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.

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 study the resistant phenotype and molecular biology character of 106 clinical isolates of Enterobacteriaceae.METHODS The 106 clinical isolates of Enterobacteriaceae were studied by agar dilution method,mutiplex PCR and DNA sequencing methods were used in further study.RESULTS The AmpC ?-lactamase was detected in 35 isolates of Enterobacteriaceae(accounted for 33.02%),34 of 35 AmpC-producing isolates were resistant to cefoxitin,1 of 35 AmpC-producing isolates was intermediate-susceptible to cefoxitin,the susceptibility to cefepime and imipenem was 68.50% and 97.10%,respectively.CONCLUSIONS A new plasmid mediated AmpC ?-lactamase is detected in one isolate of Enterobacteriaceae.The antibiotic resistance is closely associated with antibiotic resistance genes.

OBJECTIVE To investigate antibiotic resistance and antibiotics usage of meticillin-resistant Staphylococcus(MRS) and provide reference evidence in antibiotics using.METHODS Antibiotic susceptibility test was performed by biological assay system of VITEK-2.Design questionnaires to get the message of the categories,days,effects of antibacterial drug used.RESULTS Drug sensitive ratio to vancomycin,nitrofurantoin,quinupristin-dalfopristin,linezolid were all over 90.00%.The resistant ratios to some antibacterials in MRS were higher than in meticillin-sensitive Staphylococcus(MSS).The categories of antibacterials used after Staphylococcus species detection were more than before.63.01% patients′ medication was determined by antibiotic susceptibility test.Staphylococcus isolated ratio was 43.75% after antibacterial drug used.CONCLUSIONS The status of MRS is very serious.We should pay more attention to the identification and report of resistant strains and it is important to supervise Staphylococcus efficiently and medication by antibiotic susceptibility test.

Aim ① To observe the relationship between TGF?_1 and diabetic nephropathy in experimental rats;② To explore the effects of ACEI-fosinopril and ATRA-losartan on renal TGF?_1 in diabetic rats and their renoprotective mechanism. Method Four groups of rats were studied, A group:normal control rats;B group: strephtozotocin induced diabetic rats;C group:diabetic rats treated with fosinopril;D group: diabetic rats treated with losartan.Blood glucose, urinary excretion rates of albumin, TGF?_1,as well as the expressions of TGF?_1 protein and TGF?_1 mRNA in renal cortex and the relative kidney were measured. Result ① The urinary excretion rates of albumin and TGF?_1 in B,C ,D groups were significant higher than those in A group, fosinopril and losartan can decrease the urinary excretion rates of the two proteins but can’t make the rate normal. ② The expressions of TGF?_1 protein in renal cortex in B group was much higher than that in other 3 groups, fosinopril and losartan can inhibit the expression of TGF?_1. ③ The expressions of TGF?_1 mRNA in renal cortex increased greatest in B group, fosinopril and losartan can low the expression. Conclusion The overexpression of TGF?_1 protein and mRNA in renal cortex of diabetic rats may be one of the mechanisms of diabetic nephropathy. Fosinopril and losartan can suppress the expressions of TGF?_1 protein and mRNA in renal cortex, decrease the urinary excretion rates of TGF?_1. So alleviate the patholochanges in kidney.

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 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 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.