In the elderly, patient who suffered from hip fracture need to stay in bed for a long time and has a higher prevalence of complications and mortality. Considering the factors of patients in the intraoperative death and postoperative re?habilitation, we take appropriate treatment measures during preoperative, intraoperative and postoperative period respective?ly based on the concept of Enhanced Recovery. Patient will benefit from rapid rehabilitation and reduction of incidence of complications and mortality. ERAS includes preoperative fasting, preventive anagelsia, intraoperative temperature control, anesthesia and surgical approach, postoperative intravenous restriction, nutritional support and painless early motion. This ar?ticle intends to review the security , reliability and clinic efficacy of ERAS.

Objective To evaluate the causes of complications of patients with femoral Intertrochanteric fractures after gamma3 nail fixation.Methods A retrospective analysis was conducted to summarize the treatment of intertrochanteric fractures in 186 cases with Gamma3 nail from May 2006 to July 2011.Complications occurred in 24 cases during the operations.19 were males,5 females,with the age from 42 to 81,the average age of 69.00±3.27 years.According to AO/OTA classification,8 cases were type A1,1 case were type A2.1,15 cases were type A3.All patients included were acute fractures,while pathological fractures were excluded.Supine position were selected during operation,close reduction were performed in traction bed.Gamma3 nail made by Stryker Company was used to fix fractures through small incisions.Operational times were from 45 to 160 minutes,averaged by 80 min.Blood lose were 300-800 ml in average.No patient need blood transfusion.The procedure from hospitalized to operation is from 3 to 12 days,6 days in average,discharged from 3 to 16 days after operation.According to the intraoperative and postoperative follow-up evaluation of the X-ray and Harris evaluation criteria,Gamma3 nail complications were summarized in the application.Results Time of surgery in 24 cases were 45-160 min,average 80 min.Blood loss were 300-800 ml,average 600 ml,walking time 35-106 d.Harris evaluation were 75-91 point,average 81 point.The anti-spiral nail dropped into inner thigh muscles occurred in 1 case,causing defects of femoral lateral wall in 3 cases.Splitting fractures occurred in the proximal femoral shaft during the operations in 5 cases,poor fracture reduction during closed reduction in 6 cases.Fracture site were shifted lately postoperative in 5 cases,lag screw cut-out in 3cases and refracture in the site of distal femoral interlocking nail in 1 case.Conclusion Higher incidence of complications were occurred in some special types of AO classification when using close reduction and short Gamma3 nail.The reduction method,wrong indication selection and unreasonable application of equipment may result in the occurence of complications.We,therefore,should use long or short Gamma nail according to their respective induction method and scope of its application,aiming to avoid complications.

Objective Investigate the clinical efficacy of treating retreated smear-positive tuberculosis patients with conventional anti-tuberculosis chemotherapy combined with levofloxacin. Methods Divide 60 retreated smear-positive tuberculosis patients registered in our hospital between October 2012 and October 2014 into two groups using random number table method: levofloxacin group and conventional treatment group. Each group contains 30 patients that were treated for 9 months , and the efficacy the both treatment methods were compared. Results The sputum conversion rate in the levofloxacin group is 93.33% and 96.67% after treating for 6 months and 9 months , respectively; which are substantial higher than that of the conventional treatment group with sputum conversion rate of 70% and 73.33% after 6 months and 9 months of treatment , respectively (P < 0.05). The absorption rate of the levofloxacin group is significantly higher than that of the conventional treatment group (P < 0.05). The cavity improvement rate of the levofloxacin group is 73.33%, which is significantly higher than that of the conventional treatment group (33.33%) (P < 0.05). The clinical efficacy of the LVFX group is substantially higher than the routine treatment group (P < 0.05). The overall effectiveness of LVFX group reached 100% , which is significantly higher than that of the conventional treatment group (86.67%) (P < 0.05). Conclusions Levofloxacin combined with conventional anti-tuberculosis chemotherapy can effectively improve the clinical efficacy in the treatment of tuberculosis.

Objective To investigate the relationship among Machiavellianism,loneliness and coping style in adolescents.Methods 850 junior middle school students were recruited and assessed with Kiddie Machiavellianism Scale,Self-esteem Scale,and Strengths and Difficulties Questionnaire (for students).Mediating effect was analyzed by multiple regression analysis.Results ① The scores of Machiavellianism,loneliness,positive coping and negative coping were (37.35±7.52),(30.21 ± 10.72),(21.07±6.12) and (9.44± 3.84) respectively.② Machiavellianism was positively correlated with negative coping style (r=0.192,P＜0.01) and loneliness (r=0.263,P＜ 0.01),as well as negatively correlated with positive coping style (r=-0.244,P＜0.01).③ Positive coping style partially mediated the effect of Machiavellianism on loneliness,and the mediating role accounted for 37.72％ for the whole effect.Conclusion The higher the Machiavellianism is,the more serious the loneliness is.Positive coping style partially mediates the relations between Machiavellianism and loneliness.

[Objective] To investigate the therapeutic effect of Radix Astragali on neonatal hypoxic-ischemic encephalopathy (NHIE) and to explore its immunoregulation.[Methods] Fifty cases of NHIE were randomized to groups A and B. Both groups were given routine treatment and group A was treated with Radix Astragali injection additionally. Symptoms and signs, scoring of neonatal behavior neurological assay (NBNA) and subtypes of peripheral blood T lymphocyte were observed before and after treatment, [Results] Time of symptom-sign disappearance was 1.4 d shorter in group A than that in group B (t = 2.06, P

Objective To evaluate the effects of fraction of inspired oxygen (FiO2) and positive end-expiratory pressure (PEEP) on the gradient between arterial and end-tidal carbon dioxide (D(a-ET)CO2).Methods Sixty ASA Ⅰ or Ⅱ patients (body mass index ＜ 30 kg/m2),aged 25-50 yr,weighing 45-75 kg,scheduled for elective gynecological laparoscopic surgery,were randomized into A,B and C groups (n =20 each).The patients were mechanically ventilated with pure oxygen in group A,and with air and O2 (FiO2 =50％) in groups B (PEEP =0) and C (PEEP =5 cm H2O).PETCO2 was monitored during mechanically ventilation.Blood samples were obtained from the radial artery immediately after tracheal intubation (T1) and at 1 h of pneumoperitoneum (T2) for blood gas analysis.D(a-ET) CO2 and Qs/Qt were calculated.Results D(a-ET) CO2 and Qs/Qt were significantly lower at T2 in groups B and C than in group A (P ＜ 0.05).Compared with group B,D(a-ET)CO2 was significantly decreased at T2 (P ＜ 0.05),and no significant change was found in Qs/Qt in group C (P ＞ 0.05).Conclusion Decreased FiO2 and PEEP of 5 cm H2O can decrease D(a-ET)CO2 and increase the accuracy of PErCO2 for reflection of PaCO2,which is due to reduced intrapulmonary shunt.

Objective To evaluate the effect of gender matching on the outcomes of livingdonor renal transplantation.Methods A total of 419 cases of living-donor renal transplantation in our center were divided into male-donor-male-recipient (MDMR) group,male-donor-female-recipient (MDFR) group,female-donor-male-recipient (FDMR) group,female-donor-female-recipient (FDFR)group.The outcomes including graft and patient survival,acute rejection and renal function were analyzed retrospectively.Results Compared to MDMR group,MDFR group and FDFR group had lower Scr [(80.7±17.9),(87.4±21.9) μmol/L vs (120.3±72.5) μmol/L,all P ＜ 0.05] and uric acid (UA) [(318.1 ± 86.4),(303.5 ± 66.9) μmol/L vs (358.4 ± 77.8) μmol/L,P ＜ 0.05] 6 months after operation.Compared to MDFR group,FDMR group had higher Scr[(117.7±27.4) μmol/L vs (80.7±17.9) μmol/L,P ＜ 0.01],UA [(371.0±92.4) μmol/L vs (318.1±86.4) μmol/L,P ＜ 0.05] and lower glomerular filtration rate (GFR) [(70.4± 17.8) ml/min vs (79.6± 18.9) ml/min,P ＜ 0.05].Compared to FDMR group,FDFR group had lower Scr [(87.4±21.9) μmol/L vs (117.7±27.4) μmol/L,P ＜ 0.01] and UA [(303.5±66.9)μmol/L vs (371.092.4) μmol/L,P＜ 0.01].Compared to MDFR group,FDFR group showed lower GFR [(72.4±25.3) ml/min vs (82.7± 18.7) ml/min,P ＜ 0.05] 1 year after operation.Compared to MDMR group,FDFR group showed lower UA [(322.9±69.7) μmol/L vs (376.0±66.2) μmol/L,P ＜ 0.05] 2 years after operation.Compared to FDMR group,FDFR group showed lower Scr [(88.7 ±27.0) μmol/L vs (112.7±27.8) μmol/L,P ＜ 0.05] and UA [(318.3 ±61.2) μmol/L vs (396.2± 100.3) μmol/L,P ＜ 0.05] 3 years after operation.5 years after operation,there were no significant differences in above indexes,the incidence of slow graft function,acute rejection and survival of graft and patient among groups.Conclusions Male recipients of female donors have the worst renal function while female recipients have better outcomes after operation.

This study sought to assess the effects of Quercetin and Enalapril on urinary protein excretion and amount of platelet-derived growth factor-B (PDGF-B) and vascular endothelial growth factor-1 (VEGF-1) in renal tissue of diabetic rats. 29 streptozotocin-induced diabetic rats were divided into 3 groups, diabetic control group (group D, n=12); Enalapril group (group E, n=10); Quercetin group (group Q, n=7). In addition, there was one normal control group (group N, n = 5). The urinary protein excretion of 24 hours was measured at 4, 8, 12 weeks. All rats were sacrificed at 12 weeks. The amounts of PDGF-B and VEGF-1 in renal tissue were measured by immunohistochemical techniques. The 24-h levels of urinary protein excretion of D,Q and E groups were higher than that of N group; the level of Q, E groups were lower than that of D group; there was no difference between Q and E group. The expression levels of PDGF-B and VEGF-1 in renal tissue of D, Q, and E groups were significantly higher than that of N group the levels of Q and E groups were significantly lower than that of D group, no difference was found between Q and E group. The protective role of Quercetin and Enalapril in lowering urinary protein excretion may be related to the decreased amounts of PDGF-B and VEGF-1 in renal tissue.
Animals ; Diabetes Mellitus, Experimental ; metabolism ; Enalapril ; pharmacology ; Kidney ; metabolism ; Male ; Proteinuria ; metabolism ; Proto-Oncogene Proteins c-sis ; metabolism ; Quercetin ; pharmacology ; Random Allocation ; Rats ; Rats, Wistar ; Vascular Endothelial Growth Factor A ; metabolism

Objective To compare the clinical values of impedance method,optical method and microscopy when used to detect platelet abnormal results.Methods Platelet re-examinations by optical method and microscopy were carried out in case of low confidence degree in platelet test with impedance method by XE-2100 automatic hematology analyzer,and then the results by the three methods were compared.Results Most of the low-confidence-degree results by impedance method could be corrected by re-examination by optical method,and the remained had to turn to microscopy due to unsatisfied requirements of the instrument.Conclusion Optical method has to be involved to correct the platelet abnormal results by XE2100 automatic hematology analyzer,and microscopy should be applied in case optical method doesn't work.The three methods gains advantages and disadvantages of themselves,and can be supplementaries for one another.

Single nucleotide polymorphisms (SNP) is an important molecular marker in traditional Chinese medicine research, and it is widely used in TCM authentication. The present study created a new genotyping method by combining restriction endonuclease digesting with melting curve analysis, which is a stable, rapid and easy doing SNP genotyping method. The new method analyzed SNP genotyping of two chloroplast SNP which was located in or out of the endonuclease recognition site, the results showed that when attaching a 14 bp GC-clamp (cggcgggagggcgg) to 5' end of the primer and selecting suited endonuclease to digest the amplification products, the melting curve of Lonicera japonica and Atractylodes macrocephala were all of double peaks and the adulterants Shan-yin-hua and A. lancea were of single peaks. The results indicated that the method had good stability and reproducibility for identifying authentic medicines from its adulterants. It is a potential SNP genotyping method and named restriction endonuclease digest - melting curve analysis.