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.

The painless needle insertion technique, summarized by Professor WU Lian-zhong during his decades of acupuncture clinical practice is introduced in this article, which is characterized as soft, flexible, fast, plucking and activating antipathogenic qi. The Sancai (three layers) lifting and thrusting manipulation technique is adopted by Professor WU for getting the qi sensation. And features of 10 kinds of needling sensation such as soreness, numbness, heaviness, distension, pain, cold, hot, radiation, jumping and contracture are summarized. Finger force, amplitude, speed and time length are also taken as the basis of reinforcing and reducing manipulations. Moreover, examples are also given to explain the needling technique on some specific points which further embodies Professor WU's unique experiences and understandings on acupuncture.
Acupuncture Therapy ; history ; methods ; China ; History, 20th Century ; History, 21st Century ; Humans ; Needles

Bilirubin is a metabolic end product degraded under the action of heme oxygenase.It is an endogenous antioxidant and has the function of anti-atherosclerosis, clearing free radicals and protecting the tissues and organs of the body.This article reviews the metabolism and biological characteristics of bilirubin, and the correlations between bilirubin and vascular risk factors, as well as between bilirubin and ischemic stroke.

Objective To observe the effect of WeChat -based health education on young patients with initial treatment of pulmonary tuberculosis(TB).Methods A total of 180 TB patients were randomly divided into control group and observation group,90 cases in each group.All patients received health education for six months under the guidance of specialist nurses and physicians,but WeChat-based health education for the observation group and telephone health education for control group.Patients of the two groups were evaluated with TB cognitive level and compliance at 6 months after discharge.Results The pulmonary tuberculosis knowledge level of the observer group was significantly higher than that of the control group (89.8%vs 73.3%),the difference was statistically significant (χ2 =11.07,P<0.01);And after 6 months of follow-up,in the observation group,the compliances of patients taking medicine on time(97.8%vs 80.0%,χ2 =15.59,P<0.01),reasonable diet(95.5%vs 81.1%,χ2 =23.24, P<0.01),moderate exercise(97.8%vs 83.4%,χ2 =36.51,P<0.01) and timely referral(96.7% vs 82.2%,χ2 =20.63,P<0.01) were higher than those in the control group,the differences were statistically significant (all P<0.01).Conclusion WeChat -based health education is effective for improving TB cognitive level and the compliance of the patients.Since WeChat has been widely used,WeChat-based health education can be promoted.

Objective To analyze the risk factors of subclavian venous catheter-related infections in patients with traumatic hemorrhagic shock (THS) and provide a basis for prevention and control of the infection. Methods A retrospective study was conducted. 357 patients with THS and indwelling of subclavian vein catheter admitted in the Department of Emergency of Affiliated Hospital of Sichuan Provincial Luzhou Medical College were enrolled, and according to the infection state, they were divided into infection group (56 cases) and non-infection group (301 cases). The patients' data of gender, age, history of underlying disease, catheter position, catheter indwelling time, time staying in hospital, situation of antimicrobial drug used, application of tracheotomy or not, white blood cell count (WBC) levels, etc were collected for univariate analysis. The resulting indexes with statistical significance were applied for carrying out the multivariate logistic regression analysis, and then the independent risk factors involved in the development of subclavian venous catheter-related infections in the shock patients could be screened out.Results In 357 patients with THS, 56 were infected (15.7%). Univariate analysis showed: age ≥ 60 years (χ2 = 19.839,P < 0.001), with diabetes mellitus in past history (χ2 = 6.252,P = 0.012), catheter indwelling time ≥ 7 days (χ2 = 19.261,P < 0.001), time staying in hospital ≥ 7 days (χ2 = 4.315,P = 0.038), time for use of antimicrobial drug≥ 7 days (χ2 = 16.161,P < 0.001), tracheotomy (χ2 = 40.969,P < 0.001), WBC < 4×109/L (χ2 = 39.451,P < 0.001) and the disease severity grade 4 - 5 (χ2 = 8.345,P = 0.004) were the risk factors of subclavian venous catheter-related infections in patients with THS. Multivariate analysis showed: catheter indwelling time ≥ 7 day [odds ratio (OR) = 16.713, 95% confidence interval (95%CI) 3.651 - 76.624), tracheotomy (OR = 6.861, 95%CI 2.377 - 18.246), WBC < 4×109/L (OR = 4.903, 95%CI 1.887 - 12.643) were the independent risk factors of subclavian venous catheter-related infections in THS patients.Conclusion The strict implementation of aseptic catheterization, shortening the time of catheter indwelling as much as possible and the rational use of antibiotics can effectively reduce and prevent the incidence of venous catheter-related infection in THS patients.

Adolescent ; Adult ; Female ; Humans ; Male ; Middle Aged ; Occupational Diseases ; diagnosis ; etiology ; Ulna ; injuries ; Wrist Injuries ; diagnosis ; etiology ; Young Adult

Objective To research the effect of PEGylation on rBla g 2 from Blattella germanica.Methods rBla g 2 allergen expressed in E.coli was purified by Ni+affinity chromatographY,then was PEGylated by mPEG2-NHS(Mr,10×103).The PEG-rBla g 2 was purified by CM-Sepharose,a cation exchange chromatography. SDS-PAGE,Western blot and ELISA were used to characterize its biologicat actovoty.Results The relative molecular mass of the purified rBla g 2 was about 39×1023.PEG-rBla g 2 was analyzed by SDS-PAGE.Five bands were visualized by staining with Coomassie Brilliant Blue R-250,while seven bands by staining with I2-KI.Cation exchange chromatography could separate rBla g 2 and PEG-rBla g 2.The 100×103(Mr)and 130×103(Mr)of PEG-rBla g 2 could combined with the special IgE from sera of one cockroach-allergic patient by Western blot.The immunological activities of PEG-rBla g 2 in vitro decreased remarkablv bv ELISA,which was only 42%of rBla g 2.Conclusion PEGylated allergen can retain the ability of combining with special IgE from sera,while its immunological activities reduce enormously,which establishes the basic work of researching recombinant low-sensitive allergens.

Objective To investigate the risk factors for hospital-acquired pneumonia (HAP) in a neurological intensive care unit (NICU).Methods The patients aged ≥ 18 years admitted in NICU of Nanfang Hospital for ≥ 48 hours from May 2010 to April 2011 were enrolled.The possible risk factors,including the general information,the worst Glasgow Coma Scale (GCS) score,as well as Acute Physiology and Chronic Health Evaluation (APACHE) Ⅱ scores within 24 hours in NICU,whether the occurrence of HAP,whether with some underlying disease or symptoms within the time of study and using specific drug therapy or invasive procedures were investigated retrospectively.The duration of continuous medical interventions was recorded at the same time,and the continuous variables were quantified and stratified.Results A total of 243 patients were enrolled,and 50 (20.6％) of them developed HAP.Univariate analysis showed that the proportions of coma (44.0％ vs.29.0％ ;x2 =4.091,P =0.043) and APACHE Ⅱ score ≥ 15 (60.0％ vs.38.9％ ;x2 =7.232,P =0.007) in the HAP group were significantly higher than those in the non-HAP group.There were significant differences in using antacids (＜ 6 d: 38.0％ vs.19.7％ ; ≥ 6 d: 18.0％ vs.25.9％ ; x2 =7.521,P =0.023),sedatives (＜2 d: 30.0％ vs.37.3％ ; ≥2 d: 46.0％ vs.28.0％ ;x2 =6.064,P =0.048),blood products (＜3 d: 24.0％ vs.9.8％ ; ≥ 3 d: 6.0％ vs.7.3％ ; x2 =7.150,P =0.028),endotracheal intubation (＜ 5 d:24.0％ vs.10.9％ ; ≥ 5d: 26.0％ vs.15.5％ ; x2 =10.698,P =0.005),mechanical ventilation (＜ 4 d:6.0％ vs.7.8％ ; ≥ 4 d: 30.0％ vs.7.8％ ; x2=,P =0.000) and indwelling nasogastric tube (＜ 7 d:56.0％vs.37.3％ ; ≥7d: 42.0％ vs.44.6％ ;x2 =10.410,P =0.005) between the two groups.Multivariate logistic regression analysis showed that mechanical ventilation ≥ 4 d (odds ratio [OR] 6.481,95％ confidence interval [CI] 2.522-16.654; P=0.000),indwelling nasogastric tube ＜7 d (OR 12.504,95％ CI 1.614-96.869; P =0.016) and using antacids ＜ 6 d (OR 2.271,95％ CI 1.042-4.949; P =0.039) were the independent risk factors for HAP in NICU patients.Conclusions Mechanical ventilation,indwelling nasogastric tube and using antacids are the independent risk factors for HAP in NICU patients,and thus it needs to take targeted measures.

Objective To analyze the concentration of epithelial cell derived neutrophil-activating protein 78(CXCL-5) in the sy-(novial) fluid(SF) and peripheral blood in children with rheumatoid arthritis(RA) and evaluate its clinical relevance to the disease development.Methods SF and peripheral sera were taken from 26 children with RA and 16 healthy controls,and CXCL-5 was measured by enzyme linked immunosorbent assay(ELISA).CXCL-5 in SF was also measured in RA children after receiving steroid treatment.Results The levels of CXCL-5 was significantly higher than that in the SF of RA children compared with healthy controls(P0.05).Interestingly,CXCL-5 markedly decreased in RA children after steroid treatment(P

OBJECTIVE To investigate and analyze the application of antibiotics in non-surgical departments in our hospital.METHODS To make a survey of the use of antimicrobials in non-surgical departments from a total of 548 randomly selected medical records during Jan-Mar 2007,the data of reasonable use of antibacterials were obtained after evaluation and analysis.RESULTS Of the 548 patients in our study,229(41.79%)used antimicrobials.The use of antimicrobials for infection prevention was in 46 cases(20.09%),for infection treatment was in 183 cases(79.91%).From them 95 cases(41.48%)used a combination of two and more antimicrobials.The most widely used antibacterials were penicillins,cephalosporins,and quinolones.CONCLUSIONS The use of antimicrobials is generally reasonable,and meets the safe,effective,and economical goal in our hospital.