BACKGROUND:There are many studies on the establishment of animal models of femoral head necrosis, but it is difficult to simulate an ideal animal model of femoral head necrosis, especialy colapse models. OBJECTIVE: To establish femoral head necrosis model of double-foot large bird emu so as to simulate femoral head necrosis in human. METHODS: A total of 30 adult emus were frozen in liquid nitrogen and received radiofrequency heating alternately to simulate femoral head necrosis models. After 3 cycles of freezing, local frozen in liquid nitrogen and method of radiofrequency heating was alternated for closed loop liquid nitrogen freezing injury and radiofrequency heating injury. At 6, 12 and 16 weeks after model establishment, gross observation, X-ray, histology examination and MRI were conducted. Effects of model induction of avascular necrosis of the femoral head were evaluated. RESULTS AND CONCLUSION: After liquid nitrogen cold-hot alternating method, emu at 12-18 weeks gradualy suffered from femoral head necrosis signs and imaging findings. X-ray films, histological examination and MRI examination showed the avascular necrosis of femoral head was consistent with the pathological process of human femoral head necrosis, and the model had good repeatability. These results indicate that the use of liquid nitrogen cold-hot alternating method has successfuly established the model of femoral head necrosis, with a goodcolapse rate, and can be used for mechanism research and treatment evaluation of osteonecrosis.

Objective To detect and analysis on serum infectious indicators in patients before receiving blood transfusion .Meth‐ods 5 790 patients admitted to the hospital from June 2012 to April 2015 to be treated with blood transfusion were enrolled in the study and underwent detections of various infectious indicators ,including Hepatitis B surface antigen(HBsAg) ,anti hepatitis C vi‐rus antibody(anti‐HCV) ,anti human immunodeficiency virus antibody (anti‐HIV) and anti syphilis helicoid antibody (anti‐TP) . The positive rate of infectious indicators in 5 790 cases of blood transfusion before transfusion ,the positive rate of infectious indica‐tors in different departments and the positive rate of infectious indicators in patients of different gender were calculated .Results The positive rate of HBsAg was the highest ,which was 18 .2% .The positive rate of anti‐HIV was the lowest ,which was only 0 .26% .In obstetrics and gynecology department ,the positive rate of HBsAg and anti‐HIV were the highest ,and the positive rate of anti‐HCV and anti‐TP were basically the same in each department .The positive rate of HBsAg ,anti‐HCV ,anti‐HIV and anti‐TP in male blood recipients before transfusion were higher than that of female ,the difference was statistically significant(P<0 .05) . Conclusion It is very necessary to detect the serum infectious indicators in blood recipients before blood transfusion ,which can ef‐fectively block the spread of infectious diseases such as hepatitis ,AIDS ,syphilis and so on and protect blood recipients and medical workers .

In total knee arthroplasty, perioperative analgesia is transforming into multimodal analgesia.As a significantly important part of fast track surgery ( FTS ) protocol, perioperative analgesia does affect the recovery of patients.We reviewed the advantages and disadvantages of perioperative ( pre-operative, intra-operative and post-operative ) analgesia in FTS protocols in total knee arthroplasty, including the latest progress of the field.

Non-coding RNAs that can not encoding RNA protein,mainly include microRNAs and long non-coding RNAs,in bacteria,fungi,mammals,and many other biological activities life play a very wide range of regulatory role.More and more clinical researchers have begun to pay attention to the biological function of the non-coding RNAs and the relationship between the various diseases of the body,and people gradually realized that the study of non-coding RNAs has important significance for understanding human disease control and biological evolution.

OBJECTIVE: To analyze the highly cited papers in China Pharmacy so as to provide reference for drug research and application in China.METHODS: A bibliometric analysis was conducted to study the highly cited papers in China Pharmacy from 1990 to 2008 using Chinese Journal Full-Text Database(CJFD) and Chinese Science Citation Database(CSCD).RESULTS: Of all those papers,32 papers had a citation frequency of 30,being highly cited 2 to 6 years after their publication.349 papers had a citation frequency of 10,and their publishing time was mainly from 1996 to 2005.These highly-cited papers were mostly related to hospital pharmacy,followed by pharmacy administration and pharmaceutics as well as review articles.CONCLUSIONS: The focuses and hot topics of present pharmacy research in China Pharmacy were rational drug use,pharmaceutical care,the methodology and application of pharmacoeconomics etc.

OBJECTIVE:To investigate the characteristics and regularity of ADR induced by gefitinib. METHODS:31 cases of ADR induced by gefitinib in 23 pieces of literatures collected from domestic medical academic periodicals during 2004～2008 were analyzed retrospectively. RESULTS:Of total 31 cases of ADR,29.03% were occurred in 61～70 aged patients; lesion of skin and its appendants were caused by ADR in 8 cases (25.81%); 10 cases represented as digestive system injury (32.26%),6 cases as interstitial pneumonia (19.35%); 30 cases occurred during medication period,about 30% occurred within 10 days of medication; 3 patients were dead from interstitial pneumonia. CONCLUSION:It is necessary to pay attention to ADR induced by gefitinib in the clinic and strengthen clinical observation during medication in order to reduce the incidence of serious ADR.

In the 21st century,with the rapid economic development and increasing social aging levels in China,there is an increasingly urgent need to construct a correspondent cultural pattern of elderly hospice care.In this paper,the elderly hospice care cultural patterns are researched on spiritual care,the arts and aesthetics care,family ethics care and social care as well as religious concern,etc.

Objective To evaluate the effect of dexmedetomidine on p38 mitogen -activated protein kinase (p38MAPK)signaling pathways in ventilator -induced lung injury of rats.Methods 100 SD rats were divided into 5 groups(n =20)by random number table.The control group(Group C),mechanical ventilation(Group H)and different dosage of dexmedetomidine group (Group DEX1 -3 ).Group C:no mechanical ventilation with natural breathing air for 4h;Group H:high tidal volume ventilation for 4H,inhaled oxygen concentration was 21%;Group DEX1 -3:20min before mechanical ventilation,infusion of dexmedetomidine(0.5,1.0,and 2.0μg/kg)with loading dose (5mL,0.5,1.0,and 2.0μg·kg -1 ·h -1 )for 4 hours.Femoral arterial blood were collected after mechanical ventilation for 1h,2h and 4h(T1 -4 )in basic status,the arterial blood gas and the PaO2 were analysized and recorded. concentration of total protein,TNF -αand macrophage inflammatory protein -2(MIP -2)in bronchoalveolarlavage fluid(BALF)were detected in rats after ventilation for 4h;myeloperoxidase(MPO)activity in lung tissue was deter-mined;intercellular adhesion molecule -1(ICAM-1)expression and lung wet/dry weight(w/d)ratio were detected;p -p38MAPK protein expression was detected by Western blot;pathological changes of lung tissue in each group and cell apoptosis were observated.Results Compared with the group C,expression of P -p38MAPK(5.4 ±0.5)and p38MAPK/p -p38MAPK(1.64 ±0.17)increased in Group H(F =3.22,3.28,all P <0.05),accompanied by the increased expression of CAM-1 in lung tissue,MPO activity,total protein,TNF -αand MIP -2 concentration in the BALF[(6.4 ±1.1),(1.95 ±0.16)U /g,(1 459.39 ±0.29)mg/L,(182 ±9)ng/L,(436 ±31)ng/L](F =3.53, 3.66,3.21,3.32,3.43,all P <0.05);.And compared with group H,expression of p -p38MAPK and p38MAPK/p -p38MAPK in DEX2 groups and DEX3 fell(F =3.22,3.28,all P <0.05)accompanied by decreased expression of CAM-1 in lung tissue,MPO activity,total protein,TNF -a and MIP -2 concentration in the BALF(F =3.53,3.66, 3.21,3.32,3.43,all P <0.05).Compared with the group H,PaO2 at each point showed no statistically significant difference in group DEX1 -3(F =1.43,P >0.05),and no significant difference of W/D in group DEX 2 ~3(F =2.89,P >0.05 ).Heavy pathological damage of lung tissue and significant apoptosis were observed in group H. Conclusion Dexmedetomidine can inhibit the development of ventilator -associated lung injury.The mechanism may associated with the inhibition of phosphorylation of p38MAPK,thereby inhibiting the expression of downstream inflam-matory factors.

In 2016, American Association of Clinical Endocrinologists(AACE) published the guidelines for obesity and defined obesity as an adiposity-based chronic disease and obesity should be managed according to the obesity-related complications (16 complications are listed). Obesity intervention should be transferred from the purpose of weight loss to the intervention of metabolic disorder and its complications. The diagnosis and intervention of obesity in this guideline is sub- classified focus on the gender, region, and combined diseases, which is with more practical and scientific significances. This interpretation is expected to help the professional medical staffs to understand the new strategy in obesity therapy and to combine with the real world and clinical experience. New suggestions should put forward and improve the theories.

Objective To analyze the causes of postoperative lung infections in patients with pefitonectomy and give preventive strategy.Methods The clinical data of 54 patients with postoperative lung infectiom who were performed peritonectomy in our hospital were retrospectively analyzed.Results 54 case8 were analyzed.Of those cases,39 cases were male and 15 female,the average age was 65.4 years,below 60 years wag 13 cases,and others were over 60 years.The mean hospitalization time wag 17.4 days.Patients performed binary tract system operation wag 17,gagtrocnteric system 23,and inguinal hernia 14.Before operation,the patients accompanied with chronic cardiopulmonary disease were 33,gastroenteric tubing 28,radiotherapy/chemotherapy treated 5 and tracheal intubation 3.Condusion The most dangerous factors for postoperative lung infections in elderly inguinal hernia included elder age,chronic cardio and pulmonary primary diseases,preoperative radiotherapy and/or chemotherapy,gagtrocnteric tubing,and trachea/intubafion.Preoperative active treatment with chronic eardio and pulmonary primary diseases,strengthen nutrition and surpport therapy,reduce the chance of gastroenteric tubing,and tracheal intubation are effective for preven-ting postoperafive lung infections in abdominal operations.