Adult ; Female ; Gas Poisoning ; complications ; Humans ; Male ; Pulmonary Aspergillosis ; complications

OBJECTIVETo explore clinical outcomes of talus neck fracture treated with mini-plate internal fixation through dual-incision approaches.

METHODSFrom August 2010 to February 2013,18 patients with closed talus neck fractures were treated (10 males and 8 females, aged from 31 to 66 years old with an average of 38.2 years old) with mini-plate internal fixation through dual-incision approaches. According to Hawkins classification, 12 cases were type II and 6 cases were type III. All cases were evaluated with X-ray and 3D CT scan preoperatively to define type and comminuted degree of fractures. Mini-plate fixation with dual-incision approaches was performed after swelling was resolved. X-ray films were taken during following up regularly. Functional evaluation was carried out according to Visual Analogue Scale (VAS), the ankle and hind-foot score of American Orthopedic Foot and Ankle Society (AOFAS). Complications were also recorded.

RESULTSSixteen patients were followed up with an average time of 22.6 months (ranged, 17 to 46 months). No wound infection, skin and flap necrosis or implant failure were found. Traumatic arthritis in subtalarjoint was found in 1 patient. Preoperative VAS (5.94±1.12) was decreased to postoperative (1.06±1.06) (t=27.13, P<0.05). The average AOFAS score was 88.7510.19 at the latest following up; and 11 cases obtained excellent results, 3 good and 2 moderate.

CONCLUSIONMini-plate fixation with dual-incision approaches for talus neck fracture especially for talus neck comminuted fracture, an effective method, could obtain stable fixation, decrease complications.

Adult ; Aged ; Ankle Fractures ; surgery ; Bone Nails ; Female ; Follow-Up Studies ; Foot Injuries ; surgery ; Fracture Fixation, Internal ; instrumentation ; methods ; Fractures, Closed ; surgery ; Humans ; Male ; Middle Aged ; Talus ; injuries ; surgery

OBJECTIVETo explore the clinical effect of interference screw and flexor hallucis longus tendon as augmentation material in repair of chronic Achilles tendon rupture.

METHODSFrom September 2010 to June 2012,26 patients with chronic Achilles tendon rupture were treated, including 18 males and 8 females with an average age of 44.2 years old (20 to 66 years old). All patients were unilateral damage. MRI showed the Achilles tendon.ends' distance was 6.0 to 9.0 cm. The postoperative complications were observed. The curative effect was assessed by American Orthopedic Foot and Ankle Society and Leppilahti score.

RESULTSAll the 26 patients were followed up for 18 to 68 months (means 30.4 months). No neurological injury and infection of incision occurred, all patients were stage I incision healing. The shape and function of the ankle were recovered well. The average AOFAS score increased from 52.27±12.30 preoperatively to 90.92±6.36 postoperatively. Leppilahti Achilles Tendon Repair score increased from 34.23±12.86 preoperatively to 90.00±5.10 postoperatively.

CONCLUSIONThe flexor hallucis tendon transfer with an interference screw technique for repairing the chronic Achilles tendon rupture of type IV of Kuwada had advantages of simple operation, quick recovery, firm tendon fixation, and less complications.

Achilles Tendon ; injuries ; physiopathology ; surgery ; Adult ; Bone Screws ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Range of Motion, Articular ; Reconstructive Surgical Procedures ; instrumentation ; methods ; Rupture ; physiopathology ; surgery ; Tendon Injuries ; physiopathology ; surgery ; Tendon Transfer ; Treatment Outcome ; Young Adult

Objective To explore and build a real, objective, comprehensive clinical nursing individual performance indicators architecture model,and check the rationality and validity for prize distribution by clinical application. Methods The methods included that discuss new ideas of nursing performance management by multi- disciplinary experts,developed clinical personal nursing staff performance evaluation program,worded out indicators and methods for the clinical assessment of individual nurses and nurse managers respectively,then applied research in the pilot departments and hospital step by step. Results A personal performance evaluation framework model was constructed, which include clinical nurses and nursing managers. Experimental results show that the nursing staff in this regard performance program have a high degree of recognition, 98.82% (1 741/1 762) nursing staff understanding of the purpose and significance, 97.15%(1 712/1 762) nurses think the performance model structure is reasonable. After the implementation of the performance program, the outstanding rate of personal performance appraisal of nurses was 93% (1 639/1 762). Conclusions The application of scientific performance appraisal programs can play a positive role in helping improve the quality of clinical care, and promote the stable development of the care team.

Objective: To probe into the relation of nutritional status with serum lipids levels in children. Methods: The levels of serum lipids, dietary intakes and physical indices were investigated for 316 children aged 7～11 years in Beijing Chao Yang District. Results: 36.21% of energy was from fat. Of 60.1% children the daily intakes of cholesterol were equal to or more than 300 mg. The intakes of cholesterol were positively associated with TC and apoB levels. Energy percentage from carbohydrate was also positively related with HDL C level. On the other hand, the levels of TC, HDL C and apoAI in cholesterol high intake group were more than control group. The TC, TG, LDL C, apoB and Lp(a) levels in overweight/obese children were more than normal and underweight children, and the lipids levels increased with overweight degree. In boys the waist hip ratios were positively associated with TC, TG, LDL C and apoB levels, negatively with HDL C level. Conclusion: Overweight/obesity (especially abdominal obesity) and unreasonable diet were related closely with dyslipidemia in children. It could be used in early diagnosis for high risk children of dyslipidemia.

The protective effects of diallyl trisulfide on liver were examined in rats with sepsis. Sepsis was reproduced in rats by cecum ligation and puncture (CLP). Fifty-six male Wistar rats were randomly divided into sham-operated group (group S, n=8), sepsis model group (group C, n=24), diallyl trisulfide (DATS)-treated group (group D, n=24). Animals in groups C and D were further divided into three subgroups according to different observation time points, with 8 rats in each subgroup· Rats in group D and C were intravenously injected with normal saline or DATS respectively at a dose of 20 mg/kg after the establishment of sepsis model. Eight rats in groups C and D were sacrificed at 3, 6 and 24 h post-CLP and their livers were harvested for detection of interleukin (IL)-1 receptor associated kinase-4 (IRAK-4), nuclear factor-κB (NF-κB), c-fos, c-jun, malondialdehydethhe (MDA) and superoxide dismutase (SOD), tumor necrosis factor alpha (TNF-α) and for pathological examination. The results showed that the levels of serum IRAK-4, NF-κB and TNF-α in hepatic tissues were higher in group C than group S (control group) (P<0.05). After DATS treatment, the levels of IRAK-4 and NF-κB in the hepatic tissues and serum TNF-α in group D were lower than those in group C (P<0.05). The levels of c-fos and c-jun and MDA in the hepatic tissues were higher in group C than in group S (P<0.05). After DATS treatment, the levels of c-fos and c-jun and MDA in the hepatic tissues were significantly lower in group D than in group C (P<0.05). When compared with group S group, concentration of SOD in the hepatic tissues in group C was significantly lower (P<0.05). After DATS treatment, the concentration of SOD in the hepatic tissues was higher in group D than in group C (P<0.05). These findings suggested that treatment with DATS could ameliorate sepsis-induced liver injury in rats. The protective effect might be related to its ability to inhibit the signal pathway of IRAK-4 and NF-κB, thereby decreasing the production of oxygen free radicals and down-regulating the expression of c-fos and c-jun.

?AIM:To investigate the correlation between dry eye and different degrees of diabetic retinopathy ( DR ) in type 2 diabetic patients.?METHODS: In the cross-sectional study, 340 patients (340 eyes) with type 2 diabetes were enrolled. Tear film function tests including tear meniscus height, tear film breakup time ( BUT ) , fluorescein staining, Schirmer Ⅰtest were performed followed by surveying questionnaires about dry eye. Retinal status was evaluated by retinal color photography and indirect ophthalmoscopy exam with dilated pupils to evaluate DR and whether companied by macular edema.?RESULTS:The prevalence of dry eye was 49. 41%. The mean duration of diabetes in patients with dry eye was 11.15±7.07a, while 6.92±5.45a without dry eye(P<0.01). Dry eye had the positive correlation to the development of DR. The incidence of dry eye in people with mild nonproliferative diabetic retinopathy ( NPDR ) , moderate NPDR, severe NPDR and proliferative diabetic retinopathy (PDR) was 1. 097 times, 1. 724 times, 2. 86 times and 5. 43 times respectively, compared with people without DR. The occurrence of dry eye in people with macular edema increased by 3. 697 times compared with people without macular edema.?CONCLUSION: Dry eye was more prevalent in people with type 2 diabetes. The incidence of dry eye increased gradually with the occurrence and development of diabetic retinopathy.

Objective To summarize the experience in treating coronary artery fistula (CAF) by using Guglielmi detachable coils. Methods During the period from July 2009 to November 2014 at the Affiliated Changhai Hospital of Second Military Medical University, interventional treatment of CAF by using Guglielmi detachable coils was performed in 40 patients. The clinical data were retrospectively analyzed. The feasibility, safety and effectiveness of this technique were evaluated. Results Successful transcatheter closure of CAF with Guglielmi detachable coils was achieved in all 40 patients; the average Guglielmi detachable coils used in each patient was(2.33±1.38) coils. No procedure-related complications occurred. Intra-operative angiography showed that residual shunt completely disappeared in 12 patients (30%) and blood flow was significantly decreased in 28 patients (70%). All the patients were followed up for 1-65 months, neither complications such as recurrent bleeding and ischemia nor stenosis and occlusion of related arteries, or fistula cavity rupture occurred. Conclusion The use of Guglielmi detachable coil in interventional treatment of CAF is safe and effective, although its long-term effect needs to be further verified.

Objective To study the prediction value of C-reactive protein (CRP) level to ankylosing spondylitis disease activity score (ASDAS),the most widely used activity score in ankylosing spondylitis (AS).Methods A total of 386 patients with AS were enrolled and divided into 2 groups by CRP≥3.5 mg/L (n =266) and CRP ＜ 3.5 mg/L(n =120).ASDAS-CRP was evaluated in patients with CRP below the normal range (3.5 mg/L) in different subgroups.Three methods were used to test the consistency between ASDAS-CRP and ASDAS-erythrocyte sedimentation rate (ESR).Results The ASDAS-CRP showed a good correlation with the ASDAS-ESR when CRP level was ≥ 3.5 mg/L (r =0.899,P =0.000).In the group of CRP ＜ 3.5 mg/L,ASDAS-ESR showed better consistency with ASDAS-CRP when CRP level was below 1.5 mg/L(intra-class correlation coefficient 0.902;kappa coefficient 0.70).By the evaluation of variant gradient matrix,CRP 1.5 mg/L coincided with disease activity states.Conclusion There is good consistency between ASDAS-CRP and ASDAS-ESR.When CRP level is below the normal range,1.5 mg/L could be a cut-off value to calculate the optimal ASDAS-CRP score.

OBJECTIVE:To scientifically establish the variety scope of expensive drugs and to reduce the stock level to a maximum degree under the premise of supply security. METHODS: The variety scope of expensive drugs was established by modified ABC (activity-based costing) analytical method,and the management on expensive drugs was carried out by fixed-quantity system (FQS) together with fixed-interval system (FIS). RESULTS: The practice of the optimized management effectively reduced the stock quantity of expensive drugs,increased the amount of money of 75 stocked drugs to 2.473 7 million yuan from 3.935 7 million yuan;the turnover rate rose from 238.36% to 461.86%,and the turnover days were decreased from 13.03 days to 8.29 days. CONCLUSION: Computer management in combination with the modified ABC analytical method together with FQS and FIS management led to an effective and accurate inventory management of expensive drugs,which then resulted in a speedy turnover rate,decreased fund occupying and lowered drug cost.