ObjectiveTo study a standardization to establish data element in medical data resource share.MethodsThe library of data element's structural glossary items was established frist, then whole data element was established by selecting structural glossary items, finally, the input of data element's character was executed.ResultsA standardization method to establish data element was desigened based on definition, structure and national standard of data element.ConclusionIt's a important work to share medical data resource that establish data element by standardization, and it must be followed correlative standard and select logical method.

Objective To investigate surgical techniques for tibial plateau fractures involving the posterior column and the corresponding clinical effect.Methods From March 2009 to January 2012,32 patients with tibial plateau fracture involving the posterior column underwent surgical treatment in our hospital,including 21 males and 11 females,aged from 23 to 60 years (average,40.4 years).There were 30 cases of closed fracture and 2 cases of open fracture.Two patients combined with anterior cruciate ligament avulsion fracture,and 3 patients with posterior cruciate ligament avulsion fracture.Posterolateral and anteromedial approaches were used in 6 patients with posterolateral and medial columns fracture.Posteromedial and anterolateral approaches were used in 7 patients with posteromedial,medial and lateral columns fracture; a small anteromedial incision was added in 2 of them.Posteromedial and anterolateral approaches were used in 11 patients with posteromedial and lateral columns fracture.Posteromedial and posterolateral approaches were used in 2 patients with posteromedial and posterolateral columns fracture,while a single posteromedial approach was used in another patient with same fracture.Posteromedial and anterolateral approaches were used in 3 patients with posteromedial,posterolateral and lateral columns fracture,while posterolateral and anterolateral approaches were used in other 2 patients with same fracture.Results All patients obtained satisfactory exposure and reduction.They were followed up for 5 to 24 months (average,10.7 months).The average bone union time was 15.9 weeks,and the average time from operation to full weight-bearing was 18.1 weeks.The average range of motion of knee was 113.3°.According to HSS (Hospital for Special Surgery) score,the results were excellent in 22 cases,good in 6 cases,fair in 3 cases and bad in 1 case; the total excellent and good rate was 87.5％.Conclusion For tibial plateau fractures involving posterior column,satisfactory reduction and fixation can be obtained via posteromedial and posterolateral approaches which have many advantages such as earlier functional exercise,fewer complications and excellent clinical results.

Objective To learn drug resistance of bacteria isolated from a hospital of Chengdu from 2012 to 2013 .Methods From 2012 to 2013 ,39 732 clinical specimens were collected ,ATB Express half‐automatic bacteria identification system were used to identify the bacteria ,and paper diffusion(K‐B) method was used to do drug sensitive test ,results were judged according to Clini‐cal and Laboratory Standards Institute 2012 standard interpretation ,Whonet5 .6 was used to do statistical analysis .Results In the bacteria isolated from this hospital in 2012 and 2013 ,gram‐positive bacteria accounted for 27 .7% and 37 .4% respectively ,gram negative bacteria accounted for 72 .3% and 62 .6% .The top five pathogenic bacteria were E .coli(16 .3% ,20 .3% ) ,Pseudomonas aeruginosa(11 .5% ,11 .7% ) ,Staphylococcus aureus (11 .3% ,11 .4% ) ,Acinetobacter baumannii(10 .6% ,9 .3% ) ,Klebsiella pneu‐moniae(14 .7% ,12 .0% ) .The detection rates of Methicillin‐Resistant Staphylococcus(MRSA) were 56 .2% ,47 .7% .The positive rates of producing extended spectrum βlactamases(ESBLs) of E .coli and Klebsiella pneumonia accounted for 41 .0% ,32 .2% and 21 .0% ,10 .8% ,which were high sensitive to carbon penicillium alkene antibiotics and amikacin .Susceptibility monitoring results showed that the drug resistance of Acinetobacter baumannii was rising ,and the drug resistant of Pseudomonas aeruginosa to most antibiotic were decline .Conclusion The top five bacteria isolated from this hospital in 2012 and 2013 are given priority to gram‐negative bacteria ,in addition to the drug resistant trend of Acinetobacter baumannii increased slightly ,the drug resistant of other four common bacteria were decline .Clinical attention should focus on positive ESBLs ,E .coli ,Klebsiella pneumoniae ,MRSA and M ulti‐resistant bacteria .

Objective To study the function and mechanism of GIT1(G protein coupled receptor kinase interacting protein 1)in osteoblast migration.Methods GIT1 and ERK1/2(Extracellular Signal-regulated ki- nase 1/2)were detected in mice primary osteoblasts.The localizations of GIT1 and ERK1/2 were determined by immunofluorescence stain with or without PDGF(platelet-derived grnwth factor)stimulation.The association of GIT1 anti ERK1/2 was analyzed by co-immunoprecipitation and western blot.After stimulation,the co-localization of GIT1 and pERK1/2 in osteoblasts was detected by double-immunnfluorescence stain.The pERK1/2 localization was detected by immunofluorescence stain after GIT1RNAh adenovirus infection of osteoblasts.The role of this associa- tion was determined by wound healing assay.Results The co-immunoprecipitation results showed that GIT1 in- teracted with ERK1/2 in osteoblasts induced by PDGF and this association occurred in focal adhesions.GIT1 RNAh adenovirus significantly inhibited the pERK1/2 translocation to focal adhesions and osteoblast migration induced by PDGF.Conclusion GIT1 associates with ERK1/2 in osteoblasts,which is required for pERK1/2 translocation to focal adhesions and osteoblast migration.

BACKGROUND:Distal femur is a predilection site for primary bone tumors, most of which are treated with salvage treatment. There are many reports on the early-stage, mid-term and prognosis of the distal femur tumor-type artificial knee joint prosthesis, but reports on long-term function and prognosis are less.
OBJECTIVE:To study the long-term prognosis and limb function after treatment with rotating-hinge knee prosthesis.
METHODS:Thirty-four patients with distal femoral bone tumors admitted to the Department of Orthopedics, the First Affiliated Hospital of Anhui Medical University between January 2000 and June 2008 were retrospectively analyzed, including 19 males and 15 females. Al patients were subjected to rotating hinge knee prosthesis replacement.
RESULTS AND CONCLUSION:The mean fol ow-up period was 62.4 months (range 11 to 126 months). At the final of fol ow-up, 23 patients were event-free alive and 11 patients were dead. Seven of 23 survival patients suffered from prosthesis related complications, including four cases of prosthesis revision and three cases of amputation. The event-free survival rate of 23 patients undergoing replacement of domestic tumor prosthesis around the knee was 67.6%in 5 years. The mean functional score of affected limb was 19.30 (7 to 27 points):excellent in 6 cases, good in 16, fine in 5 and poor in 2. The excellent-good rate was 75.9%. The clinical outcomes suggested that the satisfactory limb function and survival rate could be achieved with the application of domestic tumor prosthesis replacement for treatment of malignant bone tumors around the knee.

Objective To discuss the femoral neck anteversion(FNA) of developmental dislocation of the hip(DDH) and guide operation with visual and digitalized picture in the dimensional(3D) CT.Methods Ninety children with unilateral DDH were selected,and they were analyzed using 3D CT.Children whose FNA exceed 45 degree received the subtrochanter osteotomy with images from different direction,FNA of hip was measured respectively before and after operation and was measured in normal and abnormal hips respectively,FNA of hip received respectively statistical treatment.Ninety patients (90 hips) were followed up ranging from 3 months to 2 years with the mean of 13 months.Results In the group younger than 18 months,the FNA whose in normal hips was(19.40?3.512)degree,the FNA while(68.45?12.272)degree in dysplasia hips respectively,the FNA measured after operation was (20.45?2.940) degree;in the group elder than 6 years,there were significantly statistical differences,the FNA in normal hips was(19.44?3.561)degree,in dysplasia hips respectively was(73.49?12.678)degree,while the FNA measured after operation was(18.28?1.931)degree.Clinical assessment was performed according to Mckay′s classification.The results showed that the overall excellent or good rate was 95.6%.Conclusions 3D CT method is a new accurate and convenient and reduplicative method for measuring FNA.It will be more helpful for related operations when 3D images are considered.

BACKGROUND: The effectiveness of femoral nerve block in perioperative analgesia for total knee arthroplasty has been widely recognized, but the need for combined sciatic nerve block remains controversial.OBJECTIVE: To investigate the analgesic effect and rehabilitation training of femoral and sciatic nerve block in the perioperative period of total knee arthroplasty. METHODS: 150 patients undergoing total knee arthroplasty were randomly divided into three groups: general anesthesia, femoral nerve block and femoral and sciatic nerve block groups. The visual analogue scale scores at rest and in activity, range of motion of the knee, postoperative hospitalization time, adverse effects and the Hospital for Special Surgery scores were recorded and compared among groups.RESULTS AND CONCLUSION: (1) The order of visual analogue scale scores at rest and in activity at each time point postoperatively was as follows: general anesthesia group > femoral nerve block group > femoral and sciatic nerve block group (P < 0.05). (2) The range of motion of the knee at different time points postoperatively was largest in the femoral nerve block group, followed by the femoral nerve block group, and smallest in the general anesthesia group (P < 0.05). (3) The postoperative hospitalization time in the femoral nerve block and femoral and sciatic nerve block groups was significantly less than that in the general anesthesia group, and the time in the femoral and sciatic nerve block group was significantly less than that in the femoral nerve block group (P < 0.05). (4) The Hospital for Special Surgery scores at 1 month postoperatively in the femoral nerve block and femoral and sciatic nerve block groups were significantly higher than those in the general anesthesia group, and the scores in the femoral and sciatic nerve block group were significantly higher than those in the femoral nerve block group (P < 0.05). But the Hospital for Special Surgery knee scores at 3 and 6 months postoperatively did not differ significantly among groups (P > 0.05). (5) These results indicate that the femoral and sciatic nerve block has better postoperative analgesia effect compared with general anesthesia and femoral nerve block under multimodal analgesia in total knee arthroplasty, which is favorable for early rehabilitative training.

BACKGROUND: Documents recorded that the correlation between micro emulsion Ciclosporin peak concentration (C_2) and area under curve was best with maximum individual difference. According to C_2, dose of Ciclosporin can be adjusted indMdually to decrease acute rejection and Ciclosporin toxicity, which has widely used in perioperative stage of renal transplanted recipients. However, some transplantation center still used tough concentration (C_0) to adjust the dose of Ciclosporin in stable stage of renal transplanted recipients. OBJECTIVE: To analyze the efficacy and safety of changing from monitoring C_0 to C_2 in stable stage recipients following renal transplantation. METHODS: Totally 65 patients with renal transplantation were enrolled in this study, including 31 males and 34 females, aged 20-57 (39.4±15.3) years. Within 3 months prior to this study, all patients did not suffered from rejection, and their serum creatinine and urea nitrogen were stable (creatinine ≤180 μmol/L). They were in stable stage after renal transplantation. Their period of transplantation and function of allograft were recorded. Their C_0 and C_2 of Ciclosporin were assayed. According to the target C_2 value 500-600 μg/L, the patients were prospectively and randomly divided into 3 groups. In the high C_2 group (n=17), the dose of Ciclosporin was decreased. In the target C_2 group (n=23), the dose of Ciclosporin was remained. In the low C_2 group (n=25), the dose of Ciclosporin was increased. All of the patients were followed-up for 12 months. The grafts function and the complications of heart, lung and brain were compared. RESULTS AND CONCLUSION: According to the target concentration of Ciclosporin C_2, the dose of Ciclosporin in the high C_2 group was decreased by 575.0 mg. The Creatinine and urea nitrogen of 88% patients were stable, while blood pressure, blood fat and blood uric acid decreased in parts of patients. In the target C_2 group, the levels of creatinine, urea nitrogen, Co and C_2 of patients were stable, no complications of heart, lung and brain occurred. According to the target concentration of Ciclosporin C_2, the dose of Ciclosporin in low C_2 group was increased by 755.0 mg. The creatinine and urea nitrogen of 84% patients were stable. All of the patients were no complications of heart, lung and brain. It is safe and effective to adjust Ciclospori dose under C_2 monitoring according to the target peak concentration (500-600 μg/L) in most stable stage recipients following renal transplantation.

Objective To assess the role of muhi-detector row CT (MDCT) in preoperative evaluation of living renal donors. Methods The data of 104 potential donors who underwent MDCT were retrospectively analyzed. All the candidates underwent 64-MDCT examination. First,unenhanced scans were performed on the kidneys. After administration of Ⅳ contrast medium,enhanced CT images of the arterial phase, venous phase, and excretory phase were obtained. The enhanced scan scope was from the top of diaphragmatic muscle to pubic symphysis. The scanning data obtained was post-processed for reconstructed images. The anatomy and variations displayed in MDCT images on kidneys, ureters, arteries and veins were recorded. The findings in surgery constituted the standard of reference for imaging findings, and the recorded results from images were compared with the findings in surgery to assess the role of MDCT in evaluation of potential donors. Results MDCT examination was successfully performed on 104 candidates. Anomalies of kidneys and ureters were found in 8 donors before surgery. The prevalence of accessory arteries and early branching in image was 27. 2 % (28/103) and 12. 6 % (13/103) respectively. There were 3 candidates with double veins and 3 with retroaortie left renal vein found in preoperative assessment. Ninety-three candidates underwent successful donor nephreetomy. The anomalies and variations of kidneys and ureters in images were all confirmed surgically. The detection rate of the accessory renal artery (ARA) was 80 %. The ARAs measuring > 1 mm in diameter and early branching were all detected by MDCT.The findings of veins found in performed sides coincided with those of MDCT images. Conclusion MDCT can accurately assess the anatomic information and variations of the donors' kidneys, and facilitate triaging donors and planning operation proposal

Objective To evaluate the anatomic changes and dosimetric variations of patients with nasopharyngeal carcinoma (NPC) during the course of simultaneous integrated boost intensity-modulated radiotherapy (SIB-IMRT) by comparison of the dosimetric differences with or without replanning.Methods Twelve cases with NPC treated with SIB-IMRT underwent repeated CT scans after 20- 25 fractions of the initiation of therapy.The original treatment plan ( Plan1 ) based on the first CT scan ( CT1 ) and the second IMRT plan (Plan 2) based on the second CT scan (CT2) were calculated with an inverse planning system (Pinnacle3,Philips Medical System).In addition,the hybrid IMRT plan,Planl (CT2),was generated by deformable registration with MIMVISTA software,and the doses in Plan 1 ( CT1 ) and Plan 2 ( CT2 ) were accumulated based on CT2.The dosimetric differences were compared among the Plan 1 ( CT1 ),Plan 1 (CT2) and Plan 1 + 2(CT2).Results Compared with CT1,the mean volumes of the right and left parotid glands in the CT2 were significantly smaller by ( 24.6 ± 11.9 ) ％ and ( 35.1 ± 20.1 ) ％,respectively.Compared with Plan 1 ( CT1 ),the dose received by 95％ of the target ( D9s ) to PGTV,PTV1 and PTV2,and mean dose (D ) to PGTV,and PTV2 were all significantly lower in the Plan 1 (CT2),indicating that the doses to targets decreased without replanning.With repeated CT and replanning after 25 fractions as shown in Plan 1 + 2 (CT2),the doses to targets would be improved.The doses to normal tissue were increased without replanning,although no statistical significance was observed.In 5 of 12 cases,the doses to the spinal cord and brainstem exceeded the constraint without replanning,while the corresponding values decreased with replanning.Conclusions During the course of IMRT for cases with NPC,the volumes of the targets and parotid glands decrease significantly.Mid-treatment CT scanning and replanning should be recommended to ensure adequate doses to the targets and safe doses to the normal tissues.