[Objective]Through a comparitive analysis between hemiarthroplaty and dynamic hip screws in femoral intertrochanteric fracture,to discuss the differences and similaries between two groups of patients.[Method]Using the methods of retrospective review,the author collected 63 cases of femoral intertrochanteric fracture,treated by hemiarthroplasty and dynamic hip screws respectively.Followed for a minimum period of 6 months,the author compared the postoperative complications,cumulative mortality rate and loss of ambulatory grades between two groups.[Result]There was no siganificant difference in operative time and introperative bleeding and no evident distinctions showed in posteroperative general conditions.But in local symptoms,DHS group appeared the cut-out from femoral head and coax vara resulting from the collapse of medial cortex,hemiarthroplaty group emerged the pain in hip without proof of loosening and infection of prosthesis.Hip scores decreased by 8.6% in DHS group and 9.2% in hemiarthroplaty group.In the opinion of the function convalescence,there was no definition to be worth recommending between two groups.[Conclusion]To eldly patients with unstable intertrochanteric fracture,fine function should be expected equal to preoperation after operation,but the chief motive is to provide the conditions which permit the patients earlier activity.So hemiarthroplaty is a reasonable alternative to a sliding screw device to treat intertrochanteric fractures.

Objective To discuss the techniques and efficacy of arthroscopy-assisted treatment for popliteal cyst. Methods From June 2004 to January 2006, 14 patients with popliteal cyst were diagnosed and treated with arthroscopy. During the operation, the popliteal cyst was removed, and then the hernial opening was repaired by suturing the medial head of the gastrocnemius tendon. The outcomes of the operation were evaluated by using Rauschning and Lindgren Grading. Results Arthroscopic examinations showed evident pathological changes in the knee joints of the 14 patients, including 6 cases of posterior horn medial meniscus tear, 1 case of chondromalacia of patella, 2 patellofemoral malalignment, 4 osteoarthritis, and 1 discoid lateral meniscal tear. The patients were followed up for 5-18 months (mean 11 months). According to the Rauschning and Lindgren Grading, 8 patients were grade Ⅱ and 6 were grade Ⅲ before the operation. After the operation, 9 patients were grade 0, 4 were grade Ⅰ, and 1 was grade Ⅱ. There was a significant difference between the pre-and postoperative grading (Z=-4.498, P=0.000). No patient had recurrence during the follow-up. Conclusions Popliteal cyst is usually induced by knee joint disorders. It was difficult to eliminate the cyst by simple resection. Arthroscopy-assisted treatment can achieve good outcomes.

Objective To analyse the differences between radiofrequency and mechanical debridement in treatment of knee osteoarthritis. Methods Randomized control and prospective case study were designed, with 24 cases in the radiofrequency treatment group and 36 cases in the mechanical debridement group (the control). All the cases were followed up for an average of 12.4 months (ranging 6 to 24months) according to Lysholm knee function evaluation score. Results The Lysholm scores for the treatment group were superior to those in the control group in cases of Outbridge grades Ⅱ and Ⅱ-Ⅲ chondromalacia (P0.05). Conclusion Radiofrequency is the first choice in treatment of chondromalacic lesions of no more than Outbridge grade Ⅲ.

OBJECTIVETo explore the therapeutic effects of amiodarone and metoprolol, either alone or in combination, on chronic heart failure (CHF) complicated by ventricular arrhythmia.

METHODSA total of 110 NYHA class II-III patients with CHF complicated by ventricular arrhythmia were randomly divided into amiodarone group, metoprolol group and amiodarone + metoprolol group. The therapeutic effects was evaluated at the end of the 1-year follow-up.

RESULTSAmiodarone, metoprolol and their combination produced statistically different therapeutic effects (P<0.05). Compared with amiodarone and metoprolol used alone, amiodarone combined with metoprolol resulted in significant cardiac function improvement (P<0.05) and ventricular arrhythmia control (P<0.01). During the 1-year follow-up, the readmission rate and cardiac event rate in the amiodarone + metoprolol group were significantly lower than those in amiodarone group (P<0.01) and metoprolol group (P<0.05). The adverse reaction rates in the 3 groups were similar (P>0.05).

CONCLUSIONThe combination of amiodarone and metoprolol produces better effect than amiodarone or metoprolol alone in the treatment of CHF complicated by ventricular arrhythmia.

Adrenergic beta-Antagonists ; therapeutic use ; Adult ; Amiodarone ; therapeutic use ; Anti-Arrhythmia Agents ; therapeutic use ; Chronic Disease ; Drug Therapy, Combination ; Female ; Heart Failure ; complications ; drug therapy ; physiopathology ; Humans ; Male ; Metoprolol ; therapeutic use ; Tachycardia, Ventricular ; drug therapy ; etiology ; physiopathology ; Treatment Outcome ; Ventricular Premature Complexes ; drug therapy ; etiology

Objective Labial gland biopsy is one of major diagnostic methods for Sj(o)gren's syn-drome(SS).Meanwhile,99TcmO-4 parotid scintigraphy has been proven useful for the clinical evaluation of SS.This study was performed to investigate the correlation between the two examinations and evaluate the semi-quantitative parotid scintigraphy in the early diagnosis and staging for SS patients.Methods There were 135 SS patients and 30 normal subjects as control group in this study.They all underwent 99TcmO-4 pa-rotid scintigraphy.Semi-quantitative analyses of parotid scintigraphy were conducted with parameters inclu-ding maximum accumulation ratio (MAR),maximum secretion ratio(MSR),time interval from stimulation to minimum count(tparotid),prestimulatory oral activity index (PRI) and poststimulatory oral activity index (POI).For comparison, the biopsy of labial gland was performed in each patient and the pathological se-verity was classified into grade 0,1,2,3,4 (also defined as subgroups).One-way ANOVA and q-teat were applied for the correlation analyses between the two examinations.Results There was significant difference between pathological subgroup 3 or subgroup 4 and the control in all the semi-quantitative parame-ters (q=6.79-38.64,P<0.O1).In subgroups 1 and 2,only PRI and POI showed significant changes compared with the control(q=8.33,8.63,all P<0.01).The pathological stages were negatively correla-ted with MAR(r=-0.679,P<0.01),MSR(r=-0.601,P<0.01),PRI(r=-0.724,P<0.01)and POI(r=-0.751,P<0.01),but only positively correlated with tparotid(r=0.364,P<0.01).Con-clusions Most semi-quantitative parameters of 99TcmaO-4 parotid scintigraphy may be well correlated with the pathological severity of labial gland biopsy in SS patients.Further,the semi-quantitative indices espe-eially PRI and POI may be helpful for the early diagnosis and staging of SS patients.

OBJECTIVETo explore the efficacy and feasibility of dog days moxibustion plaster therapy in treatment of allergic rhinitis of different patterns/syndromes.

METHODSAllergic rhinitis of lung deficiency and invasion of cold, spleen qi deficiency and kidney yang deficiency, 56 patients for each pattern/syndrome were randomized into a plaster therapy group and a nasal spray group, 28 cases in each one. In the plaster therapy group, according to the pattern/syndrome differentiation, with literature retrieval method, 3 acupoints of high frequency utility in clinic were selected as one group in acupoint plaster therapy. For lung deficiency and invasion of cold pattern/syndrome, Feishu (BL 13), Fengmen (BL 12) and Hegu (LI 4) were selected. For spleen qi deficiency pattern/syndrome, Pishu (BL 21), Zusanli (ST 36) and Dazhui (GV 14) were selected. For kidney yang deficiency pattern/ syndrome, Shenshu (BL 23), Dingchuan (EX-B 1) and Bailao (EX-HN 15) were selected. Separately, on July 13, 2013, July 23, 2013, August 2, 2013 and August 12, 2013, the aucpoint plaster therapy was applied, 2 to 4 h (1 to 2 h for children) each time. In the nasal spray group, beclometasone dipropionate aqueous nasal spray, 2 presses one nostril each time, 2 to 3 times a day, continuously for 4 weeks. The symptom score and efficacy were compared before and after treatment in the patients of the two groups.

RESULTSThe symptom scores of 3 patterns/syndromes were all apparently improved after treatment as compared with those before treatment in the patients of the two groups (all P<0.05), and the result in the plaster therapy group was better than that of the nasal spray group (P<0.05, P<0.01). For lung deficiency and invasion of cold pattern/syndrome, the total effective rate was 87.3% (20/24) in the plaster therapy group, better than 84.6% (22/26) in the nasal spray group (P<0.05). For spleen qi deficiency pattern/syndrome, the total effective rate was 83.3% (20/24) in the plaster therapy group, obviously better than 76.9% (22/26) in the nasal spray group (P<0.05). For kidney yang deficiency pattern/syndrome, the total effective rate was 79.2% (19/24) in the plaster therapy group, better than 76.9% (22/26) in the nasal spray group (P<0.05).

CONCLUSIONThe dog days moxibustion plaster therapy achieves definite efficacy on allergic rhinitis at the acupoints selected based on the differentiation of different patterns/syndromes and the efficacy is better than beclometasone dipropionate aqueous nasal spray.

Acupuncture Points ; Administration, Cutaneous ; Adolescent ; Adult ; Aged ; Aged, 80 and over ; Animals ; Child ; Drugs, Chinese Herbal ; administration & dosage ; Female ; Humans ; Male ; Middle Aged ; Rhinitis, Allergic ; drug therapy ; therapy ; Yang Deficiency ; drug therapy ; Young Adult

OBJECTIVETo evaluate the methods for the replantation of the amputated penis in Chinese men.

METHODSWe performed a meta-analysis on the domestic literature relating replantation of the amputated penis, particularly its successful methods published from 1964 to January 2012.

RESULTSWe identified 109 reports on 111 cases of replantation of the amputated penis that met the inclusion criteria, including 103 adults and 8 children. The mean age, warm ischemia time and total ischemia time were 29 +/- 11 years (range 2 - 56 years), 5.2 +/- 5.7 hours (range 0 - 38 hours) and 6.3 +/- 5.7 hours (range 1 - 38 hours). Fifty-three of the cases were treated by microsurgery and 44 by non-microsurgery. Complications occurred in 81 (73%) of the cases, including ED in 14 cases, urethral stricture in 16, urinary fistula in 8, skin necrosis in 58 and skin sensory abnormality in 31. The incidences of ED, urethral stricture and urinary fistula exhibited significant differences between the microsurgery and non-microsurgery groups of the partial amputation patients (P < 0.05). The incidence of ED was correlated negatively with the number of anastomosed dorsal nerves (r = -0.3, P = 0.05), anastomosis of dorsal veins (r = -0.2, P = 0.02) and anastomosis of arteries (r = -0.2, P = 0.03), but positively with skin sensory abnormality (r = 0.4, P < 0.01), that of urethral stricture negatively with the anastomosis of dorsal nerves (r = -0.2, P = 0.02) and arteries (r = -0.2, P = 0.016), but positively with the anastomosis of corpus cavernosum (r = 0.3, P = 0.01), that of skin necrosis negatively with the total number of anastomosed blood vessels (r = -0.2, P = 0.04), and that of complications negatively with the number of anastomosed dorsal nerves (r = -0.3, P = 0.01), dorsal veins (r = -0.2, P = 0.04), arteries (r = -0.2, P = 0.023) and micro-anastomosis (r = -0.3, P < 0.05).

CONCLUSIONEarly micro-anastomosis of the most possible penile dorsal veins, arteries and dorsal nerves is essential for the survival of the replanted penis and reduction of complications, and therefore can be regarded as a "standard" method for penile replantation in China.

Adolescent ; Adult ; Amputation, Traumatic ; surgery ; Child ; Child, Preschool ; China ; Humans ; Male ; Microsurgery ; methods ; Middle Aged ; Penis ; injuries ; surgery ; Reconstructive Surgical Procedures ; methods ; Replantation ; Retrospective Studies ; Young Adult

Carcinoma, Non-Small-Cell Lung ; pathology ; surgery ; China ; Forecasting ; Humans ; Lung Neoplasms ; pathology ; surgery ; Neoplasm Staging ; Surgical Procedures, Operative ; methods ; trends

Aim To explore the alterations of blood corticosterone (CORT) level and adrenal steroidogenic function,as well as its sex specificity in intrauterine growth retardation (IUGR) rats induced by prenatal nicotine exposure (PNE) with high-fat diet (HFD) after birth,and to make clear its mechanism through insulin-like growth factor-1 (IGF-1) signaling pathway.Methods IUGR model was established by PNE (2.0mL · kg-1 · d-1),and the offspring rats were administered with HFD until postnatal week (PW) 24 after weaning.Blood CORT concentration,adrenal steroidogenesis enzymes,expressions of IGF-1 signaling pathway and 11β-HSDs/CR system were tested.Results Compared with HFD control group,the CORT concentration in male offspring of PNE group represented a decrease trend,while an increase trend in female;the expressions of adrenal steroidogenesis enzymes (such as StAR,3β-HSD and P450cll) in male offspring decreased,while increased in female offspring (such as SF-1 and P450c21);the expressions of IGF-1 signalling pathway (IGF-1 and IGF-1R) in male offspring increased,and they significantly increased in female offspring;the expression levels of 11 β-HSD2 and GR decreased,but 11β-HSD1/11β-HSD2 ratio was enhanced in male PNE group,while in female PNE group,the corresponding gene expressions increased.Conclusions PNE could induce abnormal alterations of adrenal steroidogenic function,and exhibit apparent gender differences.The potential mechanism is related to low adrenal steroidogenesis function programming induced by nicotine and catch-up growth mediated by IGF-1 after birth.

OBJECTIVETo observe the characteristics of uterine contraction and stages of labor during delivery under continuous epidural block anesthesia.

METHODSTotaling 213 parturients in spontaneous labor under epidural block anesthesia with dilated cervical orifice of 3 cm were monitored for the contraction cycle, duration, intensity and curve types of uterine contraction, and recordings were made for 30 min before and 30, 60 and 120 min after the anesthesia took effect, respectively. The duration of the active phase in the first, second and third stages of labor was compared between 421 cases with anesthesia and 237 without anesthesia.

RESULTSSignificant difference was noted in the objective indexes of uterine contraction recorded after anesthesia had taken effect (P<0.05) in comparison with those before anesthesia, suggesting significantly attenuated uterine contraction after anesthesia, whereas these indexes underwent no significant further variation as compared between different time points after anesthesia (P>0.05). The average active phase in the first stage was significantly shorter in anesthesia group than that in the control group (P<0.05), but the average duration of the second and third stages of labor differed little between the two groups with appropriate use of oxytocin under strict monitoring (P>0.05). The rates of obstetric forceps utilization and use of oxytocin were higher in anesthesia group than in the control group (P<0.05).

CONCLUSIONEpidural block anesthesia produces certain influences on uterine contraction and stages of labor during delivery, for which appropriate treatment measures may prove beneficial.

Adult ; Anesthesia, Epidural ; methods ; Anesthesia, Obstetrical ; methods ; Female ; Humans ; Labor, Obstetric ; physiology ; Pregnancy ; Time Factors ; Uterine Contraction ; drug effects ; Uterus ; drug effects ; physiology