Anti-Bacterial Agents ; administration & dosage ; therapeutic use ; Child ; Community-Acquired Infections ; diagnosis ; epidemiology ; therapy ; Humans ; Pneumonia ; diagnosis ; epidemiology ; therapy

OBJECTIVETo explore the clinical effects of one-stage hemiarthroplasty in treating fresh subtrochanteric fracture combined with old femoral neck fracture.

METHODSFrom October 2003 to October 2013, 7 patients with fresh subtrochanteric fracture and old femoral neck fracture were treated with hemiarthroplasty in one stage. There were 5 males and 2 females, aged from 69 to 80 years old with an average of 74.5 years. According to the Garden classification, 2 cases were type IV and 5 cases were type V. According to the A0 classification of subtrochanteric fracture, all cases were type A1 (long oblique femoral subtrochanteric fractures). Biological coating long handle femoral prosthesis was used in the patients. The hip joint functions were assessed according to Charnley scoring system after all hemiarthroplasty.

RESULTSSeven patients were followed up from 12 to 24 months with an average of 18 months. There were 1 case with urinary system infection and 1 case with deep venous thrombosis. Of all, 5 cases recovered the walk ability at 6 months after operation and 2 cases could walk with the help of the crutch at 1 year after operation. According to Charnley scoring system to assess the hip joint function, the total Charnley scores reached 15.0±2.5, and 4 cases got an excellent results, 2 good, 1 fair.

CONCLUSIONArthroplasty through anterolateral approach can obtain satisfactory clinical effects in treating fresh subtrochanteric fracture combined with old femoral neck fracture, it has advantages of good joint stability, little pain, less complication, quickly recover, early activities on fields.

Aged ; Aged, 80 and over ; Arthroplasty ; methods ; Female ; Femoral Neck Fractures ; surgery ; Hip Fractures ; surgery ; Humans ; Male

ObjectiveTo probe into the ultrasonic(US) predictive value for metastasis of the cervical lateral lymph node(LNM) with the preoperative ultrasonic examination in thyroid papillary microcarcinoma (PTMC),then,to further evaluate the significance of the preoperative ultrasonic score (US) for predicting metastasis of the cervical lateral lymph node.Methods From May 2004 to May 2011,165 patients diagnosed as PTMC (the ultrasonic imaging of lymph node showed no lateral LNM) were retrospectively analyzed and the US and final pathological data from the cases were collected to determine the relevant factors and different scores.ResultsThere were significant differences(P ＜ 0.05 )among US characteristics of microcalcification,no well-defined margin,tumor located at the upper pole,the perimeter of the tumor contacted with the adjacent capsule of thyroid being ＞25 ％ and the presence of the cervical lateral lymph nodes metastasis in PTMC between the metastatic group and the non-metastatic group.The total scores of the ultrasonic ≥2.5 was the delimitation value,its sensitivity was 86.2％ and its specificity was 89.7％.ConclusionsThe ultrasonic score has definite value in the differential diagnosis for the metastasis of the cervical lateral node in the patients of no lateral LNM,when the ultrasonic score is larger than 2.5,the possibility of the cervical lateral lymph node metastasis should be noticed.

20?g/L) after surgery in one month.The survival rate for 1,3,5yr were 100%(n=17),91.5%(n=16) and 84.7% (n=14) respectively in the therapy group,and in the control group 95.45% (n=21),72.7% (n=16),40.91%(n=9) respectively.Sur- vival rate between two groups showed significant difference (P

Objective: Extracting ephedrine and berberine from the water extract of Ephedra Herba and Rhizoma Coptidis. Methods: Modified PVA was used as separating membrane and separated alkaloids. Results: A colorless ephedrine aqueous solution was obtained when extraction time was less than 8 hours; while a three constitution solution was obtained when time of extraction is over 8 hours. So is Rhizoma Coptidis. The membrane is hardly fouled. Conclusion: Purity of alkaloids from Herba Ephedra and Rhizoma Coptidis by membrane separation is Superior to that by alcoholic sediment but amount of alkaloids is reverse.

Objective To compare the effects of salmeterol and fluticasone propionate combined montelukastin the treatment of patients with bronchial asthma.Methods Ninety-eight bronchial asthma patients from April 2014 to March 2016 in the Fourth People's Hospital Sichuan Province were selected anddivided into observation group and control group with 49 patients in each group according to the above principles by prospective study.The control group was given salmeterol treatment,and the observation group was added given montelukast treatment based on the control group.The treatment days were 15 d recorded the prognosis of the two groups.Results The total effective rates of the observation group and the control group were 95.9％ and 81.6％ respectively,the total effective rate of the observation group was significantly higher than that of the control group (P ＜ 0.05).The FEV1 and FVC values after treatment in the observation group and control group were significantly higher than before treatment (P ＜ 0.05),while the FEV1 and FVC values in the observation group after treatment were significantly higher than those in the control group (P ＜ 0.05).The scores of ACT scale after treatment of two groups were obviously higher than before treatment,and the score of observation group was statistically higher than control group after treatment (P ＜ 0.05).During treatment,there was no statistical significance on adverse reaction between two groups.Conclusion Salmeterol and fluticasone propionate combined montelukast in the treatment of patients with bronchial asthma can promote the improvement of lung function,so as to improve the quality of life and clinical treatment.

ObjectiveTo evaluate the image quality of displaying the pulmonary artery and pulmonary emboli at different tube voltages and find the optimal tube voltage.MethodsSixty-six patients underwent contrast-enhanced dual energy CT pulmonary angiography (CTPA) from August 2007 to February 2010.Data obtained with 80 kVp,weighted average 120 kVp,and 140 kVp were divided into group Ⅰ,Ⅱ,and Ⅲ respectively.CT value of pulmonary artery ( grade 1—4),emboli,and muscles were measured.Corresponding signal to noise ratio (SNR) and contrast to noise ratio (CNR) were calculated.One-way ANOVA analysis and Friedman test were used to analyze statistical significance among these values.Image quality of CTPA from these three groups was assessed.The inter-reader agreement of image quality was performed by kappa test.ResultsCT value of branch 1 to 4 of ptlmonary artery was (446 ± 140) HU,(433±130) HU,(411 ±138) HU,and (392±127) HU in group Ⅰ,(303±91) HU,(290±85) HU,(276±86) HU,and (263 ±85) HU in group Ⅱ,and (244 ±70) HU,(230 ±63) HU,(216 ±72) HU,and (205 ±68) HU in group Ⅲ.There was significant difference for CT values (P ＜0.01) among three groups.CT value of pulmonary artery in 80 kVp images was higher than 140 kyp and 120 Kvp.On quantitative analysis of 37 patients,CNR value of pulmonary clots was 8.3 ± 3.3,8.0 ± 2.9,and 5.6 ± 2.2 in group Ⅰ,Ⅱ,and ⅢⅢ,respectively.CNR values of pulmonary clots in 80 kVp images and 120 kVp images were higher than that in 140 kVp (P ＜0.01 ).There was no statistical difference for image quality of CTPA among the three groups ( P ＞ 0.05 ).Agreement of image quality of CTPA derived from 80 kVp (kappa value =0.789,P ＜0.01 ) was superior to that of 120 kVp (kappa value =0.652,P ＜0.01 ) and 140 kVp ( kappa value = 0.509,P ＜ 0.01 ).Conclusions CT value of pulmonary artery in 80 kVp images was higher than that of weighted average 120 kVp and 140 kVp,and the image quality and CNR was comparable with that of weighted average 120 kVp images.This tube voltage ( 80 kVp) is optimal for CT pulmonary angiography in the evaluation of patients with suspected pulmonary embolism.

ObjectiveTo probe into the clinical efficiency of reconstruction to person who had composite tissue defect of the floor of mouth and the lower part of face with the free forearm flap and free iliac bone in the same term.MethodsBefore the surgery, the surgeon should carefully evaluate the scope and shape of defects in 11 cases who had the composite tissue defects of the floor of mouth and the lower part of face, to design the individual forearm flap, so that it matches with the defect region. During surgery, the first resumption of defects using titanium plates forming the basic shape of mandible and the occlusal relationship,then used to re-sawing to take modeling of the iliac bone,transplanted free iliac bone and fixed after the inside of the titanium plate, thereby restoring the continuity of mandible missing.ResultsFree forearm flap and free iliac bone all survived in 11 cases, the success rate of 100％. The patients were followed up for 6 to 12 months, although the shape of restoration areas were different levels of fat, but eating, swallowing and other oral function had been well improved, 7/11 could enter normal diet, 4/11 to enter liquid diet, At the same time, the patients in social activities can communicate in a language daily, sensory function of skin flap and facial appearance has been satisfactory recovery.ConclusionConformal free forearm flap and free iliac bone is an ideal way to reconstruct the composite tissue defects of the floor of mouth and the lower part of face in the same period, not only safe, practical prognostic effect, and also can significantly improve the patients quality of life, which is worthy of reference and use.

AIM:Receptor tyrosine kinase (RTK) activation is critical for growth factor-mediated cell proliferation. The present study was designed to determine the effect of the tyrphostin AG1295 and AG1296, a selective blocker of PDGF βand αRTK,on proliferative vitreoretinopathy (PVR) development.METHODS:Rabbit conjunctival fibroblasts (RCF) cells were cultured.The effects of AG1295, AG1296,PDGF-AA and PDGF-BB on RCF proliferation are evaluated by MTT assay.Homologous rabbit conjunctival fibroblasts were injected intravitreally to make animal PVR model, followed by injection of 100μmol/L of AG1295 or AG1296 respectively. The presence of tractional retinal detachment (TRD) was assessed to evaluate the effect of AG1295 and AG1296 in vivo .Electroretinography and histologic studies were performed after intravitreal injection of AG1295 into untreated eyes to evaluate toxicity. RESULTS: Both AG1295 and AG1296 (10μmol/L) significantly inhibited rabbit conjunctival fibroblast cell growth stimulated by PDGF-AA or -BB in vitro.Development of TRD was significantly reduced (P<0.05) with 100 μmol/L of AG1295 or AG1296 in vivo, but the effect of AG1295 only present till day 14. Inhibitive effect of AG1296 is longer than that of AG1295.No significant histologic or retinal functional damage was found in both drug-treated groups. CONCLUSION: PDGF αand βreceptor specific inhibitor AG1296 and AG1295 attenuated PVR without significant side effects in rabbits, and AG1296 was better than AG1295. The much longer and stronger therapeutic effect from PDGFαreceptor inhibitor indicated that PDGF α receptor is more important in the development of PVR, and inhibition of this pathway could be a useful treatment alternative to prevent PVR.

Objective To evaluate spiral CT in diagnosing vascular complications of pancreatitis. Methods The clinical and surgical results and the CT findings of 316 patients with acute or chronic pancreatitis were comparatively analyzed. Special attention was paid to the CT findings of the patients with peritoneal hemorrhage and vascular abnormality. CT Hu of celiac blood effusion was measured. Pseudoaneurysms, phlebothrombosis and venous thrombosis of peripancreatic vessels in CT enhancement were carefully analyzed. Results Acute pancreatitis was found in 275 out of the 316 patients, and chronic pancreatitis in 41 cases. Among those with acute pancreatitis, 20 had peritoneal cavity vascular complications. In the 13 cases of peritoneal cavity hemorrhage(including 5 patients complicated with digestive tract hemorrhage), CT identified 11 with as regional or diffuse slight high density fluid collections, and failed in 2 cases. CT scans detected gastric varices in 4 out of 7 patients with digestive tract hemorrhage. Of those with chronic pancreatitis, CT found celiac artery pseudoaneurysm in one, spleen artery pseudoaneurysm in one and splenic vein thrombosis with gastric varices in one. Conclusions (1)Regional or diffuse slight high or high density fluid collections were common CT findings of peritoneal cavity hemorrhage. (2)Enhanced spiral CT scanning could demonstrate peripanreatic vascular pseudoaneurysms. (3)Varices in gastric fundus and necrosis in pancreatic body and tail often indicate the formation of spleen venous thrombosis.