OBJECTIVETo compare clinical outcomes of locking plate for proximal humeral fracture whether application of inferomedial screws.

METHODSFrom January 2012 to July 2013, 46 patients with proximal humeral fracture underwent locking plates were retrospectively analyzed. There were 25 males and 21 females aged from 29 to 80 years old with an average of 55.1 years old. Among them, 25 patients were treated with inferomedial screws (support group), including 13 males and 12 females aged from 38 to 80 years old with an average of (55.8 ± 11.8) years old; 8 cases were part two fracture,10 cases were part three fracture and 7 cases were part four fracture according to Neer classification. Twenty-one patients were treated without inferomedial screws (non-support group), including 12 males and 9 females aged from 29 to 79 years old with an average of (54.2 ± 14.8)years old; 6 cases were part two fracture, 9 cases were part three fracture and 6 cases were part four fracture according to Neer classification. Operative time, fracture healing time and complications were observed and compared, Neer scoring of shoulder joint were used to evaluate clinical effect.

RESULTSAll patients were followed up from 12 to 41 months with an average of 15.6 months. Operative time and fracture healing time in support group was (1.6 ± 0.4) h and (3.0 ± 0.6) months, and (1.5 ± 0.4) h and (3.1 ± 0.6) months in non-support group, while there was no statistical difference in operative time and fracture healing time between two groups. There was significant differences in Neer score between support group (89.7± 4.9) and non-support group (83.1 ± 7.1). No complication occurred in support group,while 4 cases occurred complications in non-support group.

CONCLUSIONLocking plate with inferomedial screws for proximal humeral fracture has advantages of stable fixation, less complications, quick recovery of function and satisfied clinical effect.

Adult ; Aged ; Aged, 80 and over ; Bone Plates ; Bone Screws ; Female ; Fracture Fixation, Internal ; instrumentation ; methods ; Humans ; Humeral Fractures ; physiopathology ; surgery ; Male ; Middle Aged ; Shoulder Fractures ; physiopathology ; surgery ; Shoulder Joint ; physiopathology ; surgery ; Treatment Outcome

Objective To investigate the clinical character and treatment method of the coexistence of cervical and lumbar spinal stenosis.Method Twenty-seven cases with coexistence of cervical and lum bar spinal stenosis,9 cases with single cervical operation,7 cases with single lumbar operation,11 combined cervical and lumbar operation.Results Twenty-two cases were followed-up,average 49 months,all eases were recorded with JOA score.JOA score was(8.6±0.2)scores preoperafion,(11.7±0.3)scores 2 weeks postoperation,(13.1±0.2)scores 3 months postoperation,(13.5±0.2)scores 6 months postoperation,(13.9±0.3)scores 12 months postoperation.Relief rate was 79.2%,satisfactory rate was 93.8%.Conclusions The patient with multi-segment spinal stenosis should be treated individually,to certain responsible focus.If no responsible focus,it is better to treat with cervical spinal operation first.

Objective To explore the feasibility of various compensation approaches and their combination after canceling the drug addition at municipal public hospitals in Anshan city.Methods 2008~201 1 medical services,balance of payments of Anshan municipal public hospitals during 2008~201 1 were analyzed,to calculate the balance of profit and loss of the hospitals with the drug addition canceled,as well as the effects of various compensation models and their combinations on hospitals’balance,government financial burden,costs of health insurance and patients’out-of-packet costs.Results Without drug addition,hospitals are found with surplus drop,and doubled number of years in deficit.Losses incurred by the canceling can be covered partly by pricing adjustment of medical services or collection of pharmaceutical service surcharge,with complete compensation by collection of medical service surcharge;government financial subsidies for large equipment depreciation or medical services offer part of the compensation,which is affordable by government finance.Such deficits cannot be covered completely by any single approach,yet they can be greatly eased by a combination of the approaches mentioned above.With impacts on all stakeholders in consideration,the optimal solution is the combination of the scheme with adjusted services price plus collection of pharmaceutical service surcharge and medical services compensation.Conclusion With the drug addition policy canceled,the establishment and perfection of the compensation mechanism calls for a synergy of pricing,health insurance and government finance.

Medical psychology and psychiatry is the obligatory courses for five-year and seven-year medical students. With the rapid changes of society and continuous improvement of medical services , it is necessary to adjust and integrate the teaching content of these two courses. Teaching order of some chapters in the teaching syllabus was not helpful for students to understand the teaching content. Some teaching content was repetitive. Part of the self-study content urgently needs to teach with the development of the society and changes in disease spectrum. After the adjustment , the teaching content of the curricu-lum with strong pertinence was clear and coherent. It improved the teaching efficiency and knowledge of students;therefore, the curriculum is widely praised by the students.

Objective To explore the relationship between relocation satisfaction and psychosocial stress of transitional peri-od immigrants in the south-to-north water diversion project .Methods Stratified multi-stage cluster sampling method was used in this study ,a basic questionnaire and Psychosocial Stress Survey for Groups(PSSG) were used to investigate transitional period im-migrants who moved to Xingyang and Baofeng from Zhechuan holding different subjective feelings of migration .Results (1) Ex-cept that the evaluation of the implementation of immigration policy existed significant differences(P< 0 .05) between the two are-as ,other evaluations didn′t exist significant differences .(2) There were significant differences (P< 0 .05) in negative emotions ,pos-itive emotions ,negative coping style ,total psychological stress score between the three groups about the different evaluations of new life satisfaction ,new residence satisfaction and overall relocation satisfaction in new residence .Other evaluations didn′t exist signifi-cant differences in psychological stress .(3) Decision tree indicated that the key factors from strong to weak which influence psycho-social stress were new residence satisfaction ,new life satisfaction and overall relocation satisfaction .Conclusion The overall level of psychological stress in immigration is more intense than reference ,which positive and negative nature of evaluation has a direct link with it .

Objective:To investigate the clinical application value of argon-helium knife cryoablation combined with radioactive seed implantation in the treatment of non-small cell lung cancer(NSCLC).Methods:A total of 117 patients with NSCLC admitted to Oncology Department of Fifth Affiliated Hospital of Zhengzhou University from January 2015 to January 2017 were included in our study.And they were divided into the combination group(n=63)treated with CT guided argon-helium knife cryoablation combined with radioactive 125I seeds implantation and the control group(n=54)treated only with argon-helium knife ablation.The changes of blood routine indexes, tumor markers, tumor ablation target volume and CT value were observed before and 1, 3, 6 months after treatment.Adverse reactions during treatment and the evaluation results of efficacy were compared between the two groups.Patients were followed up for 24 months to observe the recurrence and survival rates between the two groups. Results:In the combination group, seeds of(12.49±4.91)were implanted, and the X-ray exposure was(123.16±42.75)Gy.There was no significant difference in general clinical data between the two groups before treatment( P>0.05). At 1, 3 and 6 months after treatment, as compared with control group the combination group showed the significantly decreased platelet count( t=3.154, 3.586, 2.233, P=0.027、0.019、0.034), while, there was no significant difference in white blood cell count, red blood cell count and hemoglobin level between the two groups(all P>0.05). The levels of carcinoembryonic antigen(CEA), neuron-specific enolase(NSE)and tumor volume were significantly lower in combination group than in control group at 3 and 6 months after treatment( t3=3.142, 2.926 and 4.281, t6=4.094, 5.382 and 4.535, all P<0.05), showing significant improvements of illness.While, the above levels showed no significant differences at 1 month after treatment between two groups( t=1.065, 1.037, P=0.197, 0.255). At each monitoring time, the CT value of tumor target area showed a steady downward trend( P<0.05). During the treatment, the incidence of thrombocytopenia was higher in the combination group than in the control group(47.6% or 30/63 vs.24.1% or 13/54, χ2=6.935, P=0.008), while there were no significant differences in the incidence of postoperative fever, pneumothorax, myoglobinuria, pain, bleeding and nausea and vomiting between the two groups(all P>0.05). After 6 months of treatment, the remission rate was higher in the combination group(73.0% or 46/63)than in the control group(48.1% or 26/54). The survival time and relapse-free time of the combination group were longer than those of the control group[(21.81±4.31)months vs.(18.93±5.94)months, (20.48±5.76)months vs.(16.93±7.14)months, Log Rank χ2=8.229 and 9.656, P=0.004 and 0.002)]. Conclusions:Argon-helium knife Cryoablation combined with radioactive seed implantation can effectively control the local progression of NSCLC, reduce the risk of tumor recurrence, and has high safety.

OBJECTIVETo observe the effect and mechanisim of zoledronate sodium on periprosthetic osteolysis in rat induced by polyethylene particles.

METHODSTotal 30 adult male SD rats, weighting from 250 to 300 g, were selected and randomly divided into three groups: blank control group, model control group and zoledronate sodium group respectively, 10 animals for each group. No treatment was performed in the blank control group. In model control group and zoledronate sodium group, the modle of periprosthetic osteolysis in rats were made by implanting polyethylene particles and titanium rods into their right femurs. After operation, rats in zoledronate sodium group were administered with zoledronate sodium (0.1 mg/kg each week) through subcutaneous injection for 8 weeks, then the blood was obtained and all experimental animals were sacrificed to get the right femur specimens. The femur BMD, IL-1β, IL-6, TNF-α, serum TRACP5b and CTX-I were detected.

RESULTSCompared with the model control group, the femur BMD was increased, while IL-1β, IL-6 and TNF-α were all decreased in zoledronate sodium group; the serum TRACP5b and CTX-I level were both reduced in zoledronate sodium group.

CONCLUSIONThe zoledronate sodium could effectively inhibit periprosthetic osteolysis in rats induced by polyethylene particles, which might be realized by inhibiting the activity of osteoclasts and the expression of IL-1β, IL-6 and TNF-α. It provides a new method to treat periprosthetic osteolysis of the artificial joint prosthesis.

Animals ; Bone Density ; drug effects ; Collagen Type I ; analysis ; Cytokines ; analysis ; Diphosphonates ; therapeutic use ; Imidazoles ; therapeutic use ; Joint Prosthesis ; Male ; Osteolysis ; drug therapy ; Peptides ; analysis ; Polyethylene ; pharmacology ; Rats ; Rats, Sprague-Dawley

Adult ; Air Pollutants, Occupational ; poisoning ; Humans ; Male ; Middle Aged ; Occupational Diseases ; etiology ; Occupational Exposure ; adverse effects ; Pneumoconiosis ; etiology ; Silicon Dioxide ; poisoning

Adult ; Diabetes Mellitus ; etiology ; Humans ; Male ; Nose Diseases ; etiology ; surgery ; Pancreatitis ; complications ; Reconstructive Surgical Procedures ; Ulcer

Animals ; Flunarizine ; pharmacology ; Hippocampus ; drug effects ; physiopathology ; Male ; Neurons ; drug effects ; physiology ; Penicillins ; adverse effects ; Rats ; Rats, Wistar ; Seizures ; chemically induced ; physiopathology