Objective To explore the curative effect of dynamic hip screw(DHS) and proximal femoral nail (PFN)in treatment of intertrochanteric fractures. Methods Dynamic hip screw(DHS) group is A group:30 patients, proximal femoral nail( PFN) group is B group:30 patients. In the respect of the average length of the incision, operation time,blood loss,X-ray exposure times,postoperative drainage volume,blood transfusion volume,antibiotics usage time,hospitalization time,postoperative ambulation time,healing time of fracture,criteria of Harris hip function score after half a year,complication rate,this paper made the comparative analysis of clinical efficacy and statistical analysis between the two groups. Results 60 patients were followed up for 9 months to 4 years, with the average of 2 years and 3 months and no death. The average length of the incision, operation time, blood loss, X-ray exposure times, postoperative drainage volume,blood transfusion volume, DHS group were( 13. 4 ± 1. 9) cm, (92. 8 ± 13. 0) min, (321.0±39.4)ml,(5. 8 ± 1.2)times, (84.1 ± 10. 1)ml, (316.6 ±79. 1 )ml;PFN group were(7.6 ± 1.1 )cm,(59. 0±6. 9)min, (204. 6 ±32. 7) ml, (5.0 ±0.9) times, (53. 9 ± 8. 7) ml, ( 196. 6 ± 18. 2) ml; the differences between two groups were statistically significant ( all P ＜ 0. 05 ) . Hospitalization time, postoperative ambulation time, healing time of fracture,DHS group were(6.2±3.7)d,(17.8±1.8)d,(69. 8 ± 12. 3)d, (13. 0 ± 1. 6) weeks,PFN group were(4.7 ±2. 6)d,( 16.0 ±2. 2)d, (46.9 ±4. 9)d, (11. 3 ±0.7) weeks, the difference was statistically significant (all P＜0. 05). Antibiotic use of time,hip function(Harris score standard)excellent and good rate after half a year, there's no significant difference between the two groups( all P ＞ 0. 05). Complication rate, DHS group:40% ; PFN group: 10%. The difference was statistically significant (P ＜ 0. 05). Conclusion Intertrochanteric fracture fixation PFN group had an advantage of smaller surgical trauma,less bleeding,shorter healing time,more rapid postoperative recovery,lower complication rate and other characteristics comparing with the DHS group. So it was worth being recommended for a wider use.

OBJECTIVE:To systematically review the efficacy and safety of misoprostol combined with 10% Calcium gluco-nate injection in the treatment of postpartum hemorrhage,and provide evidence-based reference for the clinical treatment. METH-ODS:Retrieved from PubMed,EMBase,Ovid,CBM,CJFD and VIP,randomized controlled trials (RCT) about misoprostol combined with 10% Calcium gluconate injection (test group) versus conventional oxytocin in the treatment of postpartum hemor-rhage were collected. Meta-analysis was performed by using Rev Man 5.2 software after data extract and quality evaluation by Co-chrane systematic review manual 5.1.0. RESULTS:Totally 7 RCTs were enrolled,involving 1254 pregnant women. Results of Me-ta-analysis showed,compared with conventional oxytocin,misoprostol combined with 10% Calcium gluconate injection can signifi-cantly reduce 2 h postpartum hemorrhage [MD=-76.76,95%CI(-105.73,-47.79),P<0.001],24 h postpartum hemorrhage [MD=-118.28,95%CI(-167.78,-68.78),P<0.001] and the incidence of postpartum hemorrhage [OR=0.19,95%CI(0.08, 0.46),P<0.001],and shorten the 3rd delivery process [MD=-3.52,95%CI(-4.20,-2.84),P<0.001],the differences were sta-tistically significant;there was no significant difference in the intraoperative hemorrhage [MD=-61.31,95%CI(-121.98,-0.64), P=0.05] and neonatal 1 min Apgar score [MD=0.10,95%CI(-0.38,0.59),P=0.67] in 2 groups. The incidences of chest dis-tress,breathlessness and stomach discomfort in test group were significantly higher than control group [OR=18,95%CI(2.42, 133.98),P=0.005],but it was mild,and there was no significant difference in the incidence of fver,chills and nausea,vomiting, diarrhea and other adverse reactions. CONCLUSIONS:Both the efficacy and safety of misoprostol combined with 10% Calcium gluconate injection in the treatment of postpartum hemorrhage are good. Due to low quality and small-scale of included studies, more large-scale and long-term follow-up studies with strict designed are required for further validation of the conclusions.

BACKGROUND: Knee arthroplasty can correct the joint deformity, alleviate the pain and improve the joint function,thereby improving the patients' quality of life. Early rehabilitative training is the key to the functional recovery of the joint.OBJECTIVE: To observe the clinical effectiveness of early gait training on the rehabilitation of patients after knee arthroplasty.METHODS: Eighty-six cases undergoing unilateral knee arthroplasty in the Department of Sports Medicine were selected and randomly divided into experimental and control groups (n=43 per group). The experimental group wasgiven rehabilitation instruction before operation, and the gait training was carried out just after the operation. The patients in the control group only received the basic rehabilitation training. The Visual Analogue Scale and the Hospital for Special Surgery scores were evaluated at baseline and 2, 4, and 8 weeks, and 6 months postoperatively, and the clinical effectiveness was compared between two groups.RESULTS AND CONCLUSION: (1) The range of motion of the knee in the experimental group was significantly higher than that in the control group at 4 and 8 weeks, and 6 months postoperatively (P < 0.05). (2) At 8 weeks and 6 months postoperatively, the Visual Analogue Scale scores in the two groups both were significantly decreased (P < 0.05). (3) At 2 weeks postoperatively, the Hospital for Special Surgery scores in both groups were significantly increased (P < 0.05);the scores at 8 weeks postoperatively in the experimental group were higher than those in the control group (P > 0.05);the scores at 6 months postoperatively in the experimental group were significantly higher than those in the control group (P < 0.05). (4) These findings suggest that compared with conventional training, early gaiting training can significantly improve the range of motion and pain of the knee, as well as enhance the functional recovery of the knee joint, which exhibits remarkable curative efficacy in the rehabilitation following knee arthroplasty.

Adult ; Antilymphocyte Serum ; therapeutic use ; Female ; Graft vs Host Disease ; prevention & control ; Hematopoietic Stem Cell Mobilization ; methods ; Humans ; Immunosuppressive Agents ; therapeutic use ; Male ; Middle Aged ; Transplantation Conditioning ; methods ; Vidarabine ; analogs & derivatives ; therapeutic use

Objective To systematically evaluate the efficacy and safety of intracoronary abciximab administration as compared to intravenous in percutaneous coronary intervention (PCI) .Methods A search was conducted in PubMed ,EMBASE ,OVID ,CBM , CNKI and VIP for the randomized controlled trials (RCTs)of intracoronary abciximab administration versus intravenous in PCI , from the date of their establishment to September 30 ,2013 ,and the domestic relevant papers published in recent 1 year were also searched manually ,the bibliographies of the included studies were searched too .According to the criteria of the cochrane Hand-book ,two reviewers evaluated the quality of the included RCTs and extracted data independently ,and then the extracted data were analyzed by using RevMan 5 .1 software .Results 8 RCTs involving 10 articles with 4 150 patients who treated with PCI were in-cluded .The results of meta-analysis showed that :(1) Compared intravenous administration and intracoronary abciximab administra-tion ,there were no significant differences in the two groups for the major adverse cardiovascular event (MACE) and the mortality (OR=0 .78 ,95% CI 0 .54-1 .14 ,P=0 .20) ,(OR=0 .56 ,95% CI 0 .24-1 .30 ,P=0 .18) .(2)Compared with intravenous adminis-tration ,intracoronary abciximab administration were not associated with any excess of major bleeding complications :(OR=1 .26 , 95% CI 0 .78-2 .02 ,P=0 .35) .Conclusion Compared with standard abciximab regimen of intravenous bolus ,intracoronary admin-istration had equivalent effects in clinical outcomes in patients undergoing PCI ,and did not increase the incidence of bleeding events .

ObjectiveTo evaluate the efficacy of preoperative oral pregabalin for attenuating postoperative pain after laparoscopic cholecystectomy.MethodsIn this prospective,randomized controlled double-blind study,sixty ASA Ⅰ or Ⅱ patients aged 19-72 yr weighing 46-86 kg undergoing laparoscopic cholecystectomy were randomly divided into 2 groups ( n =30 each):control group (group C) received placebo,and pregabalin group (group P) received oral pregabalin 150 mg 1 h before surgery.Anesthesia was induced with propofol,fentanyl and rocuronium and maintained with sevoflurane inhalation and intermittent iv boluses of fentanyl and rocuronium.The patients were intubated and mechanically ventilated.BIS value was maintained at 40-50 during operation.Static and dynamic VAS score,Ramsay score and consumption of morphine were recorded at 6,12,and 24 h after surgery.Side-effects including nausea,vomiting,headache and dizziness were also recorded.ResultsStatic and dynamic VAS scores and morphine consumption were significantly lower during the first 24 h after surgery while Ramsay scores were higher at 6 h after operation in group P than in group C.There was no significant difference in the incidence of side-effects between the 2 groups.No over-sedation occurred in group P.ConclusionPreoperative oral pregabalin 150 mg is safe and effective in reducing postoperative pain after laparoscopic cholecystectomy.

Objective To realize job satisfaction of doctors from the secondary hospital and its influencing factors and put forward countermeasures for doctor job satisfaction.Methods 2066 doctors from the secondary hospital were investigated by self-made scale,and analyzed by analysis of variance,non-conditional logistic regression analysis and other methods.Results The average score of total job satisfaction of doctors was (3.44±0.95),in which about 57.6% of doctors expressed satisfaction with the current work.The scale of job itself satisfaction had the hisheet score,that was (3.91±0.79),while the scale of job retum satisfaction had the lowest score,that was (2.85±1.16).Leadership behavior played the most decisive role in doctors job satisfaction(sβ=0.7,P<0.01).Condusion The total job satisfaction of secondary hospital doctors is just above the average and doctors are most dissatisfied with the work concentrated in the areas of return and the practice environment.

Indoleamine 2,3-dioxygenase 1 (IDO1) is the rate-limiting enzyme in the degradation of tryptophan to kynurenine. IDO1 is highly expressed in some tumor tissues. IDO1 can deplete tryptophan in tumor microenvironment, inhibit T cell function, and mediate the immune escape of tumor cells. Thus, IDO1 is considered a potential target of tumor immunotherapy. Currently, there are several IDO1 inhibitors in clinical research studies. The mechanism of IDO1-mediated tumor immune escape and the structure of IDO1 inhibitors are summarized in this review.

Environmental Monitoring ; Humans ; Occupational Diseases ; etiology ; prevention & control ; Occupational Health Services ; organization & administration ; Population Surveillance ; methods ; Risk Assessment ; Surveys and Questionnaires ; standards

To obtain ginsenoside Rg1 molecularly imprinted polymer (MIP) separating materials with high selectivity, enrichment and adsorption performance through directional separation of ginsenoside Rg1 and analogues. In this study, MIPs were respectively prepared by precipitation polymerization and surface imprinted polymerization. Their adsorption performances were compared. The results showed that ginsenoside Rg1 MIPs prepared by the above two methods had a high adsorption performance to template molecules, with the maximum apparent adsorbing capacity of up to 27.74, 46. 80 mg x g(-1), respectively. Moreover, MIPs prepared by surface imprinted polymerization showed higher adsorption capacity than that by precipitation polymerization. The experimental results indicated that as for ginsenoside Rg1 with higher polarity, MIPs prepared by surface imprinted polymerization showed higher selectivity and adsorption performance, which provides provide important reference for preparing imprinted polymers with good adsorption performance with active molecules with strong polarity.
Adsorption ; Chemical Fractionation ; methods ; Chemical Precipitation ; Ginsenosides ; chemistry ; isolation & purification ; Molecular Imprinting ; Polymerization ; Polymers ; chemical synthesis