Objective To evaluate the clinical results using modified Richards nail treating femoral intertrochanteric comminuted fractures.Methods From March 2002 to March 2005,69 patients suffered from femoral intertrochanteric comminuted fractures belong to Evan Ⅲ type or Ⅳ type were randomly divided into experimental group and control group.The experimental group was treated with modified Richards nail,including 34 patients,18 males and 16 females.The patients were from 61 to 78 years old,and the mean age was 67.5 years old.In this group,21 patients were involved in left femoral intertrochanteric comminuted fractures,13 patients were involved in right.The pattern of the fractures included EvanⅢ type in 24 cases and Ⅳ type in 10 cases.The control group including 35 patients was treated with DHS,and there were 19 males and 16 females with an average age of 65.9 years(ranged 61 to 80 years).In this group,19 patients were involved in left femoral intertrochanteric comminuted fractures,16 patients were involved in right.The pattern of the fractures included EvanⅢ type in 25 cases and Ⅳ type in 10 cases.Results The experimental group were followed-up 9-23 months with a mean of 11.60?3.78 months.The control group were followed-up 9-24 months with a mean of 11.40?4.12 months.In experimental group,the average fracture healing time was 3.65?0.97 months.While in the control group,the average fracture healing time was 4.32?1.38 months.In experimental group,the leg length measured at the 9th month post-operatively was averagely(0.82?0.36)cm shorter in the diseased side than in the healthy side,while in control group the leg length was averagely(1.08?0.51)cm shorter.There was significant difference between two groups.Compared to the control group,the curative effect was better in the experimental group.Conclusion Treating femoral intertrochanteric comminuted fractures with the modified Richards nail shows a good result,which can effectively diminish the non-union or mal-union of the fractures.

Objective To study the relationship between postoperative complications and preoperative conditions of pancreaticoduodenectomy.Methods The datas from 67 patients underwent pancreaticoduodenectomy involving age,level of albumin and total bilirubin, diabetes mellitus or other merging cruns and postoperative complications and fatality rate were retrospectively analyzed. Results Incidence rate of postoperative complications, was 29.8%; fatality rate was 4.5%. The main complications were pancreatic fistula, abdominal cavity infection, upper digestive tract bleeding, cardiac insufficiency, pneumonia, slash site dehiscence, guts fistula and so on. Conclusion Perioperative and management is important in preventing complications.

Cryptococcosis ; complications ; Eosinophilia ; etiology ; Humans ; Lung Diseases, Fungal ; complications

Objective To analyze the immediate and following up result of 122 patients with acute myocardlal infarction(AMI)which underwent emergency percutaneous coronary interventlon(PCI).Methods 122 cases of AMI patients underwent the emergency PCI by transfemoral artery approach during June 1998 to December 2005.119 casea performed primary PCI,3 performed rescue PCI.Results The successful rate of vessel visualization and operation were 95.1%.93.4%.respectively.5 eases were with the help of intra-aortic balloon pumping.Subacute instent thrombosis occurred in 2 patients.In-hopital mortality was 4.1% (5/122).The left ventricular ejection fraction in echocardiography one after week was(0.55±0.16).Average hospital day is(9.5±5.8)(1～36).6-month mortality was 5.7%(7/122).Conclusion Primary PCI expanded the indication for the treatment of STEMI patients wlth establishment of patent infarct related artery and normal blood flow,increased tlle survival of high-risk patients,and shortened the hospitalization.Rescue PCI was an effective measure for the patients failing to intravenous thrombolysis.

Dust ; Humans ; Maximum Allowable Concentration ; Occupational Exposure ; adverse effects ; Research Report ; Silicon Dioxide ; toxicity

Objective To demonstrate the result that progression of disease and prognosis of gastrointestinal cancer patients are correlated with the expression of the cluster and the abundance of lost goodwill target (LGT) fingerprint. Methods To research the period of survival and the time of death, 61 patients treated by SELDI (Surface enhanced laser desorption/ionization-time of flight-mass spectrometer)were involved in. According to the fingerprint spectrum obtained by SELDI and the appearance of fingerprints of LGT, these patients were divided into four groups namely non-peak, single-peak, double-peak, tri-peak and multi-peak groups. By means of Multi-factor analysis of variance and Cox regression analysis of risk, we compare four groups each other so as to find out one group in which patients have the greatest risk of death.Results Among the fingerprint spectrums of patients suffered from gastrointestinal cancer, which were obtained by SELDI, the patients with negative expression of LGT had low risk of death, which were lower than those of single-peak and double-peak groups, especially lower than those of tri-peak and multi-peak groups;the risk of death among the tri-peak and multi-peak groups were much higher than single-peak, the difference had statistical significance (P ＜0.05), and the death rate is rather high. Conclusion Among the serums from cancer patients tested by SELDI, the expression of LGT with tri-peak and multi-peak suggested that patient' s state of illness is about to deteriorate. This kind of fingerprint spectrum can be regarded as positive indicators,and the negative expression of LGT suggested that patient will have a good prognosis with a very low risk of death in the near future.

BACKGROUND:The auditory ossicle chain reconstruction is stil an important method to treat conductive deafness. Although a great variety of materials have been applied, the blood supply of otosteon after the implantation is ignored. Moreover, there is no real bone formed.
OBJECTIVE:To observe the angiogenesis of vascular endothelial growth factor and col agen I modifiedβ-tricalcium phosphate porous scaffold which is implanted into the otocyst of guinea pig.
METHODS:Total y 60 guinea pigs were randomly divided into experimental group (vascular endothelial growth factor and col agen I modifiedβ-tricalcium phosphate porous scaffold), col agen I control group (col agen I modifiedβ-tricalcium phosphate porous scaffold) and blank control group (β-tricalcium phosphate porous scaffold). The guinea pigs were executed under anesthesia at weeks 1, 2, 3, 4 respectively. The surface of scaffolds was observed by scanning electron microscopy. The angiogenesis of scaffolds were observed by hematoxylin-eosin staining and CD34 immunohistochemistry staining, and then the microvascular density was counted. The osteogenesis of the scaffolds was observed by toluidine blue staining.
RESULTS AND CONCLUSION:Endothelial cel proliferation and lumen formation could be observed after 1 week in the experimental group, and the angiogenesis reach the peak after 3 weeks with traffic branches formedbetween micropores. In the other two groups, the lumen formed at 2 weeks but no traffic branches were visible. The sprouting of new blood vessels in the pores were observed more in the experimental group than the other two groups (P<0.05). The adherence and proliferation of cel s could be examined in the surface and pores of the scaffold by scanning electron microscope. After 4 weeks, the osteogenesis could be observed by toluidine blue staining, especial y in the experimental group. These findings suggest that the vascular endothelial growth factor and col agen I modifiedβ-tricalcium phosphate porous scaffold can realize an effective vascularization in the environment of guinea pigs’ middle ear. What’s more, the scaffold also can promote bone formation.

Objective To compare the short-term safety and efficacy of radiofrequency ablation (RFA) and microwave ablation (MWA) for treatment of large benign thyroid nodules.Methods A total of 34 patients with large benign thyroid nodules were studied retrospectively,including 13 patients treated with ultrasound-guided RFA and 21 patients treated with MWA between Jun.,2016 and Feb.,2017 in Zhongshan Hospital.The thyroid function parameters,serum antibodies,complications and thyroid nodules volume reduction rate(VRR) were compared between the two groups during the follow-up.Results There were no statistically significant differences(P＞0.05)among those patients before and after treatment in serum free triiodothyronine (fT3),free thyroxine (fT4),thyroid stimulating hormone (TSH),anti-thyroglobulin antibodies (TG-Ab) levels,and thyroid peroxidase antibodies (TPO-Ab).One patient in the MWA group had mild hoarseness after ablation and another patient in the RFA group had intraoperative hemorrhage for about 10 mL.There were no other complications such as neck scar,postoperative infection,skin burns,tracheal and esophageal injury.One day after the ablation,all nodules were showed hypoecho and contrast-enhanced ultrasound proved there was no blood supply.One month after treatment,no statistically significant difference was found in VRR between two groups (23.8％ vs.22.6％,P =0.127).Conclusions RFA and MWA are safe and effective treatments for large benign thyroid nodules,and no significant difference was observed in short-term follow-up.

OBJECTIVE:To discusses the influencing factors on the safety and efficacy of pediatric drugs.METHODS:The errors in administration of pediatric drugs were analyzed.The drugs under current use in the pediatric pharmacy of our hospital were classified and compared as per quantity,dosage form,specification,medication safety, direction and medicine evaluation. RESULTS: The influencing factors mainly included the subjective factors(wrong drug treatment) and the objective factors (pharmaceutical factors and social factors) .CONCLUSION: To safeguard the efficacy and safety of pediatric drugs, it' s advisable that an evaluation or control system for rational use of pediatric drugs be established with the participation of the society, the hospital and patients.

Objective To examine the effect of modified electroconvulsive therapy (MECT) on the plasma oxida-tive stress level in bipolar depression. Methods Forty-two patients with bipolar depression were randomly divided into two groups. The intervention group (n=18) received antidepressants and 12 times MECT for 6 weeks and the control group (n=24) received antidepressants and Li2CO3 for 6 weeks. The Chinese versions of the 17 items Hamilton Depression Rating Scale (HAMD-17), Young Mania Rating Scale (YMRS), Clinical Global Impression Scale (CGI-S) and Treatment Emergent Symptom Scale (TESS) were used to assess participants at baseline and after 6 weeks of treatment. The plasma levels of superoxide dismutase (SOD), catalase (CAT), glutathione peroxidase (GSH-Px) and malondialdehyde (MDA)were detected at baseline and after 6 weeks to assess the level of oxidative stress. Results Repeated measures analysis of variance showed that the plasma level of SOD was higher in MECT group than in Li2CO3 group (F=15.26, P<0.01), and the level of MDA was higher in Li2CO3 group (F=18.18, P<0.01). The interactive effect of group and time was significant in GSH-Px level (F=6.39, P=0.02). The level of GSH-Px was lower in MECT group than in Li2CO3 group after 6 weeks (P<0.05). The CAT level was higher in the response patients than in non-response patients after 6 weeks (P<0.05). Con-clusions Both MECT treatment and Li2CO3 treatment can alter oxidative stress levels in patients with bipolar depression. The mechanisms underlying its therapeutic regimen may correct the imbalance of the plasma CAT level.