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 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.

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 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 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.

Objective To study the technology of flocculation of water-extraction solution in Lonicerae Japonicae Flos by uniform design method.Methods The liquid concentration ratio, chitosan dosage, temperature and pH were studied with the ratio of the precipitation and the rate of the transformation of valid target as index.Results The optimal flocculation process was: dosage of chitosan was 0.14%, pH was 6, the concentration of the solution was 1:3 and the temperature was 30℃.Conclusions The effect of purification is good, and the flocculation process can replace the traditional precipitation process.

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

Objective To study the immunodiagnostic potential of recombinant membrane protein Tetraspanin 2 of Schistosoma japonicum(rSjTsp2) as a diagnostic antigen. Methods The rSjTsp2 was expressed and purified as an antigen used in indirect ELISA to detect specific serum antibody against Schistosoma japonicum of rabbits that at different stages of infection, and the results were compared with those of ELISA using natural antigen (AWA) as antigen. Results The sensitivities of rSjTsp2-ELISA were 75.4% (46/61),77.6% (45/58) and 81.5% (44/54), respectively, 2, 4, 6 weeks after rabbits were infected with Schistosoma japonicum, meanwhile the sensitivities of AWA-ELISA were 68.9% (42/61),86.2% (50/58) and 88.9% (48/54), respectively. The sensitivity difference of two methods was not significant statistically (x2 = 0.652, 1.454,1.174, all P ＞ 0.05).Conclusions The rSjTsp2 is expressed successfully in vitro, and rSjTsp2 recombinant protein expressed in prokaryotic system has a certain application potential in immunodiagnosis.