Objective To identify the independent prognostic factors for femoral head avascular necrosis after internal fixation of femoral neck fractures.Methods A retrospective analysis was made on 246 patients (246 hips) with femoral neck fractures treated by internal fixation between January 2002 and January 2010.There were 111 male and 135 female patients aged 19-59 years.A total of 101 patients were injured in traffic accidents,79 patients in falls from the height and 66 patients in ground-level falls.Eight parameters were identified as the prognostic factors of femoral head avascular necrosis,including gender,fracture type,preoperative traction,interval from injury to surgery,reduction methods,quality of fracture reduction,time of weight bearing,and fixation removal.Multivariate Logistic regression analysis was used to explore the risk factors of postoperative femoral head avascular necrosis.Results Period of follow-up was 1-13 years (mean,7.5 years).There were 38 patients (15.4％) with avascular necrosis of the femoral head.Multivariate analysis identified fracture type (95％ CI-3.41--2.43,P ＜ 0.01),preoperative traction (95％ CI-3.77--0.6,P ＜ 0.05) and quality of fracture reduction (95％ CI -3.33--0.94,P ＜ 0.01) as the independent predictors of avascular necrosis of the femoral head.Conclusion Fracture type,preoperative traction and quality of fracture reduction are the independent risk factors for avascular necrosis of the femoral head after internal fixation of femoral neck fractures.

Objective To explore a new method for assessing the walking efficiency of the paraplegic patients assisted by functional electrical stimulation (FES). Methods The measurement system based on a standard walker was developed. During FES assisted walking of the paraplegic, the real time of the upper limb support were obtained and transformed into a 3 D center of gravity (CG) motion map with a paraplegic upper body mechanical model to describe the CG motion locus. Then the FES efficiency indicated by walking balance condition was assessed objectively and quantitatively. Results In this design, the pilot study of a paraplegic patient undergoing walking training with FES showed that the force accuracy was better than 1.01%, nonlinearity was less than 0.8%, and crosstalk was less than 3.2%. Conclusion The results showed that this system may be used as 1) an evaluation index of FES assisted paraplegic walking efficiency, 2) a balance control indicator during FES assisted paraplegic walking training and 3) a feed back signal to choose an efficient FES pattern and sequence.

OBJECTIVETo observe blood uric acid levels and Goldstein grading, as well as their correlation in Wilson's disease (WD) patients with different Chinese medical syndrome types.

METHODSTotally 906 WD patients in line with inclusive criteria were assigned to 6 groups, i.e., the heart spirit confused by phlegm group (HSCP, 26 cases), the phlegm-fire disturbing heart group (PFDH, 90 cases), the retention of damp-heat group (RDH, 113 cases), deficiency of qi and blood group (DQB, 168 cases), the deficiency of Gan-yin and Shen-yin group (DGYSY, 327 cases), the deficiency of Gan and Shen group (DGS, 182 cases) due to different Chinese medical syndrome types. Recruited were another 160 healthy subjects having similar ages and diet structures, who came for medical examinations, as the healthy control group. Venous blood was collected from the medial cubital vein of each-patient on an empty stomach in early mornings to detect blood uric acid levels. Results Blood uric acid levels were lower in each syndrome type group than in the healthy control group (146.08 +/- 67.24 micromol/L in the HSCP group; 157.08 +/- 69.77 micromol/L in the PFDH group; 162.58 +/- 97.72 micromol/L in the RDH group; 156.20 +/- 62.63 micromol/L in the DQB group; 161.83 +/- 111.23 micromol/L in the DGYSY group; 194.41 +/- 90.01 micromol/L in the DGS group; 242.39 +/- 87.55 micromol/L in the healthy control group, P < 0.01). Blood uric acid levels were higher in the DGYSY group than in the other 5 syndrome groups (P < 0.01). Correlation analyses between Goldstein grading and blood uric acid showed that, along with increased Goldstein grade (that was aggravating disease conditions), WD patients' blood uric acid levels decreased (P < 0.01).

CONCLUSIONSWD patient's blood uric acid levels decreased more. Blood uric acid levels and Goldstein grading were different in various Chinese medical syndrome types. Blood uric acid levels had certain value in assessing the severity of WD.

Asian Continental Ancestry Group ; Heart ; Hepatolenticular Degeneration ; blood ; classification ; diagnosis ; Humans ; Medicine, Chinese Traditional ; Syndrome ; Uric Acid ; blood

To investigate the inhibitory effects of Ginsenoside Rb1 (GRb1) on apoptosis caused by Herpes Simplex Virus-1 (HSV-1) in Human Glioma Cells (U251),U251 cells were infected by HSV-1 at a multiplicity of infection of 5 and GRb1,GRb1+HSV-1,HSV-1 and control groups.MTT and cell apoptosis assays were used to detect the inhibitory effects of GRbl on the apoptosis of U251 cells that caused by HSV-1 infection for various concentrations of drug and virus treatments by MTT assay.We found that in the 400 μg/mL GRbl and 400 μg/mL GRbl+HSV-1 groups,MTT values were higher than control group at all times (P＜0.05).Moreover,the apoptosis rate in the 400 μg/mL GRb1+HSV-1 group was lower than the HSV-1 group (P＜0.05).These results confirmed that,at appropriate concentrations,GRb 1 could inhibit nerve cell apoptosis in HSV-1 infections.

Objective To investigate the clinical outcomes of the surgical management for spinal tuberculosis with paraplegia retrospectively.Methods From March 2008 to April 2012,we retrospectively analyzed 78 patients with spinal tuberculosis combined with paraplegia.Among them,45 patients were male and 33 were female.The average age was 39.5(13 to 71) years.69 patients had focus-active paraplegia.41 patients had received chemotherapy before admissed to our hospital.They also received further standard chemotherapy for an average period of 2.3 (0 to 4) weeks after the admission.22 patients with complex complications (6 patients with active pulmonary tuberculosis,5 with tuberculous meningitis,7 with drug hepatitis,3 with kidney failure and 1 with unstable angina) received preoperative treatment for an average period of 4.5(3 to 8) weeks after the admission.6patients were managed with chemotherapy only.All 9 patients who had focus-healed paraplegia received surgical treatment after the admission immediately.Results All the patients were followed up clinically and radiologically for an average period of 31.4 (12 to 48) months.There was no recurrence of patients.At the final follow-up,all the patients had achieved rigid bony fusion.Both the VAS score and the Cobb angle had satisfactory improvement postoperatively and at the final follow-up.The neurological status began to improve 1-21 days after the operation.From 3 months postoperatively to the final follow-up,65 patients achieved complete recovery,7 partial recovery and 6 no recovery.The clinical outcomes for focus-active paraplegia were similar,while focushealed paraplegia had slower recovery and worse outcomes.Conclusion Patients with focus-active paraplegia combined with mild destruction and relative favourable neurological status could be treated conservatively.For patients with severe bony destruction and neurologic deficits (Frankel A-C,or combined with kyphosis),surgical treatment as early as possible is crucial to improve the neurologic status.If patients had contraindications,operation could be performed after the complications had been cured.However,the neurologic status improvement in focus-healed paraplegia is worse than focus-active paraplegia,suggesting that the reconstruction of spinal stability is important for initial treatment of spinal tuberculosis and children.

ObjectiveTo investigate whether aldosterone infusion induces glomerular or podocyte injury in rats and to evaluate the effects of eplerenoen (EPL), andodipine (CCB) and telmisartan (ARB) on aldosterone- induced injury. MethodsThirty male Sprague-Dawley rats were divided into 5 groups: control, subcutaneous infusion of aldosterone (1.5 μg/h, ALD group) and aldosterone infusion plus eplerenone (100 mg·kg-1·d-1, EPL group), amlodipine(10 nag·kg-1·d-1 CCB group), telmisartan (3 mg·kg-1·d-1, ARB group), respectively. Systolic blood pressure(SBP) and urinary albumin excretion ratio(UAER) were measured at day 0, 7, 14, 21, 28. Blood samples were harvested to detect plasma angiotensin Ⅱ, plasma aldosterone, serum sodium, serum potassium and serum creatinine at day 28. Glomerular damge was quantified by morphological glomerular injury score (GIS). Immunohistochemistry and RT-PCR were performed to evaluate podocyte lesion, and apoptosis ratio of pedocyte (ARP) in a glomerular cross section was analyzed by TUNEL. ResultsALD infusion progressively increased SBP and UAER compared with CTL (P＜0.01). SBP was significantly reduced in EPL, CCB or ARB-treated animals, meanwhile, UAER was decreased in EPL and ARB group, but not in CCB group. The ALD-infused rats exibited hypernatremia and hypopotassaemia, which were blocked by EPL adminstration but not by CCB or ARB treatment. ARB group had a significant increase in plasma angiotensin Ⅱ compared with ALD, CCB and EPL groups(P＜0.01). The ALD-infused animals developed hyperaldosteronemia compared with CTL, but with no difference of plasma aldosterone among ALD, EPL, CCB and ARB-treated rats. Treatment with EPL prevented an increase of GIS and ARP compared with CCB and ARB (P＜0.05, P＜0.01). Protein and mRNA expression of nephfin was up-regulated in ALD group (P＜ 0.01), but was significantly prevented by EPL treatment(P＜0.01), whereas CCB and ARB therapy had no such effect. Conclusion ALD infusion significantly induces glomerular and pedocyte injury which is blocked by EPL but not by CCB or ARB independently on systemic hemodynamics.

AIM To study the antidepressant effects of bioactivecompounds from entomogenous fungi(BCEF) in mice models of depression. METHODS The antidepressant effects of Bioactive compounds from entomogenous fungi were examined in the learned helplessness model( forced swimming mice, tail suspension mice) and chronic unpredictable stress mice models. Spectrofluorometer and UV spectrophotometer were used to detect the activity of MAO, central monoamine neurotransmitter in mice brain mitochondria. RESULTS BCEF0083 25,50,100 mg?kg -1 could obviously shorten the immobility time in forced swimming mice, tail suspension mice and showed some extent of dose-effect relationship. BCEF0083 25,50,100 mg?kg -1 could obviously inhibite the activity of MAO-A,B on brain remitochondria in chronic unpredictable stress mice models and could rise the content of NE,5-HT,5-HIAA,DA in defferent degree. CONCLUSION The results suggested that BCEF0083 had antidepressant effects in mice depression models. The mechanisms of BCEF0083 antidepressant effects may be related with the inhibition of MAO-A,B activity and the increased content of central monoamine neurotransmitter.

Objective To evaluate the effectiveness of health education on controlling of coal-burning-borne endemic fluorosis(referred to as endemic fluorosis) in Guizhou,and to provide a scientific basis for development of control strategies.Methods A total of 37 counties were selected in Guizhou province,and 3 townships were chosen in each project county.Heath educational activities were carried out in the classes of grade 5 in the Central Primary School of each selected township.In the meantime,3 villages were chosen in each selected township where the health education for women of child-bearing age in the community was carried out.Survey on knowledge questionnaire of endemic fluorosis control was conducted among 30 students of grade 5 in the Central Primary School and 15 women of childbearing age of each selected township before and after the health educational activities.Results The knowing rate of endemic fluorosis control of pupils in all the 37 counties increased from 45.03％(14637/32505) to 89.79％(52898/58910),of women of child-bearing age increased from 38.97％ (5729/14700) to 76.55％(19198/25080) after the health education.ConclusionsThe knowing rate of endemic fluorosis control among pupils and women of child-bearing age is remarkably increased after implementing the health education projects.They have better life and health habits,and the project has reached desired goal.

Objective:This paper aims to analyze the related effects of the low price medicine policy, and prob-lems in the implementation process. Methods:To retrieve an official website of the state food and medicine supervi-sion and administration, collect the package supplements of the low-price medicines and analyze their varieties according to their situations, and calculate he highest and lowest average daily use indicators for the medicine, etc. from January 2009 to August 2014. Results:(1) The low-price medicine list contains 533 kinds of standard medi-cines, and the coincidence rate with the essential medicines list is 51. 59%. Results also show that 96. 82% of the low-price medicines are incorporated into the national medical insurance directory. ( 2 ) The daily medicine cost difference of the maximum and minimum bidder price to the same medicine produced by different manufacturers ran-ges from 0. 01 to 30. 96 Yuan with 94. 76% of the western medicine dosage constituting the existing price rise space. (3) The daily medicine cost difference ranges from 0. 01 to 19. 35 Yuan with 92. 13% of the proprietary Chinese medicine varieties constituting the existing price rise space. Discussions:The low-price medicine varieties lack in the strict proof, the fact of low pricing the medicine has a two-way effect, and the connection between the low-price medi-cine administration policy and other policies is unclear.

OBJECTIVETo study the therapeutic effects of posterolateral depression fractures of the tibial plateau through a modified anterolateral approach.

METHODSFrom February 2011 to January 2012,13 patients with posterolateral depression fractures of the tibial plateau were treated through a modified anterolateral approach. There were 8 males and 5 females, ranging in age from 28 to 59 years old (49.2 years old on average). Data from patients were collected retrospectively as follows: X-ray, time of fracture healing and the complications of fracture healing. The patients were evaluated both clinically and radiologically according to the Rasmussen score system.

RESULTSAll the patients were followed up, and the duration ranged from 6 to 18 months (mean 13.7 months). All the patients got bony union. The average radiographic bony union time was 15.1 weeks (ranged, 11 to 17 weeks). No case of secondary articular depression was found. No complications such as malunion or joint stiffness were found. But 1 patient had superficial infection and 1 patient had common peroneal nerve injury. According to the Rasmussen score system,the mean radiological score was 16.50 ± 0.67 (ranged, 13 to 18), and the mean functional score was 25.20 ± 2.21 (ranged, 13 to 30). The mean range of knee motion was (125.3 ± 9.3)° (ranged, 0° to 135°).

CONCLUSIONTreatment of depression fractures of posterolateral tibial plateau with a modified anterolateral approach is a safe method with effective exposure, due to its stable fixation and relatively good outcome with minimal soft-tissue complications. It is regarded as an ideal procedure for depression fractures of posterolateral tibial plateau.

Adult ; Female ; Fracture Fixation, Internal ; methods ; Fracture Healing ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Tibial Fractures ; surgery