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.

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 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 .

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 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 investigate the clinical effects of transurenthral resection of muscleinvasive bladder tumor (TURBT) in senile. Methods This study was clinical prospective random research.46 senile cases with muscle-invasive bladder cancer treated by TURBT was divided into 2 groups:control group and observed group.The observed group was treated with TURBT combined with intravesical instillation of pirarubi 30 mg immediately after TURBT,the bladder wall around tumor was resected thoroughly.The control group underwent radical cystectomy and pelvic lymph node dissection. Results The clinical improvement rate was higher in observed group than control group (85.7％ s.63.6％,X2 =5.3008,P=0.021).There was not difference in 3 years recurrence rate between observed group(25.0％) and control group(13.6％) (x2 =S.3008,P＞0.05).The 1 year survival rate were 95.8％,90.9％ and 3 years survival rate were 79.2％,72.7％ in observed group and control group,respectively,and there were no differences between the two groups(X2 =0.262,P=0.609). Conclusions TURBT combined with intravesical instillation of pirarubi can enhance clinical effect and reduce recurrence rate in the treatment of the elderly with muscle-invasive bladder cancer.

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.

OBJECTIVE: To evaluate the extent of endolymphatic hydrops as shown by three-dimensional fluid-attenuated inversion recovery magnetic resonance imaging (3D FLAIR MRI) performed 24 hours after bilateral intratympanic gadolinium administration and discuss the positive rate of endolymphatic hydrops in vestibule and cochlea. METHOD: Twenty-four hours after bilateral intra-tympanic 8 times diluted gadolinium administration, three-dimensional fluid-attenuated inversion recovery MRI, using a three-Tesla unit, was performed in 48 patients, and then assessed the extent of endolymphatic hydrops in the MRI images. RESULT: Forty-eight patients showed different levels of enhancement of perilymth in the inner ear. In these patients, obvious signs of endolymphatic hydrops were visualized in vestibule,including 8 slight hydrops, 17 mild hydrops and 23 severe hydrops with a diagnostic rate of 83.3%. There were almost no complications in all 48 patients after bilateral intra-tympanic injection except short vertigo in some of them. CONCLUSION 3D FLAIR MRI resonance imaging has a high positive diagnostic rate in assessing endolymphatic hydrops of Ménière's disease and provides direct imaging evidence for diagnosing Ménière's disease.
Cochlea ; Contrast Media ; Ear, Inner ; Ear, Middle ; Gadolinium DTPA ; Humans ; Imaging, Three-Dimensional ; Injections ; Magnetic Resonance Imaging ; Meniere Disease ; diagnosis ; Vestibule, Labyrinth

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.

Nowadays, the research performance evaluation in Traditional Chinese Medicine (TCM) is basically exploring the principles and rules. What become the problems are that what index system can fully reflect the TCM performance evaluation, and what method can reflect the characteristics of TCM performance evaluation. Analyzing the status of the Korean research performance evaluation, we briefly disseminated how to establish the TCM performance evaluation.