Objective: To investigate the risk factors of deep vein thrombosis after stroke. Methods: A retrospective analysis was made on the 420 cases patients with stroke in our hospital, according to the situation thrombosis were divided into thrombosis group and non-thrombosis group, compared two groups of patients with general information, and many factors with the significant indexes were retrospectively analyzed. Results: Age≥70 years old, bedridden, Wells score≥2 points lower limb NHSS score≥3, anticoagulant therapy, higher admission D-2 dimer, lower BI score and non-rehabilitation therapy were independent risk factor for stroke in patients with acute DVT. Age≥70 years old, bedridden, leg NHSS score≥3 points, the acute stage of DVT and BI score were the independent risk factor for stroke patients follow-up period of DVT. Conclusion:There are many related risk factors for stroke in patients with deep vein thrombosis, these factors should be used to carry out monitoring and preventing deep vein thrombosis, active rehabilitation and anticoagulant therapy should be taken to improve the prognosis of patients with stroke.

Cardiomyopathy, Dilated ; genetics ; Genotype ; Humans ; Mutation

The aim of the study was to establish the clinical method for the detection of the human serum antibodies reacting to the membranous labyrinth protein using the Western immunoblotting labeled with boition streptavidin. Different control experiments were conducted, which included the human serum empty control, the biotin labeled antibody empty control, the avidin blocking control, the serum control of patient with autoimmune sensorineural hearing loss and that of patient with autoimmune disease. By comparing the different expressions in these experiments, it was suggested that the reacting band at 65kD, and the dark reacting bands at 82kD or within 56~48kD or 33~30kD should be identified as positive reaction of the human serum antibodies to the membranous labyrinth protein. The positive rates of 65kD were 30.4%~82.6% with the confidence intervals of 95%, and 23.8%~87.0% with the confidence intervals of 99%. The confidence intervals were 18%~72% and 13.4%~77.6% respectively, for 95% and 99% positive rates of the latter 3 bands combined. The reacting bands at 134kD and 70kD indicated affinity to avidin and streptavidin, which did not relate to positive reaction.

BACKGROUND:Exchange nailing has been reported to be a very good method for metaphyseal nonunion after femoral shaft fracture treated with intramedul ary nail. However, the effect of intramedul ary nail exchanging is not ideal for the treatment of nonisthmal femoral shaft nonunions.
OBJECTIVE: To compare the clinical and imaging outcomes between intramedul ary nail exchanging and intramedul ary nail retention plus augmentation plating for the treatment of nonisthmal femoral shaft nonunions.
METHODS:The clinical data of 39 patients with nonisthmal nonunions of femoral shaft fractures after failure of intramedul ary nail were retrospectively analyzed, and 21 patients were treated with intramedul ary nail exchanging and 18 patients were treated with intramedul ary nail retention plus augmentation plating. Clinical therapeutic effect was evaluated by Tohner-Wrnch standard.
RESULTS AND CONCLUSION:Al cases were fol owed-up for more than 15 months. In the intramedul ary nail exchanging group, postoperative internal fixator loosening occurred in three cases who obtained bony union by intramedul ary nail retention plus augmentation plating combined with autogenous iliac bone graft. The fixation time, blood loss, volume for suspended red blood cel s transfusion, hospitalization costs and re-operation rate in the intramedul ary nail retention plus augmentation plating group were lower than that in the intramedullary nail exchanging group (P<0.05). Al the patients in two groups obtained bony union, and the clinical and radiographic healing time in the intramedul ary nail exchanging group were longer than those in the intramedul ary nail retention plus augmentation plating group (P<0.05);according to Tohner-Wrnch standard at final fol ow-up, excel ent in 10 cases, good in six cases and poor in five cases in the intramedul ary nail exchanging group, and the excel ent and good rate was 76%;in the intramedul ary nail retention plus augmentation plating group, there were 11 cases of excel ent and seven cases of good, and the excel ent and good rate was 100%;there was significant difference between two groups (P<0.05). Due to relatively simpler manipulation, shorter fixation time, less intraoperative blood loss, slighter trauma, less hospitalization cost, lower re-operation rate and more satisfactory therapeutic effect, intramedul ary nail retention plus augmentation plating combined with autogenous iliac bone graft has been a better method for the treatment of nonisthmal nonunions of femoral shaft fractures after failure of intramedul ary nailing when compared with intramedul ary nail exchanging.

BACKGROUND: Metal-on-metal hip surface arthroplasty has improved the abradability for hip joint prosthesis and has the characteristics of normal biological stress transfer.OBJECTIVE: To observe the long-term state of hip-joint function of patients who underwent metal-on-metal hip surface arthroplasty.DESIGN: Follow-up study for cases.SETTING: Department of Orthopaedics, Jiangsu Provincial Corps Hospital of the Chinese People's Armed Police Force; Department of Orthopaedics, Affiliated Hospital of Nantong University.PARTICIPANTS: Eighteen cases (23 hips) who underwent a metal-on-metal hip surface arthroplastyprocedure in the Department of Orthopaedics, Jiangsu Provincial Corps Hospital of the Chinese People's Armed Police Force, and Department of Orthopaedics, Affiliated Hospital of Nantong University between September 2004 and July 2005 were recruited in this study. All cases, aged 28 to 54 years, include 11 males and 7 females. According to the classification of etiology, there were 13 cases of osteonecrosis(16 hips),3 cases of osteoarthritis( 4 hips ),1 case of congenital hip dysplasia (2 hips) and 1 case of posterior trauma arthritis(1 hip ). All cases applied the Conserve Plus resurfacing prosthesis (manufactured by Wright Medical Technology, USA), of which the pattern number of acetabular cup (press-fit depth: 1-2 mm) ranged from 38 mm to 56 mm in the inner diameter and from 44 mm to 62 mm in the outer diameter and that of femoral head cup ranged from 38 mm to 56 mm in the outer diameter. Preoperatively all patients signed the informed consent for the surgery, and the application of this technique also gave the approval of the Ethics Committee of the hospital.METHODS: ①After the epidural and lumbar combination anesthesia was satisfactory, the coxacava was exposed at first and the suitable size acetabular cup coated by hydroxyapatite ceramic was selected to be implanted, to be tightened and to be fixed by press-fit referring to the anatomical position. Subsequently to install the femoral head prosthesis, femoral cup was laid on the ready caput femoris and impacted by the presser to make the metal cup paste close-up with sclerotin when the concocted bone cement was overlaid on the prefabricated caput femoris surface and internal surface of prosthesis. Further, short-term of femoral cup should be kept the conformity with axial ray of the femoral neck. ②Patients were allowed to make the function exercise such as initiative stretch and contract of quadriceps muscle of thigh, passive motion of the knee joint and initiative motion of the knee joint under the non-weight loading on bed. Then they were encouraged to walk with two walking sticks two weeks after operation, progressing to get out of the two walking sticks six weeks postoperatively. All affected extremities were fixated with T-shaped tabula shoes in the abduction position after operation. ③All patients were reviewed with taking the anteroposterior radiographs of pelvis, evaluation of the clinically curative effect on the procedure of metal-on-metal hip surface arthroplasty and biocompatibility between the prosthesis and the host one year and two years after operation. Moreover, Harris score was assessed for all affected hips preoperatively, one year and two years postoperatively.MAIN OUTCOME MEASURES: ①The clinically curative effect on metal on metal hip surface arthroplasty; ②Biocompatibility;③The Harris score for the affected hips; ④The pain status of hip after operation.RESULTS: Eighteen cases were all brought into the outcome analysis at last.①The curative effect on the metal-on-metal hip surface arthroplasty: The femoral component of one case had a varus deformation of 10°six weeks after operation, but such complications as component loosening and femoral neck fractures, etc. Did not occur during the coming follow-up. The locations of rest prosthesis were satisfactory. Substantial radiolucencies were found at the rim of acetabular component (1 and 2 zone) in two hips, respectively one and two years after operation. But there was no evidence of radiolucencies around the short-stem of femoral component.②Biocompatibility: No patients were found to have obvious reactions including renal toxicity, pyretogen and rejection. No radiograph showed signs of loosening, dislocation, heterotopic bone formation, femoral neck narrowing, femoral head necrosis and prosthesis fixation failure, etc.③Harris score for the affected hips: The Harris score of all disease hips was improved from the mean 46 preoperatively to 85 one year after operation to 93 two years postoperatively. Of these,15 hips were excellent(> 90),6 hips good (80-89), and 2 hips fair(70–79).④The pain status of hip after operation: Two patients complained of slight pain, one patient of moderate pain, and no cases of severe pain happened.CONCLUSION: The long-term outcome for hip disease patients who undergo metal-on-metal hip surface arthroplasty is satisfactory.

Objective To investigate the teaching modes of the course of guide to learn in undergraduate nursing students in order to improve their quality of leaning.Methods Questionnaire survey and interview were conducted to collect the students'general appraisal on learning Science and teaching content and teaching modes as well as ingathering and suggestions of the course.Results Totally 79.5%among 117 students thought it necessary to open the course of Learning Science.96.6%students considered ten subjects of the course reasonable.83.8%students were satisfied with the alternate five-teachers'teaching modes.The most digestible teaching approach Was illustration,and the most valuable experience wag how to regulate the psyehology of learning.Conclusions The course of guide to learn in nursing undergraduate education has positive significance.Nursing educators should always explore and improve the teaching mode of this course so as to help students develop SOundly.

Objective To explore the genetic prenatal diagnosis method for acbendroplasia (ACH).Methods During May to November 2007, three ACH pedigrees were diagnosed at the Prenatal Diagnosis Center, Department of Obstetrics and Gynecology, Affiliated Drum Tower Hospital of Medical College, Nanjing University. In family 1, there was a 6-month-old male ACH infant. In family 2, the expectant mother, with 18 weeks of pregnancy, was an ACH patient. Amniocentesis was performed for prenatal diagnosis. The fetus of family 3 was diagnosed as ACH by ultrasound examination on the 39th week of gestation. Umbilical cord blood of this fetus was collected for examination. Totally, three methods, restriction enzyme (Sfc Ⅰ and Msp Ⅰ ) digestion analysis, denaturing high performance liquid chromatography (DHPLC) and sequencing analysis were performed simultaneously to detect the pathogenic mutation of flbroblastic growth factor receptor 3 (FGFR3) for the three ACH families. Results ( 1 ) The DHPLC detection: heteroduplex was detected in the patient of family 1 ; beth the patient and the fetus of family 2 showed heteroduplex results; the result of the fetus of family 3 was also heteroduplea. (2) The enzyme digestion analysis for the PCR products of 10 exon of FGFR3: after Sfc Ⅰ digestion, the PCR products of patients and the fetus of family 1 and 2 showed not only the band of 247 bp, but also bands of 162 bp and 85 bp. But their PCR products could not be digested by Msp Ⅰ , and it only showed the band of 247 bp. For the fetus of family 3, the PCR products could not be digested by Sfc Ⅰ , while after digestion by Msp Ⅰ , bands of 162 bp and 85 bp were shown up. The PCR products of the normal control could be digested by neither Sfc Ⅰ nor Msp Ⅰ. (3) The sequencing results: the heterozygote mutation of 1138 C→A was confirmed in the patient of family 1. The pregnant woman and her fetus in family 2 showed the same result. The heterozygote mutation of C→C was confirmed in the fetus of family 3. The site of 1138 was G homozygote in the normal control The three detection results of the fetus in family 2 were the same as that of the mother, which means that the fetus inherited the same pathogenic mutation from his or her mother. Conclusions Both DHPLC and restriction enzyme digestion analysis could detect the mutation of FGFR3 gene, but DHPLC is more rapid, convenient and sensitive. So DHPLC can be applied to genetic diagnosis and prenatal diagnosis for ACH patients.

Objective Matrix-assisted laser desorption ionization-time of might-mass spectrometry (MALDI-TOF-MS) was utilized to analyze the protein fingerprint in brain-gut interaction of irritable bowel syndrome (IBS) model rats' colon, so as to find the clues for IBS. Methods Fourteen healthy male adult Wistar rats were selected and divided into a control and a chronic and acute stress ( CAS) group. Colon motility, visceral sensation and behavior changes of rats were detected to evaluate the model. MALDI-TOF-MS was used to observe the overall view of protein in colon so as to study whether there are abnormalities of protein levels in IBS. Results As compared with those in the control group, the number of fecal pellets [ (6. 00 ± 1. 69 ) pellets/1 h vs ( 1. 14 ± 0. 69 ) pellets/1 h, P < 0. 01 ] and frequency of abdominal contraction induced by colorectal distention (CRD) increased, while the amount of weight gain [ (298. 88 ± 18.61)gvs (348. 00±12. 44)g, P<0.01] and consumption of sucrose solutions [ (13. 63 ± 1. 69) ml/1 h vs (19.00±3.06) ml/1 h, P<0.05] decreased in the CAS group (P <0. 05). As far as protein/peptide quality different peak was concerned, CAS rats had 12 different peaks compared with the control rats. The different proteins could be divided into 4 types, which were related to iron secretion, protein synthesis, G protein system and immunity. The protein levels of the model group were higher than those in the control group (P < 0. 05). Conclusions The CAS rats integrate the major characteristics of IBS such as altered colon motility, higher visceral hypersensitivity and psychiatric disorder and can mimic the brain-gut interaction of IBS partly. The detection of differential proteins provides reference for the pathogenesis and treatment of IBS.

In this study histochemical method was used. It has been found that on the seventh day after epidural administration of capsaicin substance p like immuno- reactivity (SPAR) in laminae Ⅰ-Ⅱ of dorsal horn of spinal cord decreased obv- iously as compared with that of vehicle treated animals, meanwhile, the activity of fluoride resistant acid phosphatase (FRAP) in both laminae Ⅱ of dorsal horn of spinal cord and the B-type cells of spinal ganglion disappeared. On the cont- rary the Leu-enkephalin immunoreactivity (ENK-IR) in laminae Ⅰ-Ⅲ of dorsal horn of spinal cord apparently increased as compared with that in vehicle group. the evidence from functional measurement showed that capsaicin can raise pain threshold, however, vehicle didnot have obvious influence on pain threshold. The foregoing results suggest that epidural administration of capsaicin in adult rat can effect the level of neurontransmitters, the activity of enzymes and block the con- duction of the primary afferent C fibers; the capsaicin-sensitive C fibers may have relationship with the ENK-containing interneurons in dorsal horn of spinal cord.