Objective To explore the effect of proximal femoral intramedullary nail with anti-rotation (PFNA) in old patients with intertrochanteric fractures.Methods 82 patients with proximal femoral fractures were randomly divided into the control group(41 cases) and the observation group(41 cases).The patients in the control group were operated through DHS steel plate,while the patients in the observation group were operated through PFNA.After followed-up for six months,the function of hip joint and quality of life (QOL) of patients were compared between two groups.Results There wasn't any serious complications in two groups.The excellent and good rate was 90.2％ in the observation group and 75.6％ in the control group,there was significant difference between the two groups (x2 =4.100,P ＜ 0.05).The QOL after operation was increased in two groups,and the QOL in the observation group was higher than that in the control group(t =4.752,P ＜ 0.01).Conclusion The proximal femoral intramedullary nail with anti-rotation in treatment of old patients with intertrochanteric fractures can not only raise surgical treatment,but also improve QOL.

Objective To investigate the relationship between serum plasma brain natriuretic peptide ( BNP ) levels and myocardial injury in neoborns after asphyxia. Methods Neoborns who were admitted to Department of neonatology, Zhongnan Hospital, Wuhan University from December 2012 to December 2013 within 3 days after birth were considered. According to the number organized in chronological order every other case, newborns with neonatal asphyxia were assigned to observation group. The observation group were further divided into myocardial injury subgroup and non-cardiac injury subgroup according to the diagnostic criteria of myocardial injury. Newborns without neonatal asphyxia or neonatal cardiovascular diseases were assigned to control group. Exclusion criteria for control group were electrolyte disturbance, liver and kidney dysfunction. Blood sample was drawn from patients within 2 hours of admission to hospital and again on day 14. Serum BNP , creatine kinase isoenzyme ( CK-MB) , serum sodium and calcium were detected for further analysis. Results In 107 cases with neonatal asphyxia, 77 infants who had complete clinical records were selected as observation group, of which 36 met the diagnostic criteria of myocardial injury and assigned to myocardial injury subgroup. Non-cardiac injury subgroup consisted of the rest 41 cases in observation group. Twenty-two cases were enrolled to control group. Within 2 hours after admission, the serum BNP level of myocardial injury subgroup were significantly higher than those of the non-cardiac injury subgroup and the control group ( 2. 35 ± 0. 44 , 2. 12±0. 64, 1. 88±0. 27, log transformed, respectively, P＜0. 05). The BNP level of non-cardiac injury subgroup were also significantly higher than those of the control group. Serum BNP and CK-MB levels of observation group were positively correlated (r=0. 212,P=0. 030). After treatment, serum BNP level of myocardial injury subgroup at 14 days after admission decreased significantly, compared to the level at 2 hours within admission (P＜0. 05). When the cutoff value for infants with myocardial injury was 108. 05 pg/mL, the area under the ROC curve was 0. 753, with a sensitivity of 75. 0％ and a specificity of 64. 5％, positive predictive value was 56. 4％ and negative predictive value was 72. 3％. Conclusions Serum BNP level can reflect myocardial injury in neonates with asphyxia and can guide clinical treatment.

OBJECTIVE To know genetic marker existence condition of plasmid,transposon and integron in multidrug-resistant Acinetobacter baumannii in Xinjiang.METHODS The plasmid(traA,traF),transposon(tnpA,tnpU,merA) and integron(intⅠ1) in MDR-ABA 20 strains were studied.RESULTS From them 5 strains(25%) were tnpU positiye,4 strains(20%) were intⅠ1 positive,4 strains were tnpU and intⅠ1 simultaneously positive,and others were negative.CONCLUSIONS IntegronⅠexists extensively in A.baumannii in Xinjiang.Their multidrug resistance is correlated with transposon and integron carried by ABA.

[Objective]To explore the application of the intramedullary nails for correction of deformity in the lower limbs and decrease the opportunity of refracture in children with osteogenesis imperfecta.[Method]From Jan.2000 to Aug.2004,8 patients(3 males and 5 females),with 13 femurs and 3 tibias totally,with deformity in lower limps were corrected by multi-osteotomy and fixed with intramedullary nails,2 for K-wires;3 for Ender nails;and 3 for flexible intramedullary nails.[Result]All deformities were perfectly corrected.All patients were available at final follow up,for 9 months to 60 months,mean 30 months.None of the complications occurred postoperatively,such as infection in the incision or pin tract,nonunion,and refracture.One patient can walk by a stick from wheel-chair help preoperatively and one K-wire was disrupted near the end.[Conclusion]Multi-osteotomy and fixed intramedullary nails,can correct the deformity in the lower limbs perfectly and decrease the opportunity of refracture in children with osteogenesis imperfecta,which has been proved to be a reliable method.

Objective To explore the new feature of colorectal carcinoma attack and its clinical significance.Method The clinical data of the 261 cases of colorectal carcinoma were retrospectively analyzed in our hospital examined patients(from 1990 to 1998).Results The morbidity of colorectal carcinoma was rapid increased with time progression ,in the former four years was 28 7% ,but in the latter four years was increased to 71 3%, former four years median of attack age was 54 years,latter four years was 63 years.they had differential histological typing and clinical manifestation.Conclusion The colonoscope technique is helpful to the early differential dignosis of the colorectal carcinoma and colectal inflammatory enteropathy.

Objective To investigate the clinical effects of TCM herbs and enema in the treatment of recurrent uterine endometriosis and control of endometriosis recurrence.Methods The recurrent endometriosis patients were randomly divided into two groups,35 cases were treated with TCM herbs and Chinese medicine enema as the observation group,35 ninhydrin treatment of patients with pregnancy-ene as the control group,two groups of patients were treated for six months,the clinical efficacy and adverse reactions were observed.Results After treatment,VRS scores compared with the corresponding group before treatment was significantly lower.VRS scores in the observation group after treatment was significantly lower than the control group.The amenorrhea rate was significantly higher than control group,the complex tidal time at the end of treatment compared with the control group was significantly shorter,the observation group,no case of adverse reactions,the control group,patients experienced adverse events,observation group 4 cases(8.57％) recurrence,in the control group of 10 cases(28.57％) relapse,the difference between the two groups were statistically significant,The patients treatment of 30 cases of lesions decreased in size,the control group,had 28 cases of lesions smaller in size,there was no significant difference.Condtusion Chinese herbal enema and topical treatment of recurrent uterine endometriosis had significant efficacy,no adverse reactions,late recurrence is low.

OBJECTIVE To investigate the coding genes of ?-lactamases,aminoglycoside modifying enzymes and the drug-resistant to chlorhexidine-sulfanilamide genes on 20 Acinetobacter baumannii isolates in Xinjiang.METHODS Twenty strains of A.baumannii were isolated from hospitalized patients,and 9 kinds of ?-lactamases genes,3 kinds of aminoglycoside modifying enzymes genes and drug-resistant to chlorhexidine-sulfanilamide genes were detected.The drug-resistant to chlorhexidine-sulfanilamide genes were labeled and cluster analysis was performed to analyze the affinity of strain.RESULTS The detection rates of ?-lactamases coding genes of TEM,ADC and SHV groups were 65%,60% and 5%,respectively.The others were not found in all 20 isolates tested.The detection rates of aminoglycoside modifying enzymes coding genes of aac(3)-Ⅰ,aac(6′)-Ⅰ and aac(3″)-Ⅰwere 60%,65%and 70%,respectively.And the detection rates of qacE△1-stull genes were 70%.There were 9 strains showed clone transmission according to cluster analysis.CONCLUSIONS Drug-resistance of the 20 strains to ?-lactam and aminoglycosides is connected with ?-lactamases and aminoglycoside modifying enzymes,and there exists clone transmission.

OBJECTIVE To study the antibiotic resistance gene of qacE△1-sul1 in Acinetobacter baumannii isolated from inpatients in Urumqi and the distribution and difference of qacE△1-sul1 genotype in Xinjiang. METHODS Bacterial strains were identified by system of API and antibiotic susceptibility test was detected by K-B and microdilution methods according CLSI.PCR was used to determine the gene of qacE△1-sul1 and compared with the sequences in GenBank. RESULTS Antibiotic resistance phenotypes showed the resistance rate to cefataxime and tetracycline was the highest(100.0%),but that to cefoperazone/sulbactam was the lowest.The positive rate of qacE△1-sul1 gene in A.baumannii was 52.2%. CONCLUSIONS High resistance in A.baumannii is found in Xinjiang.The positive rate of qacE△1-sul1 is high.Strengthening epidemiology surveillance of resistance carried by integron-carrying gene is important.

OBJECTIVE To study the isolation status and antimicrobial resistance of nonfermenting Gram-negative bacilli collected from intensive care unit(ICU) of our hospital so as to instruct the rational clinical application of antibiotics.METHODS The antimicrobial resistance of nonfermenting Gram-negative bacilli isolates collected from patients in ICU from Jan 2003 to Dec 2007 was analyzed.Antimicrobial susceptibility of clinical isolates were tested by Kirby-Bauer method.RESULTS Total 384 nonfermenting Gram-negative bacilli isolates were collected in 5 years.The most common species were Acinetobacter baumannii(219),Pseudomonas aeruginosa(117) and Stenotrophomonas maltophilla(36).The antimicrobial resistance rate of nonfermenting Gram-negative bacterial to most antibiotics were much higher.The antimicrobial resistance rate of Acinetobacter spp to imipenem,cefoperazone/sulbactam and piperacillin/tazobactam was 3.7%,28.3% and 42.9%.But the resistance rate of Acinetobacter spp to imipenem was increased in recent 2 years(58.0%).The antimicrobial resistance rate of P.aeruginosa to cefoperazone/sulbactam was the lowest.That of imipenem-resistant P.aeruginosa to cefoperazone/sulbactam was 34.0%.S.maltophilla was relatively susceptible to ceftazidime,cefoperazone/sulbactam and piperacillin/tazobactam.CONCLUSIONS Nonfermenters Gram-negative bacilli are the important pathogens in ICU.Surveillance of their prevalence and drug resistance may provide evidences for rational antibiotic choices.

494 ng/ml. The test showed a sensitivity of 100%, a negative predictive vale of 100%. Conclusion VIDAS D dimer is well sited as diagnostic tool for the exclusion pulmonary embolism.