BACKGROUND:There was a variety of surgery treatment method in senile patients with unstable intertrochanteric fractures, such as hip replacement and internal fixation, but there was a great deal of controversy about advantages and disadvantages of different methods.
OBJECTIVE:To evaluate clinical effect and safety of total hip replacement, hemiarthroplasty and proximal femoral nail in senile patients with unstable intertrochanteric fractures.
METHODS:103 senile patients with unstable intertrochanteric fractures were selected, including 43 males and 60 females at the age of 62 to 80 years old. There were 28 cases of total hip replacement, 34 cases of hemiarthroplasty and 41 cases of proximal femoral nail. Perioperative complications and recovery of hip function after repair were compared among three groups.
RESULTS AND CONCLUSION:(1) The incidence of postoperative complications of internal medicine was higher in the proximal femoral nail group than in the total hip replacement and hemiarthroplasty groups (P < 0.05). No significant difference in the incidence of complications was found between the hemiarthroplasty and total hip replacement groups. (2) The incidence of prosthesis complications was lower in the total hip replacement group than in the hemiarthroplasty and proximal femoral nail groups (P < 0.05). No significant difference in the incidence of prosthesis complications was detectable between the total hip replacement and hemiarthroplasty groups. (3) The recovery of hip function was better in the total hip replacement and hemiarthroplasty groups than in the proximal femoral nail group during 12-month folow-up (P < 0.05), and no significant difference in the recovery of hip function was found between the total hip replacement and hemiarthroplasty groups. These results showed that total hip replacement and hemiarthroplasty had good curative effect on unstable intertrochanteric fractures in senile patients, and could effectively restore the hip function and reduce complications.

Objective:To establish a GC-MS method for the simultaneous determination of 16 phthalate ester plasticizers in oral liquid preparations, compare the purification effect of liquid preparations by liquid-liquid extraction and solid phase extraction and opti-mize the operating parameters to determine the optimal experimental conditions. Methods:The samples were operated by liquid-liquid extraction and solid phase extraction, respectively. Selective ion monitor ( SIM) was adopt, phthalate esters were identified by the rela-tive abundance of major characteristic ions and the content was determined by an external standard method. Results:When the samples were operated by liquid-liquid extraction, the interference was strong with many impurity peaks. Therefore, the solid phase extraction was adopted for the sample pretreatment. GC-MS was used to detect the residues of 16 phthalate ester plasticizers in oral liquid prepara-tions. The detection limit was 0. 02μg·g-1 ,while the calibration curve showed good linearity within the range of 0. 25-8. 0μg·ml-1 with the correlation coefficient between 0. 990 7 and 0. 999 8. The average recoveries were 76. 0%-95. 4%. The relative standard devi-ations were between 2. 3% and 9. 6%(n=6). Conclusion: Pretreated by solid phase extraction, the residues of 16 phthalate ester plasticizers in oral liquid preparations can be detected by GC-MS with the properties of simple, fast, precise and sensitive, and it is suitable for the determination of phthalate esters in oral liquid preparations.

Objective To approach the value of combination mode of different CT post-processing technique in diagnosing rib fine fracture.Methods 98 patients suspected with rib fractures underwent multislice spiral CT(MSCT) scanning,and CT features of rib fractures were observed with the combination of three different images:(A)volume rendering(VR),curved planar reformation(CPR) and axial view;(B)maximum intensity projection(MIP),CPR and sxial view;and(C) VR+MIP,CPR and axial view.The results were respectively recorded.Results 265 rib fine fractures were found among 98 patients.The detecting rate of fine fractures with C group was higher than that with A group (χ~2＝6.67,P＜0.01) and B group (χ~2＝6.75,P＜0.01).Conclusion MSCT four step observation method can improve the detecting rate of rib fine fracture,that is of important clinical value.

Objective:To investigate the immune mechanism of 5-fluorouracil(5-Fu) and Octerotide(Oct)in the treatment of severe acute pancreatitis(SAP)and it’s kidney injury.Methods:55 male SAP rats induced by retrograde infusion of 5% sodium taurocholate into bilopancreatic duct were randomly divided into 3 groups:Normal saline group(n=17)were treatmented with normal saline infusion,Oct group(n=18):The first dose of Oct was 2?g/100g iv,then 0.2?g/(100g?h)continuous injection,5-Fu group(n=20):The dose of 5-Fu was 2mg/h?12h.Rats from each group were killed at 12h after opertation.The plasma levels of tumor necrosis factor-?(TNF-?),interleukin-1(IL-1)were assessed by ELISA method.Thromboxan B_2(TXB_2)and prostaglandinE_2(PGE_2)were assessed by radioimmunoassay method.The expression of TNF-? mRNA was detected by RT-PCR.The apoptosis rate of rat kidney tissue were detected by TUNEL method.Apoptosis rate of NRK cell treated by serum of different groups were assessed by flow cytometry methods.Results:The plasma level of TNF-?、IL-1 and TXB_2 in 5-Fu and Oct group were much lower than that in normal saline group.The expression of TNF-? mRNA of kidney tissue decreased significantly after the SAP was treated by 5-Fu or octreotide.The apoptosis rate of NRK cell disposed by normal saline group,oct group,5-Fu group and control group rat plasma were (38.67?11.4)%,(20.4?18.4)%,(10.5?11.0)% and (1.7?2.2)% respectively(P

Objective: To understand the effects of remuneration incentive and their influences on job satis-faction in county public hospital. Methods: Stratified random sampling was adopted. Six county public hospitals in county level in Heilongjiang province were selected as the sample. Exploratory factor analysis was used to ana-lyze the remuneration incentives, descriptive statistical analysis and logistic regression analysis were used to ana-lyze the effects and their influences on work satisfaction. Results: remuneration incentives are divided into four dimensions that comprised a total of 16 items, which including direct material rewards, indirect material re-wards, occupational rewards and social rewards. The surgeon’s job satisfaction is higher than the physician, and is lower than the obstetrics and gynecology and pediatrics. Technician and nurses’ satisfaction is lower than the general practitioner. The medical staff who worked less than5 years has the lowest satisfaction. Authorized staff’s satisfaction is lower than off-staff. Direct material rewards and occupational rewards are related to job satisfac-tion. Conclusions:Material rewards were in low level, and non-economic incentive was insufficient. The salary incentive for highly educated talents should be strengthened.

Objective To investigate the role of fibroblasts in nonunion fracture healing using extracorporeal shock wave(ESW) treatment. Methods Thirty healthy rabbits were selected to make the models of non-union fractures of the right tibias, which were then held apart by external fixation. 12 weeks after the operation, hypertrophic non-unions were confirmed in 27 of the rabbits by radiography. These 27 were divided randomly into a treatment group and a control group. The test animals were treated with ESW under general anaesthesia. The two ends of the nonunion fracture were shocked 1 000 times at 0.54 mJ/mm2 and a frequency of 60 times/minute. The nonunions of the control group were treated with external fixations only. Histological examination and transmission electron microscopy(TEM) were conducted after 2 and 6 weeks. Standardized radiographs were taken after 12 weeks of the shock wave treatment. Results ESW induced microfractures, which initiated the healing process of the nonunionfractures. X-rays showed that 8 of the 9 fractures of the treatment group had healed after 12 weeks of EWS treatment, but only 3 of the 9 in the control group had healed. Statistical analysis showed that this difference was significant at the 5% level. After 2 weeks of ESW treatment, TEM showed many collagen fibers around the fibroblasts in the treatment group, with characteristic and periodic transverse lines. This indicated that the fibroblasts had been secreting collagen fibers as osteoblasts. Six weeks later, osteoblasts and fibroblasts had formed bone lacunes, and they had become osteocytes. However osteogenetic activates were not found in the control group. Conclusions Fibroblasts are activated by ESW to better form bone tissue. This process plays an important role in rebuilding broken bones.

Objective To investigate the radiation and radioprotection in bedside digital radiography. Methods 650 cases undergoing X-ray examination in sugical wards are involved. Results The patients' X-ray radiation dose is 3.12~7.68 mGR. Conclusion To avoid unnecessary radiation, radioprotection should be emphasized when improving images' quality.

Objective To observe the effect of focal cerebral ischemic preconditioning on the expression of glial fibrillary acidic protein (GFAP) and to investigate the significance of astrocyte activation in cerebral ischemic tolerance.Methods Thirty-six healthy male SpragueDawley rats were randomly divided into reischenmic,ischemic and control groups (n = 12 in each group) after ischemic preconditioning.The former two groups received 10 minutes middle cerebral artery occlusion (MCAO) preconditioning or sham operation 3 days before the 2-hour MCAO.The rats were killed 24 hours after the second MCAO.The control group only receivedthe two sham operations with an interval of three days.The infarct volume,histopathological changes,and GFAP expression in each group were compared.Results The infarct volume after ischemic preconditioning in the reischenmic and ischemic groups was 136.85 ± 14.51 mm3and 281.37 ± 29.93 mm3 respectively.The former was significantly reduced 53.15%compared to the latter (P =0.007).At the same time,neuronal degeneration and necrosis was reduced significantly,and GFAP expression was upregulated significantly (the mean absorbance for immunohistochemical staining in both groups was 102.66 ± 8.39 and 86.28 ± 6.19respectively,P = 0.009) after ischemic preconditioning in the reischemic group.Conclusions Focal ischemic preconditioning may induce brain ischemic tolerance and promote GFAP expression.The activation of astrocytes may be one of the mechanisms of cerebral ischemic tolerance.

Objective To study the imaging characteristics of the ligaments in craniocervical junction (CCJ), and to optimize the examination methods and scanning sequences of the ligaments in this region. Methods Two groups of 51 healthy volunteers in each were selected to undergo CT and MRI examination respectively. The CT and MRI features of the ligaments in CCJ were assessed. Two senior imaging doctors compared the results of showing the ligaments in CCJ by several MRI sequences, including T1 WI ,T2 WI, proton density weighted imaging (PDWI), T2 * WI and short time inversion recovery (STIR) ,and proton density fat saturate (PDFSAT). Standard normal rank transformation was done according to the primary data,and then analysis of variance of repeated measurement was applied. Results CT and MRI could both demonstrate the ligaments (except the anterior atlantooccipital membrane only seen on MRI) and their adjoins in CCJ, while MRI had more advantages than CT. The display ratio of the anterior atlantooccipital membrane was 100% (51/51) by MRI. The display ratio of the apical ligament was 29.4%(15/51) by CT and 43.1% (22/51) by MRI. The posterior atlantooccipital membrane-dura complex,tectorial ligament-dura complex, transverse ligament, and alar ligament could be demonstrated clearly by CT and MRI, the display ratio was 100% respectively (51/51). The results of PDWi scored by two doctors were both 5.0, there were no significant differences between them (F = 0.000, P > 0.05), which were significantly higher than T, WI (M = 3.0), T2Wi (M = 3.0), T2 * WI (M = 1.0), STIR (M = 1.0), and PDFSAT(M = 3.0)(P < 0.01). Conclusion MRI was superior to CT in demonstrating the ligaments in CCJ. PDWI was the optimal MRI sequence. Imaging research of normal ligamentous structures in CCJ could provide valuable diagnostic and therapeutic information for evaluating the ligamentous diseases.

Objective To construct the bait expression plasmid pGBKT7-GR of glucocorticoid receptor(GR)binding domain.Methods The fragments of GR binding domain was amplified by RT-PCR,and then was cloned into pMD18-T.After being verified by sequencing,it was subcloned into the bait expression vector pGBKT7.Then the bait vector pGBKT7-GR was transformed into AH109 yeast cells and the expression of the bait protein was analyzed by Western blot.Toxicity and self-activation of the bait protein were detected.Results GR binding domain was amplified and cloned into pMD18-T and pGBKT7 successfully.The bait vector was transformed into AH109 yeast cells successfully,without toxicity or self-activation.The expression of the bait protein was confirmed by Western blot.Conclusion The successful construction of bait expression vector of glucocorticoid receptor binding domain lays the foundation for constructing small molecule ligand yeast three-hybrid system.