Objective To investigate the clinical effect of proximal femoral nail anti-rotation (PFNA) on femoral intertrochanteric fracture in the elderly.Methods Eighty-seven elderly patients from June 2007 to March 2012,who had femoral intertrochanter fracture and received treatment of PFNA,were enrolled in this study.Patients were comprised by forty seven people with stable fracture and forty people with unstable fracture.Results They were all followed up from 4.5months to 14 months,with the average time of 7.2 months.No death were found in hospital.The operation time was 25 min in average.During operation,losing blood was 80 ml.Ambulation time was 5.5 d,and the fracture healing time was 22 weeks in average.However,there were significant differences in intraoperative resetpostoperative position of the blade between the stable and unstable fracture patients (P＜0.01).Conclusions PFNA is one of the effective methods in the treatment of intertrochanter fracture,and it has shorter operation time,less losing blood,earlier ambulation,and hardly has complications.

Objective: To explore the prevalence and co-morbidity in depression disorder among children and adolescents in Chengdu City. Methods: Using a one-phase design, 4S8S children and adolescents in grades 1～10 were assessed with the Strength and Difficulty questionnaire (SDQ) and Development and Well-Being Assessment (DAWBA) . A structured interview with verbatim reports was reviewed by clinicians so that information from parents, teachers, and children were combined in a manner that emulated the clinical process. Results: (1) The rate of depressive disorder was 1.2% , and that in girls was much higher than that in boys after 12 years old (2.56% vs. 1.42%) . (2) The rate of depressive disorder increased with age from 0.10% (6～8 years) to 2.59% (≥ 15 years) . (3) The co-morbidity was 40% . The most common comorbidity diagnosis was anxiety disorders (29.1%) and behavior disorders (25.5%) . Conclusion: The prevalence of depressive disorder among children and adolescents in Chengdu is 1.2%. Gender and age may be the related factors. The co-morbidity is common in children and adolescents with depression disorder.

BACKGROUND: Dehydroepiandrosterone (DHEA) derived from adrenal cortex has an indirect bioeffect through differentiating into androgen or estrogen in the related peripheral tissues. OBJECTIVE: To verify the effects and mechanisms of DHEA on promoting osteoblasts (OBs) proliferation. DESIGN, TIME AND SETTING: The grouping controlled experiment was accomplished in Shanghai Sixth People's Hospital affiliated to Shanghai Jiao Tong University and Institute of Radiation Medicine, Fudan University from January 2006 to February 2007. MATERIALS: Ten SD rats were recruited, 1 day old, regardless of gender. DHEA was the product of American Sigma Company. METHODS: Rat OBs were separated and cultured in vitro. First generation of OBs cultured in a varied concentrations of DHEA (1?10-5, 1?10-7 and 1?10-9 mmol/L) for 72 hours were set up as the experiment group, while those exposed to 1?10-8 mmol/L of estradiol culture were regarded as positive controls and blank control group was set up as well. MAIN OUTCOME MEASURES: The OBs were identified by cell morphology and alkaline phosphatase (ALP) dyeing. Light microscope and methyl thiazolyl tetrazolium assay were used to detect the growth and proliferation of OBs. The formation of mineralized nodus was examined by alizarin bordeaux stain. The concentrations of osteoprotegerin in DHEA culture solution were also measured by double antibody sandwich ABC-ELISA simultaneously. RESULTS: ①Identification of primarily cultured OBs showed ALP dyeing was positive.②Proliferation rate of OBs was increased in experiment groups compared with that of the blank control group, and the most significant increase occurred in the concentration of 1?10-7 mmol/L DHEA culture (P 0.05).③ALP activity in experiment groups was higher, especially in the group with the concentration of 1?10-7 mmol/L DHEA (P 0.05).④ALP activity of unitary cell population was higher in 1?10-9 mmol/L DHEA culture group than that in blank control group (P

A 28-year-old male patient presented with a 4-year history of a solitary brown mass, and a 1-year history of multiple small papules on the left chest. Skin examination showed a quasi-round brown firm mass measuring about 1.2 cm × 1.1 cm × 1.0 cm in size on the left chest, and several brown papules with diameters ranging from 3 to 5 mm on the right side of the mass; no enlarged lymph nodes were detected in the left axilla on palpation. The mass and papules were completely resected, and histopathological examination showed clustered nevus cells in the superficial dermis of the mass and small papules, and the diagnosis of intradermal nevus was considered. There was a desmoplastic nodule in the mass, nevus cells were scattered among the fibers in the nodule, and giant nevus cells were also observed; the nevus cells in the nodule were relatively larger, epithelioid or spindle-shaped with round or spindle-shaped nuclei, obvious nucleoli, and rare mitotic figures. Immunohistochemical study showed that the nevus cells in both the intradermal nevus and proliferative nodule were positive for S100; the nevus cells in the superficial dermis of the intradermal nevus were positive for Melan-A and HMB45, while the nevus cells in the proliferative nodule were negative for Melan-A and HMB45; both the intradermal nevus and proliferative nodule tissues showed a Ki-67 index of 1%, positive staining for CD34, but negative staining for P16 and P63. Finally, the patient was diagnosed with intradermal nevus associated with desmoplastic nodule.

A simple preparative strategy was proposed for the preparation of water-soluble, bright blue-emitting carbon nanoparticles ( CNPs ) at different temperatures by hydrothermal treatment using bean curd residue as carbon source for the first time. When the temperature reaches 240 ℃, quantum yield ( QY) can be up to 15. 24%. Most importantly, such fluorescent CNPs can be served as an effective sensing platform for label-free sensitive and selective detection of Fe3+ions with a detection of limit as low as 50 nmol/L, which is nearly 2 orders of magnitude lower than the maximum level of Fe3+ions in the drinking water permitted by the European Community. These outstanding properties give promising potential for reliable detection of Fe3+ in intracellular fluid and water samples, even bioimaging and optical imaging without being hazard in the future.

Objective To investigate the clinical efficacy of adefovir dipivoxil in antiviral treatment of chronic hepatitis B and its effect on peripheral blood T lymphocyte subsets.Methods 40 cases of patients with chronic hepatitis B were selected from The Fourth People’s Hospital of Qinghai in October 2009 to June 2012,the patients were given the antiviral treatment of adefovir dipivoxil.Before treatment,3 months,6 months and 12 months after treatment,the changes of liver function indicators of alanine transaminase(ALT),aspartate transaminase(AST)and total bilirubin(TBiL),and hepatitis B virus-DNA(HBV-DNA)were recorded;the total effective rate was observed;the peripheral blood T lymphocyte subsets changes was tested and analyzed by flow cytometry.Results The ALT,AST and TBiL of the patients all improved good,and the indicators of ALT,AST and TBiL after 12 months decreased significantly than before treatment,the HBV-DNA testing of the patients recovered negative,the difference was statistically significant (P<0.05 );the total effective rate of hepatitis B patients is 92.5%;the peripheral blood T lymphocyte subsets has no significant improvement in patients after antiviral treatment for 3 months.After the treatment for 6 months and 12 months,the CD4 +T and CD4 +/CD8 +T were significantly higher than those before treatment,there was no significant changes in CD3 +T and CD8 +T before and after treatment.Conclusion Adefovir dipivoxil has a good clinical efficacy in antiviral treatment of chronic hepatitis B,and can significantly improve the patients’liver function,improve peripheral blood T lymphocyte subsets imbalance.

OBJECTIVE To investigate the tendency of bacterial distribution and drug resistance of pathogens in department of respiratory medicine,then instruct clinical application of antibiotics reasonably.METHODS By the retrospective methods,we analyzed the pathogens isolated from the sputa of the hospitalized patients with lower respiratory tract infection in the department of respiratory medicine from Jul 2007 to Jun 2009 and their drug resistance.RESULTS A total of 1508 strains of pathogens were isolated,Gram-negative bacilli were 47.3%,The most common pathogens of them were Pseudomonas aeruginosa(15.6%).The rate of the ESBLs-producing strains of Escherichia coli and Klebsiella pneumoniae were 41.0% and 35.8%,respectively.Fungi were 44.1%.And all the fungi were sentive to amphotericin B,fluconazole and ketoconazole.Gram-postive cocci accounted for 8.6%.The most common pathogen of Gram-postive cocci was Staphylococcus.Meticillin resistant strains of Staphylococcus aureus accounted for 62.4%.CONCLUSIONS The drug-resistance of pathogenic bacteria due to nosocomial infection and community-acquired infection in respiratory medical ward is increasing year-by-year.It is necessary to continuously monitor drug-resistance and rationally use antibiotics.

Objective To observe the effects of nebulized nitric oxide donors on pulmonary and systemic hemodynamics during pulmonary hypertension induced by hypoxia (FiO_2=0.1,for 1 hour)in newborn piglets. Methods Twenty-four anesthetized and mechanically ventilated piglets were randomly divided into four groups:(1)group S (n=6),control group;(2)group C (n=6),receiving saline after hypoxia;(3)group NTG,receiving nebulized nitroglycerin after hypoxia;(4)group SNP,receiving nebulized sodium nitroprusside after hypoxia. Mean arterial pressure (MAP)and mean pulmonary arterial pressure (MPAP)were monitored continuously. Arterial blood gas analysis was determined at baseline,1 hour after hypoxia,termination of nebulization and 0.5 h after nebulization. After nebulization,blood methemoglobin (MetHb)and plasma NO level were measured.Results Acute hypoxia resulted in a significant increase in MPAP. At 1 hour after hypoxia,MPAP in group C,group NTG and group SNP were significantly higher than that in group S(P0.05).After nebulization,there were no significant differences in plasma NO level and blood MetHb level between groups. No rebound pulmonary hypertension was observed after withdrawal of nebulization. Conclusion Both NTG and SNP nebulization could be used as selective pulmonary vasodilators for acute hypoxic pulmonary hypertension.

OBJECTIVE To investigate the tendency of bacterial distribution and resistance of hospitial infections,and to provide the reference for the clinical treatment and infection control in hospital.METHODS Bacteria isolated from patients in our hospital from Jan 2004 to Dec 2005 were identified by ATB expression,and bacterial susceptibility tests were performed on strains using Kirby-Bauer method.RESULTS A total of 3066 pathogens strains were isolated,among them 927 strains were Gram-positive cocci(30.2%).The most common pathogens of them were Staphylococcus.Meticillin resistant strains of Staphylococcus aureus and coagulase negative Staphylococcus(CNS) accounted for 69.0% and 77.6%,respectively.In our data,no vancomycin resistant S.aureus were isolated.There were 2134 strains of Gram-negative bacilli(69.6%),the most common pathogens of them were Pseudomonas aeruginosa,Escherichia coli,Klebsiella pneumoniae,Acinetobacter baumannii and Enterobacter cloacae.The ESBLs producing strains of E.coli and K.pneumoniae accounted for 30.1% and 40.1%,respectively.The highest susceptible to Gram-negative bacilli was carbapenem,then were cefoperazone/sulbactam,piperacillin /tazobactam and cefepime.Mainly pathogenic bacteria were multi-resistant to some antibiotics.CONCLUSIONS Drug resistance of the nosocomial infection bacteria is a serious problem.It's important and urgent to carry out surveillance of bacterial resistance for appropriate using of antibiotics and effective controlling nosocomial infections.

Objective To study the protective effects of nitroxides against hu man keratinocytes oxidative damage induced by H2O2 and its possible mechanisms. Methods Normal human keratinocyte cultures obtained from foreskin were served as test-system. Human keratinocytes were cultured in human keratinocytes growth m edia (KGM) without serum and supplemented with 0.1 mmol/L Ca2+. Experiments wer e performed in culture when the cells grew to fuse. Oxidative damage was induced by adding H2O2 directly to the culture media at different concentrations in the present and absence of nitroxides [(2, 2, 6, 6-tetramethylpiperidine (TEMPO) a nd 4-hydroxy-2, 2, 6, 6-tetramethylpiperidine (TEMPOL)]. The cell viability w as monitored and the intracellular level of reduced glutathione (GSH), the activ ities of glutathione-peroxidase(GSH-Px), superoxide dismutase (SOD), and catal ase were evaluated. Results ①H2O2 could cause damage to human keratinocytes dir ectly. There was a significantly negative correlation between H2O2 concentration and cell viability. ②The level of GSH in keratinocytes lowered with treatment of H2O2. The activities of GSH-Px, SOD and catalase decreased. ③Pretreatment o f the cells with TEMPO and TEMPOL inhibited the damaging effects of H2O2 on cell viability and on cell antioxidant enzymatic systems. Conclusion The results of the study suggest that nitroxides may provide protection for cultured human kera tinocytes against H2O2-induced oxidative injury. It is proposed that the effec ts of nitroxides against cell oxidative damage be related to their protection of cellular enzymatic activities and maintaining cellular antioxidant systems.