Objective To study the effect of operative timing on clinical outcomes in elderly hip fracture. Methods Two hundred sixty-seven patients with hip fracture were treated from July 2006 to May 2008. The patients who had an operation within two days (the early surgery group) were compared with the outcome for those who had an operation more than two days (the later surgery group). Outcomes measured were mortality, post-operative complications, operative details, the comorbidity and the activities of daily living of patients. Results One hundred and sixteen patients were included in the study. There were 45 cases in the early surgery group, including 13 males and 32 females. The patients ranged from sixty-five to eightyeight years old, with an average age of 78.76 years. While there were 71 patients in the late surgery group,including 24 males and 47 females. The patients ranged from sixty-six to one hundred and three years old,with an average age of 80.00 years. The demographic data of patients show no significant difference in two groups. There was no difference in intraoperative conditions such as anesthesia, amount of bleeding, type of fixation between two groups. Patients in early surgery group experienced shorter length of hospital stay, and fewer pulmonary complications. The mortality of early surgery group do not show a significant increase at discharge, 6 month, 12 month postoperatively compared to that of the later surgery group. However patients in the early surgery group show a significant increase of ADL scores at discharge, 6 month postoperatively,but not at 12 month. Conclusion The timing of surgery has an impact on clinical outcome in elderly hip fracture. Early surgery was associated with improved function in the first 6 month postoperatively, but not 12months, but it was not associated with mortality.

This study was conducted to investigate the paclitaxel loaded by hydrazone bonds in poly(ethylene glycol)-poly(caprolactone) micelles (mPEG-PCL-PTX) on proliferation and apoptosis of human lung cancer A549 cells and its possible mechanisms of anti-tumor activity. The cell proliferation was measured with MTT assay. Flow cytometry were used to analyze the cell cycle. The cell apoptosis was analyzed using Hoechst/P staining. The expression levels of apoptotic genes expression in the mitochondrial apoptosis pathway were detected by RT-PCR and Western blotting, respectively. The mPEG-PCL-PTX could inhibit the proliferation of A549 cells and promote the apoptosis. The Bax, caspase-3 protein expression were increased while Bcl-2 protein expression was decreased in A549 cells. Results showed that the polymer containing hydrazone bond is non-toxic in vitro, the mPEG-PCL-PTX micelles can inhibit the proliferation and induce the apoptosis of A549 cells. Key words: paclitaxel; micelle; A549 cell; proliferation; cell cycle; apoptosis

Objective To investigate the safety and efficacy of a customized guide plate which is designed by digital medical technology and manufactured by 3D printing in clinical percutaneous needling at the hip joint.Methods Enrolled in this study were 9 patients with hip disorder who required hip joint needling during the period from April 2015 to August 2015.They were 7 males and 2 females,21 to 53 years of age (average,42 years).Laterality:5 left sides and 4 right sides.Conditions:4 cases of traumatic arthritis and 5 cases of osteoarthritis.All of them underwent lamellar CT scans whose data were imported into the software of Mimics 10.01 for 3D reconstruction.Then the software of 3-matic was used to design a customized guide plate on the reconstructed models.Finally,3D printing was used to manufacture the guide plate.The needle angle,direction and depth were adjusted in vitro and the operation was simulated before actual needling in clinic.After percutaneous hip joint needling was performed in the 9 patients separately,the accuracy of needling was checked using C-arm fluoroscopy.Results The percutaneous hip joint needling was performed successfully in the 9 patients in whom the customized guide plate was used.The results were consistent with what had been designed on the reconstructed models.The operation time in the 9 patients averaged 417.7 s (range,from 387 s to 590 s).Little intraoperative bleeding was observed at the site of needling,fluoroscopy was applied only once for check.No neurovascular injury or other operation-related complications occurred.Conclusion For patients who need repeated percutaneous needling at the hip joint,the customized guide plate designed by us can improve accuracy and ensure safety and efficacy of needling.

Objective To observe the effect of vancomycin-loaded calcium sulfate for one-stage treatment of chronic osteomyelitis.Methods A retrospective case series study was made on 26 patients with chronic osteomyelitis treated from January 2014 to April 2016.There were 23 males and 3 females,with a mean age of 35.8 years (range,16-90 years).After focus debridement of osteomyelitis,the cavities were filled with vancomycin-loaded calcium sulfate and systemic antibiotics were used.Meanwhile,gentamicin was added to patients showing unclear pathogens.Three patients underwent flap transfer surgery simultaneously due to the inadequate soft tissue coverage.Wound healing,local redness and swelling,sinus recurrence,recovery of osteomyelitis and repair of bone defect were detected after operation.Results All patients were followed up for 6-30 months (mean,19.5 months).Primary healing was achieved in all patients.One patient experienced wound exudate and was effectively managed by dressing change,one patient experienced inadequate local soft tissue coverage and was effectively managed by a second flap transfer surgery,and one patient remained wound unhealing after two surgeries and was cured by infected bone resection using the Masquelet induced membrane technique.Follow-up showed local bone defect was repaired in all patients without bone infection recurrence.Conclusions For patients with chronic osteomyelitis,one-stage surgery with vancomycin-loaded calcium sulfate can control infection with simultaneous repair of bone defect.Therefore,the procedure is a simple and effective method and worthy of clinical practice.

50% of that before treatment; (3)Normal control group( n =10). The urinary retinol binding protein(RBP) and N acetal D amino glucosidase(NAG)were measured by ELISA. The urinary osmosis, 24 h urinary protein excretion and serum creatinine (Cr) were measured. Results: (1) The urinary RBP[(0.54?0.19) mg/L], NAG[(112.84?42.82) U/L] and osmosis [(553.62?248.91) mmol/L] in PNS patients were significantly higher than normal control group ( P

OBJECTIVE: To establish a proper animal model of pyogenic spondylitis, to evaluate the efficacy of silver nanoparticles for treatment of spinal pyogenic infections, and to explore the distribution of the particles in the body of the animals. METHODS: Staphylococcus aureus was inoculated into intervertebral discs of rabbits to establish a spinal pyogenic infection model. These rabbits were divided into Group A [0.1 mg/(kg.d)], Group B [1 mg/(kg.d)], and a Control group. Groups A and B were injected with different doses of silver nanoparticles solution daily at locally infected side. Two weeks later, bacterial cultures, radiographic outcomes, histopathology were analyzed. Atomic absorption spectrometry was utilized to measure silver contents in some vital organs of the rabbits to detect the distribution and accumulation of silver particles. RESULTS: Staphylococcus aureus (100 CFU/mL), induced 100% pyogenic spondylitis. 1 mg/kg dose of silver nanoparticles solution could effectively inhibit the occurrence of spinal pyogenic infection with the effective rate of 75%. While the effect of 0.1 mg/kg dose of silver nanoparticles solution was less obvious, the efficiency was only 25%. Significant numbers of silver nanoparticles were observed to accumulate in the animal. In the 1 mg/kg group silver was deposited mainly in the spinal cord, liver, kidneys, spleen, and testicles, while in the 0.1 mg/kg group it accumulated only in the spinal cord. CONCLUSION Local administration of silver nanoparticles can effectively prevent and treat pyogenic spondylitis; the particles accumulate in the body commensurate with the administered drug concentration.
Animals ; Infusions, Intralesional ; Lumbar Vertebrae ; Male ; Metal Nanoparticles ; administration & dosage ; Rabbits ; Silver ; administration & dosage ; pharmacology ; Spondylitis ; drug therapy ; microbiology ; Staphylococcal Infections ; drug therapy

At present, hepatic encephalopathy has a relatively high mortality and thus greatly affects patients’ quality of life. This article describes the changes of intestinal flora in patients with hepatic encephalopathy and analyzes the mechanism of action of intestinal flora in hepatic encephalopathy and related treatment methods. It is pointed out that the development of hepatic encephalopathy is closely associated with intestinal flora, and clinical treatment by regulating intestinal flora has achieved a marked effect in patients with hepatic encephalopathy. In the future, the research on intestinal flora in patients with hepatic encephalopathy can be deepened to provide better regimens for the treatment of hepatic encephalopathy.

Objective:To explore the effect of improved urethral irrigation on urethral stricture in patients with closed bulbar urethral injury.Methods:The clinical data of 65 male patients with closed bulbar urethral injury complicated with difficult catheterization from January 2014 to January 2018 in the First Hospital of Shanxi Medical University were retrospectively analyzed. Among them, 30 cases were treated with flexible cystoscope-guided catheterization and external urethral orifice nursing (routine group), and 35 cases were treated with flexible cystoscope-guided catheterization and urethral drug flushing (improved group). The incidence of urethral stricture 1 and 6 months after catheter removal, number of urethral dilatation and maximum urinary flow rate 6 months after catheter removal, visual analogue score (VAS) during indwelling catheter were compared between 2 groups.Results:Both groups indwelled the catheters successfully. During indwelling catheter, the inflammatory secretion in improved group was less and thinner than that in routine group. There was no significant difference in the incidence of urethral stricture 1 month after catheter removal and VAS during indwelling catheter between 2 groups ( P>0.05); the incidence of urethral stricture and number of urethral dilatation 6 months after catheter removal in improved group were significantly lower than those in routine group: 5.7% (2/35) vs. 26.7% (8/30) and (7.1±1.0) times vs. (11.4±1.8) times, the maximum urinary flow rate 6 months after catheter removal was significantly higher than that in routine group: (19.8 ± 2.9) ml/s vs. (16.3±2.3) ml/s, and there were statistical differences ( P<0.05 or <0.01). Conclusions:The system of improved urethral irrigation can be easily fabricated and can achieve convenient application. This improved treatment can facilitate the discharge of urethral secretions, alleviate the urethral inflammation, reduce the urethral scar formation, and can prevent the incidence of bulbar urethral stricture effectively.

In recent years, in the face of the risks and challenges of public health emergencies, the demand and supply of public health talents are relatively tight, and the reform and exploration of the standardized training of public health professionals has become one of the most urgent and important topics. This study analyzed the problems of curriculum system setting, implementation of practical links and composition of tutors in the training process, and learned that Wenzhou Medical University has carried out practical exploration in strengthening theoretical study, highlighting the combination of research and study, deepening professional practice, etc., which has achieved the orderly promotion of public health training supported by supporting reform measures; Take the post competence as the guidance, and vigorously improve the practicing ability; Based on the process and result assessment, promote the reform of training mode and other preliminary results. However, there are also shortcomings and deficiencies in accuracy, supply and effectiveness. Looking at the current situation, it is suggested to promote mechanism construction, increase skill training, develop training standards, improve supporting measures, establish expert committees and other reform ideas, and explore and implement a new model of degree education connection.

0bjective To investigate the relationships between the peripheral lung cancer and pulmonary vessels or bronchi by 16-row muhislice computed tomography(MSCT)and analyze the related factors.Methods Fifty-four patients with peripheral lung cancer confirmed pathologically underwent contrast-erdaanced MSC TI Multiplanar reformation(MPR)and maximum intensity projection(MIP)in all patients were used to demonstrate the relationships between the peripheral lung cancer and pulmonary vessels,bronchi.The relationships were categorized five types:Type 1,erupted at the edge of nodule. Type 2,erupted at the center of nodule.Type 3,penetrated through the nodule.Type 4,contacting the nodule but stretched or encased.Type 5,contacting the nodule but smoothly compressed.The pathology type,stage,size,density and location of the peripheral lung cancer were recorded and the relationships with five types were evaluated by using Chi-square test and correlation analysis.Results (1)Tumor-bronchi relationship:type 1(33,61.1%)was more often seen in≥2.0 cm and solid lesions with stage Ⅱ-Ⅳ.while Type 2(14,25.9%)was often seen in<2.0 am and part-solid or non-solid lesions with stage Ⅰ.(2)Tumor-PA relationship:Type 1 was more often seen in≥2.0 am and solid lesions with stage Ⅱ-Ⅳ.while Type 2 was often seen in part-solid or non-solid lesions with stage Ⅰ.(3)Tumor-PV relationship:type 4 was the most common type(29,53.7%).Type 2(13,24.1%)was more often seen in part-solid or non-solid lesions.(4)Tumor-bronchi relationship and tumor-PA relationship had a positive correlation(r=0.5265,P<0.01).Conclusions MSCT can demonstrate the relations between the peripheral lung cancer and bronchi.PA and PV.It is useful for the differential diagnosis and prognosis evaluation of the lung csncer.