OBJECTIVETo explore clinical efficacy and key matters for the treatment of femoral intertrochanteric fracture and integrity of lateral trochanteric wall by proximal frmoral nail antirotation (PFNA).

METHODSFrom June 2010 to December 2012,210 femoral intertrochanteric fracture patients treated with PFNA were retrospectively analyzed, including 76 males and 134 females aged from 46 to 96 years old with an average of 71 years old. All fracture were caused by injury and classified to type I (5 cases) type II (16 cases), type III (73 cases) and type IV (116 cases) according to Evans classification. The time of getting out of bed, postoperative complications and displacement of screw blade and fracture healing were observed, Baumgaertner criteria were used to evaluate quality of fracture reduction, Harris criteria were used to evaulate hip joint function.

RESULTSAll incisions were healed at stage I, no complications occurred except incomplete of lateral trochanteric wall patients without reconstruction, other patients could get out of bed with crutches at one week and all patients discharged from hospital at 10 days after operation. One hundred and seventy-eight patients were followed up from 3 to 17 months with an average of 10 months. One case occurred unhealed fracture displacement caused by screw blade cutting, 2 cases occurred screw blade transfomed to proximal and out femoral head, other patients obtained fracture healing at 12 to 16 weeks after operation. According to Baumgaertner criteria, 130 cases obtained good results, 45 cases acceptable, and 3 poor; while 107 cases obtained excellent results, 65 good, 3 good and 3 poor according to Harris score.

CONCLUSIONPFNA with mechanical advantage of intramedullary fixation has advantsges of stable fixation, shorter operation time, minimally invasive. Satisfied clinical effects could obtained by grasping fixation principle, dealing with negative factors in operation. Intraoperative reconstruction for integrity of lateral trochanteric wall could assure stable fixation and earlier get out of bed.

Aged ; Aged, 80 and over ; Bone Nails ; Female ; Femoral Fractures ; surgery ; Fracture Fixation, Intramedullary ; instrumentation ; methods ; Hip Fractures ; surgery ; Humans ; Male ; Middle Aged ; Retrospective Studies

Objective: To observate the clinical effect of Saffron Multi-glycoside Tablets for cardiac angina belonging to heart blood stasis type. Methods: Saffron Multi-glycoside Tablets were administered orally three times daily, four tablets each time. Results: Not only the degree of heart impediment and chest pain but also attack times and persistent pain changed for the better obviously. The effective rate is 96.67% and the effective rate of ECG is 93.33%, the amelioration rate of Chinese medical symptom is 96.67%. The control group is 72.22%, 66.67% and 69.44%, respectively. There is significant difference between the two groups. Conclusion: There is notable effect to take Saffron Multi-glycoside Tablets for cardiac angina belonging to heart blood stasis type.

Despite different opinions on its definition and classification in the past,a consensus has gradually been reached regarding the na-ming,classification,and clinical diagnosis of liver failure.The classification of liver failure is described,and the definition and natural his-tory of severe exacerbation of hepatitis B are summarized.Antiviral treatment and artificial liver support in the early stage are beneficial for clinical outcomes and prognosis.

Acute Disease ; Cohort Studies ; Humans ; Leukemia ; diagnosis ; Myelodysplastic Syndromes ; diagnosis ; Prognosis

BACKGROUND:Ankylosing spondylitis is an autoimmune disease involved in chronic systemic inflammation. Tumor necrosis factor and interleukin-6 levels increased in patients with ankylosing spondylitis. Inflammatory factors such as tumor necrosis factor and interleukin-6 can suppress CD36 expression in monocytes. OBJECTIVE: To analyze the correlation between CD36 expression in monocytes and ankylosing spondylitis. METHODS:A total of 84 newly diagnosed ankylosing spondylitis patients and 111 healthy individuals were included in this study. CD36 expressions in monocytes in ankylosing spondylitis patients and healthy individuals were tested using flow cytometer; meanwhile, biochemistry, immunology, routine blood examination and related inflammatory markers were determined between the two groups. RESULTS AND CONCLUSION:Results of baseline data in both groups demonstrated that CD36 fluorescence intensity in monocytes was significantly lower in patients with ankylosing spondylitis compared with healthy controls (P < 0.01). CD36 fluorescence intensity in monocytes was negatively correlated with C-reactive protein, erythrocyte sedimentation, interleukin-6 and tumor necrosis factor. In addition, CD36 fluorescence intensity in monocytes was negatively correlated with BASDAI score. Logistic regression analysis showed that erythrocyte sedimentation, interleukin-6, tumor necrosis factor and CD36 fluorescence intensity in monocytes were associated with ankylosing spondylitis, and risk factors for ankylosing spondylitis (P < 0.05). These findings confirm that inflammatory cytokine in patients with ankylosing spondylitis weakened the expression of CD36 in monocytes. There was a remarkable association between low expression of CD36 expression in monocytes and ankylosing spondylitis. CD36 expression of monocytes clinicaly may be considered to be an effective indicator to evaluate inflammation and disease activity in patients with ankylosing spondylitis.

Objective To evaluate the clinical safety and efficacy of Cheatham-Platinum(CP)covered stent in treatment of aortic coarctation.Methods The therapeutic efficacy was retrospectively analyzed in 15 patients with aortic coarctation who were treated by BIB balloon dilation and CP covered stent implantation.Results All patients were well recovered,the stent did not appear displaced,folded,aorta dissection and rupture.The pressure difference was 5-10 mm Hg(1 mm Hg=0.133 kPa)between proximal part and distal end after operation.Following up(20±12)months,the therapy efficacy of all the patients was stable and there was no fracture,removal,aortic stenosis or dysarteriotony.Heart ultrasounds demonstrated good close of the cases with patent ductus arteriosus.Conclusion CP covered stent is a safe and available clinical therapy,featured by minimum aorta injuries.

Objective To determine the accuracy and radiation dose of dual-energy computed tomography (CT) in evaluating solitary pulmonary nodules (SPNs) by virtual non-enhanced images.MethodsSixty-one patients with SPNs including 39 malignant and 18 benign nodules proved by pathology underwent DECT scans. The CT values of SPNs on enhanced weighted average and virtual non-enhanced images were compared by using Liver VNC processing unit in terms of their diagnostic accuracy for distinguishing malignant and benign nodules with a 20 HU threshold. Diagnostic accuracy was compared. In 28 patients of all patients, image noise and quality score of the non-enhanced and virtual non-enhanced images were compared, and radiation doses of each patient were recorded. The paired t test was used to analyze the noise difference between the plain scan and virtual non-enhanced scan. The Mann-Whitney U test was used to analyze statistically significant differences of the image quality score and radiation dose between the non-enhanced scan and virtual non-enhanced scan. ResultsThe sensitivity, specificity and accuracy for distinguishing benign and malignant nodules by using the virtual non-enhanced image of were 89. 7％(35/39), 72.2％ (13/18), 84.2％ (48/57)respectively.The noise of common CT and virtual nonenhanced images were(8. 49 ± 1. 94) HU and( 10. 14 ± 2. 18 ) HU, and there were statistically difference (t＝9.45,P＜0. 01 ). The quality scores of common CT and virtual non-enhanced images were (4.71 ±0. 46 ) and ( 4.42 ± 0. 57 ), and there were no statistical difference ( U ＝ 290. 00, P ＞ 0. 05 ). The radiation doses of common CT and DECT were ( 3. 72 ± 0. 48 ) mSv and ( 3.78 ± 0. 45 ) mSv, and there were no statistical difference ( U ＝ 350. 50,P ＞ 0. 05 ). ConclusionDECT by using virtual non-enhanced images is useful tool to distinguish the benign and malignant SPN without additional radiation dose.

Objective To evaluate the therapeutic and adverse effects of metallic intratracheal stent placement in relapsing polychondritis with severe tracheobronchial malacia.Methods Five tracheal stents had been implanted in three patients with traeheobronchial malacia.One patient was implanted with two tubular steuts in trachea and one“Y”shaped stent for bilateral bronchi.Another patient used a tubular stent in total tracheal segment.The last patient used a tubular stent in the upper segment of trachea.Results All the stents were implanted successfully with obvious improvement of dyspnea after the treatment. Conclusions Metallic intratracheal stent placement can really relieve symptoms and improve the life quality in patients with tracheobronchial malacia caused by relapsing polychondritis.

Objective:To investigate the diagnostic value of high resolution CT for temporal bone traumatic facial nerve paralysis and the guidance significance for surgery.Method:Twenty-nine patients of traumatic facial nerve paralysis were investigated.The predictive diagnosis was made according to the clinical data and the image features of HRCT,then a comparative analysis of the preoperative image features and the surgical findings were carried out.Result:The trend of temporal bone fracture displayed on the CT scan was basically consisted with the surgical findings.The direct CT signs of facial nerve injury include the bone fracture line went through the tube,bone tube rupture or continuity interruption,while the indirect CT signs include local incrassation of the facial nerve,lower bone density of the tube,geniculate fossa expansion,oppressed facial nerve,et al.The predictive diagnostic accordance rates of all the image features were above 90%as to the surgical findings.Conclusion:High resolution CT could localize the trend of temporal bone fracture,and is helpful to estimate the extent of facial nerve injury and other complications.High resolution CT could provide reliable basis for clinical diagnosis and trotment.

Objective To evaluate the effect of convalescent training on patients after special prosthesis replacement in treatment of giant cell tumors. Methods 20 patients with giant cell tumors were treated with convalescent trainings postoperatively,including trainings of muscle strength,joint movement, balance, noumenal sense and gait and were emphasized for earlier training of active muscle contraction. Results According to Enneking score system of bone and muscle postoperation, the lowest for extremitas superior postoperation score of 5 patiens was 20,the highest was 28, the average was 26.6. 4 patiens score was higher than 24, the good rate was 80.0 %.15 patiens extremitas inferior score was from 14 to 27, the average was 21.5, the good rate was 86.7 %. Conclusion Earlier staged joint functional rehabilitation exercise after special prosthesis replacement in treatment of giant cell tumors could prevent ankylosis,improve adhering of capsule,ligament and other soft tissue,and recover the joint function to maximum.