OBJECTIVETo compare the efficacy of internal fixation (including PFNA and PFN) versus hip replacement (including FHR or THA) in the treatment of trochanteric fractures in adults.

METHODSReports of studies using randomized controlled trials (RCT) to compare internal fixationg with hip replacement in the management of intertrochanteric fractures were retrieved (up to January 1, 2013) from the Cochrane Library, PUBMED Data, CNKI (China National Knowledge infrastructure), Elsevier, the Chinese Biomedical Database, Wanfang Data, and manually. Methodological quality of the trials was critically assessed, and relevant data were extracted. Statistical software RevMan 5.0 was used for data-analysis.

RESULTSSeven articles were included in the meta-analysis. The results showed that,compared internal fixation with hip replacement,there were statistical significance in the duration of surgery time [WMD = -2.66, 95% CI (-5.25,-0.06), P = 0.05], intra-operative blood loss [WMD = -24.20, 95% CI (-30.38, -18.02), P < 0.000 01], hospital stays time [WMD = -4.72, 95% CI (-5.18, -4.25), P < 0.000 01], bearing load time [WMD = -29.54, 95% CI (-30.77, -28.31), P < 0.000 01], total complications rate [WMD = 0.15, 95% CI (0.11, 0.22), P < 0.000 01], the good rate of Harris scores [WMD = 1.09, 95% CI (0.54,1.32), P < 0.05]. However, there were no statistical significance in the rate of deep venous thrombosis [WMD = 1.09, 95% CI (0.47, 2.55), P > 0.05]. CON- CLUSION: Hip replacement (containing FHR or THA) for the treatment of intertrochanteric fractures is superior to internal fixa- tion in regards to the duration of surgery time, the mean duration of hosipital stays, mean post-operative down time, intra-opera- tive blood loss, the rate of post-operative good Harris scores. But there is not enough evidence to show any difference between hip replacement (containing THA or FHR) and internal fixation in regards to the rate of deep venous thrombosis. However, internal fixation for the treatment of intertrochanteric fractures is superior to hip replacement (containing FHR or THA) in regards to total complications rate.

Arthroplasty, Replacement, Hip ; methods ; Fracture Fixation, Internal ; methods ; Hip Fractures ; surgery ; Humans

ObjectiveTo evaluate the impact of anatomic and non-anatomic liver resection on prognosisofpatientswithsmallhepatocellularcarcinoma( HCC ) usingaMeta-analysis.MethodsLiterature on anatomic versus non-anatomic liver resection for the treatment of small HCC ( ≤5 cm) was retrieved. ResultsFour nonrandomized controlled trials were included consisting of 776 patients:484 undergoing anatomic liver resection and 292 non-anatomic resection.The age ranged from 53.4 to 63.0 years.Male ∶ female ratio was 3.56 ∶ 1.87.1％ patients were Child-Pugh class A.Most patients (94.5％ ) had a single tumor.No significant differences were found conceming the 1,3,and 5 year disease-free survival rate between the two groups.There was no significant difference in overall survival and disease-free survival between the two groups at 1,3,and 5 years.Sensitivity analysis found anatomic resection was superior to non-anatomic resection in 3 year disease free survival rate (OR =0.72,95％ CI:0.52 - 0.99,P =0.04). ConclusionsAnatomic liver resection elevated the 3 year disease free survival rate of patients with small hepatocellular carcinoma when compared with non-anatomic hepatectomy but failed to further elevate long-term disease free survival and overall survival.

Objective To develop an ELISA method for determination of heparin-induced thrombocytopenia (HIT)antibody. Methods The compound formed between human platelet factor 4 (PF4)and heparin was used as the coating antigen,incu-bating the patients plasma with the coating antigen in the well,after washing,the second antibody labeled HRP was added in the well to incubate and washing again,the chromogenic substrates was added in the well to incubate,when the stop reaction was finished,the absorbance A450/A630 was detected,and the test results were judged according to standard,this method was compared with IBL method and was optimized and evaluated the performance.Results An indirect ELISA method was de-velop with the purified human PF4,the optimal dilution of sample and second antibody were 1∶100 and 1∶1 500 which de-tected by the orthogonal test,the intra-and inter-assay average coefficients of variation were 7.66% and 7.76%(<10%) respectively that detected by repeated measurement the three positive standard plasma.Through measureing the 100 healthy human plasm with no history of using heparin,the positive and negative predictive reference values were 0.304 and 0.456. IBL and this method detected 100 hemodialysis patients samples at the same time,and the result of statistical analysis was that,the sensitivity,speciality and accuracy of this method were 90%,97.78% and 90%,respectively.The negative and posi-tive predictive value were 81.8% and 98.88% respectively,and the difference was statistically significant [K=0.84(0.81~1)and Pexac=0.012<0.05].The difference was statistically significant,consistency was optimal,95% confidence interval was 92.59%~92.59%.Conclusion Comparing with the IBL,the method reported by this article had the similar perform-ance and good consistency,and it could satisfy the clinical detection and diagnosis of HIT patients.

Objective The expression and impaired function of ion channels might be one of the pathophysiological mecha -nisms responsible for diarrhea in inflammatory bowel disease ( IBD) .Proper animal model is the key to explore detailed pathophysiolog-ical process.The purpose of this study was to build a rat model of acute colitis induced by dextran sodium sulfate (DSS) in C57BL/6 mice and evaluate diarrhea-associated clinical , histological , pathological parameters and expressions of ion channel protein . Methods C57BL/6J mice of model group were treated with 4%DSS solution for 7 days to induce acute colitis.Mice body weight, stool moisture, stool consistency and the degree of hematochezia were recorded .The histopathological changes of mice colon specimens were observed visually and microcosmically, and the ion channel SLC26A3 protein was detected by Western Blot . Results All experimental mice survived.In the experiment, compared with control group , bloody diarrhea and weight lose occurred in model group , along with increased stool moisture ([73.30 ±8.31]% after experiment vs [44.32 ±6.42]% before experiment, P=0.004), and rapidly in-creased disease activity index (DAI) of acute colitis ([3.50 ±0.87] after experiment vs [1.0 ±0.00] before experiment, P=0.000).At the end of this experiment , compared with control group , the model group resulted in higher colonic damage score and pathological inflammation score (P=0.00, P=0.002), significantly shortened co-lon (P=0.00) and decreased expression of SLC26A3. Conclusion The intestinal mucosal injury and phenotypic features of 4%DSS-induced acute colitis are very similar to those of human ulcerative colitis .Impaired expression of intestinal ion transporter SLC26 A3 coexists with diarrhea in model group mice , and this model can support the research on mechanism of functional changes of ion channels in inflammatory diarrhea .

The effect of initial substrate concentration on the growth,metabolic activities of Photosynthetic bacteria (PSB) in the process of hydrogen production is studied.The empirical relation of the initial substrate concentration to the specific growth rate,specific substrate consumption rate and specific hydrogen production rate of PSB are developed based on the modified Monod model.It is found that the results given by the model are well agreed with the experimental data in growth phase and stationary phase of PSB.Meanwhile,the optimal substrate concentration in the process of growth,metabolism and hydrogen production is 50 mmol/L.Furthermore,when the initial substrate concentration deviates 50 mmol/L,the activation of PSB is limited or inhibited,and the inhibiting effect is more prominent than the limiting effect.In addition,it is demonstrated that initial substrate concentration has little effect on the specific substrate consumption rate.

Objective To study CT and MRI appearance of transient hepatic attenuation difference (THAI)) .to reveal the cause of THAD),and to avoid false positive and misdiagnosis.Methods 10 cases appearing THAD in CT and 5 cases appearing THAI) in MRI were reviewed and all were processed with plain scan and dy- namic contrast with CT or MRI.Results 7 cases appeared transienl hypertransfusion of CT,4 cases appeared tran- sient hypertransfusion of MRI;3 cases appeared transient Hypoperfusion of CT,1 case appeared transient hypoperfu- sion of MRI.Conclusion The appearance of THAD in CT and MRI,was related to the quick-scan with CT and MRI only sufficient comprehension of the characteristics of blood supply in normal physiology and pathology of liver, combined with plain scan,could make correct decision possible in the final diagnosis when it occurred regional perfu- sion difference in liver.

The growth characteristics of hydrogen-production photosynthetic bacterial biofilm in a plate-type biofilm bioreactor were studied experimentally.The effect of hydraulic and nutritional conditions on the surface coverage,thickness,dry weight,and density of Rhodoseudomonas palustris biofilm was observed,respectively.Glucose in the influent concentration range from 0.05 to 10 g/L was used as the sole carbon source.Liquid flow rate was varied from 37.8 to 1080ml/h in the experiments.Experimental results showed that the hydraulic and nutritional conditions had significant influences on the growth rate and structure of biofilm.In a lower flow rate range,high liquid flow rate was propitious to the diffusion of substrate from liquid phase to solid-liquid interface,which resulted in the fast development of biofilm on the solid-liquid interface.However,some parts of biofilm were scraped off when the flow rate exceeded a threshold.At a fixed liquid flow rate,the biofilm density increased with the increase in the substrate concentration.The biofilm having thick and loose structure was developed under low substrate concentration condition.The biofilm structure was convenient for the nutrient transfer in the biofilm,which is a survival strategy of microorganisms facing adverse circumstances.

The Illustrations of Moxibustion, a remained book in Dunhuang Caves, is available the earliest monograph about moxibustion methods with both pictures and writing since recorded writing. In treatment of 5 kinds of strain and 7 kinds of impairments, point association for correspondence between man and universe was adopted human point distribution according to Jiugong and Bagua; and point association method of viewing the situation as a whole according to humam point distribution on the head, the body and the limbs; it wrote and drew available the earliest naked figures for acupuncture and moxibustion in simple natural materialism; and it is the most reasonable, the most complete explanation of sexual science in Chinese medicine, and is a sample for treatment of 5 kinds of strain and 7 kinds of impairments by ancient physicians stressing moxibustion, with convenient point selection and safety.
Acupuncture ; Acupuncture Points ; Acupuncture Therapy ; Caves ; China ; Humans ; Medicine, East Asian Traditional ; Moxibustion

Objective To observe the anatomic and imaging morphology ofjugnlar bulb and its relationship with the surrounding structures, and to investigate the classification ofjugnlar bulb and its clinical significance. Methods We dissected 30 human temporal bones and studied multi-slice spiral CT imaging data of temporal bone of 120 cases and blood vessel cast mould specimen of the jugular bulb of 6 cases, to observe the morphology of jugnlar bulb and its spatial relationship with the surrounding structures. We made an imagined sagittal plane on the medial well of the tympanic cavity, with a horizontal tangent line of the proximal wall of the tympanic cavity and a vertical tangent line of the posterior wall of the tympanic cavity as coordinate axes (X axis and Y axis), respectively, so the 4 quadrants ( Ⅰ , Ⅱ, Ⅳ, Ⅳ) were formed. The jugular bulb was classified intro 4 types according to the quadrant where its top was projected and subtyped according to its position on the inner or outer side of the plane. The operation via mastoid approach was simulated on specimen to observe the effect of jugnlar bulb on the operation route. Results Some jugular bulbs were flat type and others were prominent types. The classification in the group of CT image: type Ⅰ , 11 case (9%);type Ⅱ, 63 cases (53%);type Ⅲ, 25 cases (21%);type Ⅳ, 21cases (17%). The classification in the group of specimen: type Ⅰ, 1 case (3%);type Ⅱ, 11 cases (37%);type Ⅲ, 8 cases (27%);type Ⅳ, 10 cases (33%). Each type of the jugular bulb had different effects on the operative approach. Conclusions The classification method with the 4 quadrants is a simple and three-dimensional way to describe the position of the jugular bulb for imaging diagnosis or operative scheme design.

OBJECTIVETo detect central obesity and related adverse cardiovascular disease risk factors by waist-to-height ratio (WHR) among normal weight adults in Chongqing area.

METHODSA total of 20 000 participants aged 18 - 59 from one hour economic cycle of Chongqing area were selected by group sampling method. We measured the height, waist circumference (WC), body weight, blood pressure, blood lipid and blood sugar. Body Mass Index (BMI) and WHR were computed. We analyzed the differences of the correlated indexes between non-central obesity group (WHR < 0.5) and central obesity group (WHR ≥ 0.5) of those had normal weight (18.5 ≤ BMI (kg/m(2)) < 24). And we used logistic regression method to analyze the relation between central obesity and related adverse cardiovascular risk factors.

RESULTSAmong 11 612 normal weight subjects, 1801 (15.51%) participants were normal weight central obesity. Of non-central obesity group and central obesity group, the levels of waist WC were (73.71 ± 5.91) and (84.47 ± 4.58) cm (F = 328.74, P < 0.01); diastolic blood pressure levels were (72.85 ± 10.30) and (78.22 ± 11.90) mm Hg (1 mm Hg = 0.133 kPa, F = 23.62, P < 0.01); triglyceride levels were (1.22 ± 0.95), (1.97 ± 1.91) mmol/L (F = 114.70, P < 0.01); total cholesterol levels were (4.66 ± 0.84) and (5.04 ± 0.92) mmol/L (F = 13.10, P < 0.01); high density lipoprotein levels were (1.41 ± 0.31), (1.25 ± 0.29) mmol/L (F = 29.44, P < 0.01); low density lipoprotein levels were (2.65 ± 0.74) and (3.03 ± 0.77) mmol/L (F = 9.98, P < 0.01); glycemia levels were (4.94 ± 0.82) and (5.25 ± 1.37) mmol/L (F = 47.21, P < 0.01). The results of the logistic regression analysis showed the central obesity normal weight group was 1.28 (1.02 - 1.60), 1.49 (1.20 - 1.84), 2.24 (1.92 - 2.60), 1.77 (1.53 - 2.05), 1.58 (1.15 - 2.16) and 1.31 (1.06 - 1.63) times more likely than the normal group to have significantly elevated levels of systolic blood pressure, diastolic blood pressure, triglyceride, high density lipoprotein, low density lipoprotein and blood glucose.

CONCLUSIONWHR can effectively reflect the normal weight central obesity and the risk factors of cardiovascular disease;the adverse cardiovascular disease risk was high among normal weight central obesity adults.

Adolescent ; Adult ; Body Height ; Body Mass Index ; Body Weight ; Cardiovascular Diseases ; epidemiology ; China ; epidemiology ; Female ; Humans ; Male ; Middle Aged ; Obesity ; Obesity, Abdominal ; epidemiology ; Risk Factors ; Waist Circumference ; Young Adult