Culture ; Drugs, Chinese Herbal ; Formularies as Topic ; Humans ; Language ; Medicine, Chinese Traditional ; Tablets ; Translations

Objective To analyze the features of hidden blood loss in the elderly femoral intertrochanteric fractures treated with extramedullary dynamic hip screw (DHS), intramedullary nails (Gamma 3, PFN) and hip arthroplasty (LBFH). Methods The clinicle records of 193 elderly patients (ages ≥75 year old) with femoral intertrochanteric fractures treat by DHS,Gamma3, PFNA and LBFH in our hospital were retrospectively analyzed. The estimated blood loss were calculated by Gross equation, according to the height,weight and changes of blood routine test reoperative and postoperative,the differences of hidden blood loss among DHS group,Gamma 3 group, PFN group and LBFH group were compared. Results Total blood loss in intramedullary nail groups were significantly higher than DHS group [(766 ± 83) mL],P < 0.05). No significant difference was found between PFN group [(887 ± 75) mL] and Gamma 3 group [(903 ± 91) mL] (P > 0.05), The hidden blood loss were significantly higher in the intramedullary nail groups than those in the LBFH group [(453 ± 98) mL,accounting 54%] and DHS group [(429 ± 59) mL,accounting 56%] (P < 0.05). No significant difference of hidden blood loss was found between Gamma 3 group [(742 ± 137) mL, accounting 82%] and PFN group [(711 ± 153) mL,accounting 80%], (P > 0.05). Conclusion Noteworthy, the hidden blood loss is major part of perioperative total blood loss in the elderly femoral intertrochanteric fractures , intramedullary fixations may result in greater hidden blood loss than extramedullary fixations and hip arthroplasty ,which may cause postoperative anemia.

ObjectiveTo observe the effect of early systemic rehabilitation trainings on the function recovery in patients after replantation of severed digit. Methods21 patients were planned systemic rehabilitation trainings more than 2 months after operation. Total Active Measurement (TAM) and Two Points Distance (2-PD) were used for the assessment of motor and sensory function. Employment situation were also followed-up after being discharged from hospital. ResultsThe omni-efficiency of motor and sensory function of the 21 cases was 92.3% and 88.5%. 19 cases of them returned to the original work, 2 cases changed another work. ConclusionThe early systemic rehabilitation trainings are very useful for the hands function and vacation ability of the patients after replantation of severed digit.

As a kind of standard medical equipment for peacetime round and wartime first aid,the first-aid kit is composed of a special kit and the unitized medicines and equipments in it.The situations and advances of such information of the kit are introduced in this paper as its classification,functions,quality,structure and the articles equipped with it.

BACKGROUND: The clinical manifestation of senile depression is not typical. The patients with senile depression seldom visit in general hospital, which is hard for clinical doctors to identify the disease at early time.OBJECTIVE: To research the traits of Coping style and social support in the recovered senile depressive patients.DESIGN: Case-control observation.SETTING: Department of Psychology in North China Coal Medical College.PARTICIPANTS: Ninety-six senile depressive patients at convalescent stage were selected for depressive group in clinic service of Beijing Anding Hospital from November 2004 to October 2005. Inclusion criteria: ①Aged≥60 years old. ② Coded with depression with DSM-Ⅳ. ③ Being the period of recovery, geriatric depression scale(GDS)≤10. ④Informed consent was obtained from each participant. Exclusion criteria: ① Depression resulted from other factors for instance substance abuse and schizophrenia,etc. ②Serious and instable body disease such as cerebrovascular disease,liver and kidney disease, falling sickness, disease of internal secretion. Totally 104 questionnaires were sent out, and 96 were qualified. 37 were male and 59 were female in the depressive group, aged 60-87 years old,with average of (68±6)years. The course of disease was 0.3-11 years, with mean of 2 years. The elderly from ordinary community of Beijing were invited for control group. Inclusion criteria: ①Aged ≥ 60 years old; ② No mental disease. ③ Informed consent was obtained from each participant.Exclusion criteria: The same to the depressive group. There are 100 participants in the control group, 44 were male and 56 were female, aged 60 to 84 years old, with average (67±5) years old. There were no significant differences between depressive group and control group in gender, age, education, living conditions and marriage status.METHODS: 96 senile depressive patients at convalescent stage and 100healthy aged were investigated with self-made questionnaire, Geriatric Depression Scale (GDS), Social Support Rating Scale (SSRS) and Simplified Coping Style Questionnaire (SCSQ).MAIN OUTCOME MEASURES: The scores of the self-made questionnaire, GDS, SSRS and SCSQ answered by participants in each group.RESULTS: All the 196 participants entered the result analysis. There was not disqualified questionnaire. There were significantly lower scores of positive coping style and higher scores of negative coping style in the depressive group than the control group(P ＜ 0.05 ). There was lower score of social support, subjective social support and use of social support in the depressive group than the control group (P ＜ 0.05). The scores of objective social support was not significantly different in each group. There was remarkable positive correlation between active coping style and score of social support, subjective social support and use of social support in recovered senile depressive group (P ＜ 0.01). Passive coping style was negatively correlated with score of social support, subjective social support and use of social support(P ＜ 0.01 ).CONCLUSION: Subjective social support and use of social support and negative coping style are the major risk factor in the onset of senile depression.

Objective To investigate the incidence of AKI and its relationship to mortality of inpatients by analyzing the changes of serum creatinine(SCr). Methods We collected the data of SCr in Peking Union Medical College Hospital through Jun 2006 to May 2007 and then selected the patients who were subjected to SCr determination more than one time. The relationship between the frequency of SCr determination and gender, age was analyzed. The relationship of increased SCr to gender, age, frequency of determination was also analyzed. The risk stratification based on SCr was investigated. In our study, we investigated the incidence of AKI in different diagnostic groups. The relationship between AKI and mortality in ICU and MICU unit was analyzed. Results There were 36 855 patients in one year, 16 934 patients were subjected to SCr determination only one time, 15 233 patients were subjected to SCr determination at least two times. Elder men were subjected to SCr determination more frequently (P<0.01). Along with the increase of SCr concentration, the frequency of SCr determination were increased significantly (P<0.01). Using the increasing of SCr exceeding 50% as the criteria for diagnosis of AKI, the incidence of hospital-acquired AKI was 8.46%, and it was higher in patients with injury and poisoning (16.7%), infection (16.0%), hematological system diseases (16.1%), neoplasms (12.7%). The incidence of AKI was 27.7% and 55.2% in ICU and MICU, respectively. Mortality of patients in MICU was increased along with the increasing of SCr level Mortality of patients with AKI in ICU was 23.3%, that was significant higher than patients without AKI, the adjust OR was 2.7 (P<0.01). Conclusions The incidence of AKI evaluated by analyzing SCr changing is significantly higher than that using experienced clinical diagnosis. This method is convenient in clinic for early diagnosis of AKI.

Objective To observe the Influence of Daotan decoction on nonalcoholic steatohepatitis (NASH) in Rats, and its relative mechanisms was analyzed. Methods The rat nonalcoholic steatohepatitis model was induced by high fat diet. The rats of therapeutic groups were treated with small, middle and high dose Daotan decoction respectively. Their general condition, liver index, and the fat change and inflammation of liver were observed. The serum ALT、triglyceride(TG), total cholesterol(TCH), low density lipoprotein(HCL-C), high density lipoprotein(LDL-C)were determined respectively. Results The liver index of therapeutic groups were markedly reduced respectively compared with those of model group(P0.05). The liver inflammation in therapeutic groups were improved better those in model group(P

Diagnosis, Differential ; Endophthalmitis ; diagnosis ; diagnostic imaging ; etiology ; pathology ; Humans ; Infant, Newborn ; Male ; Meningoencephalitis ; complications ; diagnosis ; diagnostic imaging ; pathology ; Suppuration ; Tomography, X-Ray Computed

BACKGROUND: Microglia is the immune effect cell in central nervous system, if it is activated, it will release neuron poisoning factors and inflammatory factors, and bring fatal injury.OBJECTIVE: To investigated the effect of focal cerebral reperfusion on activation of microglia and the effect of the regulation of electroacupuncturing Shuigou and Baihui.DESIGN: A randomized and controlled study.SETTING: The department of Physioltherapy, the 458 Hospital of Chinese PLA; Dongfang Hospital Affiliated to Shanghai Tongji University; The department of Histology-embryology, Tongji Medical College of Huazhong University of Science and Technology.MATERIALS: This experiment was processed at Histology-embryology Center of Tongji Medical College of Huazhong University of Science and Technology in March 2002. Total 80 Wistar rats were randomly divided into 8 groups with 10 in each group.METHODS: ① Normal control group: The rats were not given any treatment and killed next day. ② Sham operation group: Only artery was separated, no suture inserted, killed next day. ③ 6, 12 and 24-hour reperfusion groups: The rats' right middle cerebral artery (MCA) ischemia-reperfusion model was made by embolus suture technique, then the rat was killed after 30 minutes' occlusion at MCA and reperfusing respectively 6, 12, 24hours. ④ 6-hour reperfusion + electroacupuncture group: Electroacupuncture was carried out immediately after the model was made, then the rat was killedafter 30 minutes' occlusion at MCA and reperfusion 6 hours (The frequency was 4 Hz-16 Hz. Stimulus intensity increased 1 V per 10minutes and the final intensity was 3V. The stimulus was lasted 30 minutes). ⑤ 12-hour reperfusion + electroacupuncture B group: Electroacupuncture was carried out immediately after the model was made and 8 hours later, then the rat was killed after 30 minutes' occlusion at MCA and reperfusion 12 hours. ⑥ 24-hour reperfusion + electroacupuncture group: Electroacupuncture was carried out immediately after the model was made and 8, 16 hours later, then the rat was killed after 30 minutes' occlusion at MCA and reperfusion 24 hours.MAIN OUTCOME MEASURES: To calculate numbers of microglia and to observe its morphological changes.RESULTS: Data of totally 67 rats was entered the results analysis. No microglia was seen in the normal and sham operation groups. Large quantity of microglia was activated at the border of ischemic area in 6, 12 and 24reperfusion group, their quantity was largely increased, reaching apex at reperfusion 12 hours [(35.38±1.77), (54.25±1.67), (49.29±2.21)/200sights]. The quantity in every 6, 12 and 24 reperfusion + electroacupuncture group was less than that in model group [(32.11±2.80), (50.88±2.64),(45.45±3.95)/200 sights, P ＜ 0.05].CONCLUSION: The microglia in brain is activated after the cerebral ischemia-reperfusion and induces toxic effect on neurons. The electroacupuncture can decrease activation of microglia so as to protect the neurons.

Objective To study the features and risk factors of ischemic leukoaraiosis (LA) progression in elderly patients aged 80 years and over. Methods The 56 elderly patients with ischemic LA confirmed by MRI were enrolled in this study. The characteristics and risk factors of ischemic LA were comparatively analyzed between baseline and 3 years later by single and multi-variable logistic regression analysis. Results Ischemic LA progressed mostly in the subcortical white matter in elderly patients, especially the frontal lobes (progression of white matter lesion was present in 40% in the frontal lobes at baseline and 52% after 3 years), followed by the parietal lobes (35% at baseline and 36% after 3 years); Furthermore, previous high homocysteine (Hcy) and chronic bronchitis were risk factors of ischemic LA progression. Conclusions Ischemic LA progresses mostly in the subcortical white matter in the elderly, especially the frontal lobes; High Hcy and chronic bronchitis are risk factors of ischemic LA progression in elderly patients.