BACKGROUND:There is no consensus on the choice of anatomic plate or dynamic hip screw for the treatment of intertrochanteric fracture. Current research is limited to smal-sample studies, and it is difficult to carry out a large-sample multicenter analysis. OBJECTIVE:To carry out Meta-analysis about the literature on anatomic plate versus dynamic hip screw in the treatment of intertrochanteric fractures, in order to evaluate the efficacy of anatomic plate versus dynamic hip screw in the treatment of intertrochanteric fractures. METHODS:The PubMed database (1995-2013), EMCC database (1995-2013), CBM database (1995-2013), CNKI database (1995-2013), VIP database (1989-2013) and Wanfang database (1995-2013) were searched by computer to col ect the control ed trials of anatomic plate versus dynamic hip screw for the treatment of intertrochanteric fractures. Then, the retrieved studies were screened according to predefined inclusion and exclusion criteria. The quality of the included studies was evaluated to extract useful y data, and Meta-analysis was performed by using the RevMan5.0 software. RESULTS AND CONCLUSION:A total of 19 control ed trials were included with a total of 1 730 cases. Among them, 764 cases were belonged to the anatomic plate group, and dynamic hip screw group included 966 cases. The Meta-analysis results indicated that there were no statistical y significant differences in fracture healing time, prognosis excellent and good rate and postoperative complications between two groups (P=0.34, 0.58, 0.80);the operative time, intraoperative blood loss and postoperative drainage volume in the anatomic plate group were lower than those in the dynamic hip screw group (P<0.000 01). The results indicate that anatomic plate and dynamic hip screw have the similar clinical efficacy for the treatment of intertrochanteric fractures, but the anatomical plate has relatively simple operation and less bleeding. Due to the poor quality of the included literatures and high bias occur and influence the effect, so more wel-designed multi-center randomized control ed trials should be performed to provide high-quality evidence.

Objective To investigate two fixation methods for reconstruction of anterior cruciate ligament(ACL)with autogenous patellar tendon graft and their instant stability.Methods 15 specimens were divided into three groups.The first group was treated with 1/3 bone-patellar ligament-bone replacement and in terference screw fixation,the second group was treated with 1/3 bone-patellar ligament and Krackow locked bilateral suture,and in the third group the intact ACL was not treated.The mono-axial tensile tests were performed on a versatile hydraulic material testing machine(WE-5A)to compare the linear load,maximum load,linear straining,maximum straining,linear displacement,maximum displacement,rupture displacement,destructive energy,elastic modulus,and ultimate strength of ACL in the three groups.Results The ACL stability and rigidity in the group of 1/3 bone-patellar-bone replacement and interference screw fixation were higher than those in the other two groups.The differences between test results were statistically significant.Conclusion The ACL reconstruction with 1/3 bone-patellar ligament-bone replacement and interference screw fixation is a good method to ensure higher strength of graft and better joint stability.

Objective To investigate the effect of multidisciplinary intervenient on survival of patients with malignant tumor. Methods Six hundred and thirty-nine malignant tumor patients were randomly assigned to the intervenient and the control group. A total of 584 completed the follow-up study. The intervenient group received comprehensive treatment for 2 years,while the control group was in a process of self-rehabilitation. The 2-year survival rate was compared between the groups by using Cox proportional hazard model. Results The 2-year survival rate was 94. 74% (108/114) or 80. 67% (121/150) in II stage patients of the intervenient or control group, respectively ( P < 0. 01 ) . The 2-year survival rate was 88. 03% (163/177) or 82. 8% (184/222) in early and medium stage patients of the intervenient or control group,respectively(P <0. 01). Conclusion The multidisciplinary intervenient may help to improve the 2 year survival of early or moderate stage malignant tumors.

Adult ; Bronchi ; Foreign Bodies ; Humans ; Male ; Trachea ; pathology

Objective To evaluate the value of using fluorescence in situ hybridization (FISH)technique for the detection of chromosome aberration of urine exfoliated cells for the diagnosis of bladder tumor.MethodsFISH technique were used to detect the abnormalities of chromosome 3,7,17 and 9p16 site from 20 normal people, and to establish the threshold.The morning's first urinations were available from 75 patients with bladder cancer and 25 patients without urothelial tumor, then were detected using FISH technique and urine cytology respectively.The sample was considered positive if two or more probes results higher than the criteria,or one probe has two or more abnormal results.Results The sensitivity of single using were 73.3％ (55/75),76.0％ (57/75),62.7％ (47/75) and 62.7％ (47/75) for the 4 probes (3,7, 17 and 9p16)respectively.The sensitivity of combined detection was 85.3％ (64/75) and specificity was 96.0％ (24/25) The sensitivity and specificity of urine cytology examination was 9.3％ (7/75) and 100％ (25/25) .The sensitivity of FISH examination was significantly higher than that of urine cytology examination (85.3％ vs 9.3％ ,x2 = 57.00, P ＜ 0.001) .Sensitivity of FISH examination was not correlated with cancer pathologic grading(low vs high : 84.2％ vs 86.5％, x2 = 0.08, P ＞ 0.05)and clinical stage (ta-tl : 82.9％, t2-t4 :87.5％, x2 = 0.32 ,P ＞ 0.05) .ConclusionFISH technique is a non-invasive and effective method for the early diagnosis of bladder tumor and is more sensitive than urine cytology.Furthermore, FISH technique can be used to predict the tumor's biological behavivor and prognosis.

Objective This paper aims to make clear the post-disaster medical needs of residents in the disaster areas and changes among the poor population, for the purpose of policy recommendations on post-disaster medical assistance. Methods Such methods as in-home questionnaire survey and literature study were used to study the income, prevalence rate and mental health of 4 380 households in 10 counties (cities and districts) in the disaster areas. Results In the hardest hit areas, 80. 4% and 52. 8% of residents in rural and urban areas are dependent on government relief respectively;the proportion of poor population resulting from the disaster rose from 5% before the disaster to over 75% afterwards in the hard-hit areas, while such a population rose to 15% in the hardest-hit areas and about 10% in general disaster areas;It is estimated that the new medical aid funds in Sichuan Province will reach 350 million yuan, two-fold that of the budget for 2009;In the hardest hit areas, the two-week prevalence rate per thousand people is twice that found in the third survey of health services in 2003, characterized of acute respiratory illness and rheumatoid;In the hardest-hit areas, nearly 70% of the residents are exposed to high mental health risks. Conclusion Recommendations: Strengthening the raising and use of medical aid fund;dynamic management for the population in need of post-disaster medical aid;Developing appropriate medical aid packages to fit post-disaster health needs and postdisaster disease characteristics;and consolidating the connection between medical aid and primary medical insurance system.

Objective To evaluate the curative effect by using transmission straight wire appliance in treatment of adult patients with protruding,to compare with MBT straight wire technique,and to discuss their similarities and differences.Methods Totally 40 protruding patients were assigned into two groups randomly:the transmission straight wire technique group were treated with transmission straight wire appliance,and the MBT straight wire technique group were treated with MBT appliance together with extraoral arch or screw implant anchorage.Cephalometric measurements were compared before and after treatment.Results Average period of treatment was (19 ±4) months for transmission group and (23 ± 4) months for MBT group.The difference was statistically significant (P＜0.05).After treatment,U1/SN,U1/NA,U1-NA,L1/NB,L1-NB,U1-AP,L1-AP,UL-EP,LL-EP were significantly reduced for both patients groups (P＜0.01).U1/L1,nasolabial angle and z angle were increased for both groups (P＜0.05).MP/SN increased by 1.93°(P＜0.05)for transmission group vs.0.81° (P＞0.05) for MBT group.There was no statistically significant difference between the two groups (P＞0.05) except MP/SN (P＜0.05).However,the retraction of anterior teeth in transmission group was greater than that of MBT group,and U1/NA changed (-20.95±8.79)° in transmission group vs.(-16.00 ± 6.52)° in MBT group.Conclusions Both techniques can achieve satisfactory results for protruding cases.The transmission technology can improve soft tissue profile quicker,but anterior teeth have excessive vertical trend,where attention should be paid to control torque on anterior teeth.

Anesthesia safety plays an important role in the medical safety of the perioperative.At present the medical institutions in many countries apply crew resource management model for training and assessment in anesthesiology,surgery and emergency.It emphasizes the training of nontechnical skills,called crisis resource management(CRM).This article analyzes the causes of human error incidents and preventive measures and introduces CRM principles in medical principles and anesthesia correlation and applications.CRM helps to foresee the crisis of environment and deal with the crisis source to ensure the safety of patients.

BACKGROUND:After knee joint replacement, patients are often treated with Rivaroxaban and Enoxaparin Sodium for postoperative anticoagulation, avoiding the formation of deep vein thrombosis in lower limbs. OBJECTIVE:To explore the application effects of different anticoagulant drugs in patients with knee joint replacement. METHODS:Ninety patients underwent knee joint replacement in Xiangya Second Hospital of Central South University from July 2011 to July 2014, were randomly divided into two groups, with 45 patients in each group. The experimental group was treated with Rivaroxaban, while the control group was treated with Enoxaparin. RESULTS AND CONCLUSION:Postoperative drainage volume, total blood transfusion, bleeding index, quantity of blood platelet, activated partial thromboplastin time, thrombin reduction time, whole blood viscosity, plasma viscosity, D-dimer coagulation index, HSS score at postoperative 2 weeks, average ecchymosis area, average thigh circumference, and average leg circumference were significantly better in the experimental group, than in the control group (P<0.05). The incidence of deep vein thrombosis of lower limbs in the experimental group was lower than that in the control group (P<0.05). Experimental findings indicate that, both Rivaroxaban and Enoxaparin can exert anticoagulation effect during the knee joint replacement, and Rivaroxaban is better.

Adult ; Blast Crisis ; Female ; Humans ; Leukemia, Myelogenous, Chronic, BCR-ABL Positive ; complications ; diagnosis ; Ulcer ; diagnosis ; etiology