Objective To investigate the the effect of Amiodaroneo on acute myocardial infarction (AMI) and atrial fibrillation (AF) in elderly patients,and provide the basis for the treatment.Methods A total of 108 patients with AMI and AF in our hospital from January 2009 to June 2013 were collected and randomly divided into control and experimental groups,each group of 54 cases.The control group was treated with cedilanid and the experimental group were treated with amiodarone.AF control rate,sinus rhythm maintenance rate and adverse reactions of the two groups were analyzed and compared after treatment.Results The AF control rate of experimental group was significantly higher than that of control group in 6 h,12 h,24 h and 48 h after treatment (x2=5.173,5.066,4.757,6.684,P＜0.05).Sinus rhythm maintenance rate of experimental group was increased compared with control group (47 cases vs.24 cases,x2=21.748,P＜0.01).Adverse reaction rates of the experimental group was lower than the control group (x2 =15.621,P＜0.01).Conclusions The treatment of AMI and AF by amiodarone is betterr and safe than cedilanid alone,so it is worth popularizing and applying on clinic.

Objective To explore the method and clinical effect of via -nasal ileus tube combined urografin to treat early postoperative inflammatory intestinal obstruction.Methods Retrospective analyzed the data of 27 patients with early postoperative inflammatory intestinal obstruction who treated through via -nasal ileus tube intervention. Results The 27 patients were cured through conservative treatment and the cure rate was 100%.The symptom of 10 cases got complete remission 4 to 7 days after put the ileus tube,17 cases got complete remission 8 to 13 days. The passage of gas by anus recovery time was average (12.3 ±2.6)days,time of therapy was average (16.1 ± 3.7)days.The patients were followed up for 6 months to 1 year,none of the patients relapsed.Conclusion The early postoperative inflammatory intestinal obstruction should be treated through conservative treatment positively,decom-pression by via -nasal ileus tube combined urografin has important role to diagnose and treat the disease,the therapy can enhance the therapeutic effect validly and shorten the treatment cycle,it is safe to use in clinic and the effect is satisfactory.

Objective:To evaluate the curative effect of mirror therapy combined with rehabilitation training in the treatment of stroke hemiplegic upper limb motor dysfunction. Methods:To choose 48 patients, were randomly divided into control group, 24 cases in each group to observe, are basic rehabilitation training, observation group joint mirror therapy, using FMA, ARAT, BMI, respectively, evaluation of patients with general motor function, upper limb motor function, daily life ability, numerical measurement of radial carpal extensor emg. Results:After the treatment, the control group, the observation group the FMA level, ARAT level, MBI level, EMG level was higher than that before treatment, the observation group than that in the control group, the observation group FMA, ARAT, MBI, the difference of EMG signals is higher than that of control group, with significant difference(t=14.14,t=4.55,t=5.84, t=9.14;P<0.05).Conclusion: mirror therapy combined with rehabilitation training is really helpful to upper extremity motor functional recovery of stroke patients with hemiplegia, is of positive significance to improve the living ability of the patients.

Objective To survey the Keshan disease conditions and its trend in the historical serious illness areas of the disease in Arong Banner,and to provide epidemiological evidence for scientific prevention and control of Keshan disease.Methods According to the requirements of National Keshan Disease Surveillance Program,two villages in 2 townships of Arong Banner were selected as monitoring sites in 2012,population in monitoring sites was conducted clinical examination and electrocardiogram (ECG) tracings;suspected cases of Keshan disease were conducted chest X ray and ultrasound heartbeat graph examination.At the same time,residents' income and staple food structure were investigated.Results The abnormal rate of ECG was 7.92％ (66/833).The detection rate of cardiac enlargement was 20.00％ (9/45) by chest X ray,in which a slight increase was 8.89％ (4/45),moderate increase was 4.44％ (2/45) and severe increase was 6.67％ (3/45).The detection rate of Keshan disease patients was 132.05/10 000 (11/833),including latent Keshan disease [72.03/10 000 (6/833)] and chronic Keshan disease [60.02/10 000 (5/833)].In the ECG abnormal changes of Keshan disease cases,ST-T change and right bundle branch block were common,accounting for 100.00％ (11/11) and 63.64％ (7/11),respectively;frequent ventricular premature contraction was 2 cases,accounting for 18.18％ (2/11),degree I ° atrioventricular block and complete left bundle branch block was both i case,accounting for 9.09％ (1/11).Annual per capita income in Arong Banner was 8 100 yuan;dweller staple food was rice,flour and other grain crops,rice accounted for 70％-80％,flour 15％-25％ and purchased non-local grain accounted for 95％.Conclusions Keshan disease has been under control at a lower level in Arong Banner,but new latent and chronic Keshan disease occur slowly,gradually and gradually accumulated;life quality and dietary structure have influence on the incidence.In the future,we should pay more attention to Keshan disease and do a good job on prevention and control of Keshan disease.

Objective To discuss the treatment of intraoperative periprosthetic fractures on the femoral side,and to evaluate the results of functional recovery after treatment.Methods Fifty-four cases of intraoperative periprosthetic fractures on the femoral side encountered from July 2002 to December 2006 were retrospectively studied.Fractures on the femoral side were classified by Mallory classification system.X-ray films were taken to evaluate the healing patterns of the fractures.Results Cerclage wires were adequate for stable type I and type Ⅱ fractures,while it could be treated expectantly when the fracture did not involve proximal femur in stable type Ⅱ.Unstable type Ⅱ fractures were taken care of with a long-stem uncementoid component.Type Ⅲ fractures were taken care of with a long-stem uncementoid component or LCP plate.Additional cortical strut allografts were used for the management of unstable fractures and the fractures with poor host bone stock.The average follow-up time was 23.5 months(5-52 months).All fractures were healed as shown by radiography except one case of type I fracture.There was no evidence of loosening or periprosthetic osteolysis on follow up radiograph.The mean postoperative Harris Hip Score was 94.5.Conclusion The treatment of intraoperative periprosthetic fracture around the femoral implant can successfully restore the function of the hip joint in most patients.Cerclage wires,long-stem uncementoid component and additional cortical strut allograft were effective treatment methods for different types of intraoperative periprosthetic fractures on the femoral side.Expectant treatment can achieve satisfactory result in stable type II fractures when the fracture did not destroy proximal femur.

Objective To study the contribution of cortical strut allografts for periprosthetic femoral fractures in total hip arthroplasty. Methods A retrospective study was performed with the data of 22 patients who were admitted from Oct. 2002 to Jul. 2006 and had used strut allografts in the treatment for periprosthetic femoral fracture. Fractures occurred intraoperatively in 18 patients and postoperatively in 4 patients. Of the 22 patients, 4 cases were classified as type A, 13 as type B and 5 as type C fractures according to the Vancouver Classification System. All the fractures were treated with non-cemented stem and supported by cortical strut. The allografts were fixed to the femur by cerclage wire and/or cables. Functional outcome was measured by the Harris hip score. Results All patients were followed-up for a mean of 27.5 months (range of 8-45 months). Fracture union was achieved in 6-14 weeks (range of 16.5 weeks) in 21 patients. The strut fractured at 17 weeks postoperatively in another one patient. The integration of allograft and host bone was confirmed by X-ray examination in all patients at the final follow-up. One patient experienced pain in the affected limb, and stiffness in the ipsilateral knee occurred postoperatively in 3 patients. Conclusions Cortical strut allograft can provide both mechanical and biological stability as biological bone plates. Fixation of cortical strut allograft is a useful technique for the management of periprosthetic femoral fractures, and can lead to a high rate of fracture union and increase the host bone mass during the period of a short-term follow-up. It suggests that the cortical strut allograft should be used routinely to strengthen fixation in periprosthetic femoral fractures.

Objective To approach the effective treatment for simple bone cyst in adult. Methods Forty-eight cases were divided into two groups by visiting order, 20 cases (steroid group) were treated by prednisolone acetate and 28 cases (open resection and allograft group) were treated by open resection and allograft. The curative effect were contrasted between two groups. Results The follow-up time was 5-46(26.58 ± 10.81) months. Aecording to the Chigira's healing criteria for simple bone cyst, grade Ⅰ , Ⅱ , Ⅲ,V were 1, 2, 10 and 7 cases respectively in steroid group, contrasting to 0, 3, 5 and 20 cases respectively in open resection and allograft group. The recovery rate was 85.0%(17/20) in steroid group and 89.3%(25/28) in open resection and allograft group, which was no statistically significant difference between two groups (P＞0.05). Conclusions Although the two remedies are no obvious difference in curative effect,simple bone cyst at lower extremity of weight-bearing with obvious osteolysis in adult is recommended to open resection and allograft, otherwise or at upper extremity to steroid injection.

Objective To investigate the charaeteristcs of the acute poisoning patients in the emergency department of a general hospital in a new emerging district by analyzing the data of Hangzhou.Methods A retrospective study of the characteristics of the poisoning patients in emergency department of Tongde Hospital of Zhejiang Provinee from January 2004 to December 2004 was conducted and statistically analyzed.Results There were 318 poisoning patients in this year, accounting for 8.3% of the total patients in emergency department.Among these poisoning patients,female was 58.8% and male 41.2%;patients aged 21～30 years old accounted for 53.3%;alcoholic poisoning was the major cause and accounted for 34.3%,and 83.3% were male;as the second eanso,sedative accounted for 34.0%,and 72.4% were female;food poisoning accounted for 6.91%,and students was 90.9%.There was no relation between season and poisoning type.In the poisoning patients,30.8% were career men,and 19.5% were unemployed,19.6% were students,and 85.2 % were deliberate.Conclusion Young persons and career men were the high-risk group of poisoning, poisoning type was connected with work and gender.

Tibia shaft fracture is the most common long bone fractures clinically and intramedullary nail fixation is the best choice due to superior biomechanical characteristics for unstable tibia shaft fractures.At present,the common approaches for intramedullary nail insertion are divided into supra-patellar approach and infra-patellar approach.The semi-extended position of supra-patellar approach contributes to better fracture reduction but lead to potential patella-femoral cartilage injury.In contrast,flexion or hyper-flexion position of infra-patellar approach might result in unsatisfactory fracture reduction,then have an impact on clinical outcome.Therefore,the clinical outcome might be different because of approach choice.However,there is no consensus about the optimal surgical approach for intramedullary nailing.Thus,we performed the review to discuss the approaches for tibia intramedullary nailing and compare their strengths and weaknesses.

0.05),but it was significantly lower than that in LTP group (P