BACKGROUND:Currently, there is a lack of effective hip preserving therapy in patients with alcohol-induced osteonecrosis of femoral head. Artificial hip replacement is the only choice for the patients whose function of the hip joint is affected by the colapse of the femoral head in the late stage. Therefore, to understand the pathogenesis of alcohol-induced osteonecrosis of femoral head is of great significance for the effective hip preserving therapy in patients.
OBJECTIVE: To review the research progress in apoptosis of bone cels in the pathogenesis of alcohol-induced osteonecrosis of femoral head both at home and abroad in recent years, so as to provide a theoretical basis for the study of the treatment of alcohol-induced osteonecrosis of femoral head.
METHODS:PubMed and Embase databases were retrieved by the first author using computer to search relevant articles addressing the effect of apoptosis of bone cells in the pathogenesis of alcohol-induced osteonecrosis of femoral head. The keywords were “osteonecrosis of femoral head and apoptosis”, “bone cell, apoptosis, gene, signal” or “osteonecrosis, alcohol”in the title and the full text. Repetitive and old literatures were excluded, and finally 40 foreign language articles were included in result analysis.
RESULTS AND CONCLUSION: In recent years, the theory of apoptosis of bone cells in the pathogenesis of alcohol-induced osteonecrosis of femoral head has been gradually recognized and has become the focus of research on the pathogenesis of alcohol-induced osteonecrosis of femoral head. Apoptosis of bone cells plays an important role in the pathogenesis of alcohol-induced osteonecrosis of femoral head. Various genes, such as p53, Bcl-2 family, tumor necrosis factor, Caspase, are crucial to control the apoptosis of bone cells. Although we have made some progresses at the gene level, there is still a lack of relevant studies on alcohol-induced osteonecrosis of femoral head due to the complexity of pathogenesis.

AIM: To analyze the characteristics of internal fixation implantation therapy for comminuted patella fracture. METHODS: A computer-based search of Pubmed database and Chinese Journal Full-text Database was undertaken, and the quotations of each literature were checked after the primary screening. Inclusion criteria: the papers about the application of internal fixation materials in comminuted patella fracture, those published in authority journals within recent five years were preferred. Exclusion criteria: repeated study or Meta analysis. RESULTS: Internal fixation approach differs as the fracture type. Tension band fixation is generally accepted to treat transverse patella fracture. Kirschner wire plus tension band fixation are inferior to transverse fixation, but in comminuted fracture it can induce more complications; despite of wide application, nickel titanium patella fixator is unsuitable for comminuted fractures due to its hypersensibility and carcinogenicity; silk or steel wire loop fixation fits various comminuted fractures, but metal cerclage is predisposed to induce infection and breakage because of insufficient fixation force. CONCLUSION: There is no common way for comminuted patella fracture therapy. Further researches on material and method which can cure all kinds of comminuted patella fracture are still needed.

Objective To investigate the causes and treatment of lymphatic fistulas(LF) after radical operation of gastric cancer . Methods We observed the clinical data of 31 cases of lymphatic fistulas after the radical operation of gastric cancer , including the amount of drainage from the abdominal cavity, the levels of hemoglobin and serum albumin, post operative morbidity and the survival rate. Meanwhile, the difference in the amount of abdominal drainage before and after using octreitide was observed in LF patients. Results The rate of complications in the LF group was significantly higher than that in the non LF group(control group) (P

The research documents about educational system of medical schools were reviewed,and after deep analysis,some inadequacy was found by means of how to learn from advanced skills and how to improve the benefit of health service.This paper also put forward the chain of thought about reform of educational system of medical schools.

Academic teaching,scientific research and social service are the three major functions of higher school and there is an internal logical relationship among them.To give better explanation and evaluation on the relationship among the three functions of higher school,the pa-per puts forward the theory of bearing which is based on the relevant studies and its merits and demerits.

Objective:To explore the clinical characteristics and diagnosis and treatment of occult poisoning caused by long-acting anticoagulant rodenticides.Method:Records of 12 patients from July 2008 to April 2011 diagnosed as anticoagulant rodenticide occult poisoning,who had been misdiagnosed initially at other hospitals were analyzed retrospectively.Elements from the records included clinical symptoms and signs,laboratory findings for prothrombin time (PT) and activated partial prothrombin time (APTT),and initial misdiagnosis and treatment outcome at our hospital.Results:The clinical presentations of patients were insidious and serious,often presented as skin ecchymose,hematuria,menorrhagia and gastrointestine bleeding.Laboratory examinations showed prolonged PT and APTT; bleeding was controlled effectively by administoring vitamin K1 daily.There were statistical difference between PT and APTT before and after the treatment (P＜0.01).Conclusion:Coagulation disorders might be caused by the reduced acquisition in vitamin K dependent coagulation factors,which tends to be neglected due to a hidden medical history,delayed signs of poisoning,and various organs involved.A detailed patient history and systematic review may improve the diagnostic accuracy.Once diagnosed is made,vitamin K1 should be given as soon as possible.

Clinical data of 150 pregnant women,who were confirmed with maternal thyrotoxicosis during January 2010 to January 2014,including 104 cases of gestational transient thyrotoxicosis (GTT) and 46 cases of Graves disease (GD),were retrospectively analyzed;65 normal pregnant women served as controls.Patients with GD had lower body mass index (BMI) than those with GTF and normal controls [(18 ± 5),(20 ± 4) and (22 ± 4) kg/m2,respectively,P ＜ 0.05].The frequency of thyrotoxic history and hyperthyroidism symptoms in GD patients were significantly higher than that in GTT patients [33％ (15/46) vs.3％ (3/104) and 52％ (24/46) vs.15％ (16/104),respectively,both P ＜0.01].In the first trimester,patients with GD presented lower TSH levels than those with GTT and controls(M =0.021,0.045and 1.660 mU/L,respectively,P ＜ 0.05) and higher free T4 (FT4) (M =24.99 vs.19.99 pmol/L,P ＜0.05),free T3 (FT3) (7.10 vs.5.85 pmol/L,P ＜ 0.05),thyroid peroxidase antibody (TPOAb) (99.22vs.4.54 kU/L,P ＜ 0.05) and thyrotrophin receptor antibody (TRAb) (5.28 vs.0.11 U/L,P ＜ 0.05)levels than patients with GTT.In the second trimester,there were 67％ (70/104) GTT patientsand 4％ (2/46) GD patients had normal TSH;and FT4 returned to normal in 82％ (85/104) GTT patientsand 17％ (8/46) GD patients.In the third trimester,there were 100％ (104/104) GTT patients and 9％ (4/46)GD patients had normal TSH;and FT4 returned to normal in 100％ (104/104) GTT patients and 48％ (22/46)GD patients.

Objective To analyse change of neuroendocrine hormone and cardiac ultra ejection force in patients with heart failure before and after treatment with Huangqi Decoction.Methods 100 patients diagnosed with chronic heart failure were collected.According to the different treatment regimens divided into two groups ( control group: conventional western medicine; traditional Chinese medicine group: conventional western medicine treatment +Astragalus Decoction orally for 2 weeks) , before and after treatment,nerve endocrine hormone using echocardiography evaluation index and ejection force were detected in two groups, and compare the results of data.Results Compared with control group, Chinese medicine group with better anti heart failure treatment, performance: the plasma calcitonin gene related peptide (CGRP), atrial natriuretic peptide (ANP), C type natriuretic peptide ( CNP ) , neuropeptide Y ( NPY ) levels were significantly lower ( P<0.05 ) . Capacity index significantly improved cardiac function (P<0.05).Left atrial diameter, left atrial maximum, minimum volume decreased significantly (P<0.05).Ejection force of left atrium and left ventricular increased significantly ( P<0.05 ) .The results were statistically significant.Conclusion Huangqi decoction can inhibit the secretion of CGRP, ANP, CNP,NPY and other neuroendocrine hormones in patients with heart failure, reduce cardiac load, increase cardiac ejection force.

[Objective]To study the effects of titanium cable system used as a treatment alternative for comminuted patella fractures.[Method]Fifty-seven cases of comminuted patella fractures were treated from November 2004 to August 2007.The patients were divided into three groups:the group of titanium cables,AO modified tension band and nickel titanium-patella catcher respectively,according to the choice of internal fixation.The operation time,the amount of blood loss,the first knee exercise time after operation,length of hospitalisation,medical expenses,time off for employees,complication and long-term knee function were studied.All the data were analyzed and compared by statistical ways.[Result]The 57 patients were followed up for 11 to 48months(means,22.4 m).Patients who were fixed with titanium cables could start most early extending and flexing the knee(5.6 d after operation),but most expense in medical usages(9500 RMB).The good or excellence rate was 95.1% in patients treated with titanium cables cerclage,which was better than that of the other two groups.[Conclusion]Titanium cables cerclage can cure comminuted patella fractures.The method had advantage of better long-term curative effect and less complication,and so on.It's worthy to be recommended for the therapy of comminuted patella fracture.

Objective To investigate the protective effects of morphine preconditioning on the lungs against ischemia-reperfusion (I/R) injury and the possible mechanisms.Methods Twenty-four Japanese long-ear white rabbits weighting 2.5-3.0 kg were used in this study. The animals were anesthetized with intramuscular atropine 0.5 mg and intravenous 3 % pentobarbital 30 mg ?kg-1, tracheostomized and mechanically ventilated ( VT 10 ml?kg-1, RR 30 bpm, FiO2 100% , PEEP 1 cm H2O) . Right carotid artery was cannulated for BP monitoring and blood sampling. An elastic band was placed around the hilum of left lung via thoracotomy to perform lung ischemia. Body temperature was maintained at 36-38℃( rectal) . The animals were randomly allocated to one of 3 groups (n = 8 each) : (1) Sham group; (2) I/R group was subjected to 2 h in situ left hilar occlusion followed by 2 h reperfusion and (3) morphine preconditioning group received morphine 4 mg?kg-1 via pulmonary artery 30 min before I/R. Mean pulmonary artery pressure (MPAP) and peak inspiratory pressure (PIP) were monitored and recorded. Arterial blood samples were taken before occlusion of lung hilum (baseline) and at 5, 30, 60, 90 and 120 min of reperfusion for blood gas analysis, and determination of plasma endothelin-1 concentration. The animals were killed at the end of 120 min reperfusion. The lungs were removed for determination of lung water content (W/ D ratio), percentage of neutrophils in the broncho-alveolar lavage fluid ( BALF) and microscopic examination.Results MPAP and PIP were significantly lower while PaO2 was significantly higher at 30, 60, 90 and 120 min of reperfusion in morphine preconditioning group than in I/R group. Plasma endothelin-1 concentration was significantly lower at 60 and 120 min of reperfusion in morphine preconditioning group than in I/R group ( P