The direct anterior approach is an ideal minimally invasive surgical procedure, which exposes the hip joint through an intermuscular and internervous interval. Compared with other approaches, the direct anterior approach for total hip arthroplasty has several advantages, including less postoperative pain, faster functional recovery and higher patient satisfaction. However, the direct anterior approach could be associated with longer learning curve and higher rate of perioperative complications. We converted the operative position from the classic supine to the lateral decubitus position, aiming to inherit the advantages of the direct anterior approach and to overcome the difficulty of exposing the femoral side in the supine position. The degree of extension, external rotation and adduction of the hip joint was significantly increased in the lateral decubitus position compared to those in the supine position, which provided safe reaming of the femoral medullary cavity and precise implantation of the femoral stem. Therefore, the surgeons do not need to change the operating habits of the acetabular side. The reason is that the exposure of acetabulum in the lateral decubitus position is the same as that in familiar posterior approach. Familiarity with the surgical anatomy and understanding the limitations of the anterior hip approach are the key factors for successful execution.

Objective To compare and assess the antihypertentive efficacy and safety of barnidipine hydrochloride and felodipine in the elderly hypertentive patients. Methods 69 elderly patients(60-75 years old ) with mild or moderate essential hypertension were selected and randomly assigned to two groups, one was medicated with barnidipine (36 patients) and another (33 patients) with felodipine. Placeboes were given for 2 weeks, then the testees were administered barnidipine 10mg/d or felodipine 5mg/d for 2 weeks, followed by an increased administration of dose titration to barnidipine 15mg/d or felodipine 10mg/d for another 2 weeks in those patients with DBP≥90mmHg. Both groups were administered once daily. Results After 4 weeks administration no statistical difference was found on the total effectiveness between barnidipine and felodipine groups (100.0% vs 93.9%). Both SBP and DBP declined by 20.7?7.8mmHg and 17.6?4.5mmHg respectively in barnidipine group, and 20.2?9.6mmHg and 17.6?6.1mmHg respectively in felodipine group. The decline of blood pressure showed no significant difference between the two groups. The mild harmful respond occurred in 4 of 36 patients of barnidipine group (11.1%), and in 3 of 33 patients of felodipine group(9.1%).Conclusion The results suggested that barnidipine is effective and well tolerated in antihypertension of the old patients.

Adult ; Chromosome Aberrations ; Chromosome Disorders ; epidemiology ; Gold ; Humans ; Lymphocytes ; Male ; Middle Aged ; Mining ; Occupational Exposure ; Young Adult

ObjectiveTo analyze the internet-based cognitive behavior therapy (ICBT) intervent medical university students' social anxiety,and provide experiences and theoretical basis for future social anxiety interventions.Methods45 medical students of social anxiety were voluntarily divided into the one-to-one intervention group,one-to-five intervention group and control group.The control group did not intervene,one-to-one intervention group and one-to-five intervention group were interfered single person or team by cognitive behavioral therapy,respectively.The level and symptom of social anxiety of the 3 groups were assessed before and after the intervention by social phobia inventory(SPIN) and Social anxiety symptoms interview inventory.ResultsAfter the intervention,the scores of SPIN and the 3 subscales within it (fear,avoidance and physiological) of one-to-one ICBT group and one-to-five ICBT group were lower than those of the control group (SPIN scores:one-to-one ICBT group 15.60 ±7.87,one-to-five ICBT group 14.87 ± 8.83,control group 20.20 ± 11.46).Variance analysis showed that,in addition to physiological subscale(F =0.641,P ＞ 0.05 ),the scores of SPIN,fear and avoidance subscales had significant differences among the3 groups (F=3.764,P=0.018; F=3.606,P=0.021 ; F=5.444,P=0.005).In the analysis of participants'social anxiety symptoms,after treatment,in one-to-one ICBT group,there was 1 participant changed into subthreshold social anxiety and 1 participant into normal in the 2 threshold social anxiety participants.All the 3 subthreshold social anxiety participants changed into normal.In one-to-five ICBT group,there was 1 threshold social anxiety participant lapsed to subthreshold social anxiety,1 subthreshold social anxiety participants still remained in subthreshold social anxiety,2 symptomatic social anxiety participants changed into normal.But there were no significant changes in control group.ConclusionsAll the two methods of intervention have a certain effect.The effect of one-to-one intervention therapy is most significant.

Objective To explore the value of transthoracic echocardiography(TTE) and 64-slice spiral computed tomography(CT) in the diagnosis of complex congenital heart disease(CHD). Methods Ninety-seven patients diagnosed as CHD by TTE underwent 64-slice spiral CT for cardiovascular examination. The results were compared with the results by cardiovascular angiography and from surgery. Results The total diagnosis accordance rated by TEE was 90. 2% and that by spiral CT was 92.5%. There was no difference in diagnosis accuracy rate between TTE and spiral CT. The diagnosis accuracy rate in intracardiae defomities by TTE was 99.2 %, higher than 87.50% by spiral CT. However, the diagnosis accuracy rate in extracardiac defomities and ventricular-arterial connections was 99. 0% by spiral CT, higher than 78. 6% by TTE. The combination of TTE and spiral CT can raise the diagnosis accuracy rate to 99. 1%. Conclusions TTE is of significant value in complex CHD diagnosis,especially in the diagnosis of intracardiac defomities. The combination of TTE and spiral CT can raise the diagnosis accuracy rate of various kinds of complex CHD.

BACKGROUND: Several studies have confirmed that activation of intervertebral disc enzymes is closely related to matrix degradation. Matrix metalloproteinase and tissue inhibitor of metalloproteinase have been shown to exert important roles in the process of extracellular matrix degeneration in intervertebrel disk. Besides these two enzyme systems, whether other proteeses that exhibit degrading effects on extracellular matrix are involved in the intervertebral disk degeneration remains poorly understood.OBJECTIVE: To detect the cathepsin K expression in normal and degenerated human intervertebrel disc cells and investigate the correlation between cathepsin K and intervertebral disc degeneration.METHODS: Cathepsin K expression was detected in intervertebral disc tissue from 30 patients with lumbar intervertebral disc protrusion using immunohistochemistry SP method and ELISA. At the same time, the intervertebral disc tissue from 15 healthy adult cadavers and/or spine fracture patients was taken as control, Cathepsin K protein expression in normal and degenerated human intervertebral disc tissues were compared.RESULTS AND CONCLUSION: Cathepsin K expression was observed in normal and degenerated intervertebral disc tissues.The expression level was significantly higher in degenerated tissue than normal tissue (P ＜ 0.05). These findings demonstrate that Cathepsin K possibly participates in the intervertebral disc degeneration.

Objective To discuss the feasibility,safety,technical points and clinical effects of completely thoracoscopic resection of benign neurogenic tumors on apical chest.Methods From January 2004 to June 2009,11 patients underwent surgical resection of benign neurogenic tumours on apical chest.A complete thoracoscopy was used in 5 cases,and the remaining 6 cases received traditional open thoracotomy.By analysis on the clinical symptoms,tumor types,complications,operative time,blood loss and drainage time after operation,the advantages and disadvantages of complete thoracoscopy were compared to traditional open thoracotomy for resection of benign neurogenic tumors on apical chest.Results There was one patient in each group that suffered from light transient Horner's syndrome,who recovered spontaneously.The group of complete thoracoscopy was superior to the group of traditional open thoracotomy in operative time,blood loss during the operation,drainage time and postoperative hospital stay.Conclusion For benign neurogenic tumors on apical chest,a resection with complete thoracoscopy is as safe and effective as the traditional open thoracotomy,and the former is characterized by less operative trauma and quicker recovery.

The Kato-Katz (KK) method is a well-known method of fecal examination for helminthiases. Its diagnostic sensitivity was found very high for clonorchiasis. The present study evaluated the correlation of Clonorchis sinensis egg counts by the KK method with those by direct smear and formalin-ether (FE) technique. The egg counts obtained by the KK method (Y) were correlated with the counts by direct smear (X) with the equation of Y = 659.4 + 0.266X (r2= 0.738), but not with those by the FE method. The present study demonstrated that the KK method and direct smear were useful for both qualitative and quantitative diagnosis of clonorchiasis, especially in the field.
Animals ; Cellophane ; Clonorchiasis/*diagnosis/parasitology ; Clonorchis sinensis/*isolation & purification ; Comparative Study ; Ether, Ethyl ; Feces/parasitology ; Formaldehyde ; Humans ; Parasite Egg Count/*methods ; Sensitivity and Specificity

Objective:To construct a phage display antibody library of special antigen responding to serum starved U251 cell,from which the serum responding gene and protein would be gotten.Methods:U251 cells were cultured in serum-absent midium for 48 h.Its protein was extracted and used to immunize BALB/c mice.Total RNA of the spleenocytes of immunized mice was extracted.VH and VL were amplified by RT-PCR and were linked into ScFv(Single chain fragment of variation) with a linker.ScFv was recombined to pCANTAB5E vector and was transformed to TG1 strain.Results:The library capacity was up to 3?106 cfu/L.A positive clone was identified from 8 random clones of this library.Conclusion:The special ScFv phage library is constructed successfully.It is the basis for screening special antibodies which can recognize serum responding protein.

Throughin-depth study and thinking ofthe current situation of medical education,this paper exploredtraining strategies of applied talents in medical colleges under the new situation.From the training ofapplication talents in medical colleges under new situation,we should focus on the current reality,learn experience.Combined with the characteristics of medical specialty,we should explore the model of strengthening the humanistic quality moral training of current medical application talents from the curriculum,teaching content selection,teachers' construction,environment shaping,teaching methods,assessment and evaluation,and thus to adapt to the medical mode conversion,alleviate the doctor-patient contradiction and promote medical students employments.