Objective To evaluate the effect of the interlocking nail for extremity fractures. Methods This study reviews 1224 cases of extremity fractures treated with locking intramedullary nail fixation from October 1996 to June 2004, including 92 cases humeral shaft fracture; 210 cases intertrochanteric fractures; 488 cases femoral shaft fractures; 92 cases supracondylar femoral fractures; 342 cases tibia and fibular fractures. According to the AO classification there were 642 type A, 364 type B and 218 type C. There were 986 cases (72.4%) high-energy injury; 405 cases were multiple injury. There is 778 male and 446 female with mean age 39 years (range 16-92 years). Duration from injury to operation was 8 days(3 hour-30 days). Close reduction was 1203 cases and open reduction were 21 cases. Results Mean follow-up period is 24 months(6-70 month), mean operation time was 90 minutes(40-480 minutes). Union was in 1204 cases, union rate was 98.2%, mean union time was 5 months (3-12 months) on average, there were nonunion in 22 patients: 4 in humeral shaft, 8 in femoral shaft, 4 in supracondylar femur, 6 in tibia shaft, the nonunion rate is 1.8%. Late deep infection occurred in 3 patients: 1 in femoral shaft, 1 in supracondylar femur, 1 in intertrochanteric femur, the infection rate is 0.2%. There were 16 split in intraoperation: 4 in humeral nail, 4 in Gamma nail, 9 in supracondylar nail. Iatrogenic nerve palsy occurred in 6 patients: 2 in radial nerve, 2 in sciatic nerve, 2 in common peroneal nerve, the occurrence is 0.4%. One femoral nail was broken, locking screw were broken in 9 patients (0.6%), femoral shaft fracture of distal nail end occurred in 3 cases: 1 in Gamma nail, two in supracondylar nail. 53 patient complained uncomfortable in entry point (8 shoulders; 9 hips; 36 knees). Conclusion The result is satisfactory in bone healing low infection reduced blood loss and rapid recovery of the joint and body with the close interlocking nailing to be treatment of fresh extremity shaft fracture. It is a perfect method, however the complication should be pay more attention.

Objective To analyze and evaluate the related data of bottom clearance in Fuling section of Three Gorges Reservoir. Methods Bottom clearance in Fuling section of Three Gorges Reservoir was carried out in Fuling district during the period from May to December in 2002. All the data related to clearance were collected before and after the bottom clearance. Based on the collected data, the effect of clearance was assessed. Results 5 882 general pollution sources, 68 contagion pollution sources were cleaned in Fuling district, the clearance rates of both were 100%. The rat densities in agriculture areas and the dismantling cities were 3.97% and 2.97% respectively before rat extinguishment, then became 0.65% and 0.33% after rat extinguishment. Conclusion Through the bottom clearance of Three Gorges Reservoir, contagion and general pollution sources in the emigrant areas have been cleaned up, so water pollution in Three Gorges Reservoir and the rats mediated diseases have been prevented and controlled.

Objective To evaluate the efficacy and safety of vasopressin(Pitr- essin)on esophageal variceal bleeding in patients with cirrhosis.Methods 42 cirrhotic patients with acute esophageal variceal bleeding confirmed by endoscopy were randomly divided into 2 groups and administered with Pitressin and Pituitrin for 48 hrs respectively.The balloon tubes were placed in the stomach before the treatment,and the duration of hemostatsis,volume of transfusion,rebleeding and short-term survival period were recorded.Results After 12 hrs treatment,the hemostatic rate in Pitressin group was 72.7%,significantly higher than that in Pituitrin group(40.0%,P

Objective To investigate the protection mechanism of ulinastatin on bacterial endotoxin-induced acute lung injury. Methods Acute lung injury was induced by Escherichia colilipo-polysaccharide(LPS)5 mg·kg-1·d-1,intratracheally. Twenty SD rats were randomly divided into control group(n=10)and ulinastatin group(n=10). Ulinastatid group received ulinastatin 50 kU·kg-1 ,the control groups received the same amount of 0. 9% sodium chloride solution. Then the expression changes of rat AQP-1 and AQP-5,alveolar wall thickness change and the degree of pulmonary edema were detected. Results After the injection of LPS into the rat,the expression of AQP-1 and AQP-5 in control group were continuously decreased,but those in ulinastatin group decreased were not obvious. The lung wet/dry weight ratio in the control group increased significantly,the not obvious changes in the ulinastain group. The thickness of the alveolar in 24,48,72 h of the control group were(3. 84±0. 68),(6. 32±1. 08),(11. 03±2. 47)μm, respectively,and those in the ulinastian groups were(2. 31±0. 44)(,3. 76±0. 82)(,2. 94±0. 67)μm,respectively. Conclusion The AQP-1 and AQP-5 induced the occurrence of pulmonary edema by changing the cell permeability. Ulinastatin can slow down the process so as to reduce the degree of endotoxin-induced lung injury.

Objective To explore the effect of comprehensive intervention measure on antimicrobial use and incidence of healthcare-associated infection(HAI)in patients in sports medicine department.Methods Antimicrobial use and incidence of HAI in hospitalized patients in the surgical departments (sports medicine department and other surgical departments)of a hospital between January 2006 and December 2010 were analyzed retrospectively(before intervention),from January 2011, comprehensive intervention based on clinical-centered multi-department cooperation was adopted by sports medicine depart-ment,the other surgical departments over the same period were not comprehensively intervened;antimicrobial use and inci-dence of HAI in patients in surgical departments between January 2012 and December 2013 were monitored prospectively (after intervention ),effectiveness of intervention was evaluated.Results Antimicrobial use and incidence of HAI in pa-tients in sports medicine department after intervention were both lower than before intervention (55.75% vs 95.26%,χ2=753.42;0.10% vs 0.32% ,χ2 =15.13,both P <0.01).Antimicrobial use in patients in other surgical departments after intervention was lower than that before intervention(65.63% vs 73.79% ,χ2 =251.57,P <0.01 );incidence of HAI was higher than that before intervention(0.55% vs 0.42% ,χ2 =19.04,P <0.01).Conclusion Comprehensive in-tervention measure based on clinical-centered multi-department cooperation is safe and effective,it can reduce antimicrobial use and incidence of HAI in patients in sports medicine department.

CT data regarding PUMCⅡ d2 adolescent idiopathic scoliosis obtained from one female patient were input into modeling software minics 11.11 to obtain medical simulation model.Then finite element analysis models of AIS patients (T1-S) were created by introducing simulation models into software abaqus 6.7.Finite element models of T6 11 segments were corrected by 5 different correction methods:simple concave bracing,simple convex pressurization,concave distraction and convex compression simultaneously,concave distraction prior to convex compression and concave distraction after convex pressurization.Abaqus software was used to simulate correction of scoliosis with vertebral arch pedicle screw by loading 50 N,100 N,and 200 N distraction forces on the concave side pedicles of the end vertebrae T6 and T11.The displacement of vertebrae T6 in Y-axis (sagittal plane) and Z-axis (coronal plane),which respectively represented the correction effects of kyphosis and scoliosis,was compared between prior to and after correction.Simple concave distraction provided better outcomes in terms of displacement of T6 in Z-axis than the remaining four methods (P ＜ 0.01).Concave distraction and convex compression simultaneously,concave distraction prior to convex pressurization and concave distraction after convex compression produced identical displacements of T6 in Y-axis,which were all better than simple concave distraction (P＜ 0.01).The present findings imply that for curative effects of five methods on correction of scoliosis in the coronal plane:simple concave distraction＞ concave distraction and convex compression simultaneously = concave distraction prior to convex compressio= concave distraction after convex compression ＞ simple convex pressurization;for curative effects of five methods on correction of kyphosis in the sagittal plane:simple convex compression ＞ concave distraction and convex compression simultaneously = concave distraction prior to convex compression= concave distraction after convex compression＞ simple concave bracing.Simple concave distraction could not produce obvious corrective effects on kyphosis rather than lead to worsened kyphosis to some extent.Simple convex compression could not produce obvious corrective effects on scoliosis rather than result in aggravated scoliosis to some extent.

Objective To investigate the characteristics of clinical course and outcome in elderly patients with nonvariceal upper gastrointestinal bleeding (NUGB) Methods The 206 hospitalized patients were devided into elderly group (≥60 yrs, 105 cases) and non elderly growp (

Objective To evaluate the impact of preoperative renal artery embolization in renal cell carcinoma patients with venous tumor thrombus.Methods A total of 249 RCC patients with venous tumor thrombus underwent radical nephrectomy and thrombectormy in our hospital.Seventy-four patients received preoperative renal artery embolization while other 175 patients did not.The related items were analyzed.The tumor thrombus level was divided into 5 groups with American Mayo clinic classification system.Considering the significant difference in tumor situation and treatment strategies, we took the hepatic vein as a cut-off line, dividing patients into two subgroups, the early and advanced tumor thrombus groups.There were 208 patients in the early tumor thrombus group and 41 patients in the advanced group.The related items were analyzed respectively.Results Patients in the embolization group tended to have larger tumors and higher percentage of advanced tumor thrombus.For all patients, the embolization group had longer operation time [(4.8 ±2.1) h vs.(4.1 ±2.2) h ,P <0.05] and greater median blood loss (900ml vs 500 ml,P <0.05), compared to the non-embolization patients, and RAE did not show benefits on perioperative outcomes seemingly.However, subgroup analysis of patients with advanced tumor thrombus ( above hepatic vein) , in spite of the larger size of tumor, preoperative RAE showed significant benefits on reducing operation time [(7.0 ±1.7)h vs.(8.2 ±1.8)h, P<0.05)] and intraoperative blood loss (2 000 ml vs.3 000 ml, P<0.05) and decreasing blood transfusion (1 525 ml vs.2 050 ml ,P>0.05).Conclusion Preoperative RAE may be more appropriate for patients with advanced tumor thrombus because of its benefits in reducing operation time, intraoperative blood loss and elevating the operative security.

Objective:To investigate the effect of intermittent hormonal therapy(IHT) for patients with different stage/grade prostate cancer(PCa).Methods:The number of cycles and the duration of ON/OFF therapy for 45 PCa patients receiving IHT were observed.Maximal androgen blockade(MAB) the-rapies were used for six to nine months,and then stopped until the serum prostate specific antigen(PSA) was decreased below 0.2 ?g/L,which lasted for three months.It was decided whether MAB went on according to the level of PSA.Results:The average follow-up time was 40.7?13.4 months.Forty-one patients started the second cycle of treatment,of whom,8 became androgen-independent and 7 were at T3-4M0 or M1 stages and the Gleason scores were above 8.Sixteen patients entered the third cycle,of whom,14 were at lower than stage Ⅲ and 13 had the Gleason scores below 7.From the first to the fourth courses of treatment,the average intervals were 8.7?5.4(47.1%),8.4?4.9(49.3%),7.0?3.4(43.7%),and 3.7?0.6(42.5%)months respectively.Five patients developed bone metastasis.No one died up to now.According to the evaluation criteria,patients were divided into tolerance(n=16) and intolerance groups(n=29).Compared with the intolerance group,the patients who tolerated the treatment well had lower Gleason scores(P=0.002),lower PSA levels(P=0.053) and lower tumor stages(P=0.001).There was no evidence that age,lymph node metastasis,bone metastasis and the state of recurrence were associated with an increased risk of the outcome.Non-conditional Logistic regression analysis showed that the proportion of patients at stage Ⅳ was the only independent risk factor for the tolerance of the treatment(OR=12.113,95%CI 1.330-110.312,P=0.027).Conclusion:Intermittent hormonal therapy is more effective and proper for the patient with highly differentiated tumor and at lower stages(≤Ⅲ).The patients who progressed to hormone-independence are mostly at stage Ⅳ with poorly differentiated tumor.Intermittent hormone therapy could be more adaptive for the patients at lower than stage Ⅲ.

Objective To investigate the clinical effect of mild hypothermia on neonatal bilirubin encephalopathy, and the value of 18F-fluorodeoxyglucose (18F-FDG) positron emission tomography (PET)/CT and amplitude integrated electroencephalogram (aEEG) for diagnosis and evaluation of curative effect. Methods From May, 2013 to December, 2014, 29 newborns with bilirubin encephalopathy were divided into conventional group (n=15) and mild hypothermia group (n=14). The conventional group received conventional therapy, and the other group received mild hypothermia in addition. The aEEG and neuron-specific enolase (NSE) were measured before and after treatment, as well as the glucose metabolism rate with 18F-FDG PET/CT after treatment. Results The NSE was lower after treatment in both groups (t>9.670, P<0.001), and was lower in the mild hypothermia group than in the conventional group (F=46.146, P<0.001). After treatment, sleep-wake cycle (SWC), epileptiform activity and the degree of abnormality were obviously improved (P<0.05), and were better in the mild hypothermia group than in the conventional group (P<0.05). The cerebral glucose metabolism rate was significantly better in the mild hypo-thermia group than in the conventional group (t>2.943, P<0.01). The cerebral glucose metabolism rate was negatively correlated with aEEG and NSE (r>0.640, P<0.05). Conclusion Mild hypothermia therapy could further promote the energy metabolism of brain cells in neonatal bilirubin encephalopathy. 18F-FDG PET/CT and aEEG can be used for early diagnosis and therapeutic evaluation.