Objectives To evaluate plain radiographs and computed tomography (CT) scans in respect of assessment of articular fragment displacements (step and gap) in displaced acetabular fractures. Methods A retrospective evaluation was done to analyze the CT scans and plain radiographs of 64 patients who had been treated for displaced acetabular fractures in our hospital from January 1998 to May 2003. Of them, 20 met the inclusion criteria. In a blind method, 3 independent reviewers measured step and gap deformities on plain radiographs and CT scans utilizing a standardized measurement technique. The sensitivity and specificity of plain radiographs in detecting step and gap displacements (2 mm and 4 mm) in comparison of those of CT scans were determined. Moreover, intraclass correlation coefficient and intraobserver reliability were also calculated. Results Compared with CT, plain radiographs showed poor sensitivity in detecting step deformity (sensitivity = 44.3%). As far as fracture type was concerned, plain radiographs were particularly poor at detecting step deformity in fractures involving a single column of the acetabulum (sensitivity = 0%). Excellent intraobserver and intraclass reliability existed among the 3 reviewers. Conclusions Compared with CT scans, plain radiographs are poorly sensitive in detection of step and gap deformities in patients with acetabular fractures, and particularly poor at detecting step deformities. Therefore, in treatment of displaced acetabular fractures, CT scans are essential and should not only be used together with plain radiographs in the preoperative evaluation but also be considered in the postoperative assessment of fracture reduction and predicting future outcomes.

Objective To explore the ursodeoxycholic acid efficacy and safety analysis of nucleoside drugs for HBeAg-positive with high viral load in patients with liver cirrhosis, and its effect on peripheral blood Th17, Treg levels.Methods 80 patients with high viral load B HBeAg-positive from November 2012 to February 2014 were selected and randomly divided into control group and observation group, 40 cases in each group.Patients in control group received conventional treatment, observation group was treated with ursodeoxycholic acid based on the control group, antiviral efficacy and adverse reactions, peripheral blood Th17, Treg levels were compared between two groups.Results After treatment, the ALT, AST, ALB, TBil levels between two groups were significantly lower compared with before treatment(P<0.01), the ALT, AST, ALB, TBil levels in observation group were significantly lower than the control group ( P<0.01 ); HBV-DNA negative rate ( 85.0%) and decrease of HBV-DNA in observation group were significantly higher (7.5%) than those in control group, the difference was statistically significant (χ2 =48.322, t =11.490, P<0.01); ALT normalization rate (52.5%), HBeAg seroconversion rate (57.5%) in observation group was significantly higher than those in control group(15.0%, 17.5%), the difference was statistically significant (χ2 =12.579,χ2 =13.653, P<0.01);complications compared with the situation observed group of death, hepatocellular carcinoma, spontaneous bacterial peritonitis, gastrointestinal bleeding compared with control group, the difference was not statistically significant (χ2 =1.01, χ2 =2.05, χ2 =3.12, χ2 =0.21, P>0.05).After treatment, the Th17 levels elevated, Treg level decreased in two groups, Th17 level in observation group was significantly higher than control group, Treg levels were significantly lower than the control group, Th17/Treg ratio was higher than the control group (P<0.05).Conclusion Ursodeoxycholic acid can significantly improve liver function of patients with HBeAg positive with high viral load, increase the rate of HBeAg seroconversion, inhibit HBV viral replication and delay progression of the disease, and less adverse reactions.It can increase the number of Th17 cells, reduce the number of Treg cells in patients, which may be one of its antiviral mechanism.

Objective To investigate the clinical effect and safety of paracetamol in premature infants with patent ductus arteriosus(PDA). Method A protrospective comparsion study was performed onthe data of premature infants with PDA. Seventy-two premature infants with echocardiographically comfirmed PDA were randomized into the oral paracetamol group(n1=18) and the ibuprofen group(n2=54), and the rate of ductal closure, side effects and complications were compared between the two groups. Results The ductus was 66.7% (12 infants) in the paracetamol group, which was similar to 70.4% (38 cases) in the ibuprofen group, with no significant difference(χ2=0.087,P=0.768).Except for the incidence of hyperbilirubinemia in the paracetamol group was higher than that in the ibuprofen group (P<0.05), no statistical differences were found in the other index (P>0.05), including oliguria,NEC,renal impairment,the incidence of IVH3-4 and gastrointestinal bleeding. Conclusions The clinical effect of paracetamol in premature infants with PDA is similar to that of ibuprofen , withlower incidence of hyperbilirubinemia, and paracetamol is worthy of amplication in clinical practice.

Objective:To solve the ultimate problem of research on tongue's texture,that is the real appearance and development rules of tongue's texture on healthy person.This article is proposed to provide the references on feature recognition of creature and judgments on cases of tongue's texture.Methods:After taking the continuous,systematic and different ages samples of tongue's texture by three medical instruments and the multidirectional double smoothing dimension extraction algorithm of area of tongue's texture,the binary images of tongue's texture are extracted and stored in computer database of tongue's texture to analyze comprehensively and systematically.Results:Among the 5 535 healthy person,it can be divided into two groups,the number of one group which couldn't diagnose tongue's texture exactly with naked eyes(without any amplification)is about 1 074 accounted for 19.40%and the number of another group which could diagnose tongue's texture clearly with naked eyes and computers is about 4 464 accounted for 80.60%.There are 18 sorts according to the appearances of tongue's texture in which the number of straight tongue's texture is about 69.00%,the horizontal tongue's texture is about 18.54%, the oblique tongue's texture is about 11.48%and the other tongue's texture is about 0.99%.Conclusions:The tongue's texture of healthy person show appearances of regularity,straight,horizontal and oblique texture.From the development rules of tongue's texture on 30 continuous observing healthy person and among the 1 233 cases,these conclusions could be made that any kind of slightly imbalance of yin and yang or obstruction of entropy flow will lead to the changes of color,diaphragm,material being of tongue's texture.It will also change according to the patient's condition.

Objective To assess the correlation of the characteristics of coronary lesion and the risk factors to the coronary heart diseases using angiography techniques. Methods Coronary heart disease (CHD) patients were divided into two groups according to the ages of patients: elderly group (67 cases, 60 88 years); non elderly group(61 cases, 25 59 yeas). Angiography was performed in all CHD patients and their risk factors were analyzed by Logistic regression. Results The coronary changes were characterized in most patients by multi vessels lesion(76 1%) in elderly group, while by single vessel lesion (54 1%) in non elderly group. Stenosis of the coronary artery in the elderly group was severer than that in the non elderly. Logistic regression showed that ageing, sex, hyperlipemia were the risk factors for CHD( P

Objective To investigate the efficacy of emergency vacuum sealing drainage (VSD) in the treatment of crush syndrome. Methods A total of 102 patients with crush injury were randomly screened out and divided into emergency VSD group (n = 50), delayed VSD group (n = 22) and control group (n = 30). The variances of indices of crush syndrome after VSD between three groups were analyzed. Results The vital sign, urine volume, laboratory examination results were improved and the incidence rate of crush syndrome, complications and mortality rate were significantly decreased in emergency VSD group than those in delayed VSD group and control group (P < 0.05). For patients with crush syndrome, the incidence of complications, duration of hospital stay and mortality rate were significantly decreased in emergency VSD group and delayed VSD group than those in control group (P < 0.05). Conclusion Emergency VSD can suck the exudate of the necrotic tissues and the wounds, maintain draining wounds and prevent infection and hence is helpful to prevent and treat the crush syndrome.

To investigate the efficacy of a combination therapy on gluteal muscle contracture, 286 definitely diagnosed patients were subjected to surgical treatment, and then functional exercises and physical therapy. The patients with severe symptoms were asked to have a set of specially-designed functional exercises. All the patients were followed up for 3 to 24 months by hospital visit, correspondence or telephone interview. The effective rate was 100%, and the curative rate was up to 94.6%. Few patients developed complications and relapse was rare. It is concluded that the combination therapy, including surgical removal of diseased tissues, functional exercises and physical therapy, is an effective approach for the treatment of severe juvenile gluteal muscle contracture.
Buttocks ; Exercise Therapy ; Follow-Up Studies ; Muscle Contraction ; Muscle, Skeletal/*pathology ; Patient Compliance ; Physical Therapy Modalities ; Time Factors ; Treatment Outcome

Objective To analyze the clinical characteristics of severe retinopathy of prematurity (ROP) in extremely low birth weight infants (ELBWI),and to evaluate the management model of ROP screening of ELBWI and the clinical effects and treatment timing of photocoagulation with intravitreous injection of vascular endothelial growth factor inhibitor (Avastin).Methods Forty-five cases of ELBWI (birth weight ＜ 1000 g) survived finally in our neonatal intensive care unit from July 1,2004 to June 30,2011 were reviewed.ROP screening was regularly performed in 4 ～ 6 weeks postpartum with binocular indirect funduscope by ophthalmologists.Newborns with severe ROP were treated with laser photocoagulation in the fundus.Some newborns that developed aggressive posterior ROP(APROP) were treated with combined intravitreous injection of Avastin and photocoagulation.Results Thirteen of 45 cases (28.89％) had not developed to ROP finally.Six cases (13.33％) developed to stage 1 ～ 2 ROP and then spontaneous recovery during the follow-up period.Twenty-six newborns (57.78％) developed to severe aggressive posterior ROP (APROP) and need to be treated with photocoagulation.All 3 APROP infants (6.67％) were received intravitreous Avastin injection prior to photocoagulation.The visual acuity of all 45 patients (100％) in this study was preserved.Conclusion ELBWI have a higher morbidity of severe ROP.Timely screening and intervention are effective to prevent disease progression.Intravitreous Avastin injection prior to photocoagulation may be necessary to preserve the visual acuity of infants with APROP.Respiratory management is the key for post-operation care.

Objective To analyze the incidence of retinopathy of prematurity(ROP)among extreme-ly preterm infants,and to evaluate the treatment methods and effects among those with severe ROP.Methods A retrospective analysis was performed to analyze incidence of ROP in 96 cases of extremely preterm infants who were born at a gestational age of 〈28 weeks and survived beyond a postmenstrual age of at least 1 year from Apr 2006 to Oct 2013,and to analyze the treatment outcomes of photocoagulation and ranibizum-ab intravitreal injection among the infants with severe ROP.Results Fifty-six of 96 cases(58.33%)grew into ROP finally and 21 cases(21.88%)grew into severe ROP,2 cases(2.08%)grew into aggressive poste-rior ROP.Fifteen cases with severe ROP were treated with laser photocoagulation.Four cases with severe ROP were received ranibizumab intravitreal injection prior to photocoagulation.Two cases with severe ROP were only treated with ranibizumab intravitreal injection.The eyesight of 96 patients (100%)in this study were all preserved.Conclusion ROP screening should focus on extremely preterm infants because of higher incidence of ROP and severe ROP among them.The infants with severe ROP should be treated with laser photocoagulation in time.The infants in critical condition or with aggressive posterior ROP can be treated with ranibizumab injection.

ObjectiveTo observe the effect on stress response to indwelling gastric tube assisted by bronchofiberoscope and traditional way in patients with severe craniocerebral injury in intensive care unit(ICU). Methods 126 patients admitted in Department of Surgery ICU in Lanzhou University Second Hospital were randomly divided into bronchofiberoscope assisted indwelling gastric tube group(experimental group) and the traditional way of indwelling gastric tube group(control group), 63 cases in each group. In the experimental group, the rod of mirror, Olypus BF-P60, was coated with lidocaine gel, through the nasal cavity it was sent into interior, when arrived at epiglottis, the operator adjusted the mirror head and let it go into the esophagus(about 10 cm), then put a steel wire as a guide into a hole for biopsy, and simultaneously, as the operator pulled out the rod, the wire was continuously pushed slowly further inside; after the bronchofiberoscope was completely withdrawn, valelinum liquidum was used to ensure sufficient lubrication to the external and internal walls of the indwelling gastric tube ready to be sent into the stomach, afterwards the tube was slowly pushed along the guide wire to an appropriate location and then the wire was pulled out, the operator injected air, when he or she heard the gurgling sound as the gas passing water, fixed the tube. In the control group, the traditional way of indwelling gastric tube was applied. Before and after indwelling gastric tube for 1, 3, 5 minutes, the changes of systolic pressure(SBP),diastolic pressure(DBP),heart rate(HR), end-expiratory carbon dioxide partial pressure(PETCO2) and plasma concentrations of norepinephrine(NE), adrenaline, angiotensinⅡ(AngⅡ), glucose(GLU) were examined.Results The plasma levels of SBP, DBP, HR, PETCO2, adrenaline, NE, AngⅡ and blood GLU had no statistical significant differences before operation in comparisons between both groups(allP>0.05). Compared to those before indwelling the tube, the levels of SBP, DBP, HR, PETCO2, NE, adrenaline, AngⅡ and GLU at various time points after the indwelling in experimental group were of no statisticalsignificant differences(allP>0.05), while the levels of SBP, DBP,HR, adrenaline, NE, AngⅡand GLU in control group at various time points after indwelling were higher obviously than those before operation, and the level of PETCO2 was decreased significantly compared with that before operation. The differences in the above indexes were significant between the treatment and control groups at 1 minute after indwelling〔SBP(mmHg, 1 mmHg=0.133 kPa): 125.1±15.4 vs. 135.5±13.6, DBP(mmHg): 85.6±16.1 vs. 91.1±17.2, HR(bpm): 99.4±13.8 vs. 107.9±16.5, PETCO2(mmHg): 32.5±2.8 vs. 29.8±4.1, NE(ng/L): 365.4±29.7 vs. 475.7±49.9, adrenaline(ng/L): 75.4±7.2 vs. 83.6±7.4, AngⅡ(ng/L): 65.3±6.9 vs. 73.3±9.1, GLU(mmol/L): 10.1±1.9 vs. 13.4±3.0, allP<0.05〕; the differences in the above indexes remained significant between the treatment and control groups till 5 minutes after indwelling〔SBP(mmHg): 123.7±14.8 vs. 129.7±15.1, DBP(mmHg): 84.3±14.6 vs. 88.4±14.2, HR(bpm): 97.7±13.6 vs. 31.6±3.9, PETCO2(mmHg): 33.5±3.1 vs. 31.6±3.9, NE(ng/L): 363.9±31.3 vs. 457.7±48.4, adrenaline(ng/L): 74.6±7.8 vs. 83.5±8.5, AngⅡ(ng/L): 64.3±8.4 vs. 71.9±5.9, GLU(mmol/L): 9.6±2.3 vs. 12.7±3.1, allP<0.05〕.ConclusionCompared with traditional way, the indwelling of gastric tube assisted by branchofiberoscopy can induce milder stress response.