Objective To investigate the clinical effects of subemergency treatment of femoral intertrochanteric fractures in elderly patients.Methods From June 2013 through February 2014,47 patients older than 65 years were treated for femoral intertrochanteric fracture at our department and completed full follow-ups.Of them,20 received subemergency operation.They were 9 men and 11 women,with an average age of 72.2 ± 4.8 years.By the Evans-Jensen classification,there were 2 cases of type Ⅰ,5 of type Ⅱ,5 of type Ⅲ,5 of type Ⅳ,and 3 of type Ⅴ.The time from injury to surgery ranged from 0.5 to 1.7 days (average,0.8 days).The other 27 patients underwent selective operation.They were 11 men and 16 women,with an average age of 74.9 ± 5.7 years.By the Evans-Jensen classification,there were 3 cases of type Ⅰ,6 of type Ⅱ,6 of type Ⅲ,7 of type Ⅳ,and 5 of type Ⅴ.The time from injury to surgery ranged from 2 to 5 days (average,3.4 days).We compared the 2 groups in terms of in-hospital complications,fracture healing time,length of hospital stay,and hip scores at the last follow-up.Results All the patients were followed up for 12 to 15 months (mean,13.4 months).The rate of in-hospital complications in the subemergency operation group (35.0％,7/20) was significantly lower than that in the selective operation group (51.9％,14/27),and the length of hospital stay in the former (12.1 ± 1.6 days) was significantly shorter than in the latter (16.1 ± 1.8 days) (P ＜ 0.05).There was no significant difference between the 2 groups in fracture healing time (13.1 ± 1.8 weeks versus 13.6 ± 1.2 weeks) (P ＞ 0.05).According to the hip scores at the last follow-up,the subemergency operation group had 16 excellent,2 good,one fair and one poor cases (with an excellent to good rate of 90.0％) while the selective operation group had 21 excellent,2 good,2 fair and 2 poor cases (with an excellent to good rate of 85.2％),showing no significant difference between groups (P ＞ 0.05).Conclusion Subemergency operation can reduce not only in-hospital complications but also length of hospital stay for old patients with femoral intertrochanteric fracture.

Objective:To probe into effects of Mifepristone on the Th1/Th2 balance at materno-fetal interface.Methods:Sixty three healthy women in early pregnancy were randomized into two groups,30 women used mifepristone 200 mg,and 33 women as control.Their decidual tissue was collected by curettage in 48 hours of taking the drug.The Th1/Th2 cytokine expressions in decidua were analyzed by immunohistochemistry.Results:In the decidual tissue of normal early pregnancy,there were significantly higher densities of Th2 cytokines,IL-4 and TGF-?2,and lower density of Th1-type cytokine,IFN-? and IL-2.After having treated by Mifepristone,the decidual tissue appeared to significantly higher densities of Th1-type cytokines(IL-2, IFN-?).Conclusion:Our findings suggest that Mifepristone can up-regulate expression of the Th1-type cytokines,and cause a shift towards Th1 bias,which leads to abortion.

Objective To analyze the effect of Kecrkang oral Liquid on extracorporeal bacteriostasis. Methods Tube dilution method was adopted to test the effect of different concentrations of Keerkang oral liquid on bacillus coli, klebsiella pneumoniae, bacillus aeruginosus, staphylococcus aureus, staphylococcus epidermidis, β-Streptococcus hemolyticus, streptococcus pneumoniae, haemophilus influenzae and candida albicans. Results Keerkang Oral Liquid has obvious inhibited effects to all the bacteria that mentioned above. Conclusion Keerkang Oral Liquid has obvious extracorporeal bacteriostasis and resistance to fungi.

Objective To analyze the inhibitive effect of Keerkang Oral Liquid on adenovirus (ADV3) , parainfluenza virus (HVJ) , respiratory syncytial virus (RSV) , and herpes simplex virus 1 (HSV-1) , herpes simplex virus 2 ( HSV-2 ) in cell culture. Methods Sensitive cell culture was adopted, and chick embryo kidney (CEK) cells and bit hamster kidney (BHK) cells were used to infect homologous virus. Keerkang Oral Liquid was given after 2 hours, then cytopathie phenomenon (CPE) was observed. Results When the amounts of infected virus are less than or equal to 100TCID50, the group which was given Keerkang Oral Liquid showed CPE, while the virus control group showed 25%～75% CPE. Besideds Keerkang Oral Liquid showed inhibitive effect on maximum non-venom concentration (TD0) , medium effective concentration (IC50), minimum valid concentration (MTC) and therapeutic index (TI) ofADV3, HVJ, RSV, BSV-1, and HSV-2 by 0.5, 0.25, 0A25-0.0625 ml/ml and 4.8 respectively. Conclusion Keerkang Oral Liquid has obvious inhibitive effects on ADV3, HVJ,RSV and HSV-1, HSV-2 in cell culture, which provides experimental basis for treating ADV3, HVJ, RSV and HSV-1, and HSV-2.

Objective The bidirectional cavopulmonary shunt (BCPS) is a major step in the staged palliation of functionally univentricular heart defects.Whether to preserve of additional pulmonary blood flow (APBF) has been a highly controversial issue.The purpose is to mathematical model and set out to determine the significa advantages and disadvantages of bidirectional cavopulmonary shunt with additional pulmonary blood flow:a theoretical analysis nce of APBF and the appropriate APBF ratio.Methods We used models of the univentricular circulation after the bidirectional cavopulmonary anastomosis with additional pulmonary blood and to computational analyze the impact of APBF on oxygen delivery,APBF flow on the CVP and SaO2.Results The influence of APBF depends on the ratio of superior vena cava flow to inferior vena cava flow ( QSVC/QIVC ).For QSVC/QIVC ＞ 0.3,APBF may be associated with decreased oxygen delivery.For QSVC/QIVC ＜ 0.3,appropriate APBF may be associated with increased oxygen delivery.A linear relationship exists between the increase of APBF and CVP,and the slope was depended on the value of pulmonary vascular resistance.Estimating APBF from CVP measurements may be a feasible method.A nonlinear relationship between the increase of APBF and oxygen saturation,and estimating APBF from SaO2 measurements may result in errors.BCPS and appropriate APBF may optimal the oxygen delivery with the increase of age and the decrease in QSVC/QIVC.For patients who accepted BCPS without APBF,there is a decreasing tendency of oxygen delivery with the increase of age and the decrease in QSVC/QIVC.For patients who suffered pulmonary arterivenous malformation,there is a more obvious decrease in oxygen delivery.ConclusionFor patients under age who has normal pulmonary vascularbed ( that is,QSVC/QVC ＞ 0.3),elimination of additional pulmonary blood flow can improve the oxygen delivery under a given cardiac output.For patients who with hypoplastic pulmonary vascular or in older patients under age,APBF is necessary to improve oxygen delivery.For patients who have to accept BCPS as the final procedure,preserving of APBF is suggested.

PURPOSE: Cardiopulmonary bypass (CPB) is one of the most fundamental and important subjects in cardiovascular surgery. Thus, it is insufficient to understand CPB through only traditional education methods as a comprehensive knowledge based on anatomy and physiology of the circulating system and surgical techniques is essential. The aim of this study was to develop a multimedia CPB teaching program for a more rewarding learning experience. METHODS: Among all teaching materials, text and picture-based lectures, movies on surgical procedures, and animations were chosen to be included in the teaching programs. Firstly, we made lecture notes and a powerpoint lecture with narration. Secondly, we made and edited movie files on surgical procedures, and incorporated sound in the movies. Thirdly, we developed animation files including all CPB procedures using flash 5.0. Finally we made a CD ROM and a web page for CPB and other basic surgical techniques. A basic wurgical procedures Self-test was also included. Questionnaires were given to medical students to evaluate the effectiveness and the ease of use of this program. RESULTS: The developed CPB educational program was distributed in a CD-ROM. An internet homepage (http: //surgery.chungbuk.ac.kr) for basic surgical procedures was constructed with the multimedia CPB lecture. The results of the questionnaires were positive, Proving the improved understanding of CPB. CONCLUSION: This multimedia education program on CPB not only can help medical students to easily understand the structures and principles involved in CPB, but also give indirect experience of this surgical procedure.
Cardiopulmonary Bypass* ; CD-ROM ; Education ; Humans ; Internet ; Learning ; Lectures ; Multimedia* ; Narration ; Physiology ; Reward ; Students, Medical ; Teaching Materials ; Surveys and Questionnaires

Objective:To evaluate the value of 99Tc m-hydrazinonicotinamide-(poly-(ethylene glycol)) 4-E((poly-(ethylene glycol)) 4-c((Arg-Gly-Asp)fK)) 2 (3PRGD 2) imaging on predicting pathological complete response (pCR) outcomes to neoadjuvant chemotherapy (NAC) in patients with breast cancer and to compare it with 18F-FDG imaging. Methods:From October 2017 to October 2019, 41 patients (age: (61.5±7.8) years) who were diagnosed with stage Ⅱ and Ⅲ breast cancer and planned to receive preoperative NAC in the First Affiliated Hospital of Fujian Medical University and Xiehe Affiliated Hospital of Fujian Medical University were prospectively enrolled. All patients underwent both 99Tc m-3PRGD 2 and 18F-FDG imaging before NAC (baseline), and after the first and the fourth NAC cycle. The tumor/background ratio (T/B; 99Tc m-3PRGD 2) and SUV max ( 18F-FDG) in breast tumors and axillary lymph node (ALN) metastases were separately calculated. The relative T/B changes (ΔT/B 1, ΔT/B 2) and SUV max changes (ΔSUV max1, ΔSUV max2) after the first and the fourth NAC cycle compared to baseline were obtained. Patients underwent surgery after NAC and the pathology was used as the gold standard to determine whether patient achieved pCR. The predictive performance of ΔT/B and ΔSUV max regarding the identification of pCR or non-pCR was evaluated by using ROC analysis and the AUCs were compared by Delong test. Results:Of 41 patients, 13 (31.7%) were achieved pCR after NAC. For breast tumors, the AUCs of ΔT/B 1, ΔT/B 2, ΔSUV max1 and ΔSUV max2 were 0.827 ( P=0.001), 0.687 ( P=0.057), 0.859 ( P<0.001) and 0.713 ( P=0.030) respectively, and the AUCs of ΔT/B 1 and ΔSUV max1 had no significant difference ( z=0.33, P=0.740). For ALN metastases, the AUCs of ΔT/B 1, ΔT/B 2, ΔSUV max1 and ΔSUV max2 were 0.859 ( P=0.002), 0.778 ( P=0.014), 0.572 ( P=0.523) and 0.802 ( P=0.007) respectively, and the AUC of ΔT/B 1 was significantly higher than that of ΔSUV max1 ( z=2.10, P=0.035). Conclusion:The early relative changes of breast tumors and ALN metastases in 99Tc m-3PRGD 2 imaging during NAC can offer predictive information for pCR to NAC in patients with breast cancer, and early relative changes of ALN metastases in 99Tc m-3PRGD 2 imaging may have a higher predictive value for pCR than 18F-FDG imaging.