In this review,concepts concerning etiology and nonoperative and operative treatment methods have been analyzed.This article is based almost exclusively on peer-reviewed studies.The etiology of nontraumatic osteonecrosis of the femoral head may have genetic basis.The interaction between certain risk factors and a genetic predisposition may determine whether this disease will develop in a particular individual.Early diagnosis and intervention prior to collapse of the femoral head is key to a successful outcome of joint-preserving procedures.The rational for use of joint-sparing procedure in the treatment of this disease is based on radiographic measurements and findings with other imaging modalities.The results of joint-preserving procedures are less satisfactory than the results of total hip arthroplasty for femoral head than have already collapsed.New pharmacological measures as well as the use of growth and differentiation factors for the prevention and treatment of this disease may eventually alter our treatment approach,but it is necessary to await results of clinical research with long-term follow-up of these patients.

OBJECTIVE:To determine the dissolubility of paracetamol in Ganmaoqing tablets produced by different manufactories and to evaluate the internal qualities METHODS:The content of paracetamol in Ganmaoqing tablets was determined by HPLC with Nova-Pak C18 or Sphereclone ODS(2) column as fixed phase and methanol-water(1∶3) as mobile phase Paracetamol was detected at 249 nm with UV detetor The flow rate was 0 5ml/min Rotating basket method was used in dissolution test RESULTS:The method could determine the content of paracetamol in Ganmaoqing tablets satisfactorily The dissolution rates of eight samples were quite different CONCLUSION:The method is simple,rapid and reliable It is very necessary to establish the dissolubility standard for Ganmaoqing tablets

Objective To evaluate timing of tracheal intubation impact on the therapeutic effect of acute severe organophosphate poisoning( ASOPP) patients. Methods Retrospectively analyze 82 ASOPP patients with respiratory failure ( RF). The patients were divided into timely tracheal intubation group(n = 42) and delay tracheal intubation group (n =40) ,and compare the therapeutic effect of these two groups. Results Compared with timely tracheal intubation patients and delay tracheal intubation patients,total time of mechanical ventilation,hospital day decreased significantly (P<0.01) ,cure rate increased significantly (P<0.01) ,but complications [intermediate myasthenia syndrome (IMS) .pulmonary infection,cardiac damage and so on] had no significant difference(P>0.05). Conclusion It was exact that the therapeutic effect of timely tracheal intubation on rescuing the ASOPP patients, and the best time to tracheal intubation was in RF early period.

Objective To observe the effect of bisoprulol on malignant ventricular arrhythmia (MVA) and heart rate turbulence (HRT) in ambulatory electrocardiogram monitoring for twenty-four hours in patients with unsta-ble angina pectoris (UAP). Methods 40 UAP patients with premature ventricu]ar beats were observed. All patients were examined with ambulatory electrocardiogram monitoring for twenty-four hours before and after bisoprolol (5mg, Qd) was administered for 7 days. The number of patients with MVA、turbulence onset (TO) and turbulence slope (TS) were analyzed. Results After bisoprolol was administered for 7 days in patients with UAP,the number of pa-tients with MVA decreased by 14.2%. TO decreased and TS increased, and HRT was improved. Conclusions HRT had clinical prognostic value for malignant ventricular arrhythmia and sudden death in patients with UPA. Bisoprolol can improve HRT and reduce the incidence of MVA.

Objective To explore the differences of the joint function and the patient's satisfaction between two different methods to reconstruct limb length for unilateral Crowe Ⅳ developmental dysplasia of the hip (DDH).Methods The clinical controlled study were used.21 cases with unilateral DDH Crowe Ⅳ treated with total hip arthroplasty were divided into 2 groups randomly.The patients in the first group were reconstructed the limb with the compensatory length and those in the second group were did with the real length.The patients were followed up 10 years.Two independent sample t-test was used to compare these two operations.Harris scores and SF-36 scores were used in the test.Survival analysis with Kaplan-Meier method was involved in the survival of the prosthesis and then test with Log-rank test.X-ray films of different period were compared to confirm the prosthetic loosening.Results Seventeen patients were followed up 8-10 years.There were no significant differences both in Harris score and most of the SF-36 scores at the median follow-up of 10 years.The item mental healthy of SF-36 expressed significant difference.Five patients required revision.There were 10 cases suffered with polyethylene wear,6 cases with severe osteoporosis in greater trochanter,and 3 cases with osteolytic reaction.Conclusion There are no significant differences between the two surgical method in the survival rate of prosthesis and the joint function in the median follow up.The satisfaction of the control groups is lower than the trial groups both at the early stage after the operation and the median follow up.The revision rate between the two groups is similar but the reason is different.

10.3969/j.issn.1000-8179.2013.12.010

Objective To explore the prognosis and related factors of brain glioma .Methods 133 patients who have been con-firmed pathology with brain glioma from Jan .2001 to Dec .2010 were retrospectively analyzed .The factors such as sex ,age ,func-tional status ,histological character ,the longest diameter of tumor ,surgical excision of part or all of the tumor ,whether or not being radiotherapy after surgical excision were selected to evaluate by single factor and multiple factors analysis .Results The median fol-low-up time was 36 months ,The follow-up rate was 93% .73 cases were followed up for 3 years ,the 1- ,2- and 3- year survival rate was 93% ,82% and 70% ,respectively ,the median survival time was 62 .7 months .Multiple factors regression analysis showed that histological character ,the longest diameter of tumor and whether or not being radiotherapy after surgical excision were related to prognosis .Conclusion High-grade of histological character ,the longest diameter of tumor≥6 cm predict poor prognosis ,postop-erative radiotherapy can improve the survival of glioma .

Objective To assess the clinical significance of modular femoral component in restoring femoral offset after total hip arthroplasty.Methods Data of 75 patients,who had undergone THA with modular femoral component from June 2009 to June 2012,were retrospectively analyzed.There were 42 males and 33 females,aged from 44 to 83 years (average,64.7±12 years).There were 40 cases of left hip and 35 cases of right hip.The average Harris hip score was 54±6 (range,32 to 65) before operation.The Zimmer M/L Taper hip prosthesis with Kinectiv technology was used in all patients.Preoperative templating was utilized to accurately predict the prosthetic size and the femoral offset.During the surgery,the femoral offset was measured accurately,and the appropriate femoral neck prosthesis was selected in order to restore the femoral offset and reconstruct hip abductor moment arm.The femoral offset and leg length were measured according to X-rays after operation.The Harris hip score was used to assess the clinical results.Results The femoral offset was reconstructed in all patients,ranging from-3.0 to 3.0 mm (average,1.3±0.3 mm).The average leg length discrepancy was improved to 3.0±0.8 mm.All patients were followed up for 6 to 36 months (average,19.7 months).The average hip abduction angle was 40°±10° at 12 weeks after operation.The average Harris hip score was 86±13 (range,65-94) at 12 weeks after operation and 95±15 (range,78 to 98) at final follow-up.There was no hip dislocation and femoral acetabular impingement syndrome.Conclusion Modular femoral component can restore femoral offset without changing the leg length,which can result in good hip abductor strength,range of motion of the hip and stability,as well as less complications.

OBJECTIVE To invesigate the prevalence of SHV-producing Enterobacteriaceae isolates in Hunan Province and identify the subtype of SHV encoding gene and the epidemiological aspect of SHV-producing isolates. METHODS Isolates were collected and identified as well as subjected to ESBLs detection.PCR and DNA sequencing were used to determine the genotype of SHV enzymes.The homology of SHV-producing strains were detected by RAPD. RESULTS Twenty-six of 171 Enterobacteriaceae isolates were confirmed to produce blaSHV genes,and 5 subtypes of SHV-type ?-lactamases were determined,including 9 strains of SHV-28,7 strains of SHV-12,7 strains of SHV-1,2 strains of SHV-11 and 1 strain of SHV-5.There were 6 RAPD types in 19 isolates of SHV-producing Klebsiella pneumoniae,5 RAPD types in 5 isolates of SHV-producing Enterobacter cloacae. CONCLUSIONS SHV-12 is the predominant genotype of SHV ESBLs producing Enterobacteriaceae in Hunan Province,and clone spread has played a certain role in SHV-type ?-lactamase producing K.pneumoniae.SHV ESBLs are not found in Escherichia coli.

Objective To investigate the influencing factors of pain and the changes of vital signs in newborn infants. Methods Forty two newborn infants were rated by the behavioral scale of acute pain in newborn infants. The scores of pain were compared among infants with different gender,gestational age,birth weight,birth age,type of puncture and whether by vaginal birth or not. At the same time,the respiration rate,heart rate,blood pressure and oxygen saturation (SO2)were dynami-cally recorded by the multi-function monitor in the process of puncture. Results The average score of pain was 7.6. There was no significant difference among newborn infants with different gender,gestational age,birth weight and type of puncture(P> 0.05),while significant differences among infants with different birth age and whether by vaginal birth or not (P=0.015 and 0.043 respectively). In the process of puncture,the SO2 was significantly decreased,while the respiration rate,heart rate,sys-tolic and diastolic blood pressure were significantly increased. Conclusions Pain is prevalent in newborn infants and accom-panied by obvious changes of vital signs. The means of childbirth and birth age have significant influence on the neonatal pain. It is suggested to pay close attention to the neonatal pain and take effective interventions.