BACKGROUND:There are objections to the efficacy and safety of total hip arthroplasty and artificial femoral head arthroplasty in the treatment of femoral neck fracture.
OBJECTIVE:To assess the efficacy and safety of one-stage total hip arthroplasty and femoral head arthroplasty for > 60-year-old patients with femoral neck fractures.
METHODS:According to the search strategy of Cochrane colaboration network, we searched PubMed (1966 to December 2014), EMbase (1974 to December 2014), Cochrane Library (Issue 3, 2011), China Biology Medicine database(1978 to December 2014), China National Knowledge Infrastructure (1994 to December 2014), VIP database (1989 to December 2014), and Wanfang Database (1979 to December 2014). Twenty-one articles on total hip arthroplasty and hemiarthroplasty for elderly femoral neck fractures were included. Two reviewers independently evaluated the quality of the included studies and extracted the data. In case of disagreement, settlement was made by negotiation. Meta-analysis was performed by RevMan 5.0 software in the included studies.
RESULTS AND CONCLUSION:(1) Literature analysis: five randomized controled studies, three quasi-randomized controled studies, and thirteen retrospective cohort studies were included, containing 2 250 patients. (2) Meta-analysis: No significant differencein rate of dislocation, deep infection rate and mortality rate in 1 year after replacement was detected between total hip arthroplasty and hemiarthroplasty for elderly femoral neck fractures (dislocation rate:RR=1.38, 95%CI: 0.81-2.34; deep infection rate RR=1.12, 95%CI: 0.60-2.11; mortality rateRR=0.90, 95%CI: 0.69-1.18). Reoperation rate was higher in the hemiarthroplasty group than in the total hip arthroplasty group (RR=0.46, 95%CI: 0.32-0.66). Harris score on the affected side between1 and 4 years was significantly higher in the total hip arthroplasty group than in the hemiarthroplasty group (MD=5.64, 95%CI: 2.82-8.46). (3) Results suggested that if physical conditions permit, compared with hemiarthroplasty group, femoral neck fractures patients aged > 60 years old in the total hip arthroplasty group had better hip function, but no significant difference was found in dislocation, deep infection and mortality between both groups.

Total 406 community residents entered in fitness improvement program with “management by objectives model of health promotion” from 2009 to 2011.The fitness status was monitored by Xuhui Physical Constitution Center before and after entering the program.The results showed that the level of fitness assessment,the composite score,lung capacity and reaction time were improved with the years (P ＜ 0.01) ; the step index and sitting-and-reach test in 2010 was better than those in 2009(P ＜ 0.01) ; the grip strength in 2010 and 2011 was better than that in 2009 (P ＜ 0.01); the test of single leg-standing with closing eyes in 2011 was better than that in 2009(P ＜ 0.05).There was no difference in body mass index before and after program (P ＞ 0.05).The results indicate that physical fitness and overall health can be improved by management by objectives model for health promotion.

Acute Kidney Injury ; etiology ; Hemolytic-Uremic Syndrome ; complications ; etiology ; therapy ; Humans ; Shiga Toxin ; toxicity

Objective To observe the expression of CD166 in advanced non-small cell lung cancer (NSCLC),and to explore the relationship between expression of CD166 and clinical characteristics,platinum-based chemotherapy effect of NSCLC patients.Methods A total of 64 cases of NSCLC patients at stage of Ⅲ,Ⅳ were enrolled.Tumor tissue samples were obtained before chemotherapy by bronchoscopy or lung biopsy,and immunohistochemical was used to detect the expression of CD166.All patients received platinum-based chemotherapy(NP/TC/ GP) for 2-4 cycles as the first line treatment.RECIST criterion was used for therapeutic evaluation.Results 46.9% (3 0 cases) of the patients with CD 1 6 6 was positive.The CD 1 6 6 expression was related with smoking (smoking 62.1%,no-smoking 34.3%,x2 =4.916,P =0.027) and degree of differentiation (moderately,low grade 68.2%,high grade 35.7%,x2 =6.112,P =0.013).The effectiveness rate of chemotherapy in CD166 positive patients was 23.3% (7 cases),was significantly lower than 61.8% in CD166 negative patients(21 cases,x2 =9.565,P =0.002).Conclusion NSCLC had CD166 expression,and the expression positive rate was increased in patients with smoking,and low differentiation cancer.The effectiveness rate of platinum-based was decreased in patients with CD166 positive expression,and detection of CD166 can predict the late NSCLC platinum-based chemotherapy effect.

Objective To investigate the relationship between homocystine (Hcy) ,methylenetetra hydrofolate reductase(M T H-FR) C677T and gestational diabetes mellitus (GDM ) .Methods A total of 91 GDM cases(GDM group) and 123 cases with normal pregnancy(control group) were detected for the C677T polymorphism of M T HFR and serum levels of Hcy and glucose .Results Serum Hcy level in GDM group was remarkable higher than that of control group (P< 0 .05) .Hcy level was positively correlated with fasting plasma glucose ( P < 0 .05) .The genotype frequencies (CC ,CT ,TT ) of M T HFR C677T in GDM group and control group were with significantly difference(P< 0 .05) .Hcy was significantly higher in women with C677T TT genotype than those with CC genotype(P< 0 .05) .Conclusion Hcy could be related to GDM .The mutation of M T HFR might affect serum Hcy level , and be involved in the occurrence and development of GDM .

Objective To investigate the effect of the genotypic analysis of donor from cardiac death donation on the initial dose of Tac for liver transplant recipients and provide individualized administration for the early use of Tac in liver transplantation patients.Method Thirty recipients with a different genotype of CYP3A5 from cardiac death donors were collected from March 2010 to February 2013.The matched recipients were randomly divided into experiment group and control group.There was an adjustment of initial doses of Tac according to the donors' different CYP3A5 genotypes in experiment group but not in control group.Result In experiment and control groups,the average Tac blood concentrations at the 7th day after operation were (7.47 ± 1.83) and (8.68 ± 5.14) ng/mL,and the percent of recipeints reaching the optimal Tac concentrations was 72.2％ and 38.9％,respectively (P＜0.05).In experiment and control groups,22.2％ and 55.6％ recipients needed adjustments of Tac concentrations respectively (P＜0.05).Conclusion Individualized adjustment of Tac initial doses of recipients according to cardiac death donors' different CYP3A5 genotypes was benefit for reaching optimal concentrations as soon as possible and could decrease the rate of rejection,and reduce the side effects of Tac.

Objective To study the expression and significance of Neogenin,Hepcidin and serum ferritin(SF)in patients with cancer-related anemia.Methods To test the serum levels of Neogenin,Hepcidin and SF in 107 cases,including 55 cases with cancer-related anemia and 52 cases of non-anemia with tumor by ABC-ELISA.Results ①The serum levels of Neogenin in patients with cancer-related anemia were 0.77 ± 0.45 ng/ml,which were lower than 0.98 ± 0.60 ng/ml in non-anemia group (t=2.003 8,P <0.05).The serum levels of Hepcidin in patients with cancer-related anemia were 6.03±4.25 μg/ml, which was higher than 4.51±2.23 μg/ml in non-anemia group (t=2.319 5,P <0.05).②There were no difference in pa-tients between anemia and non-anemia (t=1.898 0,P >0.05).③In patients with cancer,there were positive correlation be-tween Neogenin and Hb (r=0.212 4,t=2.226 4,P <0.05),there were negtive correlation between Hepcidin and Hb (r=-0.310 1,t=3.345 2,P <0.01),but there were no correlation between SF and Hb (P >0.05).④There were positive cor-relation between Hepsidin and SF (r=0.486 6,P <0.01).Conclusion There were lower expression of Neogenin,higher ex-pression of Hepcidin in patients with cancer-related anemia is a complex process.The abnormal expression of Neogenin and Hepcidin which were lead to the loss of use of iron are the key factors attribute to anemia in patients with cancer.

nts were tend to suffer from AKI, with the most common cause of pre-renal injury and drugs such as antibiotics and contrast medium used in X-ray imaging. Outcomes of the patients with AKI depends on severity of their kidney injury.

Objective To evaluate the diagnostic value of clinical laboratory indexes on judgment of hypovolemia in the patients with nephrotic syndrome (NS).Methods The blood volume of each 50 cases of healthy adult men and women was assessed with indocyanine green-pulse dye densitometry (ICG-PDD).The normal range of blood volume and the cut-off value of hypovolemia were determined.The blood volume of 81 patients with NS was also measured with ICG-PDD and then these patients were divided into the hypovolemic group (21 cases) and the non-hypovolemic group (60 cases) according to the cut-off value of hypovolemia.The test data of clinical laboratory indexes of the patients in the two groups were compared,and the indexes with statistic difference were screened out.Their diagnostic values on judgment of hypovolemia were evaluated by receiver operating characteristic (ROC) curve analysis,and finally the indexes with high judgment accuracy were selected.Results ①The cut-off values of hypovolemia are ＜ 52.9 ml/kg for the male and ＜ 52.5 ml/kg for the women,which were determined with ICG-PDD.②The five clinical laboratory indexes,including orthostatic heart rate (OHR) increase ＞ 10 bit per minute,fractional excretion of sodium (FENa) ＜ 1,transtubular potassium gradient (TTKG) ＞ 60％,blood urea nitrogen/serum creatinine ratio (BUN/Scr) ＞ 20,and urine specific gravity (SG) ＞ 1.020,were used to judge the hypovolemia in NS patients in this study.ROC curve analysis showed that the diagnostic accuracy in judgment of hypovolemia by one index or two indexes combination only belonged to medium level.However,the diagnostic accuracy in judgment of hypovolemia by the following three indexes combination,i.e.OHR increase+FeNa+BUN/Scr,FeNa+ BUN/Scr+SG,OHR increase+TFKG+BUN/Scr,or ORG increase+FeNa+TTTKG,reached high level.Conclusion This study obtained the cutoff value of Chinese adults hypovolemia are ＜ 52.9 ml/kg for the male and ＜ 52.5 ml/kg for the women,which are determined with ICG-PDD,through evaluation we recommend applying the above four specific combinations of three indexes for diagnosis of hypovolemia in NS patients.

Objective summarize the delicacy management practices through the NSFC application procedures in a university affiliated hospital,to provide further reference for improvement of the NSFC project approvai ratio.Methods To summarize the management experiences by analyzing the approval number,project category and funds of NCFS from 2006 to 2015.Results The delicacy man agement practices include cultivate scientific research atmosphere by strengthen motivation,initiate application as early as possible,enlarging application number by extensive mobilization,improve applica tion quality by massive training,multi-round updates,tutorial,prevent avoidable errors by cross-over review.Conclusions Delicacy management by scientific research management department during the application process is critical to improve the project approval ratio of NCFS in a hospital.