Objective To summarize the experiences in treatment of intertochanteric fractures with proximal femur nail antirotation (PFNA). Methods A retrospective study was done on 136 patients with intertrochanteric fractures treated with PFNA from March 2006 to September 2008. Postoperative reduction quality, long-term radiographic results and function of hip were evaluated separately. All the patients had closed fractures. The operation involved orthopedic traction bed, C-arm image intensifier,closed reduction or limited open reduction and locking technique. Results All patients were followed up for 10-18 months (average 14.5 months), which showed fracture healing in all patients. According to Harris criterion, the function of the hip joint obtained excellence in 129 patients ( 94.9% ). Conclusion PFNA has advantages of simple procedure, minimal invasion, firm fixation and early functional exercises and is an effective method for treatment of intertrochanteric fractures.

Objective To evaluate the effect of the intermittent deferomamine(DF) therapy on relieving iron overload caused by transfusion in children with ? thalassemia.Methods Sixteen children who were finally diagnosed as ? thalassemia major were treated with deferomamine for 124 times totally to low the iron overload. The serum iron(SI), serum ferritin(SF) and urine ferritin were detected each time with radio-immunity technique and difference was compared before and after treatment. Meanwhile, weather DF involved children′s liver and renal function was observed in whole procedure.Results Iron overload exists in 16 cases of ? thalassemia major children by a long- term hypertransfusion therapy, with average level SI 33.69?6.72 mmol/L,SF 441.19? 54.70 ?g/L,urine ferritin 8.64?6.79 ?g/L. The difference was significant (paired-samples t test,t =6.173 P 0.05).Conclusion The study suggest that intermittent low-dose DF therapy is effective for iron overload caused by transfusion in ? thalassemia children, without apparent side effects.

Objective To investigate technical skills on outflow reconstruction in right lobe graft adult-adult living donor liver transplantation for avoiding of venous congestion. Methods The clinical data of 21 donors and recipients who underwent right lobe living donor liver transplantation were analyzed retrospectively. Donor's standard liver volume was between 1150. 1 and 1629. 8 cm3,graft weight was between 585 and 920 g, the ratio of graft volume to recipient's estimated standard liver volume (GV/ESLV) was between 43 % and 67 %, graft-recipient weight ratio (GRWR) was between 0. 82 % and 1.59 %, the ratio of remnant liver volume to donor's standard liver volume(RLV/SLV) was between 32 % and 55 %, all graft macrosteatosis was less than 10 %. For graftwith middle hepatic vein (MHV), a triangle large orifice was made by joining MHV to right hepatic vein (RHV), then anastomosed to recipient' s enlarged orifice of RHV. For graft without MHV, if tributary of MHV＞5 mm, autologous or allogenic blood vessel was used as interposition graft to connect to IVC, and if no large MHV tributary, graft RHV was anastomosed to IVC directly. Graft's right portal vein was anastomosed to main trunk of recipient's portal vein, graft's right hepatic artery to recipient's hepatic artery, and graft's right hepatic duct to recipient's right hepatic duct. Results Among the 21 right lobe grafts, 4 right lobe grafts had MHV, 17 right lobe grafts had no MHV.Autologous greater saphenous veins were adopted in 2 cases, cryopreserved iliac arteries were adopted in 5 cases, and RHV was anastomosed directly to IVC in 10 cases. Outflow was all patent in 7 cases having reconstruction of MHV tributaries one month after operation. One-year survival rate was 75 %, 85. 7 % and 70 % respectively in MHV group, MHV tributaries reconstructed group and RHV directly anastomosed to IVC group with the difference being not significance among these three groups (P＞0. 05). Biliary complications occurred in 7 cases during the follow-up period. One case developed small-for-size syndrome, which was cured by splenic artery embolization. No severe complication occurred in donors. All donors returned to normal life during a follow-up period of 6 to 31 months. Conclusion If outflow tract was reconstructed properly, right lobe graft without MHV has equivalent clinical outcomes to right lobe graft with MHV. Using of autologous or allogenic blood vessel as interposition vessel graft for right lobe graft without MHV is an effective modality to prevent hepatic congestion and secure functional graft volume to meet recipients metabolic demand.

OBJECTIVETo observe the ultrastructure changes of cerebral cortex neuron and endothelial cell in hypoxia preconditioning mice and the effects of Tongxinluo (TXL, Chinese traditional medilihe) on them.

METHODSMice were randomly divided into 4 groups: control group, hypoxia group, hypoxia preconditioning (HP) group and Tongxinluo (TXL) group. The hypoxia preconditioning mice were exposed by repetitive hypoxia for 5 runs. The animal's tolerance time of each hypoxia run was recorded. The ultrastructure change of cerebral neuron and endothelial cell were studied by electron microscope.

RESULTSThe hypoxic tolerance time in HP and TXL groups were significantly increased run by run. Compared with HP group, the tolerance time of TXL group were increased in every run. The ultrastructure of cerebral neuron and endothelial cell in hypoxia group changed obviously, mitochondrion and endoplasmic reticulum destroyed. However they were slighter in HP group than those in hypoxia group. The change in TXL group had no obvious differentce with control group and were slighter than those in HP group.

CONCLUSIONHypoxia preconditioning shows that organism has a strong self-repairing ability. Tongxinluo self-repairing; could increase self-repairing ability and adaptive ability of mice to hypoxia obviously.

Adaptation, Physiological ; Animals ; Cerebral Cortex ; pathology ; Drugs, Chinese Herbal ; pharmacology ; Endothelial Cells ; ultrastructure ; Hypoxia ; physiopathology ; Hypoxia, Brain ; physiopathology ; Ischemic Preconditioning ; methods ; Male ; Mice ; Neurons ; drug effects ; ultrastructure

OBJECTIVETo observe the clinical effect and mechanism of migraine treated with pine needle moxibustion.

METHODSForty-three patients were randomly divided into 2 groups of pine needle moxibustion group (group A, 21 cases) and medicated thread moxibustion of Zhuang medicine group (group B, 22 cases). Same acu-points were selected as the main points for both groups, namely Fengchi (GB 20), Baihui (GV 20), Taiyang (EX-HN 5), Shuaigu (GB 8), Cuanzhu (BL 2), Sizhukong (TE 23), Yanglingquan (GB 34), Waiguan (TE 5) and Ashi points. Pine needle moxibustion was applied for the group A. Processed lighted pine needles were banded together with one even head to do moxibustion on acupoints or pain points. While, lighted medicated thread was adopted for the group B to do moxibustion. Therapeutic effects, the content of high-sensitivity C-reactive protein (hs-CRP), Mg2+ in the serum and the degree of pain of the two groups were compared.

RESULTS(1) In the group A, the complete remission rate was 47.6% (10/21) and the effective rate was 90.5% (19/21). In the group B, the complete remission rate was 13.6% (3/22) and the effective rate was 50.0% (11/22). The two rates in the group A were superior to those in the group B (both P < 0.01); (2) In the group A, the content of hs-CRP was decreased from (4.29 +/- 0.98) mg/L to (2.11 +/- 0.87) mg/L, and Mg2+ was increased from (0.67 +/- 0.28) mmol/L to (1.07 +/- 0.16) mmol/L. In the group B, the contents of the above mentioned indices were respectively decreased from (4.30 +/- 1.07) mg/L to (3.38 +/- 1.15) mg/L and increased from (0.68 +/- 0.21) mmol/L to (0.88 +/- 0.25) mmol/L. There were significant differences between the two groups after treatment (both P < 0.05). (3) The degree of pain in the group A after treatment was much lower than that in the group B (P < 0.05).

CONCLUSIONThe clinical effect of migraine treated with pine needle moxibustion is better than that with the medicated thread moxibustion of Zhuang medicine. And it has obvious regulation effect on the levels of hs-CRP and Mg2+ in the serum of patients.

Acupuncture Points ; Adolescent ; Adult ; C-Reactive Protein ; metabolism ; Female ; Humans ; Magnesium ; blood ; Male ; Middle Aged ; Migraine Disorders ; metabolism ; therapy ; Moxibustion ; Young Adult

Objective To understand the prevalence of urinary incontinence(UI) and its related factors so as to develop a three-tier program for prevention of the disease.Methods A cross-sectional study was carried out in two townships of Jixian county,Tianjin,during July to November 2007.A total of 743 people aged 60 years and over were selected under cluster sampling,and all information were collected with a standardized structured questionnaire by face-to-face interview.All the data were analyzed with multivariate logistic regression method to explore the related factors for UI in the elderly.Results The overall prevalence of UI was 33.38 percent among people aged 60 years and over in two townships.Risk factors flor UI in men would include older age (OR=1.39).occupation(OR=5.00),awareness of UI(OR=1.91),having in chronic respiratory diseases(OR=2.23),prostate(OR=11.47),neurological(OR=11.76),or motor systems (OR=2.48).while protective factors would include high educational level(taking primary school or below as control group),OR for the junior middle school group appeared to be 0.35,for senior middle school group it was 0.77.and ofundergraduate group it was 0.53.Risk factors for UI in women would include older age(OR=1.31),constipation(OR=1.46),awareness of UI(OR=1.94),increased bodv nlass index(when normal weight group served as control group,OR in the overweight group was 1.03 and in the obesity group OR was 1.54),suffering from chronic respiratory diseases(OR=4.84).diabetes mellitus(OR=2.36),or motor system diseases(OR=1.37),more gravidity(OR=1.03),more parity(OR=1.02),suffering from perinea laceration(OR=1.72) and wound infection during delivery(OR=1.65),while protective factors would include physical exercises(OR=0.64).Conclusion Prevalence of UI was higher among the elderly people in rural areas of Jixian county,Tianjin.UI in the elderly might have been influenced by various factors which suggesting the intervention strategy should be targeted at those related factors as well as focusing on primary prevention.

Objective To explore the risk factors on chronic diseases related to falls in the urban-community elderly and to provide evidence for developing a three-tier program for prevention. Methods A cross-sectional study was conducted in one community of Beijing. People aged 60 years and over were selected, using a stratified cluster sampling method, and data on falls within the past 12 months and falls-related chronic diseases were collected through face-to-face interview. Results The incidence of falls was 18.0% within one year among the 1512 interviewees. Seven factors showed statistical significances through univariate analysis including diabetes mellitus (OR =1.62), postural hypotension (OR=1.84), hypertension (OR=1.48), cerebral infarction (OR=1.98), cataract (OR=1.56), osteoarthritis (OR=1.50), dementia (OR=5.34) and depression (OR=4.61). Data from multivariate logistic regression analysis showed that the risk factors for falls would include dementia (OR=4.82), depression (OR=4.27), postural hypotension (OR=1.92) and suffering from several kinds of chronic diseases etc. Conclusion The incidence of falls in an urban elderly community of Beijing was considered to be high. The risk of falls was higher among persons suffering from dementia and depression and having more than two kinds of chronic disease. The chances of falls would parallel the increase of several kinds of chronic diseases among the elderly, suggesting that measures should be actively taken to prevent from falls.

OBJECTIVETo investigate the effects of losartan on left ventricular hypertrophy (LVH) and plasma transforming growth factor-beta1 (TGF-beta1) in elderly patients with essential hypertension (EH).

METHODSThe elderly patients with EH were divided into two groups, namely EH+LVH group and EH group according to the data of echocardiogram. The systolic and diastolic blood pressures of the patients were monitored. Plasma TGF-beta1 was measured before and after 6 months' treatment with losartan, and the relationship between TGF-beta1 and other index were analyzed.

RESULTSAfter 6 months' treatment, the blood pressure of EH+LVH group and EH group were significantly lowered (P<0.01). Significant improvement of IVSTd, LVPWd, E/A, and LVMI (P<0.01) and obvious reduction of plasma TGF-beta1 (P<0.01) occurred in EH+LVH group after 6 months' treatment. Correlation analyses indicated that the plasma TGF-beta1 level was positively correlated to LVMI (P<0.01).

CONCLUSIONLosartan can reversed LVH in elderly patients with EH partially by lowering plasma TGF-beta1 level.

Aged ; Antihypertensive Agents ; therapeutic use ; Female ; Humans ; Hypertension ; blood ; complications ; drug therapy ; Hypertrophy, Left Ventricular ; blood ; drug therapy ; etiology ; Losartan ; therapeutic use ; Male ; Middle Aged ; Transforming Growth Factor beta1 ; blood

OBJECTIVETo investigate the clinical features and epidemiological data of 72 cases of male perianal warts.

METHODSSeventy-two cases of perianal warts in our clinic dated from June, 2004 to April, 2006 were enrolled in the study, whose clinical information and epidemiological data were collected and analyzed.

RESULTSPerianal warts were most commonly seen in young and middle-aged men aged from 18 to 45, only 12.5% of whom had homosexual behaviors. Sauna was another predisposing factor of perianal warts in males in China (chi2 = 5.03, P < 0.05). Primary eruptions of the anus and rectum, like perianal pruritus, eczema, anus fissure, and haemorrhoids, often impaired the local integrity of skin/mucosa. Classical condyloma acuminate was found in 61 (84.72%) of patients, who were susceptive to the infections of HPV 6/11, and were flat condylomas related to HPV16/18. Cryotherapy was believed to be one of the most efficient therapeutic choices for flat perianal warts. Suppression of cellular immune response was identified in the patients by comparison between the subgroups of peripheral T cells and the normal control.

CONCLUSIONSauna is an essential predisposing factor of perianal warts in males, while anus sexual intercourse is not the main route of HPV infection. Classical condylomata acuminate constitute the majority of the eruptions, and flat condylomata come next. The study also provides some useful data for understanding the clinical and epidemiological features of perianal warts in Chinese males for the sake of prevention and treatment of the disease.

Adolescent ; Adult ; Anus Diseases ; classification ; epidemiology ; Condylomata Acuminata ; classification ; epidemiology ; Humans ; Male ; Middle Aged

OBJECTIVETo study the effects of noise on bioactivity of norepinephrine (NE) and cardiovascular system.

METHODSA total of 130 workers exposed to the occupational noise in one enterprise were selected as noise exposure group, and 134 workers not exposed to the occupational noise and other poisons served as control group. Fasting venous blood was drawn to determine the content of NE in peripheral blood with ELISA. According to Occupational Health Surveillance Manage regulations, the occupational noise exposures crowd was examined.

RESULTSThe average of NE in exposure group was (0.1387 +/- 0.099) ng/ml, and (0.1019 +/- 0.080) ng/ml in control group. There was significant difference in NE between exposure and control group. There was significant difference in the detection rate of BP, HR and ECG between exposure and control group.

CONCLUSIONThe occupation noise can increase the NE in peripheral blood, and maybe affects the cardiovascular system in this way.

Adult ; Blood Pressure ; physiology ; Case-Control Studies ; Electrocardiography ; Female ; Heart Rate ; physiology ; Humans ; Male ; Middle Aged ; Noise, Occupational ; adverse effects ; Norepinephrine ; blood