Objective To evaluate the clinical outcomes of open reduction and locking plate fixation with or without auto-iliac graft for humeral shaft nonunion.Methods Between January 2008 and May 2012,65 cases of humeral shaft nonunion were treated in our department.They were 48 men and 17 women,24 to 54 years of age (39.8 years).Of them,43 were atrophic and 22 hypertrophic.The radial nerve was exposed and protected during operation.After the nonunion portion was debrided,the humeral length was recovered.Next the fracture sites were fixated by a locking plate.The defected area was filled with auto-iliac graft if necessary.The visual analogue scale (VAS) scores and The Short Form-36 (SF-36) scores were documented after operation; the functional recovery was evaluated using Constant scoring at the last follow-up.Results The patients obtained a mean follow-up of 13.8 months (from 10 to 32 months).Of them,50 achieved clinical bone union after an average of 3.8 months (from 3 to 7 months).The remaining 6 cases showed no sign of union 9 months postoperatively.Of the 50 patients with union,the mean VAS score was decreased significantly from the preoperative 5.1 ± 3.2 points to the postoperative 1.4 ± 0.8 points,and the mean SF-36 score was increased significantly from the preoperative 45.7 ± 16.9 points to the postoperative 72.9 ± 18.5 points (P ＜ 0.05).The function was scored at the last follow-up as excellent in 34 cases,good in 12,fair in 2 and poor in 2,giving an excellent to good rate of 92.0％.The radical nerve injury was repaired within 3 months postoperation in 3 patients.Rotation deformity occurred in 3 cases without obvious functional limitation.No implant complications such as plate breakage and screw loosening were observed.Conclusion Open reduction and locking plate fixation with or without auto-iliac graft is one effective treatment of humeral shaft nonunion,but damage to the radial nerve should be avoided and fixation of 6 layers of cortex should be maintained at both fracture ends during operation

OBJECTIVE:To evaluate the effect of clinical pharmacist intervention on the application of antibiotics in patients with respiratory infection from our hospital. METHODS:Each 500 patients were selected from respiratory department of our hospi-tal during Jan. to Jun. in 2016 and Jul. to Dec. in 2016. The patients were divided into pre-intervention group and post-intervention group. The application of antibiotics,the occurrence of ADR and anti-infective effects were compared before and after clinical phar-macist intervention,and the rationality of antibiotics use was evaluated. RESULTS:After intervention,the utilization rate of antibi-otics decreased from 92.60％ to 74.20％;the proportion of single drug therapy and triple and more drugs therapy were decreased significantly,with statistical significance(P<0.05). The incidence of ADR reduced from 14.20％ to 5.80％;the rate of infection control increased from 95.03％ before intervention to 97.04％;antibiotics cost decreased significantly,with statistical significance (P<0.05). The incidence of irrational drug use,nonstandard dosage,irrational drug combination and no etiological support as well as total irrational rate decreased from 7.40％,3.60％,5.80％,7.80％,20.60％ to 4.00％,1.40％,2.00％,4.20％,9.60％,with statistical significance(P<0.05). There was no statistical significance in the proportion of double drug therapy or emergency and se-vere rescue rate (P>0.05). CONCLUSIONS:The intervention implemented by clinical pharmacists effectively reduce the utiliza-tion rate of antibiotics and the incidence of ADR,improve the rate of infection control,reduce antibiotics cost and the occurrence of irrational drug use. However,there are still some problems in respiratory department of our hospital,such as irrational drug use, nonstandard dosage,irrational drug combination and no etiological support,etc. Continuous follow-up intervention is needed.

Female ; Humans ; Infant ; Mutation ; Pain Insensitivity, Congenital ; complications ; genetics ; pathology ; Receptor, trkA ; genetics

Aged ; Female ; Humans ; Solitary Fibrous Tumor, Pleural ; surgery

Objective To learn and evaluate the present prescriptions from outpatient departments of 21 public hospitals in Songjiang district,and to promote rational drug use.Methods A total of 75,600 outpatient prescriptions from 21 public hospitals in Songjing district were collected monthly from January 2008 to October 2010 and analyzed statistically using indexes for prescription evaluation.Results of the 75,600 prescriptions,the types of drugs in each prescription averaged 2.35,the ratio of antibiotics use and injection agents use were 35.77％ and 17.40％,respectively.The percentage of essential drugs without added profit accounted for 41.91％ of the total drug use,and the average drug cost per prescription was RMB 85.99.Comparison of indexes for prescription evaluation showed that the ratio of antibiotics use and injection agents use as well as the average cost per prescription in secondary hospitals were significantly higher that those in community health centers (P＜0.01),while the percentage of essential drugs without added profit and the average number of drugs in each prescription were statistically smaller than those in community health centers (P＜0.01).Conclusion Drug use in outpatient departments of 21 public hospitals was rational in general,especially noteworthy is the significant improvement made at community health centers in recent three years.

This paper introduces a free and publicly open ICU database: multi-parameter intelligent monitoring in intensive care II: MIMIC-II, which has been built up and maintained by the laboratory of computational physiology at the Massachusetts Institute Technology, Beth Israel Deaconess Medical Center and Philips Healthcare over the past decade. This paper briefly introduces its infrastructure, implementation and applications in clinical studies. Clinical study pertaining to circadian variation in heart rate and blood pressure during sepsis is shown as a typical example of research performed with MIMIC-II. In this study, it was found there was significant difference in circadian variation in both heart rate and blood pressure between survival and non-survival groups in septic patients. This study tackled several important techniques necessary for the investigation of the circadian rhythm.
Blood Pressure ; Circadian Rhythm ; Critical Care ; Data Mining ; Databases, Factual ; Heart Rate ; Humans ; Medical Informatics

Child ; Cytochrome P-450 CYP3A ; genetics ; Disease Susceptibility ; enzymology ; Female ; Genome-Wide Association Study ; Humans ; Male ; Polymorphism, Genetic ; genetics ; Precursor Cell Lymphoblastic Leukemia-Lymphoma ; genetics

Objective To explore the feasibility and efficacy of selective arterial embolization for the treatment of hemobilia occurred after biliary tract surgery.Methods The clinical data of 16 patients with massive hemobilia after biliary tract operation,who were treated in our hospital during the period from March 1989 to August 2009,were retrospectively analyzed.Conservative treatment of hemobilia was initially adopted in all patients,and,if it failed,interventional management was carried out.Emergent artery angiography was performed in all patients,which was followed by selective arterial embolization of the bleeding arteries with Gelfoam particles and coils.Results Of the total 16 cases,15 received selective arterial embolization therapy and the remaining one died.No re-bleeding occurred during a follow-up period of 8 months to 3 years.Conclusion For the treatment of arterial hemobilia occurred after biliary tract surgery,selective arterial embolization with Gelfoam particles and coils is a safe,mini-invasive and effective therapy with few complications.

Objective To explore the two-dimensional images features and color flow characteristics of scrofula, as well as their application in the localization of scrofula. Methods A total of 110 cases of the scrofula confirmed by operation were retrospectively analyzed. Two-dimensional images and color flow characteristics, the relationship with vascular traveling and the invasion site were recorded. Results Lymph nodes of the lateral neck region along with large vessels were most commonly involved, then followed the submaxillary lymph nodes and the lymph nodes anterior neck longitudinally. There might be multiple lesions behaving differently on two-dimensional images and with different color flow characteristics. Conclusion Most of scrofula can be diagnosed clearly according to the two-dimensional images and color flow characteristics. The description of relationship between involved lymph nodes with vascular, the depth and position of scrofula make the operation safety.

Objective To review the epidemiologic features of norovirus infection outbreaks in Zhejiang province during 2004-2014.Methods Epidemiological data of norovirus infection outbreaks in Zhejiang province from January 2004 to February 2014 were collected from the Emergency Public Reporting System in Zhejiang Provincial CDC.The distribution of time,area,population,route of transmission and genotype of norovirus were analyzed.Results There were 16 outbreaks of norovirus infections with 2 037 cases during 2004-2014 in Zhejiang province.Eleven outbreaks occurred during February and April,and 13 outbreaks occurred in schools.The outbreaks in schools mainly involved students aged 15-20 years,while other outbreaks took place mainly in the young and middle-aged population.The sex ratio of male to female was 1.05 ∶ 1.Among 16 outbreaks,10 were induced by norovirus G Ⅱ infections,3 were induced by norovirus G Ⅰ infections and 3 were induced by norovirus G Ⅰ and G Ⅱ infections.Fourteen outbreaks were caused by water pollution.Conclusion Outbreak of norovirus infection usually occurs in schools during winter and spring in Zhejiang province,and the epidemic of disease is mainly associated with polluted water.