-5）. ResultCompared with the sham operation group， the model group showed disordered and sparse bone trabecula with fewer connections， decrease in serum levels of BALP， BGP， and PINP （P<0.01）， increase in levels of CTX-Ⅰ and TRAP5b （P<0.01）， reduction in mRNA expression of β-catenin and Runx2 in femoral tissue （P<0.01） and protein expression of Lrp-5， β-catenin， and Runx2 （P<0.01）. Compared with the model group， estradiol and each dose of Ershiwuwei Guijiuwan increased the volume of bone trabecula， made thebone trabecula closely arranged， reduced the loss of the trabecular meshwork， raised the serum levels of BALP and BGP （P<0.01）， and lowered TRAP5b level （P<0.01）. PINP level was significantly increased in the high-dose Ershiwuwei Guijiuwan group and estradiol group （P<0.01） and CTX-Ⅰ level was significantly decreased in the high-dose Erwenwuwei Guijiuwan group and the estradiol group （P<0.01） compared with those in the model group. The mRNA expression of β-catenin in femoral tissue and protein expression of Lrp-5 and β-catenin in estradiol group and three Ershiwuwei Guijiuwan groups were significantly increased （P<0.05， P<0.01）， and the levels of Runx2 mRNA and protein were significantly increased in the high-dose Ershiwuwei Guijiuwan group and the estradiol group （P<0.01） compared with those in the model group. ConclusionTibetan medicine Ershiwuwei Guijiuwan is effective for the osteoporosis in ovariectomized rats， which may be related to the classic Wnt/β-catenin signaling pathway. It affects bone metabolism by up-regulating the expression of osteogenesis-related genes in the signaling pathway.

Humans ; Asthma/drug therapy* ; Biological Therapy