BACKGROUND:Recently, periprosthetic femoral fractures have been a common complication after total hip replacement. Vancouver type B1 periprosthetic femoral fractures commonly received internal fixation due to stable femoral prosthesis and less bone defects.
OBJECTIVE:To evaluate the effect of the application of Synthes cable system in the treatment of Vancouver type B1 periprosthetic femoral fractures after total hip replacement.
METHODS:From May 2009 to October 2012, 18 patients with Vancouver type B1 periprosthetic femoral fractures were treated with Synthes cable system in the Department of Orthopedics, Nantong First People’s Hospital. There were 8 males and 10 females with an average age of (62.67±8.67) years ranging 45 to 80 years. They received a further consultation at 1, 3 and 6 months after treatment. The function of hip joint was evaluated by Harrris evaluation standard:ful marks, 100 points, ≥ 90 points, excellent;80-89 points, better;70-79 points, good;<70 points, poor.
RESULTS AND CONCLUSION:Al 18 patients were fol owed up for 6 to 43 months. Mean healing period was (19.06±4.04) weeks. Harris score was (22.3±3.6) points before treatment in 18 cases. Harris score was higher significantly at 1, 3 and 6 months after treatment compared with that before treatment (P<0.01), and the recovery of hip function was good. Results indicated that Synthes cable system could help to restore the normal anatomic structure of femur in the greatest extent, showing simple operation, little injury, high stability and high safety. It is an ideal method for treating Vancouver type B1 periprosthetic femoral fractures.

Objective To research the nutritive condition and establish prediction model of chlorophyll-a(Chla) in a surface water source of Zhengzhou, China. Methods The water temperature(WT), Secchi-depth(SD), chemical oxygen demand(CODMn), total nitrogen(TN), total phosphorus(TP), Chla were determined in two sampling sites of the water source by standardized methods from Mar, 2004 to Oct, 2004. Nutritive condition of the water source was analyzed by trophic level index(?)[TLI(?)]. The influence of some environmental factors on Chla was analyzed by correlation analysis and stepwise multiple regression. Chla was predicted by establishing a stepwise multiple regression equation. Results In the spring, summer and autumn, nutritive condition of the water source was from the maximum of mesotropher, the maximum of light eutropher to the minimum of middle eutropher. A positive correlations were found between the standardized Chla and WT, CODMn, TP. A negative correlation was found between the standardized Chla and SD. The equation was ln(CChla+1)=-0.114+0.083 48 WT+6.874 TP+0.193 CODMn(R2=0.900, F=62.674, P

Objective To study the clinical curative effect of adefovir and lamivudine in the treatment of chronic hepatitis B .Methods 68 patients with chronic hepatitis B were randomly divided into the treatment group and control group,34 cases in each group.The treatment group was treated with adefovir and lamivudine for 48 weeks,the control group was treated by lamivudine for 48 weeks.12,24,36,48 weeks after treatment ,the changes of liver func-tion,ALT index in HBV DNA,HBV DNA and the changes of serum HBeAg negative rate ,HBeAg/HBeAb seroconver-sion rate and adverse reaction were observed and compared .Results With the extension of treatment time ,ALT,HBV DNA in the two groups were gradually decreased , there were significant differences before and after treatment ( t=4.63,4.65,P<0.05).24,36,48 weeks after treatment,ALT,HBV DNA in the treatment group were significantly lower than those in the control group[ALT (89.9 ±16.7) U/L,(60.1 ±13.8) U/L,(44.6 ±8.9) U/L vs (90.7 ± 17.6) U/L,(72.0 ±14.1) U/L,(61.3 ±24.5) U/L;HBV DNA (4.92 ±1.44) U/L,(3.35 ±1.37) U/L,(2.53 ± 1.31) U/L vs (5.02 ±1.41) U/L,(3.69 ±1.40) U/L,(3.02 ±1.35) U/L],there were significant differences between two groups(F=4.32,4.56.4.76,all P<0.05).After treatment,the HBV DNA and HBeAg negative con-version rate,HBeAg/HBeAb seroconversion rate in two groups were increased significantly ,the differences were statis-tically significant(χ2 =4.63,4.36,4.21,4.27,4,35,4.23,all P<0.05).At the 24th week of treatment,the serolog-ical markers of HBV had no significant difference , but after 24 weeks, serum markers in the treatment group (67.65%,32.35%,26.47%,85.29%,38.23%,35.29%) were obviously higher than those in the control group , the differences between the two groups were significant (χ2 =4.43,4.73,4.23,4.32,4.34,4.46,4.76,4.34,4.22, 4.29,4.34,4.45,all P<0.05).Conclusion Adefovir and lamivudine combination therapy in the treatment of chro-nic hepatitis B has obvious clinical effect ,has no serious adverse reactions ,which is suitable for clinical application .

BACKGROUND:The effects of artificial joint replacement, osteotomy and reconstruction in the treatment of Crown Ⅳ-type congenital dislocation of hip in adult are not very satisfied. OBJECTIVE:To evaluate the effect of artificial total hip arthroplasty and hip-self procedure in the treatment of Crown Ⅳ-type congenital dislocation of hip in adult patients. METHODS:Twenty-three adult patients with Crown Ⅳ-type congenital dislocation of hip were treated with artificial total hip arthroplasty and hip-self procedure. There were 2 males and 21 females with an average age of (24.26±3.56) years ranging 20 to 35 years. The effect was evaluated according to the Harrris evaluation standard, and the statistical analysis was performed. RESULTS AND CONCLUSION:Al of the patients were fol owed-up for 12-60 months, averaged of (26.60±13.16) months. Statistical comparison with the SPSS 19.0 system showed there was significant difference of the Harrris scores between preoperation and postoperation period (P<0.05). The artificial total hip arthroplasty and hip-self procedure can be used to reconstruct the normal function of hip joint, relieve pain and increase the joint stability, which is considered as the best method for the treatment of Crown Ⅳ-type congenital dislocation of hip in adult.

Objective To explore the relationship between distortion product otoacoustic emission (DPOAE) test and pure tone audiometry (PTA), and the application of DPOAE test in occupational health inspection of noise-exposed work. Methods Using the judgment sampling method, 510 noise-exposed workers in an automobile engine factory were selected as the observation group. The observation group was divided into 5 subgroups according to the characteristics of PTA threshold and frequency of hearing loss. Another 50 non-noise-exposed workers in the factory were selected as the control group. DPOAE and PTA were used to detect the pure tone hearing threshold and DPOAE amplitude, signal-to-noise ratio and pass rate of each frequency in the two groups of workers. Results At 0.5-6.0 kHz, the pure tone hearing threshold value of each subgroup was higher than the control group (all P<0.05). At 3.0-6.0 kHz, the DPOAE amplitude and signal-to noise ratio of each subgroup were lower than that of the control group (all P<0.05). At 1.5 kHz, the pass rate of DPOAE in subgroup 1, subgroup 2 and subgroup 3 were higher than the control group (all P<0.05). At 2.0-6.0 kHz, the pass rate of DPOAE in subgroup 4 and subgroup 5 were lower than the control group (all P<0.05). The area receiver operating characteristic curve (AUC) of the observation subgroups and control group were 0.71-1.00 by the PTA. The AUC values of the observation subgroups and control group were 0.57-0.97 by DPOAE. The AUC value in subgroup 5 and control group had a significant difference between the two examination methods (P< 0.01); while the subgroup 1, subgroup 2, subgroup 3, subgroup 4 and control group were no significant differences respectively (all P>0.05). Conclusion DPOAE is easy to operate and can objectively reflect the hearing level of workers exposed to noise. It can be used as a supplementary means of PTA and applied to occupational health examination and hearing monitoring screening.

Objective To explore the effect of antinuclear antibody ( ANA+dsDNA),extractable nuclear antigen (ENA) and antineutrophil cytoplasmic antibody (ANCA) on the clinical manifestation and cerebrospinal fluid characteristics of neuromyelitis optica (NMO).Methods All 41 patients with NMO in PUMC hospital from 1985 to 2009 were retrospectively reviewed.All patients underwent examination of serum ANA+dsDNA,ENA and ANCA.Fourteen positive-autoantibody patients were compared with 27negative-autoantibody patients in gender,onset age,duration,relapse ratio,first demyelination event,the extent of optic neuritis and myelitis,EDSS,CSF protein,WBC,Oligoclonal band, 24 hours IgG index and myelin basic protein.Results The 14 NMO patients (34.1%) had positive non-organ-specific antibodies.NMO patients who had negative autoantibodies were compared with NMO patients with positive autoantibodies with significantly higher EDSS (the EDSS score were 4.5 and 2.5 respectively,U=92.5,P=0.008),more complete damage of spinal cord (3/14 vs 0/27, x2=6.736, P=0.0095) and tended to have higher visual Function Scale in remitting phase.There was no significant difference on the gender,onset age,duration,relapse ratio,first demyelination event.The positive-autoantibody patients had higher CSF WBC (2.0 vs 0,U=68.0,P=0.007) and tended to have lower 24 hours IgG index (-8.663 vs 0.163,U=30.0,P=0.053).There was no significant difference in CSF protein,MBP and OB.Conclusion NMO patients with positive autoantibodies have more severe intrathecal autoimmune inflammatory and disability,so they might need more intensive treatment.

Objective To explore the diagnostic value of conventional ultrasound(US) and contrast enhanced ultrasound(CEUS) in predicting extrathyroidal extension of papillary thyroid cancer(PTC).Methods Eighty-five PTCs in 75 patients were selected for thyroid surgery underwent ultrasound and contrast-enhanced ultrasound.The degrees of contact between PTCs and capsule were observed by US and CEUS respectively(0,0-25％,25％-50％,≥50％),and the diagnostic efficiency in different degree of contact (＞0 ％,≥25 ％,≥50％) as preoperative diagnostic criteria were analyzed.The diagnostic efficiency between US and CEUS in predicting extrathyroidal extension of PTC were compared.Results Of the 85 PTCs,extrathyroidal extension was presented in 57 (67.06％) based on pathologic results.When the degree of contact (＞ 0 ％,＜ 25 ％,25 ％-50 ％,≥ 50 ％) was gradually increased,the incidence of extrathyroidal extension of the thyroid cancer was also gradually risen (P ＜0.001).Comparing the sensitivity,accuracy,odds ratio,and Az value of three groups(＞0％,≥25％,≥50％),it showed that the general diagnostic efficiency between two groups(＞0％,≥25％) was similar by US and CEUS.However,the sensitivity and accuracy of ＞0％ contact with the adjacent capsule were markedly higher than those of the other two groups(P ＜0.001).Selecting ＞0％ contact with the adjacent capsule as preoperative criteria,the Az value of CEUS was markedly higher than that of US (Z =2.208,P =0.027).Conclusions The preoperative imaging feature of more than 0％ contact with the adjacent capsule is more sensitive and accurate degree in predicting extrathyroidal extension of PTC.Compared with US,CEUS may serve as a better useful tool to predict extrathyroidal extension of PTC.

AIM:To investigate the inhibitory effects of triptolide on cell proliferation and metastasis in Burkitt's lymphoma cell line Raji cells.METHODS: The effects of triptolide on the growth of Raji cells were studied by 3-(4,5-Dimethyl-2-thiazolyl)-2,5-diphenyl-2H-tetrazolium(MTT) assay.The effects of triptolide on the cell apoptosis of Raji cells were detected by using Annexin Ⅴ/PI double-labled cytometry.The effects of triptolide on CXCR4 expression on Raji cells were studied by flow cytometric analysis.Chemotaxis assays were performed to observe the effects of triptolide on migration of Raji cells towards recombinant human SDF-1?(rhSDF-1?)in vitro.RESULTS: Triptolide inhibited the proliferation of Raji cells in a dose-and time-dependent way with a 24 h IC50 value of 43.06 nmol/L and a 36 h IC50 value of 25.08 nmol/L.Following the treatment of triptolide,the cell apoptosis rate was increased as the treatment concentration increased and the culture time extended.The effects were dose-and time-dependent.Triptolide could downregulate the expression of CXCR4 on Raji cells in a dose-dependent manner.Moreover,chemotaxis assay suggested that triptolide could block the migration of Raji cells to rhSDF-1? in vitro,and the inhibition was dose-dependent.CONCLUSION: Triptolide could inhibit the cell proliferation and induce the cell apoptosis of Raji cells.Furthermore,it could block the cell metastasis of Raji cells in vitro and the underlying mechanism might be related to the inhibition of the SDF-1/CXCR4 axis.

Objective: To observe the relationship between plasma levels of NT-proBNP and pulmonary hypertension in patients with left heart failure (LHF).
Methods: A total of 391 LHF patients were enrolled in our study, according to pulmonary arterial pressure, the patients were divided into 3 groups: Control group, the patients without pulmonary hypertension,n=102, Mild pulmonary hypertension group,n=94 and Moderate to severe pulmonary hypertension group,n=195. Plasma levels of NT-proBNP, left ventricular diameter (LVD), right ventricular diameter (RVD) and left ventricular ejection fraction (LVEF) were examined and compared among 3 groups.
Results: Plasma levels of NT-proBNP and RVD in Mild pulmonary hypertension group and Moderate to severe pulmonary hypertension group were higher than Control group, those indexes in Moderate to severe pulmonary hypertension group were higher than Mild pulmonary hypertension group,P<0.05-0.001. While LVD and LVEF were similar among 3 groups, P>0.05.
Conclusion: Plasma levels of NT-proBNP were increased in LHF patients combining pulmonary hypertension, the changing trend elevated with the increased pulmonary hypertension accordingly.

Objective To investigate the career decision-making self-efficacy as well as the psychological well-being of medical students and to discuss the correlation between them.Methods A cross-sectional survey with cluster random sampling was performed anonymously among 714 students of different majors and different grades in an medical University.The contents of the survey included the career decision making self-efficacy scale (CDMSE) as well as the self-reporting inventory(SCL-90).All data in the two groups were analyzed with t test; comparison of data between groups were analyzed with One-Way ANOVA; multiple comparison was analyzed with S-N-K; Pearson and Partial correlation analysis were used to analyzed the correlation between the career decision making self-efficacy and wellbeing.Results Totally 659 students completed the inventory,with response rate being92.3％.Average score of the participants' career decision-making self-efficacy was (124.72 ± 26.76)points,situating at the middle and lower level.There were differences in the scores of career decision making selfefficacy among different sexes,sources,grades and being student cadres or not (P =0.019,0.000,0.027,0.026) ; No differences was found among students of different majors and whether being the only child(P =0.243,0.223).Results of the SCL-90 inventory demonstrated that medical students had some psychological problems including obsessive-compulsive,interpersonal sensitivity and anxiety.Correlation analysis showed that psychological well-being and career decision-making self-efficacy was negatively correlated.Conclusions Measures should be taken to improve the medical students' career decision-making self-efficacy according to their psychological characteristics and to improve the medical students' psychological status by the improvement of career decision-making self-efficacy.