[Objective]To discuss the application of the short reconstruction intramedullary nail in treating intertrochanteric fracture.[Method]From Jan 2000 to Aug 2004,35 patients(14 males and 21 females)with femoral intertrochanteric fracture were treated by short reconstruction intramedullary nail.Various data were analyzed for evaluating the characteristics and curative effect.[Result]The mean incision length was 3.5 cm,the average duration of operation and intraoperative X-ray fluoroscopy was 65 min and 0.16 min,respectively.The mean blood loss was 50 ml.None of the complications occurred postoperatively,including nonunion,deep venous thrombosis or infection of the incision etc.except only 1 malunion due to inappropriate surgical skill.Internal fixation loosening didn't appear in 97% of the patients.[Conclusion]Using short reconstruction intramedullary nail to treat intertrochanteric fracture can obtain satisfing outcomes of different concerns,such as time-saving,small incision,few complications,quick recovery and so on,which indicates that it should be the first choice for the treatment of femoral intertrochanteric fracture.

Objective To investigate whether tolterodine combined with pelvic floor electrical stimulation is more effective than tolterodine alone in the treatment of wonen with overactive bladder(OAB) and the underlying mechanism.Methods Seventy-three female patients with OAB were recruited from our hospital during Oct.2009 to Dec.2010 and prospectively studied,of whom 39 cases were given tolterodine(2 mg each time,twice daily for4 weeks)alone while the other 34 cases were given tolterodine combined with pelvic floor electrical stimulation for the treatment of OAB.Data on urgency,incontinence,micturition frequency,nocturia episodes and voided volume were collected before and after 4 weeks' treatment using a week micturition diary.Results The differences of changes of OAB symptoms between the 2 groups had statistical significance (P ＜ 0.05).Patients in the tolterodine combined with pelvic floor electrical stimulation group reported treatment benefit than the tolterodine group in the micturitions and the volume voided per micturition(P ＜ 0.05).There were no difference in the number of urgency episodes per 24 hours,incontinence episodes and nocturnal episodes (P ＞ 0.05).Conclusion A combination of toterodine with pelvic floor electrical stimulation could significantly improve the OAB symptoms,and is a potential therapy for female patients with OAB.

Objective To evaluate the effect of spinal-epidural and epidural anesthesia for pain relief in labor. Methods Totally 6671 cases selected from pregnant women delivered from Aug. 2001 to Oct. 2004 in our hospital were reviewed retrospectively. All cases were divided into three groups,1482 cases in spinal-epidural group (combined epidural) and 1111 in epidural group (epidural) who received pain relief during labor; 4078 as control group without any pain relief during labor. Delivery method and maternal, fetal complications among three groups were compared. Results (1) Delivery methods were significantly different (P0.05) in postpartum hemorrhage and neonatal asphyxia between spinal epidural 4.3%(63/1482) 1.0%(15/1482), epidural 4.1%(45/1111),0.8%(9/1111), and control 3.9%(159/4078), 1.4%(56/4078). Conclusions Anesthetic pain relief in labor may reduce the CS rate, but increase the rate of forceps delivery. Pain relief is associated with arrested and prolonged active phase, prolonged second stage. However, pain relief in labor doesnot enhance the rate of postpartum hemorrhage and neonatal asphyxia.

0.05).The morbidity of AAD was obviously lower in group B than that in group A(P

Objective To establish an accuracy test method for MDCT dose assessment based on information in DICOM images.Methods The type of MDCT studied in this paper was widely used in clinical practice.A software package developed by java language was used to automatically read doserelated information from DICOM files of MDCT.The CTDIvol and DLP of each pectoral or abdominal scan was calculated based on these information and the basic scan parameters such as collimation,mAs and pitch.The calculated values were compared with the displayed values.Results For pectoral scans,the difference between the calculated and displayed values was between-2％-8％ for CTDIvol,and-2％-5％ for DLP.For abdominal scan,the difference between the calculated and displayed values was 0-2％ for CTDIvol,and-2％-3％ for DLP.Conclusions This method is useful for MDCT dose assessment and is worth disseminating its application for general use.

Objective To study roles of GRP78 and GRP94 in tumorigenesis and progression of colorectal carcinomas (CRC).Methods Colorectal carcinoma tissues of 124 cases were studied for GRP78 and GRP94 proteins by immunohistochemistry and Western blotting.The correlations among the expression of proteins and clinicopathologic parameters and overall survival of CRC were analyzed using univariate and Cox regression analyses.Results The overexpression of GRP78 and GRP94 was detected in the cytoplasms or plasma membrane of the tumor cells.They were positively correlated with tumor differentiation,staging,lymph node metastasis and remote metastasis.Survival analysis showed that overexpression of both proteins was associated with poor outcome of CRC ( P =0.025,P =0.010,respectively).Cox regression analysis demonstrated that the expression of GRP94 was an independent poor prognostic factor for CRC.Conclusions Up-regulated expression of GRP78 and GRP94 was possibly involved in the pathogenesis,growth,invasion and metastasis of colorectal carcinomas.GRP78 and GRP94could be seen as a marker for the aggressive behavior and poor prognosis in colorectal carcinomas.

Objective To study the relationship between morning blood pressure surge with carotid artery intima-media thickness in good controlled elderly hypertensive patients.Methods A total of 151well controlled elderly hypertensive patients was selected in this study.Through the ABPM examination,the morning blood pressure peak was calculated,and then these patients were divided into two groups according to the morning blood pressure peak.The patients whose morning blood pressure peak ≤30 mmHg were divided into non-morning blood pressure surge group (NMS group),and the patients whose morning blood pressure peak ＞ 30 mmHg were divided into morning blood pressure surge group (MS group).The carotid IMT of these patients was measured with ultrasonic detection.The hypertension-related factors with blood pressure and morning peak phenomenon and the impact of IMT were analyzed,and the relationship between the morning blood pressure peak and IMT was analyzed with linear regression analysis.Results Two groups of 151 cases were well-controlled hypertension,76 patients with morning blood pressure showed peak phenomenon,accounting for 50.3％.Age,gender,body mass index,blood lipids,blood glucose,the maximum systolic blood pressure,average systolic blood pressure,minimum systolic blood pressure,maximum diastolic blood pressure,average diastolic blood pressure and minimum diastolic blood pressure had no difference between the two groups ( P ＞ 0.05 ).However,the morning blood pressure peak in patients with MS group [ (42.34 ± 7.10)mmHg] and IMT [ (0.89 ± 0.13 )mm] was higher than the NMS group [ (21.16 ±5.23) mmHg,(0.84 ±0.14) mm,P ＜0.01 orP ＜0.05],and carotid IMT and peak morning blood pressure was positively correlated ( r =0.56,P ＜0.01 ).Conclusions Good controlled elderly hypertensive patients remained the phenomenon of the morning blood pressure surge,the morning blood pressure peak might lead to carotid atherosclerosis.

Objective To investigate the features,prevention and treatment of complications of ultrasound-guided hepatic puncture biopsy.Methods One hundred and seventy-five cases underwent ultrasound-guided hepatic puncture biopsy were retrospectively analyzed.Results The incidence of complications was 16 cases (9.1%),including 5 cases with vasovagal episodes(2.9%),4 cases with ache which needed medicine treatment (2.2%),3 cases with hemorrhage in liver capsule(1.7%),3 cases with hypoglycemia(1.7%),1 case with serve hemorrhage in abdominal cavity(0.6%).Hemorrhage limited in liver capsule,vasovagal episodes,hypoglycemia and ache were relieved with corresponding treatments.One case with hemorrhage in abdominal cavity was handled with percutaneous microwave ablation therapy guided by contrast-enhanced ultrasound.Conclusions Ultrasound-guided hepatic puncture biopsy has good value and low complication.The most severe complication is hemorrhage,which can be handled with percutaneous microwave ablation therapy guided by contrast-enhanced ultrasound.

Fine needle aspiration cytopathology of the breast is an effective means of distinguishing malignant from benign,and the aspirated sample collections techniques is the primary and key part of fine needle aspiration.Fine needle aspiration cell block has been improved and used on preoperative breast cancer molecular portraits.This paper will provide an introduction to application of specimens collection techniques,application and development of fine needle aspiration cell block on preoperative breast cancer molecular portraits.

Breast calcification is a specific sign of nonpalpable early breast cancer,the accurate localization and biopsy can obviously improve the diagnosis rate of early breast cancer,and imaging-guided needle localization is the premise of accurate biopsy of breast calcification.As the recommended guidance,mammography-guided localization and biopsy has certain limitations in localizing and biopsying breast calcification,however,high-resolution uhrasound makes it possible to localize the nonpalpable calcification in breast,and which has a certain advantage.