Objective To investigate the perioperative management of hip fracture in the elderly aged 80 years and over Methods An retrospective data of the elderly aged 80 years and over who received surgical treatment between Jan 1996 and Jun 2003 were reviewed The surgical procedure was determined according to the fracture type, osteoporosis and patients' health status Data of comorbidities, in hospital complications and other important data were collected Follow up lasting more than 6 months was made to evaluate the recovery Results Eighty two cases were femoral neck fracture while 88 cases were intertrochanteric fracture Their ages ranged from 80 to 96 years with an average of 84 9 years One hundred and twenty eight cases (75 3%) had preoperative comorbidities in which the circulation system was most often involved Thirty six cases (21 2%) had postoperative complications , among which the central nervous system and circulation system were most often involved The average in hospital time was 18 6 days , and 2 cases died of cerebral embolism and respiratory dysfunction in perioperative period respectively Totally 81 5% of them showed a good functional recovery in the follow up Conclusions The right operative intervention to the very aged hip fracture patients is feasible and effective Monitering the perioperative medical conditions and careful nursing should be emphasized

Anemia ; blood ; chemically induced ; drug therapy ; etiology ; therapy ; Antineoplastic Agents ; adverse effects ; Blood Transfusion ; Erythropoietin ; blood ; therapeutic use ; Hemoglobins ; metabolism ; Humans ; Neoplasms ; blood ; complications ; drug therapy ; Receptors, Erythropoietin ; blood

Objective To analyze the prevention and management of in-hospital complications to the surgical treatment of hip fractures in elder patients (≥80 years). Methods An retrospective data of 198 hip fracture patients with surgical treatment between Jan. 1996 and Mar. 2004 was reviewed. Their age ranged from 80 to 98 years with an average of 85.2 years. 93 cases were femoral neck fracture (Garden type Ⅰ 2 cases, type Ⅱ 10 cases, type Ⅲ 52 cases and type Ⅳ 29 cases) while 105 were intertrochanteric fracture ( Evan type Ⅰ 3 cases, typeⅡ 37 cases, type Ⅲ 39 cases and type Ⅳ 26 cases). Local anaesthesia, general anaesthesia and epidural anaesthesia were used in 2, 38 and 158 cases respectively. Femoral neck fractures were treated with bipolar femoral head replacement in 77 patients, total hip replacement in 13 patients, and compressive cannulated screw fixation in 3 patients respectively. Intertrochanteric fractures were treated with close reduction and dynamic hip screw (DHS) internal fixation. Results The average operation duration and blood loss were 53 min and 110 ml respectively in the bipolar femoral head replacement group, 94 min and 165 ml in the total hip replacement group, 35 min and 30 ml in the screw fixation group and 40 min and 60 ml in the DHS group. 17 cases under cemented hip replacement suffered obviously transient arterial blood pressure drop. 36 cases (18.2%) had postoperative complications, among which the mental system and circulation system were more inclined to be involved. The average in-hospital time was 18.6 days and 2 cases died in hospital. The average time from admission to operation (waiting time ) was 6 days. Among 46 cases longer than 7 days, 9 cases (19.6%) had postoperative complications. Among 152 cases no longer than 7 days, 27 cases (17.8%) had postoperative complications. It showed no statistical significant difference between the two groups in complication incidence. Conclusion To gain good results in elderly patients of hip fracture by operation, less invasive and quick anaesthetic technique and operative procedures are encouraged. Meticulous preoperative preparation, active preventing and treating the intraoperative and postoperative complications should be emphasized on.

Adult ; Causality ; Cross-Sectional Studies ; Efficiency ; Female ; Humans ; Male ; Middle Aged ; Occupations ; Social Support ; Stress, Psychological ; Surveys and Questionnaires

Aim To observe the effects of cytokine signaling inhibition protein-3(SOCS3) on the liver fibrosis progression and reverse.Methods C57BL/6 mouse model was established by subcutaneous injection of carbon tetrachloride(CCl4).After a successful model of fibrosis, one-month normal diet was given to induce the reverse fibrosis model, while normal mice of the same gender and weight were as control group.Mice were sacrificed at 1, 2, 3, 4, 5, 6, 7, 8 weeks, respectively, then the liver tissue was harvested for the observation of its injury by hematoxylin and eosin(HE) staining.Then Masson staining was applied for the detection of changes in collagen, and the immunohistochemistry(IHC) for the observation of type Ⅰ Collagen(Colla-1), alpha smooth muscle actin(α-SMA), transforming growth factor beta 1(TGF-β1) and SOCS3 protein expression.In vitro formation of fibrosis was induced by TGF-β1 stimulating HSC-T6 cell lines, which was then reversed by MDI medium, with co-incubation of HSC-T6 cells with plasmid in the process of the reverse.Western blot was employed to detect SOCS3, Colla-1, α-SMA, TGF-β1 expression.Results The expression of SOCS3 and TGF-β1 increased in mouse model of fibrosis with the worsening fibrosis process and decreased in the reverse process.Over-expression SOCS3 in the reverse process reduced the development of liver fibrosis;meanwhile, the expression of TGF-β1 was also reduced accordingly.Conclusion SOCS3 may influence the development of the liver fibrosis and its reverse via regulating the expression of TGF-β1.

Objective To explore the protective role of the receptor tyrosine kinase inhibitor in chondrocyte in vitro.MethodsReverse transcription-polymerase chain reaction (RT-PCR), immunocytochemistry (ICC) and toluidine blue staining were used to understand the changes of phenotype expression of collagenⅠ, Ⅱ and proteoglycan in chondrocyte in vitro. Results Genistein of 20 μg/mL and 25 μg/mL concentrations decreased the expression of collagen Ⅰ and increased the expression of collagen Ⅱ and proteoglycan (P< 0. 05). Conclusions This study showes that genistein can effectively inhibit the expression of collagen Ⅰ above certain concentration, and it can improve the expression of collagen Ⅱ and increase the synthesis of proteoglycan.

Objective To explore distribution and genetypes of plasmid-mediated quionlone resistance genes qnrA.qnrB and qnrS in Enterobacteriaceae isolates iu Renmin Hospital of Wuhan University.Methods The qnrA,qnrB and qnrS genes in Enterobaeteriaceae isolates including nonrepetitive 129 isolates of E.coli.13 isolates of E.cloacae and 37 isolates of k pneunoniae were detected by PCR.Antibiotic suseeptibility testing for 15 antibiotics were also performed by K.B in virto.MICs of ciprofloxacin were determined by agar dilution methed.Plasmid conjugatable test wag applied to examine whether qnrA,qnrB and qnrS genes were located in conjugatable plasmid.For qnr-positive strains,integrase I and SHV-1,TEM-1,CTX-M,OXA-I,OXA-Ⅱ,OXA-Ⅲ,DHA and EBC β-lactamases genes were examined.Results 25 qnr-positive isolates were detected among 179 Enterobaeteriaceae isolates,including 6 qnrA-positive isolates,9 qnrB-positive isolates and 10 qnrS-positive isolates,which were presented in 3.35%.5.02%,and 5.59%respectively.All positive isolates were susceptible to imipenem but resistance to some other drugs.2 qnrA-positive isolates and 4 qnrB-positive isolates of them were susceptible to Quinolones.The plasmid wag eonjugatable in 2 qnrA-positive isolates and 4 isolates carrrying qnrB and qnrS.23 qnrA-positive isolates harbored type 1 Integrase,but one isolate with both qnrB and qnrS did not carry Type 1 Integrage.14 isolates of them were TEM-1 producing strains.6 isolates were OXA-Ⅲ-producing strains.and 7 isolates of them were EBC-producing strains.Conciusions In HuBei province,a low prevalence of qnrA,qnrB and qnrS wag determined in Enterebacteriaceae isolates.Muhidrng-resistance was found in qnr-pesitive isolates and qnr genes were detected in quinolone susceptible strains.Extendedspectrum β-lactamages could be presented in qnr-positive isolates too.

Objective To explore the expression and significance of hedgehog signal molecules (Ptch,Smo and Gli1 ) in chronic pancreatitis tissues in rats.MethodsSixty SD rats were randomly divided into CP group (n =50) and control group (n =10).DBTC solvent (8 mg · ml-1 · kg-1 ) was injected into the rat via tall vein in CP group.In control group,rats were treated only with the solvent at a dose of 1ml/kg body weight.All rats were sacrificed 6 weeks later to observe the pancreatic pathologic changes.Collagen accumulation in pancreatic sections was determined by staining for Sirius red.Expressions of Ptch,Smo,Gli1 mRNA and protein in pancreatic tissues were assessed by RT-PCR and immunohistochemistry.ResultsThe rate of chronic pancreatitis development in rats in CP group within six weeks was 73.9％.Collagen content was markedly higher in CP group than that in control group [ ( 38.52 ± 6.49 ) ％ ~s (7.37 ± 2.28 ) ％,P ＜ 0.05 ].No Path,Smo,Gli1 protein expression was observed in normal pancreatic tissues in control group.The positive rate of Ptch,Smo,Gli 1 expression was 73.5％,64.7％ and 52.9％ in CP group,and the difference between the two groups was statistically significant (P ＜ 0.05).The expressions of Ptch,Smo,Gli1 mRNA were 2.38 ±0.42,3.85 ± 1.03,4.63 ± 1.49 in CP group,which were significantly higher than those in control group (0.23 ±0.16,0.14 ±0.05,0.57 ±0.12,P ＜0.05).ConclusionsThe Ptch,Smo,Gli1 was highly expressed in pancreatic tissues in CP rats,suggests hedgehog messenger pathway may play an important role in the chronic inflammation and fibrosis of chronic pancreatitis.

AIM: To establish a HPLC method for determination of curcumol and germacrone in Zedoary Turmeric Oil and Glucose Injections. METHODS: RP-HPLC was applied for quantitative analysis of curcumol and germacrone. Hypersil ODS2 column (250 mm? 4.6 mm, 5 ?m) and gradient elution was used. Mobile phase A was acetonitrile and mobile phase B was water. Phase A time-percentage composition was as follows:0-3 min,45%;3-30 min,45%→65%;30-38 min, 65%; 38-45 min, 65%→90%;45-55 min,90%→100%;55-65 min,100%. The flow rate was at 1.0 mL?min -1 . Diode array detector was set at 214 nm and column temperature was at 25 ?C. RESULTS: The calibration curves of curcumol and germacrone were linear in the range of 0.26 - 6.5 ?g(r= 0.999 9 ) and 0.112 5 - 2.812 5 ?g(r=1), The average recoveries of them were 102.1% and 98.8% (n=5), respectively. CONCLUSION: Curcumol and germacrone can be determined by the method, and this will improve the quality control of Zedoary Turmeric Oil and Glucose Injections.