Objective To compare the curative effect and biomechanical performance of cannulated compression screw (CCS) and dynamic hip screw-blade (DHS-B) in the treatment of patients with femoral neck fracture.Methods Between February 2010 and February 2014,102 patients with femoral neck fracture were treated with CCS or DHS-B at our department.They were 54 males and 48 females,aged from 15 to 86 years.There were 30 subcapital fractures,51 transcervical ones and 21 base ones.CCS was used in 60 patients and DHS-B in 42.In-hospital data were collected retrospectively to compare the curative effects in 2 groups.Furthermore,femoral neck fracture models were established using 12 adult cadaveric femoral specimens.The 12 models were randomized into 2 equal groups (n =6).Group A was subjected to fixation by 3 CCSs and group B to fixation by DHS-B.The 2 groups were compared in terms of axial loading test,rotation test and destructive axial loading test.Results The operation time (59.4 ± 20.2 min),incision size (4.1 ±0.6 cm) and intraoperative blood loss (25.9 ±9.9 mL) in the CCS group were significantly less than those in the DHS-B group (88.6±22.9 min,12.1 ±1.2cmand 156.7±107.1 mL) (P ＜0.05).The Harris hip score for the DHS-B group (91.9±9.8) was significantly higher than that for the CCS group (87.2 ± 9.2) (P ＜ 0.05).There were no significant differences between the 2 groups in hospital stay,partial weight-bearing time,or postoperative complications (P ＞ 0.05).At 500 N vertical loading,the stress values at both medial and lateral sides of the femur in group A were significantly smaller than those in group B (P ＜ 0.05).There were no significant differences between groups A and B in the average sinking displacement of femoral head or the torque at a torsion angle of 6° (P ＞ 0.05).The maximum load in group A (2,135 ±120 N) was significantly smaller than that in group B (2,986 ± 98 N) (P ＜ 0.05).Conclusion In treatment of femoral neck fracture,DHS-B fixation is obviously superior to CCS fixation,because the former is in better agreement with the femoral biomechanical property,and performs better in anti-rotation and anti-compression,leading to better functional recovery of the affected hip.

Objective To design a new type of field operation instrument for easy to spread a rescue surgery rapidly in field first -aid at the present stage. Methods The traditional field operation instrument set is innovated in its composition, structure and function. The packing instrument procedure can be omitted. The new field operation instrument set is made of four different operation instrument boxes, two of which can be put into a standard field medical case. Results It is designed to be convenient to have a rescue surgery rapidly and to be washed, sterilized, conveyed and kept in aseptic storage. Conclusion The new field operation instrument case has such advantages as compactness, reasonable allocation and function completed, so it can be used easily.

DiGeorge Syndrome ; diagnosis ; therapy ; Humans ; Infant, Newborn ; Male

Objective To explore the risk factors of coal-burning-borne endemic fluorosis (endemic fluorosis) and to provide a scientific basis for making prevention and control strategy.Methods One hundred children with dental fluorosis and 30 adults with skeletal fluorosis who lived in Wushan county and Fengjie county,the endemic fluorosis regions northeast of Chongqing were randomly selected as the case group in 2010.One hundred healthy children and 30 healthy adults were selected from the population where the cases were selected from as the control group and 30 healthy external adults control were selected from Yubei district,a non-endemic fluorosis area.Fasting venous blood was draw from all subjects and the content of zinc (Zn),copper(Cu),calcium (Ca),magnesium(Mg),and ferrum(Fe) in venous blood was measured by atomic spectrophotometric.Instant urine was collected from all subjects and urinary fluorine was measured by fluorine selective electrode.We also did questionnaire survey to 100 dental fluorosis children and 100 control children about their situation of fluorine pollution and knowledge related to endemic fluorosis.Results Children's blood Zn of the ease group[(70.88 ±9.28) μmol/L] was lower than that of the control group [(75.53 ± 10.78)μmol/L],and the difference was statistically significant(P ＜ 0.05).But the average blood Cu content[(30.28 ± 2.58)μ mol/L] and the average urinary fluorine of the case group [(0.74 ± 0.36)mg/L] were significantly higher than that [Cu (28.45 ± 4.05)μmol/L and urinary fluorine (0.48 ± 0.21)mg/L] of the control group in children,respectively,and the differences was statistically significant(P ＜ 0.05).The average blood Zn content of adults in the case group[(91.13 ± 10.29)μ mol/L] was lower than that of the control group[(99.57 ± 11.73)μmol/L],and the difference was statistically significant (P ＜ 0.05).The average content of Mg[(1.57 ± 0.19)mmol/L],Fe[(8.17 ± 1.01) mmol/L] and urinary fluorine[(2.37 ± 1.01)mg/L] in the case group were higher than that [Mg(1.46 ± 0.16) mmol/L,Fe(7.72 ± 0.96) mmol/L and urinary fluorine(0.92 ± 0.85)mg/L] of the control group,respectively,and the differences were statistically significant(P ＜0.05).In the questionnaire survey,we found that the following were important related factors (OR values were 2.7335,0.3339,2.8428,0.4633,0.5439,0.4009,0.4805 and 0.3994,P ＜ 0.05) between the case group and the control group:using local coal for heating,furnaces and stoves improvement,eating local coal fire baked food,knowing the harm of endemic fluorosis to the health of human body,knowing endemic fluorosis can be prevented,knowing consuming baked food can cause endemic fluorosis,knowing drinking milk can prevent endemic fluorosis and having the habit of eating calcium tablets.Conclusions In addition to the main pathogenic element of fluorine,body Zn content is closely related to the process of coal-burning-borne endemic fluorosis in the two counties,fluorosis patients have lower blood Zn levels,Zn deficiency is an auxiliary factor in the etiology of fluorosis.Reduce the use of local coal for heating,do not consume the baked food,improve stoves,learn more knowledge about endemic fluorosis and ingest anti-fluoride elements can reduce the risk of endemic fluorosis.

Humans ; Infant, Newborn ; Kidney ; abnormalities ; Male ; Polycystic Kidney Diseases ; congenital

Adult ; Antiviral Agents ; administration & dosage ; therapeutic use ; Drug Therapy, Combination ; Female ; Hepatitis B e Antigens ; Hepatitis B, Chronic ; drug therapy ; immunology ; Humans ; Interferon-alpha ; administration & dosage ; therapeutic use ; Male ; Nucleotides ; administration & dosage ; therapeutic use ; Polyethylene Glycols ; administration & dosage ; therapeutic use ; Recombinant Proteins ; administration & dosage ; therapeutic use ; Treatment Outcome ; Young Adult

OBJECTIVETo measure the expression of phosphatidylinositol 3-kinase (PI3K) and protein kinase B (PKB) in liver tissue among low-birth-weight newborn rats treated with L-arginine (L-Arg) in early life, and to investigate the effect of L-Arg on insulin resistance.

METHODSEighteen pregnant rats were randomly divided into three groups: control, model and intervention (n=6 each). The control group was fed with normal protein feed (protein content=21%) during pregnancy to establish a normal-birth-weight newborn rat model, and the model and intervention groups were fed with low-protein feed (protein content=10%) during pregnancy to establish a low-birth-weight newborn rat model. Newborn rats from the three pregnant rat groups were also assigned to control, model and intervention groups. During 21 days of lactation, maternal rats in the control and model groups were fed with normal protein feed and normal drinking water, while maternal rats in the intervention group were fed with normal protein feed and drinking water rich in L-Arg (200 mg/kg·d). After ablactation, the three groups of newborn rats were fed with normal protein feed and normal drinking water. Liver tissue samples were collected from these newborn rats at 1, 3 and 8 weeks after birth. Protein expression of PI3K and PKB in liver tissue was measured by Western blot.

RESULTSAt 1 week after birth, the newborn rats in the intervention group had significantly higher protein expression of PI3K than in the model group (P=0.045), but there was no significant difference when compared with the control group (P=0.503). At 8 weeks after birth, the newborn rats in the intervention group had significantly higher protein expression of PKB than the model group (P=0.039), but there was no significant difference when compared with the control group (P>0.05).

CONCLUSIONSA supplement of L-Arg in early life can boost protein synthesis, increase protein expression of PI3K and PKB in liver tissue, promote insulin signaling and reduce insulin resistance.

Animals ; Animals, Newborn ; Arginine ; pharmacology ; Birth Weight ; Female ; Liver ; metabolism ; Male ; Phosphatidylinositol 3-Kinases ; genetics ; Phosphorylation ; Pregnancy ; Proto-Oncogene Proteins c-akt ; genetics ; Rats ; Rats, Sprague-Dawley

OBJECTIVETo examine serum adiponectin level in preterm infants and to evaluate the relationship between serum adiponectin and bone mineral density in preterm infants.

METHODSSeventy-two appropriate-for-gestational-age neonates were classified into three groups according to their gestational ages: early preterm (31-33(+6) weeks, 13 cases), late preterm (34-36(+6) weeks, 16 cases), and full-term (37-42 weeks, 43 cases). Venous blood was collected at one week of their life to measure serum adiponectin concentration. During the period, omnisense ultrasound bone sonometer was applied to measure speed of sound (SOS) of the left tibia.

RESULTSThe median of tibia SOS in the early preterm group was significantly lower than in the late preterm and full term groups (P<0.05), and the median of tibia SOS in the late preterm group was lower than in the full-term group (P<0.05). Serum adiponectin level was lowest in the early preterm group, and the full-term group had the highest serum adiponectin level. Serum adiponectin level was positively correlated with tibia SOS in preterm infants (r=0.664, P<0.05). According to the result of multivariate linear stepwise regression analysis, serum adiponectin and birth weight were independent predictor of tibia SOS in preterm infants.

CONCLUSIONSSerum adiponectin level is lower in preterm infants than that in full-term infants. There is a positive correlation between serum adiponectin and bone mineral density in preterm infants.

Adiponectin ; blood ; Birth Weight ; Bone Density ; Female ; Humans ; Infant, Newborn ; Infant, Premature ; blood ; Linear Models ; Male

OBJECTIVE: To investigate the incidence of neonatal asphyxia and possible contributing factors for the development of severe asphyxia in Hubei Enshi Tujia and Miao Autonomous Prefecture, China. METHODS: A total of 16 hospitals in Hubei Enshi Tujia and Miao Autonomous Prefecture were selected as research centers. A retrospective analysis was performed for the clinical data of 22 294 live births in these 16 hospitals from January to December, 2016 to investigate the incidence rate of neonatal asphyxia and possible contributing factors for the development of severe asphyxia. RESULTS: Of the 22 294 neonates born alive, 733 (3.29%) were diagnosed with neonatal asphyxia, among whom 627 had mild asphyxia and 106 had severe asphyxia. The neonates with low maternal education level, maternal anemia during pregnancy, chorioamnionitis, abnormal amniotic fluid, abnormal umbilical cord, placenta previa, placental abruption, Tujia Minority, preterm birth, and low birth weight had a higher incidence of severe asphyxia (P<0.05). CONCLUSIONS The incidence rate of neonatal asphyxia in Hubei Enshi Tujia and Miao Autonomous Prefecture is higher. Low maternal education level, maternal anemia during pregnancy, chorioamnionitis, abnormal amniotic fluid, abnormal umbilical cord, placenta previa, placental abruption, Tujia Minority, preterm birth, and low birth weight may be related to the development of severe neonatal asphyxia.
Asphyxia Neonatorum ; epidemiology ; China ; Humans ; Incidence ; Infant, Newborn ; Retrospective Studies

OBJECTIVE: To investigate the clinical features and outcome of neonatal acute respiratory distress syndrome (ARDS) in southwest Hubei, China. METHODS: According to the Montreux definition of neonatal ARDS, a retrospective clinical epidemiological investigation was performed on the medical data of neonates with ARDS who were admitted to Department of Neonatology/Pediatrics in 17 level 2 or level 3 hospitals in southwest Hubei from January to December, 2017. RESULTS: A total of 7 150 neonates were admitted to the 17 hospitals in southwest Hubei during 2017 and 66 (0.92%) were diagnosed with ARDS. Among the 66 neonates with ARDS, 23 (35%) had mild ARDS, 28 (42%) had moderate ARDS, and 15 (23%) had severe ARDS. The main primary diseases for neonatal ARDS were perinatal asphyxia in 23 neonates (35%), pneumonia in 18 neonates (27%), sepsis in 12 neonates (18%), and meconium aspiration syndrome in 10 neonates (15%). Among the 66 neonates with ARDS, 10 neonates (15%) were born to the mothers with an age of ≥35 years, 30 neonates (45%) suffered from intrauterine distress, 32 neonates (49%) had a 1-minute Apgar score of 0 to 7 points, 24 neonates (36%) had abnormal fetal heart monitoring results, and 21 neonates (32%) experienced meconium staining of amniotic fluid. Intraventricular hemorrhage was the most common comorbidity (12 neonates), followed by neonatal shock (9 neonates) and patent ductus arteriosus (8 neonates). All 66 neonates with ARDS were treated with mechanical ventilation in addition to the treatment for primary diseases. Among the 66 neonates with ARDS, 10 died, with a mortality rate of 15% (10/66), and 56 neonates were improved or cured, with a survival rate of 85% (56/66). CONCLUSIONS Neonatal ARDS in southwest Hubei is mostly mild or moderate. Perinatal asphyxia and infection may be the main causes of neonatal ARDS in this area. Intraventricular hemorrhage is the most common comorbidity. Neonates with ARDS tend to have a high survival rate after multimodality treatment.
China ; Female ; Humans ; Infant, Newborn ; Meconium Aspiration Syndrome ; Pregnancy ; Respiratory Distress Syndrome, Newborn ; Retrospective Studies