Objective: To study effect of comprehensive nursing on patients with arrhythmia after acute myocardial infarction (AMI).Methods: According to random number table, a total of 100 patients with arrhythmias after AMI were selected in our hospital, and randomly and equally divided into routine nursing group and comprehensive nursing group (received comprehensive nursing based on routine nursing).NYHA cardiac function class, incidence rate of arrhythmia, standard reaching rate of health knowledge, mean bed time, mean length of hospital stay, mean hospitalization fee and satisfaction were compared and analyzed between two groups after treatment.Results: Compared with routine nursing group after treatment, there was significant rise in percentage of NYHA class I (24% vs.54%), and significant reductions in percentages of NYHA class III (38% vs.12%) and IV (10% vs.4%),P<0.05 or<0.01;significant reductions in incidence rate of arrhythmia (64% vs.12%), mean bed time[(5.01±0.63) d vs.(2.88±0.65) d], mean length of hospital stay[(16.15±2.00) d vs.(10.00±1.22) d]and mean hospitalization fee[(6984.95±652.30)RMB vs.(5274.95±632.30)RMB], and significant rise in standard reaching rate of health knowledge (72% vs.96%) and treatment satisfaction (80% vs.96%) in comprehensive nursing group, P<0.05 or<0.01.Conclusion: Comprehensive nursing can effectively improve therapeutic effect and shorten length of hospital stay in patients with arrhythmia after acute myocardial infarction, and it is worth extending.

Objective To evaluate whether eight kinds of dosimeters satisfy the clinical mammography dose measurement through the comparison of energy response.Methods According to GB/T 19629-2005,the energy responses of eight available mammography dosimeters were determined for ten standard radiation qualities in the range 25-40 kVp at the SSDL using a refrence-class dosimeter.Results Except 2000S,the energy response factors of all the other dosimeters were consistent within ±5%.Conclusions The energy response of ionizing chamber type is better than other types of dosimeters.

Objective To study the method and clinical results of Infrared Fluoroscopic Navigation Guiding system guided percutaneous vertebroplasty for the treatment of osteoporotic vertebral compression fractures.Methods Twenty-two cases with 32 osteoporotic vertebral compression fractures underwent percutaneous vertebroplasty guided by Infrared Fluoroscopic Navigation Guiding system.The fracture segment was within T6-L 4(14 thoracical vertebrae,18 lumbarver vertebrae).The compression ratio was from 20% to 90% in which 5 vertebral bodies were 75%.12 vertebral bodies underwent PVP,and 20 vertebral bodies underwent PKP in which balloon expansion were used in 12 vertebral bodies and sky expansion were used in 8 vertebral bodies.Single vertebral body injection were in 14 cases,two vertebral body injection were in 6 cases,three vertebral body injection were in 2 cases including 18 vertebral bodies injection via unilateral pedicle of vertebral arch and 14 vertebral bodies injection via bilateral pedicle of vertebral arch.Restoration of vertebra height and cement leakage was observed by postoperative X-ray and CT scan.Changes of preoperative and postoperative vertebral body volume measured by CT volumetry was compared.Preoperative and postoperative Vasual analogue scale(VAS)score was compared.Results PVP was successful in 22 cases with 32 vertebral bodies.No nerve and spinal cord damage,lung embolism and heart and brain vessel acute reaction occurred.Operative time was(18.4?4.5)mins per vertebral body.X-ray dosage was(12.2?3.4)dGy per vertebrae.The amount of bone cement was(4.4?2.5)ml per vertebrae.The vertebral body volume was improved from preoperative(22.2?8.6)cm3 to postoperative(24.8?6.9)cm3 with a significant differences(P

[Objective]Through a comparitive analysis between hemiarthroplaty and dynamic hip screws in femoral intertrochanteric fracture,to discuss the differences and similaries between two groups of patients.[Method]Using the methods of retrospective review,the author collected 63 cases of femoral intertrochanteric fracture,treated by hemiarthroplasty and dynamic hip screws respectively.Followed for a minimum period of 6 months,the author compared the postoperative complications,cumulative mortality rate and loss of ambulatory grades between two groups.[Result]There was no siganificant difference in operative time and introperative bleeding and no evident distinctions showed in posteroperative general conditions.But in local symptoms,DHS group appeared the cut-out from femoral head and coax vara resulting from the collapse of medial cortex,hemiarthroplaty group emerged the pain in hip without proof of loosening and infection of prosthesis.Hip scores decreased by 8.6% in DHS group and 9.2% in hemiarthroplaty group.In the opinion of the function convalescence,there was no definition to be worth recommending between two groups.[Conclusion]To eldly patients with unstable intertrochanteric fracture,fine function should be expected equal to preoperation after operation,but the chief motive is to provide the conditions which permit the patients earlier activity.So hemiarthroplaty is a reasonable alternative to a sliding screw device to treat intertrochanteric fractures.

Objective To calculate effective dose based on the dose-area Product (DAP) measured in dental cone beam computed tomograhic (CBCT) scanning and using a conversion coefficient.Methods The method of the DAP was used to calculate the effective dose from KODAK 9500 dental CBCT scanner with fields of view (FOV) of 16 cm×15 cm and 12 cmu×8 cm.The DAP-values (mGy · cm2) were measured using a transmission ionization chamber connected to an electrometer (Doseguard 100,RTI Electronics AB,Sweden) and the chamber was placed directly on the exit of the X-ray tube.All measurements were repeated three times and averaged on each FOV data.The conversion coefficient of 0.080 μSv/mGy · cm2 was used to estimate the effective dose on the basis of DAP values,which was quoted from a literature.Results DAP values were found between the two FAOs to vary from 512 to 1 083 mGy · cm2,and the effective doses calculated with 0.080 μSv/mGy · cm2were 41 to 87 μSv.The effective doses given in this paper was lower than those reported in other literatures.Conclusions DAP measurement was found to be well defined and easy-to-use method of determining effective dose for some CBCT Units.However,determination of specific conversion coefficient in the CBCT must be further developed.

[Objective]To study the effect of semi-constrained total elbow arthroplasty in rheumatoid elbow arthritis.[Method]Eighteen semi-constrained total elbow replacements were performed on 22 rheumatoid patients with 28 elbows(Morrey Stage:6 of Ⅲ Stage,17 of Ⅳ Stage,5 of Ⅴ Stage).The elbows were reviewed retrospectively after a followup of mean 26 months(range12~44 months).Mayo Elbow Performance was used to evalue the function of preoperative and postoperative elbow.The curative effect and complications were observed.The statistically significant differences were analyzed.[Result]Elbow arthroplasty was successful in 22 rheumatoid patients with 28 elbows.After 6 weeks function exercise the Mayo Elbow Performance was improved from(31.6?29.2)to(82.1?24.3)with a statistically significant difference(P

Objective To retrospective analyze the treatment of hallux valgus with the procedure of osteotomy of the base of the first metatarsal, combining with osteotomy of the base of the second and/or third metatarsal(s), and to study the indications and effects of this procedure. Methods 35 cases 56 hallux valgus feet were treated by operative procedure from January 1994 to December 2003. 26 cases 43 feet underwent the operative procedure of osteotomy of the base of the first metatarsal, 9 cases 13 feet with painful callus under the second and/or third metatarsal(s) head underwent osteotomy of the base of the first, second and/or third metatarsal(s). The axial and lateral films of all feet with loading were taken before and after operation. The change of anatomic indexes and AOFAS of the patient postoperatively were recorded and analyzed. Results In the group with osteotomy of the base of the first metatarsal, AOFAS score was 47.6?5.8 preoperatively, and 84.3?5.7 postoperatively. In the group with osteotomy of the base of the first, second and/or third metatarsal(s), AOFAS score was 44.7?5.7 preoperatively, and 85.7?4.5 postoperatively. There were significant differences between the preoperative and postoperative rontgenographic index and AOFAS in each group. Conclusion The operative procedure is effective. The operative procedure of osteotomy of the base of the first metatarsal can get good result in moderate and severe hallux valgus patients. Osteotomy of the second and/or third metatarsal(s) were recommended in cases with painful callus under the second and/or third metatarsal(s). Normal forefoot appearance and function can be restored by the procedure to reestablish the transverse arch.

Objective To study curative effects of infrared fluoroscopic navigation guided percutaneous vertebroplasty for osteoporotic vertebral compression fractures. Methods A total of 28 cases of osteoporotic vetebral compression fractures(41 vertebrae) underwent infrared fluoroscopic navigation guided percutaneous vertebroplasty.The fracture was located at T_6～L_4 segment,including 16 thoracic vertebrae and 25 lumbar vertebrae.Fluoroscopic images of the spine were obtained,calibrated,and saved after the reference shelf was fixed on the spinous process of fractured vertebrae.The trajectory,a virtual tool corresponding to the tracked tool,was overlaid onto the saved fluoroscopic views in real time.Postoperative X-ray and CT examinations were performed to observe the vertebral body diaplasis as well as the distribution and leakage of bone cement.The vertebral body volume was measured with CT volumetry preoperatively and postoperatively.The visual analogue scale(VAS) scores were compared before and after operation. Results The bone cement was successfully injected in all the 41 vertebrae.Percutaneous vertebroplasty was performed in 13 vertebrae,while percutaneous kyphoplasty was conducted in 28 vertebrae(including balloon expansion in 12 vertebrae and "sky" expansion in 16 vertebrae).Vertebral body injection was performed via unilateral pedicle in 26 vertebrae and via bilateral pedicle in 15 vertebrae.Of the 28 cases,cement injection was carried out in one vertebral body in 17 cases,in two vertebral bodies in 9 cases,and in three bodies in 2 cases.No intraoperative deaths,nerve root or spinal cord injuries,or pulmonary embolism and cardiovascular or cerebrovascular emergencies occurred.The operative time for each vertebra was 7.7～20.7 min(14.2?3.3 min) in percutaneous vertebroplasty and 11.2～32.4 min(21.8?5.4 min) in percutaneous kyphoplasty.The X-ray exposure dose for each vertebra was 5.4～19.6 dGy(12.5?3.6 dGy).The amount of injected cement for each vertebra was 2.2 ～6.8 ml(4.6?1.2 ml).The vertebral volume was elevated from preoperative 21.4?4.6 cm3 to postoperative 25.8?5.4 cm3(t=5.623,P=0.000).The VAS scores decreased from preoperative 7.6?1.2 to postoperative 2.9?0.7(t=12.946,P=0.000).No serious complications or vertebral collapses were found during follow-up examinations for 3~14 months(mean,8 months) in the 28 cases. Conclusions Use of infrared fluoroscopic navigation for guiding percutaneous vertebroplasty is feasible.

Objective To discuss the techniques and efficacy of arthroscopy-assisted treatment for popliteal cyst. Methods From June 2004 to January 2006, 14 patients with popliteal cyst were diagnosed and treated with arthroscopy. During the operation, the popliteal cyst was removed, and then the hernial opening was repaired by suturing the medial head of the gastrocnemius tendon. The outcomes of the operation were evaluated by using Rauschning and Lindgren Grading. Results Arthroscopic examinations showed evident pathological changes in the knee joints of the 14 patients, including 6 cases of posterior horn medial meniscus tear, 1 case of chondromalacia of patella, 2 patellofemoral malalignment, 4 osteoarthritis, and 1 discoid lateral meniscal tear. The patients were followed up for 5-18 months (mean 11 months). According to the Rauschning and Lindgren Grading, 8 patients were grade Ⅱ and 6 were grade Ⅲ before the operation. After the operation, 9 patients were grade 0, 4 were grade Ⅰ, and 1 was grade Ⅱ. There was a significant difference between the pre-and postoperative grading (Z=-4.498, P=0.000). No patient had recurrence during the follow-up. Conclusions Popliteal cyst is usually induced by knee joint disorders. It was difficult to eliminate the cyst by simple resection. Arthroscopy-assisted treatment can achieve good outcomes.

Objective To compare the efficacy of two-incision microinvasive and modified Harding approaches for total hip arthroplasty in aged patients.Methods From May 2003 to December 2006,21 old patients(aged 82 on average) received two-incision microinvasive total hip arthroplasty in our hospital.The outcomes of the surgery was compared with those of 39 cases(mean age,83),who underwent the operation through the modified Harding approach.Results No significant difference was observed in intraoperative blood loss between the two groups [(270?94) ml vs(280?107) ml,t=-0.360,P=0.720].On the 2nd day after the surgery,the patients in the two-incision group could raise their legs straight upward without needing help.At day 10,they could raise the legs straight up to a mean of(53?12)?,which was significantly higher than that in the Harding group [(32?16)?,t=5.262,P=0.000].However,the Harris scores were similar in both the groups in 6 months after the operation(80.6?12.6 vs 79.5?13.2,t=0.313,P=0.756).The incidence rates of orthopedics and systemic complications in the two-incision group was not significantly different from those in the Harding group [9.5%(2/21) vs 8.1%(3/37),?2=0.000,P=1.000;19.0%(4/21) vs 37.8%(14/37),?2=2.210,P=0.137].Conclusions The short-term outcomes of microinvasive two-incision total hip arthroplasty is better than that of modified Harding approach in aged patients.However,the long-term results of the two procedures are similar.