BACKGROUND:Hip arthroplasty is an effective means currently in repair of femoral neck fractures. With the increased in the amount of surgery, surgery failure rate also has increased. In particular, prosthesis loosening and fracture are very common after replacement.Qiangguyin can promote the formation of osteoblasts, resist osteoporosis, inhibit osteoclast activity, and increase bone density. Drynaria invigorates the kidney, strengthens the bone and tendon and relieves pain, and has bidirectional regulatory effects on promoting bone formation and inhibiting bone resorption.
OBJECTIVE:To investigate effects ofQiangguyin on periprosthetic bone density in patients with femoral neck fracture after hip arthroplasty.
METHODS:96 patients with femoral neck fracture were equaly divided into observation group and control group based on the random number table. Both groups were given selective joint replacement. Patients were implanted with femoral head made by US Stryker Corporation, and fixed with bone cement. After replacement, patients in the control group were treated with calcium D3 tablets and capsules alfacalcidol. On this basis, the treatment group was given theQiangguyin oral drug intervention for a month. Bone density surrounding the prosthesis was observed in both groups. Alkaline phosphatase and tartrate-resistant hydrochloric acid phosphatase activities were detected. Repair effects were compared.
RESULTS AND CONCLUSION:The surgery was successfuly completed in al patients. No infection or loosening of the prosthesis occurred. Ambulation time and healing time were significantly less in the observation group than in the control group (P < 0.05). No significant difference in bone density surrounding the prosthesis was detected between the two groups before medication, and an obvious increased trend was found after medication (P < 0.05). Bone density was significantly higher in the observation group than in the control group after medication (P < 0.05). Serum alkaline phosphatase activity was significantly higher in the two groups after medication, but tartrate-resistant hydrochloric acid phosphatase activity was significantly decreased, which showed significant differences as compared with that before medication (P < 0.05). Simultaneously, significant differences in serum alkaline phosphatase activity and tartrate-resistant hydrochloric acid phosphatase activity were detected between the observation and control groups after medication (P < 0.05). At 6 months after replacement, the excelent and good rate of joint function was significantly higher in the observation group than in the control group (94%, 79%,P < 0.05). These results indicate that Qiangguyin could resist bone resorption and suppress excessive bone turnover, improve bone density around the prosthesis, and restore joint function after hip arthroplasty.

Objective:To explore the effect of repetitive high-frequency magnetic stimulation (H-F rTMS) of the dorsolateral part of the prefrontal cortex (DLPFC) combined with smoking-related cues on nicotine addicts′ cigarette craving, the concentration of exhaled CO and sleep quality.Methods:Sixty nicotine addicts were randomly divided into groups A, B and C, each of 20. All were given H-F rTMS five times a week for two weeks, while those in groups A and B watched smoking and non-smoking pictures for ten minutes, respectively. Before and after the intervention, all of the subjects self-reported their cigarette cravings using a visual analogue scale. Exhaled CO (CO ppm) was measured and the Pittsburgh sleep quality index (PSQI) was evaluated. Results:After the intervention the average craving score, CO ppm and PSQI score had improved significantly in all three groups. The average craving score and CO ppm of group A were both significantly better than in the other two groups. Conclusions:rTMS can significantly improve cigarette craving, CO ppm and sleep quality of cigarette adicts. Viewing smoking-related pictures as an addition to rTMS can even better the effects of rTMS.

Objective To evaluate the concept of artery first and total mesopancreatic excision in radical resection of pancreatic head carcinoma through both anterior and posterior approaches.Method The anterior approach was to identify the superior mesenteric artery (SMA) and the posterior approach to confirm the possibility of negative margin at the origin of SMA,on the posterio-lateral vascular wall of superior mesenteric vein (SMV) and the supposed posterior of the mesopancreas.The resection scope were with the celiac trunk and common hepatic artery as the upper boarder,the SMA as the left boarder,the inferior mesenteric vein (IMA) level as the lower boarder,to achieve a complete mesopancreatic excision,namely the en bloc resection of all the involved nerve,the lymph tissue and vascular tissue along the right side of the axial composed by SMA and celiac trunk.Results Of the 15 patients,11 had radical Whipple procedure,among which 2 had a combining SMV resection and reconstruction.1 case suffered from delayed gastric emptying and 2 cases from bile leakage.There was no mortality.The postoperative pathology reported carcinoma in all 11 cases,with duodenum and low bile duct involved in 4 cases,with the duodenum involved in 6 cases,no surrounding tissue involvement was identified in 1 case.Nerve involvement was found in 7 (7/11),vascular involvement in 10 (10/11),and lymphnode metastasis was (2.5 ± 3.8/12.9 ± 4.9).Conclusions The radical resection of pancreatic head carcinoma using the concept of artery first and the total mesopancreatic excision is helpful for an early evaluation of the possibility of radical resection and guarantees negative margins.

Objective To ummarized the clinical characteristics of lactic acidosis combined with hypoglycemic coma,diabetic ketoacidosis and hyperkalemia,so to improve the physician's treatment ability by summary the clinical feature of lactic acidosis combined with hypoglycemic coma,diabetic ketosis and hyperkalemia.Methods Analyzed the clinical characteristics and disease development of one case with lactic acidosis combined with hypoglycemic coma,diabetic ketoacidosis and hyperkalemia,and reviewed literature.Results The patient had hypoglycemia and acidosis at the same time due to taking phenformin and glibenclamide.After 2 days,the patient was better through correcting acidosis,intravenous fluid therapy,lowering blood potassium and controlling blood glucose.Conclusion Because acidosis caused the potassium transfer from intracellular to extracellular,the latter leads to hyperpotassemia,lactic acidosis caused by phenformin should be treated with intravenous fluid therapy,correcting acidosis.

Objective To investigate the effect of repetitive transcranial magnetic stimulation (rTMS) combined with the mirror therapy (MT) on the recovery of upper limb function recovery 3 to 6 months after a stroke.Methods Forty-five male patients were randomly assigned to an MT (A) group,an rTMS+MT (B) group or an MT +rTMS group (C),each of 15.All received conventional medical treatment and stroke rehabilitation.In addition,group A received 60 min of MT daily,5 days a week for 4 weeks.Group B received 10 min of rTMS over the M1 area of the affected hemisphere followed by 50 min of MT treatment,and group C received 50 min of MT treatment followed by 10 min of rTMS.rTMS was delivered at a frequency of 10 Hz and an intensity of 90％ resting motor threshold.The latency of motor evoked potential (MEP) for the affected abductor pollicis brevis muscle and its central motor conduction time (CMCT) were observed before and after the treatment.The upper extremity portion of the Fugl-Meyer assessment (FMA) was performed along with a functional test for the hemiplegic upper extremity (FTHUE).The motricity index (MI) was also quantified.Results Average MEP latency and CMCT had decreased significantly in all three groups after the treatments.The average MEP latency of group B was significantly shorter than that of group A,and CMCT was also significantly shorter than for groups A and C.Moreover,after the intervention,all of the groups had significantly improved their average FMA,MI and FTHUE scores,with the average FMA score of group B significantly better than those of groups A and C.The average FTHUE score of group B was also significantly better than that of group A.Conclusions MT either alone or in combination with rTMS can improve cerebral motor cortex excitability and motor recovery after a stroke.Ten minute rTMS sessions followed by 50 min of MT have the best effect.