Objective To set up care service quality evaluation indicators and establish weight coefficient for assessment of elderly institution in Chongqing.Methods SEVQUAL Model was used as the theoretical guidance,through Delphi expert inquiry,analytic hierarchy process (AHP),the weight of each indicator in five grades and consistency check was calculated.Results The care serv ice quality evaluation indicators contained five first-grade indexes and twenty second-grade indexes.The first-grade indexes included tangibles,reliability,responsiveness,assurance,empathy,respectively.The results of the consisten-cy check of the single grade sorts had a satisfying consistency(CR＜0.10).Conclusions The scientific meth-ods and comprehensive indicators were applied to the construction of care service quality e-valuation indicators for elderly institution in Chongqing.In some degree,this construction of indicators may improve quality of care service and provide useful reference evidence for quality assessment in elderly in-stitution.

Adolescent ; Adult ; Air Pollutants, Occupational ; adverse effects ; analysis ; Cadmium Compounds ; adverse effects ; analysis ; Eye ; drug effects ; Humans ; Oxides ; adverse effects ; analysis ; Young Adult

Objective To analyze the effect of reconstruction for the proximal or distal femoral defect by a composite of massive frozen allograft and prosthesis replacement. Methods According to Enneking's classification, malignant bone tumors of the proximal or distal femur were widely resected in 28 cases. Reconstruction of the affected hip or knee joint after major joint removal was done by a composite of allograft and prosthesis. A conventional femoral component with a stem long enough to provide good fixation in the femoral shaft was threaded over a customized allograft. After the assembly had been reduced and checked for size and position, the allograft was cemented to the femoral component, and the composite was in turn cemented into the femoral shaft with PMMA. Results 26 patients were followed up from 6 to 78 months with an average of 41 months. 3 cases died within 18 months following operation; 4 case sustained recurrences within 8 months postoperatively, and underwent re-resection; and the others were alive without diseases. All patients had no dislocation, loosening or breakage of prosthesis. X-rays showed the time of bone healing between allograft and host femur was an average of 7.4 months (range, 5 to 11 months), and the rate of bone healing was 92% (24/26). Absorption was seen around allograft greater trochanter of femur in 9 cases and at femoral condyle in 6 cases. 13 cases with total hip composite replacement had good active extension-flexion degrees of an average of 85?( range, 71? to 124?), and 13 with total knee composite replacement had a rang of motion of 92?(range, 68? to 135?). The postoperative average ISOLS scale score of 26 cases by Enneking's system was 26.2 point (range, 22 to 28). Conclusion The clinical result demonstrated the composite of massive frozen allograft and prosthesis replacement has the advantages of both allograft and prosthesis. Its best indications are that the patients with a major femoral defect from benign or low grade malignant tumor have longer survival expectancy.

Objective To evaluate mid-term clinical and radiographic outcomes associated with cementless total hip arthroplasty(THA) in a consecutive series of patients with osteonecrosis of the femoral head. Methods This study examined the mid-term (equal to or more than 5 years) results of THA. From January 1998 to March 2001, a series of 71 patients (80 hips) who had undergone THA with cementless components in our hospital were involved in this study. All patients were evaluated both clinically and radiographically. Clinical outcomes were evaluated according to Harris evaluation score. Components migration, bone changes around the implant, the polyethylene wear rate and direction of the acetabular polyethylene wear were measured radiologically. Kaplan-Meier analysis was performed to evaluate the survival of the femoral and acetabulum components. End point was radiographical loosening or revision of the acetabular component, and revision of the femoral component for any reason. Results 62 hips in 54 patients were followed up at least 5 years. The mean Harris hip score improved from preoperation (44.0?8.4) points to (92.4?5.7) points at the time of final follow-up. No component was seen to be loose radiographically or had been revised because of any reason at the time of final follow-up. Only one focal area of pelvic osteolysis in one patient and twelve small focal areas of femoral osteolysis in another patient were identified. The mean linear wear rate was (0.125?0.074) mm/year. When loosening was used as the end point for failure, the survival rate of the acetabular and femoral components was 1.0 (95% confidence interval, 0.98 to 1.00) in both groups. Conclusion Cementless THA in patients with osteonecrosis of the hip had a satisfactory clinical and radiographic outcome at a minimum of five years follow-up. Because polyethylene wear and osteolysis can not avoided, radiographical follow-up for cementless components is very important.

[Objective]To evaluate the safety and efficacy of total hip resurfacing arthroplasty in treating osteoarthritis secondary to congenital dysplastic hip.[Method]From May 2005 to June 2005,13 hips in 12 cases with osteoarthritis secondary dysplastic hip were adopted in this study.There were 8 females and 4 males,aged from 30 to 59 years,average 47 years.All the 13 hips were subluxation according to Hartofilakidis classification system.Posterolateral approach was used during operation and all the acetabular cups were reconstructed at the true acetabular location.The pronthesis were cementless acetabular cup and cement femoral head.[Result]The average operation time was 110 min,blood loss volume was 387 ml during operation,drainage volume was 200 ml and the extremity was lengthened for about 9 mm.All the incision healed well and there have not any complications such as femoral neck fracture,infection,dislocation and neurovascular injury.Follow-up for 12 to 13 months,all the joints had good or excellent clinical results.The average range of motion of the hip:flexion improved from 106.7? to 120?,abduction improved from 25.8? to 46.4?,external rotation improved from 20.8? to 45?,internal rotation improved from 3.3? to 28.6?.The Harris score increased from 42 preoperatively to 96 postoperatively.Radiographically,the positions of the prostheses were normal,the average abduction angle of the cup was 39?,the average stem-shaft angle wes 141?,the positions of acetabular rotation centre were moved down and medially for average 9 mm and 11.5 mm respectively,the acetabular superolateral bone coverage of the hips was 89.5%,no radiolucent line was observed.[Conclusion]Total hip resurfacing arthroplasty has got good short-term results in the treatment of osteoarthritis secondary to dysplastic hip.Because of the less quantity and short follow-up time,the long-term results and indications for other kinds of dysplastic hip are worthy of further studying.

Objective To summarize the experiences of total hip replacement in the treatment of osteoarthritis secondary to congenital dislocation of hip in adults. Methods From April 1998 to April 2000, fourteen hips in nine adult patients with osteoarthritis secondary to congenital dislocation of hip undergone total hip replacement were included in this study. There were seven females and two males. The age of the patients at surgery ranged from 27-53 years (mean, 45.56 years). Five patients underwent bilateral total hip replacements and 4 had unilateral total hip replacement. Results The incision healed smoothly. The duration of follow up ranged from 6 months to 2 years. All the patients could walk independently after the surgery. They could take care of themselves and restored to previous job. The average Harris score was increased from 33.93 to 89.21 points after the surgery. Conclusion Total hip replacement is an effective method in the treatment of osteoarthritis secondary to congenital dislocation of hip in adults. The four special problems encountered in the procedure such as the position of the acetabular component, the implantation of the femoral stem, the reconstruction of the abductor power, and correction of the leg length discrepancies should be considered. It is a challenging work to the orthopaedic surgeon and the careful preoperative planning is recommended.

Objective To seek the factors affecting distortion product otoac oustic emisson in newborn hearing screening. Methods All newborns in our hospital received hearing sc reening by DPOAE and wer e investigated for the factors such as: birth history, pregnancy history, family history, the social position of the family. All data were analysed by SPSS. Results 82.8%(3 242/3 944) newborns passed the hearing sc reening. Pass rates were h igher in right ears, female baby, monocyesis, normal or high birth weight and fo rceps delivery. The Results of the first hearing screening were correlated with birth weight,sex and fetus number by logistic regression. Conclusion The factors suc h as sex, ways of labor, fetus number, fetus age, and birth weight can affect t he results of first hearing screening significantly.

Objective To analyze the specific peptide of cystatin C (CysC) and its characteristics by bioinformatics technology,and verify the predicted results by mass spectrometry.Methods Online software was applied to analyze the physicochemical properties and homology of CysC peptides hydrolyzed by trypsin and predict the associated parameters of ionized fragmentation of specific peptide by mass spectrometry.Precursor ion scan and product ion scan were conducted on the samples of synthetic specific peptide.The recombinant human CysC and serum samples were analyzed by mass spectrometry after trypsin digestion.The results of analysis were compared with the outcomes predicted by bioinformatics.Results T3 (ALDFAVGEYNK) was considered as the specific peptide of CysC by software analysis.When selecting[M + 2H] 2 + for product ion scan,almost all the y and b ions of fragmentation were observed using tandem mass spectrometry (MS/MS),showing consistency with Skyline predictions.Moreover,both the peptides from the human recombinant CysC and serum sample following the trypsin digestion were eluted at the same time with the isotope-labeled T3 * under the fixed conditions.Conclusion Bioinformatics technology could be available for picking out the specific peptides of target protein quickly and efficiently and predicting the ionized fragmentation precisely by mass spectrometry scanning.

Automobile Driving ; China ; Humans ; Seat Belts ; utilization

Objective To retrospectively analyze the short-term clinical effects of the two-stage cementless total hip arthroplasty in the treatment of chronic infection after the internal fixation of the adult proximal femoral fracture.Methods From June 2006 to June 2011,9 patients who had suffered a chronic infection after an internal fixation of the proximal femoral fracture,including 8 males and 1 female,aged from 31 to 74 years (average,52.6 years),were treated with two-stage cementless total hip arthroplasty.There were 3 cases of femoral neck fracture,and 6 cases of intertrochanteric fracture.In the first stage,after surgical debridement and thorough removal of all the implants,an antibiotic-loaded cement spacer was implanted.All patients postoperatively underwent intravenous and oral antibiotics,and the erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) were tested.When the values of ESR and CRP become normal,the second stage operation using cementless components was performed.Results The presence of infection was confirmed by a positive culture of joint fluid obtained intraoperatively in two cases;one case was staphylococcus aureus and another one was staphylococcus epidermidis.The second stage arthroplasty was performed 6-14 months (average,9 months) after the first stage operation.All 9 patients were followed up for an average of 23.2 months (range,6 to 50 months).No recurrent infection,component loosening,bone osteolysis and cement spacer or component dislocation occurred.The Harris score improved from 74.6 (range,64 to 86) before the first stage operation to 90.9 (range,86 to 97) at the final follow-up.Conclusion The two-stage cementless total hip arthroplasty is an effective strategy for the treatment of chronic infection after the internal fixation of the adult proximal femoral fracture.