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.

Lenalidomide is an oral immunomodulator with multiple functions including immune regulation, anti-tumor, and regulation of tumor microenvironment. Since the United States Food and Drug Administration (FDA) approved lenalidomide for the treatment of mantle cell lymphoma, recent studies have indicated that lenalidomide monotherapy or lenalidomide combinations in other types of lymphoma also has broad prospects. The treatment progress of lenalidomide in lymphoma will be summarized in this paper based on the new reports in the 57th American Society of Hematology (ASH) annual meeting.

PET-CT is the only current medical imaging technology to provide both metabolic and morphologic information in anatomical configuration mode,with high sensitivity and non-invasion.As one of the optimal measures in tumor diagnosis and therapy,abnormally-increased FDG uptake of some subtypes therefore makes an increasing application of PET-CT in lymphoma.The progress of PET-CT in lymphoma will be summarized in this paper based on the reports from the 58th American Society of Hematology Annual Meeting.

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.

Objective To study the effect of nursing intervention on postural hypotension of aged with heart disease.Methods Nursing intervention were gived to the 68 aged patients with heart disease and postural hypotension.The effect of nursing intervention on postural hyporension and hypotension associated symptoms were observed.Results The postural hypotension was improved and the incidence of hypotension associated symptoms were reduced after nursing intervention.Differences were statistically significant(P＜0.01).Conclusion Nursing intervention was effective on the improvement of postural hypotension.

Objective To investigate etiology and clinical features of acute pancreatitis (AP) in young patients. Methods In total, 423 patients with AP admitted to Renmin Hospital of Wuhan University, Wuhan, Hubei province during January 2006 to December 2009 were retrospectively analyzed, 55 cases aged 34 years or less as young group and another 55 cases aged more than 34 years as middle- and elderly-age group. Their etiology, clinical features and illness scores based on some standard criteria were assessed. Results Proportion of varied etiologies of AP in young group was different from that in middle- and elderly-age one (x2 = 17. 107, P = 0. 009) , mainly as biliary and idiopathic pancreatitis in young group and as biliary and alcoholic pancreatitis in middle- and elderly-age one. Incidence of diet-related and idiopathic pancreatitis were higher in young group than that in middle- and elderly-age one ( x2 =4. 853, P = 0. 028 and x2=4. 274, P = 0. 039 ). Scores of the acute physiology and chronic health evaluation II ( APACHE II ) , Ranson criteria and the bedside index for severity in acute pancreatitis ( BISAP) were all lower in young group than those in middle- and elderly-age one (t = 5. 381 , P = 0. 000; t = 4. 388 , P = 0. 000 and t=3. 083, P = 0. 003 ) . There was no statistically significant difference in scores of computed tomography severity index ( CTSI) between young group and middle- and elderly-age one (t = ±0. 750, P > 0. 05 ) . Recurrence rate of AP was lower in young group than that in middle- and elderly-age one ( x2 =4. 251, P = 0. 039). Cholecystitis was more complicated in young group, pregnancy was more complicated in young group (x2 =4. 151 , P =0. 042) , and elevated blood glucose was more complicated in middle- and elderly-age one (x2 = 13. 285 , P = 0. 000 ) . Conclusions Etiology of AP varies in young patients with more dietary factors, occurrence of systemic complications and risks for death are lower in young group than those in middle- and elderly-age one, and there was no statistically significant difference in local complications and severity of illness between the two groups.

Acute Lung Injury ; etiology ; surgery ; Burns, Inhalation ; surgery ; Humans ; Lung Transplantation ; Male ; Middle Aged ; Respiratory Aspiration ; complications ; Sulfuric Acids ; poisoning

Accidents, Occupational ; Adult ; Ammonia ; poisoning ; Bronchiolitis Obliterans ; etiology ; surgery ; Female ; Humans ; Lung Transplantation

BACKGROUND:Epidemiologic reports have indicated that excessive weight-bearing exercise is one of important risk factors for lumbar degeneration, but the effects of weight-bearing activity on normal lumbar motion pattern are stil not clear. OBJECTIVE:To measure the changing characteristics and rules of position at the center of rotation of the lower lumbar spine during a weight-lifting activity of normal person. METHODS: Fourteen asymptomatic subjects with a mean age of (25±5) years were recruited for this study. The L4-5 and L5-S1 segments of each subject were CT-scanned to construct 3D models using dual X-ray imaging system and spiral CT examination combined technology in the aid of computer software. The physiological load and lumbar spinal 3D motion under the loading condition were reproduced when matching the flexion, neutrality and extension in the dual X-ray imaging system and on dual oblique lumbar X-ray image. Coordinate systems were established at the vertebral body of L4-S1 to obtain the center of rotation during flexion-to-neutral, neutral-to-extension and the ful flexion-extension motion. RESULTS AND CONCLUSION: (1) Under physiological load, the center of rotation of L4-5 of normal person was located about 1.0 mm anterior to the central axis of the vertebral body, and the center of rotation of L5-S1 was located about 0.7 mm anterior to the central axis of the vertebral body. (2) With weight loading, the center of rotation of both two segments shifted backward about 0.5 mm. There was no statistical difference between these two loading conditions. (3) When the center of rotation in flexion and extension was calculated respectively, the moving range of the center of rotation at both L4-5and L5-S1 became larger due to taking loads of 10 kg (P < 0.05). In flexion, the center of rotation at L5-S1 significantly shifted forward during a weight-lifting activity (P < 0.05). (4) These results confirm that compared with non-weight-bearing condition, the trajectory of the center of rotation was found to be increased when taking loads, especialy during the flexion-to-neutral motion.

Objective To observe the clinical efficacy of cytokine-induced killer cells (CIK) combined with three dimensional conformal radiotherapy synchronization XELOX regimen in the treatment of local recurrence of rectal neoplasms.Methods A total of 81 patients with local recurrence of rectal neoplasms were divided into treatment group (41 patients) and control group (40 patients) by random digits table method.In treatment group,41 patients received simultaneous three dimensional conformal radiotherapy combined with XELOX chemotherapy,then received CIK treatment.In control group,40 patients received concurrent chemoradiotherapy.The immune function,quality of life (QOL) scores,recent efficacy,survival rate and adverse reactions were analyzed.Results In treatment group,the level of CD3+,CD4+,CD4+/CD8+ and CD16+ CD56+ increased and the level of CD8+ decreased significantly after treatment than those before treatment (0.671 ± 0.012 vs.0.625 ± 0.022,0.378 ± 0.043 vs.0.315 ± 0.035,1.59 ± 1.41 vs.1.02 ± 1.14,0.184 ±0.008 vs.0.121 +0.023,0.237 ±0.030 vs.0.308 ±0.031,P ＜0.05).Compared with those in control group after treatment,the level of CD3+,CD4+,CD4+/CD8+ and CD16+ CD56+ in treatment group increased and the level of CD8+ decreased significantly (P ＜ 0.05).QOL scores of 70.7％ (29/41) patients in treatment group was improved,significantly higher than the 32.5％ (13/40) in conctol group (P =0.001).The response rate(RR) in treatment group was 92.7％(38/41),significantly higher than that in control group [75.0％ (30/40)] (P =0.030).The 1-year survival rate in treatment group and control group were 90.2％(37/41) and 85.0％(34/40),there was no significant difference (P =0.473).The side effect in treatment group and control group showed no significant difference (P＞0.05).Conclusion CIK combined with concurrent chemoradiotherapy in the treatment of local recurrence of rectal neoplasms can improve patients 'immune function,QOL and recent efficacy.