Objective To explore the measurement of femoral neck shortening (FNS) after cannulated screwing for elderly femoral neck fractures and the effect of FNS on hip functional outcome.Methods Totally 214 elderly patients with femoral neck fracture were included in this study who had been treated by fixation with cannulated screws from June 2007 to October 2013.They were 71 males and 143 females,with an average age of 77.2 years.According to Garden classification system,65 cases were types Ⅰ and Ⅱ (undisplaced fractures),and 149 types Ⅲ and Ⅳ (displaced fractures).The postoperative X-ray and follow-up X-ray films were compared to observe whether the trailing end of screw shaft was exposed to the outer cortex of the proximal femur.We chose the screw which had the longest exposure of trailing end to measure the length of the exposed screw shaft as the length of FNS.FNS indexes were defined according to the ratio of the length of exposed screw shaft to the thickness of screw head.FNS degree 1:＜ 1 screw head; FNS degree 2:1 to 2 screw heads; FNS degree 3:＞ 2 screw heads.The relationships of the FNS length respectively with thefemur length decrease and Harris scores of hip functional outcome were analyzed statistically.Results FNS occurred in 78 cases,giving an incidence of FNS of 36.4％ (78/214).Of them,12 cases (15.4％)were defined as degree 1,24 cases (30.8％) as degree 2,and 42 cases (53.8％) as degree 3.There was a significant positive correlation between the FNS length and the femur length decrease(r =0.919,P =0.000).The average Harris score at 12 months postoperation for 180 cases was 77.3 points (ranging from 32 to 98 points).The average Harris score for those with FNS was significantly lower than that for those without FNS (t =9.904,P =0.000).There was a significant negative correlation between the FNS length and Harris scores (r =-0.707,P =0.000).Conclusions Our measurement of FNS and FNS indexes are easy to be used in clinic.Severe FNS can influence the function of hip joint.

Objective To compare the clinical outcomes between oblique and non-oblique fixation with cannulated screws for femoral neck fractures in the elderly patients.Methods Totally 189 patients of over 65 years old were treated for femoral neck fracture from June 2007 to October 2013 at our department.Oblique fixation with cannulated screws was used in 130 cases.They were 43 males aud 87 females with an average age of 77.8 ± 7.5 years.According to Garden classification,40 cases were of Garden types Ⅰ and Ⅱ (undisplaced fractures),and 90 of Garden types Ⅲ and Ⅳ (displaced fractures).Of them 26 were Pauwells type Ⅲ.Non-oblique fixation with cannulated screws was conducted in 59 cases.They were 24 males and 35 females with an average age of 75.5 ± 8.2 years.According to Garden classification,12 cases were of Garden types Ⅰ and Ⅱ (undisplaced fractures),and 47 of Garden types Ⅲ and Ⅳ (displaced fractures).Of them,15 were Pauwells type Ⅲ.The fracture union,postoperative complications,rate of reoperation and Harris scores at the last follow-up were compared between the 2 groups.Results All the 189 patients were followed up for 10 to 38 months (average,17.4 months).The oblique fixation led to a union rate of 99.2％ (129/130),a fixation failure rate of 3.1％ (4/130) and a femoral head necrosis rate of 2.3％ (3/130),which were not significantly different from those resulted from the non-oblique fixation [98.3％ (58/59),10.2％ (6/59) and 5.1％ (3/59) respectively] (P ＞ 0.05).However,the rate of femoral neck shortening [35.4％ (46/130)] and the reoperation rate [3.1％ (4/130)] in the oblique fixation group were significantly lower than those in the non-oblique fixation group [50.8％ (30/59) and 15.3％ (9/59) respectively] (P ＜ 0.05).The mean Harris hip score at the last follow-up for the oblique fixation(75.7 ± 14.3) was significantly higher than that for the non-oblique fixation (70.8 ± 16.7) (P ＜ 0.05).Conclusion As oblique cannulated screwing can reduce the rates of femoral neck shortening and reoperation to some extent,it may be a better fixation choice than the non-oblique cannulated screwing for femoral neck fracture in elderly patients.

Compared with hip replacement, internal fixation in the treatment of the elderly femoral neck fracture, especially the application of cannulated screws, is minimally invasive, easy to operate and economical. In recent years, it becomes the research focus in the field of orthopedic clinical research. However, configuration of cannulated screws is still controversial. Most clinicians believe that three cannulated screws being placed in parallel in an inverted triangle configuration is better than that in a triangular configuration in biomechanics and clinical effect. Nonparallel strong oblique nailing technique allows the screws to share more weight to reduce postoperative complications, so that it is more suitable for elderly patients with osteoporosis. However, the related complications of internal fixation such as nonunion, femoral neck shortening and other problems are still the focus of domestic and foreign scholars. Issues about how to control the indication of internal fixation surgery, understand related factors of the complications, and prevent complications are required to be further explored.
Aged ; Bone Nails ; Femoral Neck Fractures ; surgery ; Fracture Fixation, Internal ; adverse effects ; methods ; Humans ; Internal Fixators

Objective To identify the impact of estradiol on the goiter and the function of the thyroid gland with different dosages of estradiol.Methods 48 Wistar rats(female,normal state) were divided into 4 groups: Ⅰ,ovx,Ⅱ,sham;Ⅲ,ovx+E_(2)-low and Ⅳ ovx +E_(2)-large.In each group,we applied nuclide scanning of()~(131)I and()~(99)mTcO4 to detect the thyroid iodine uptake and adopted the technique of RT-PCR to test the expression of NIS.Quantity of TSH、FT_(3)、FT_(4) and the estradiol were examined.Results The expression of NIS was inhibited in group Ⅰ and group Ⅳ.Conclutions Estradiol can enhance the capability of the thyroid glands uptaking iodine and inhibit the expression of NIS and so estradiol is a very important component in the pathogenesis of goiter.

Humans ; Hypoxia-Ischemia, Brain ; diagnosis ; therapy ; Infant, Newborn ; Time Factors

Objective To explore drinking water pollution by algae in Wuhan. Methods Sampling was carried out in different kinds of tap waters and tank waters for algae detection and identification. Results The detection rate of algae in tap waters was 89% in tank water it was 86% and at the same spot the genera and number of algae in the tank waters increased by 37% and 60% compared with the tap waters respectively. Conclusion Drinking water has been polluted by algae in different degree in Wuhan.

Objective To identify main problems and related factors existing in monitoring and evaluation(M&E)of HIV/AIDS prevention and control in China through status quo investigation and problem analysis.Methods Data collected from the existing information and field investigations were analyzed with horizontal,longitudinal comparison and GAP analysis to identify current situation and problems.Results 1)Basic situation in the seven aspects,including;institution,staff,funding,use of indicators,data management,result feedback and operation of M&E was defined;2)Problems in the five aspects,including coordination mechanism,staff ability,use of indicator system,data analysis and use and level of M&E were identified.Conclusions In order to improve the overall quality of M&E of HIV/AIDS prevention and control in this country,a unified nationwide M&E system of HIV/AIDS prevention and control should be established.

Objective To investigate the implementation effect of group health education mode in cataract department. Methods Through the establishment of clinical health education path and repeatedly broadcast in group health education after surgery for 1200 cases of cataract patients,effect of health education and satisfaction on surgery were assessed and surveyed. Results Knowledge of health education was known by about 88.5% of patients or their family;satisfaction with nurse care was up to 95.0%; health education time of the nurses was reduced but their work efficiency was improved. Conclusions Implementation of group health education mode and clinical health education path could satisfy patients' demands of health education in large-scale cataract surgery and ensure the quality of health education.

Female ; Humans ; Infant, Newborn ; Male ; Serologic Tests ; Syphilis, Congenital ; diagnosis ; drug therapy

Objective: To evaluate the suitable candidate DNA barcoding of plants in Rehmannia Libosch. ex Fisch. et Mey., and unravel the origin of cultivated R. glutinosa. Methods: Nuclear DNA ITS and chloroplast gene psbA-trnH, rbcL, and matK sequences of species in Rehmannia Libosch. ex Fisch. et Mey. were amplified and sequenced. The Kimura 2-Parameter (K2P) distances were calculated. Identification analyses were performed using Nearest Distance, BLAST1, and Neighbor-Joining (NJ) methods. Results: A comparison on the sequences within species in Rehmannia Libosch. ex Fisch. et Mey. indicated that the rbcL sequences were identical, the matK sequences were similar by 99.9%-100%. All inter-specific distances (ITS and psbA-trnH data) were far higher than all intra-specific genetic distances. Minimum interspecific distance (ITS and psbA-trnH data) were higher than coalescent depth. The NJ trees (ITS, psbA-trnH, and combined data) indicated that all population of R. glutinosa formed a monophyletic clade [Bootstrap (BS)=96%, 55%, and 58%]. The clades including R. glutinosa and R. solanifolia were clustered with R. piasezkii and R. elata in ITS and combined trees (BS=55% and 68%), and clustered with R. piasezkii and R. chingii in psbA-trnH tree (BS=80%). The NJ trees (ITS, psbA-trnH, and combined data) supported that three cultivated varieties of R. glutinosa were clustered with wild populations from Wenxian, Zhengzhou, Nanyang, and Beijing (BS=51% and 69%). Conclusion: Chloroplast genes rbcL and matK can not be used to identify the medicinal plants of Rehmannia Libosch. ex Fisch. et Mey. ITS and psbA-trnH are two efficient barcodes for authentication of R. glutinosa and its relative species. R. piasezkii and R. chingii may be as both parental species of tetraploid R. glutinosa. Furthermore, it appears that native wild populations are involved in the origin of cultivated R. glutinosa in Wenxian county.