Objective To understand the status of malaria prevalence in Shanghai,so as to provide the evidence for evaluat-ing and promoting malaria elimination. Methods The data of population,malaria endemic and monitoring in Shanghai from 2005 to 2012 were collected and analyzed. The malaria positive rates in febrile patients and normal population,the malaria antibody lev-els of the floating population and location pupils,and the species and density of mosquitoes were investigated and the results were analyzed. Results The blood examples from 400 177 febrile patients with 0.36%of the total population were examined for malar-ia,and the annual rates of blood examination varied from 0.15%to 0.83%in the period of 2005 to 2012. Before 2010,the annual blood examination rate was lower than 0.20%,but increased significantly since 2010 because of the implementation of the Action of Malaria Elimination in Shanghai from 2010 to 2020. Totally 604 malaria cases were found and the positive rate of blood examina-tion was 0.15%. During the period of 2006 to 2008,more than 100 malaria cases were found every year,but the number of malaria cases decreased since 2009,and only 26 cases was found in 2012. Since 2011,all the malaria cases have been found infected out of China according to the questionnaire investigation. The malaria positive rate of blood examinations decreased from 0.61% to 0.03%yearly. The proportion of local residents who had the blood examination was 79.02%,but that of the malaria positive in float-ing population was 83.44%. The active case detection was carried out in 15 759 persons and five cases were found in 2007 and 2008,respectively. The level of malaria antibody was tested in 1 239 440 floating population with the average positive rate of 0.04%. The level of malaria antibody was also tested in 7 065 local pupils but there was no positive for malaria. Only Anopheles si-nensis was found in Shanghai suburb,but no other Anopheles mosquitoes were found at the city or towns. The peak of Anopheles den- sity was from the end of July to August. Conclusions Malaria surveillance is carried out efficiently in Shanghai,and the result shows Shanghai is in the phase of malaria elimination. The more attention should be paid to persons coming from malaria endemic areas for the malaria blood examination and the general and advanced hospital should maintain the ability of malaria blood exami-nations simultaneously.

Objective To investigate serum leptin and adiponectin levels and their relationship in elderly coronary artery disease (CAD).Methods A total of 88 subjects aged 55 yeas or older were enrolled in which coronary angiograms were performed.The subjects were divided into CAD group (52 patients) and control group (36 patients) by angiography.Serum concentrations of leptin and adiponectin were evaluated by ELISA system.Results Serum concentrations of leptin were significantly increased in CAD group compared with that in control group [(9.38 ±3.51) μg/L vs.(7.27 ±3.25) μg/L,P ＜0.05].On the contrary,serum concentrations of adiponectin were significantly decreased in CAD group compared with that in control group [(11.08 ±3.87) mg/L vs.(13.34 ±4.94) mg/L,P＜0.05].Logistic regression analysis revealed that only serum leptin was the independent risk factor for CAD.Serum adiponectin concentrations had a negative relationship with leptin concentrations (r =-0.320,P =0.002).Conclusion Lower serum adiponectin levels are related to higher serum leptin concentrations.Elevated serum leptin but not decreased serum adiponectin is the independent risk factor for CAD.

Objective To investigate the clinical value of spiral computerized tomographic shaded surface display (SSD) and multiplanar(MPR) imaging of complex shoulder fractures. Methods Twenty four cases of complex shoulder fractures including 16 cases with displaced proximal humeral fractures and 8 cases with displaced fractures of glenoid fossa were examined preoperatively with X ray, 15 cases of them were examined with SSD and MPR. On the basis of X ray or SSD and MPR of SCT all fractures were classified with Neer and modified Ideberg system; the true rate of fracture classification by use of two methods was compared with each other. Results Evidenced by intraperative observation, 10 of 16 displaced proximal humeral fractures cases were Neer three part fractures, 6 were four part fractures cases. Among the 8 cases of glenoid fossa fractures, there were 2 cases of type Ⅲ, 3 cases of type Ⅳ and 3 cases of type Ⅴ. The true rate of SSD and MPR of SCT is 93.3%(14/15) while X rays is 41.7%(10/24); there was significant difference between two methods (Fishers exact test, P=0.02). All SSD and MPR of SCT play an important role in the treatment of complex shoulder fractures. Conclusion SSD and MPR of SCT is able to clearly display complex shoulder fractures three dimensionally. It is helpful to correctly classify the fractures, select appropriate surgical approach, prepare surgical instruments and understand the complexity of the fractures.

Objective To investigate the influence of common X-ray, two-dimensional computed tomography (2D-CT), spiral computed tomography (SCT), and three-dimensional (3-D) reconstruction on the classification in displaced proximal humeral fractures. Methods Three groups were divided on the basis of various imaging methods, including group A (common X-ray), group B (common X-ray and 2D-CT), and group C (3-D reconstruction of SCT and 2D-SCT). 46 cases of displaced proximal humeral fractures were classified with Neer system. The true rate of fracture classification by use of three methods was compared with each other, and clinical significance of SCT and 3-D reconstruction was evaluated.Results Based on operation, 46 cases of displaced proximal humeral fractures in group A included 26 cases of Neer two-part fractures, 13 cases of three-part fractures, and 7 cases of four-part fractures. The true cases of common X-ray were 22 in Neer two-part fractures and 8 in three and four-part fractures, there was significant difference between Neer two-part fractures and Neer three and four-part fractures (P

AIM: To investigate the pathogenic factors and prevention and cure of drug-induced renal damageMETHODS:According to the clinical manifestations,110 cases of drug-induced renal damage were divided into two types∶one type had acute renal failure(ARF),another had hematuria and proteinuria but no ARFOf 110 cases,65(32 ARF)were treated with glutathione,45(31 ARF) as controlRESULTS:Of 110 cases,49(472%)had received more than two kinds of nephrotoxic agents,72(655%) had had fever and had received antibiotics or dehydrantsThe effective rates for ARF in above-mentioned two groups were 906% and 645% respectivelyThe effective rates for hematuria and proteinuria were 848% and 572% respectively with significant difference(P

The distribution of GABA-containing neurons in the anterior horn of L_(4～5) segments of rat spinal cord and their relationship with somatic efferent were studied by combined method of HRP and immunocytochemistry and immunoelectron microscopic method. The results showed that under light microscope, the GABA-immunoreactive cell bodies and terminals were seen in all layers of the anterior horn including Rexed′s layer IX which located in the anterolateral part of the anterior horn. The GABA-positive neurons had round or triangle cell body with many processes and could be divided into two (large and medium) types. Under electron microscope, GABA-immunoreactive products appeared as small granular deposits located in perikarya, dendrite and axon. In axon terminals the immunoreactive products located at periphery of the synaptic vesicles and on the outer membrane of the mitochondria. The GABA-positive dendrites received symmetrical afferent synapses from GABA-positive or negative axon terminals. The combined method of HRP and immunocytochemistry showed that in Rexed′s layer IX there were HRP single labeled neurons, GABA single labeled neurons and HRP/GABA double labeled neurons. The double labeled neurons accounted for 79% of total HRP labeled cells. Above mentioned results first identified the neurons in Rexed′s layer IX of the anterior horn contain GABA which participate in somatic efferent and receive autoregulation from GABA-neurons and nonGABA-neurons at synaptic level.

Objective The aim of this research is to evaluate the influence of nursing intervention on the compliance of patients with dysfunctional uterine bleeding in climacteric period. Methods We divided 96 patients with dysfunctional uterine bleeding in climacteric period from February to December in 2006 into the intervention group and the control group with 48 cases in each group.The control group was given medication instruction simply by the doctors and no nursing intervention.The intervention group was given health education and follow-up supervision.The general information and medical history of patients were registered at the first visit. The medication, adverse effect and effect of drugs were also registered at every visit. All patients were given follow-up visit 3 months later.The medication and visiting compliance and the treatment effect were observed. Results One patients missed follow-up visit in the intervention group and 11 patients missed in the control group.The medication compliance was 87.2% and the visit compliance was 93.6% in the intervention group,which was superior to those of the control group (67.6%,56.8%).The effect of hormone treatment was also better than that of the control group,P ＜ 0.05. Conclusions Nursing intervention couhl improve the compliance and medication effect of patients with dysfunctional uterine bleeding in climacteric period.

This paper introduces the design and implementation of Bluetooth wireless management and monitoring system. Combined with hospital information system, this system replaces the current monitoring system in hospital, and thus the efficiency of hospital can be improved.

Objective To compare the clinical effects of patellar resurfacing with patella reservation and patellaplasty in the total knee arthroplasty(TKA)for osteoarthritis so as to discuss appropriate management of patellas in TKA.Methods A retrospective study was conducted on 198 patients with osteoarthritis treated by TKA from January 2002 to December 2008.There were 62 patients managed by patellaplasty(patellaplasty group)and 136 patients by patellar resurfacing with patella reservation(patellar resurfacing group).The osteophytes of the patella were removed to make the articular surface of patellas similar to the primary one.Knee Society Score(KSS),Bristol patellar score,satisfaction survey and evaluation of joint range of motion(ROM)were performed during the regular follow-up.Incidence of postoperative anterior knee pain were analyzed and X-ray films were reviewed to understand the condition of the implants.Results A total of 125 patients were followed up,including 43 patients from the patellaplasty group and 82 from the patellar resurfacing group.The mean follow-up period was 51 months(range,36-80 months).Both groups showed significant improvement of each score postoperatively.No significant differences were found between the two groups regarding KSS score,patellar score and patient satisfaction in the follow-up one year later;but KSS function score in the patellar resurfacing group was superior to that in the patellaplasty group,with statistical difference.The incidence of anterior knee pain of the two groups had no statistical significance.Postoperative radiographs revealed no significant differences between the two groups concerning patellofemoral congruence,incidence of postoperative anterior knee pain or incidence of patellar related complications.Conclusion Patellar resurfacing with patella reservation for osteoarthritis in TKA can achieve satisfactory patellofemoral congruence and low incidence of intraoperative anterior knee pain,with comparable mid-term results with patellaplasty.

Objective To evaluate the surgical procedures and clinical efficacy of endoprosthetic replacement as a salvage procedure for intertrochanteric fracture suffered failure of internal fixation.Methods The study involved 18 intertrochanteric fracture patients that suffered failed internal fixation from 2001 to 2009,including 16 patients with failed dynamic hip screw (DHS) fixation and two with failed proximal femoral nail anti-rotation (PFNA).The patients were at mean age of 76.5 years (range,58-92 years).The treatment methods included total hip arthroplasty in five patients and the bipolar hemiarthroplasty in 13.Harris score was used to evaluate the function outcome during the follow-up.Results The mean operation time lasted for 115 minutes,with intraoperative blood loss of 500 ml.Two patients presented with intraoperative complications.Of all the patients,three patients died within three months after operation and three patients were lost to follow-up.The remaining 12 patients received complete follow-up for a mean of 2.3 years ( range,1-7 years).One patient with hip joint dislocation was treated with closed reduction and distraction for three weeks.At the latest follow-up,the pain disappeared or was reduced in all the patients,including two patients with moderate pain and four with mild pain after some movements.The average Harris score was increased from preoperative 34 points to 83 points at one year after operation.Conclusions Endoprosthetic replacement is an effective salvage procedure for the failed treatment of the intertrochanteric fracture,as it can attain satisfactory pain relief and functional improvement.