Impacted femoral neck fractures should be treated operatively as displaced fracture. Many authors suggested emergency operation. The principle of treatment of femoral neck fractures is anatomic reduction, fragmental compression,and rigid fixation. Closed reduction must be done in most cases. When close anatomic reduction can not be achieved, open reduction should be considered.Implants used recently consist of pins , screws,hook pins and gliding screws with side plate. Every implant has its own advantages, disadvantages and indications. The principle of treatment of femoral neck fractures in young patients is emergency operation (within 12h after trauma), anatomic reduction (open reduction when necessary), and rigid fixation with screws. Some authors stated the necessity of anterior capsularoctomy.

Osteoporosis is considered as the most important factor which causes the fracture of the femoral neck. Comminution of fracture and rigidity of fixation are greatly affected by the degree of osteoporosis. Femoral neck fractures in young patients are mainly caused by severe trauma. Although Garden classification is widely accepted in classifying femoral neck fractures, in the recent decades some doctors have found out some shortcomings in Garden classification in practical application. It has been suggested to classify the femoral neck fractures simply into displaced and undisplaced ones. Arthroplasty used to be thought as the choice of treatment of femoral neck fractures in the elderly. Application of arthroplasty must accord with the indications, not only with the age of the patient or the degree of the displacement of the fracture. There is no X ray diagnosis specially for the avascular necrosis of femoral head secondary to femoral neck fracture, other than Ficat Arlet grade system. MRI is considered to be the only method to diagnose the avascular necrosis of femoral head at an early stage and to defect its extent and location.

Employment ; Humans ; Japan ; Surveys and Questionnaires

Background Suprachoroidal hemorrhage (SCH)is a rare but devastating complication of ophthalmic surgery,and it is crucial to be aware of the risk factors and select effective treatment. Objective Present study was to assess the treatment and risk factors of SCH induced by intraocular surgery. Methods Retrospective case series were carried out to investigate the clinical data of 15 eyes from 15 patients with SCH at Peking Union Medical College Hospital.The risk factors of SCH were analyzed.Written informed consent was obtained before any medical examination and treatment.SCH was occurred in 10 eyes during intraocular surgery,while the SCH was diagnosed in other 5 eyes 1-3 days after operation.Surgical drainage was carried out in 8 eyes,of which 3 eyes combined with vitrectomy besides surgical drainage and other 5 eyes were treated with medication alone.Results SCH was completely removed and absorbed in 12 eyes.The visual acuity was improved in 6 eyes,unchanged in 6 eyes and decreased in 3 eyes.Nine eyes complicated with retinal detachment and reattached in 6 eyes after treatment.Seven eyes combined with hypermyopia,6 eyes combined with glaucoma,and 1 eye was aphakia.Four patients combined with hypertension,and 2 patients had diabetes mellitus. Conclusions SCH induced by intraocular surgery develops rapidly and violently,and it can result in vision loss without effective treatment.Suturing surgical incision immediately,applying hypertonic agents and sclerotomy drainage are the urgent approaches to treat SCH.Medicines and/or sclerotomy could be optional according to the amount of bleeding and other ocular complication.The risk factors of SCH include myopia,glaucoma and the instantly dropping of intraocular pressure.

RhoA, a small GTPase, is involved in a wide array of cellular functions in the central nervous system, such as cell motility, cytoskeleton rearrangement, transcriptional regulation, phagocytosis and cell growth. It is not known how spinal cord injury (SCI) affects the expression of RhoA in different nerve cells. In the present study, we investigated the changes of RhoA expression in remote areas of the injury at the 3rd, 7th and 30th day after SCI, which was established by T10 contusion method. Moreover, we examine its expression profile in neurons, astrocytes and microglia. RhoA was found to be weakly expressed in these nerve cells in normal spinal cord. Western blotting showed that, after SCI, the total RhoA expression was up-regulated, and the RhoA expression was increased and peaked at the 7th day. Double immunostaining revealed specific and temporal expression patterns of RhoA in different nerve cells. The expression of RhoA in neurons started to increase at day 3, peaked at day 7 and then decreased slightly at day 30. Expression of RhoA in astrocytes increased moderately after SCI and peaked at day 7. There was no obvious change in RhoA expression in microglia after SCI in remote areas. This study demonstrated that, after SCI, RhoA expression exhibited different patterns with different nerve cells of spinal cord. RhoA expression patterns also changed with time after SCI, and among different nerve cells in the injured spinal cord. These findings can help us better understand the roles of RhoA in SCI.

According to the limited class hours and requirements of medicinary major curriculum application,this paper attempts to make some choice of physical chemistry teaching contents and emphasize on the first class,and also to explore bilingual teaching of partial chapters and experimental teaching.

Objective To explore the molecular mechanism of inhibition of LPS-induced inflammation by fenoterol, a β2 adrenoceptor agonist in monocyte. Methods Concentrations of interleukin 1β (IL-1β), tumor necrosis factor α (TNF-α) and MCP-1 from cell supernatants from THP-1 cells and wild type or MyD88- / - mice peritoneal macrophages stimulated by LPS in the presence or absence of fenoterol were determined by use of an ELISA system. Expression of MyD88 (myeloid differentiation factor 88) stimulated by LPS in the presence or absence of fenoterol were determined by Western blot. Results Fenoterol inhibited LPS-induced activation of MyD88 and secretion of inflammatory cytokines (TNF-α, MCP-1, and IL-1β). The reaction of MyD88- / - mice peritoneal macrophages to LPS was much lower than that of the wild type mice peritoneal macrophages. Conclusions MyD88 plays an important role in inflammation induced by LPS. The inhibition of LPS-induced expression of MyD88 by fenoterol is associated with its anti-inflammatory effect.

Objective: To study the antitussive, expectorant and antiasthetic effects of Fortunella hindsii leaves. Methods: The antitussive effects were observed by the method of ammonia-induced cough in mice, the expectorant effects were observed by the method of phenolsulfonphthalein excretion in mice, and the antiasthmatic effects were observed by the method of histamine phosphate spray in guinea pigs. Results:The leaves of Fortunella hindsii at low, medium and high doses could decrease the cough times and prolong the cough latent period (P<0. 05 or P<0. 01), high dose could promote the phenol red excretion (P<0. 05), and high and medium do-ses could prolong the incubation period of guinea pigs for asthma caused by histamine phosphate (P<0. 05 or P<0. 01). Conclu-sion:The leaves of Fortunella hindsii have promising antitussive, expectorant and antiasthmatic effects.

Objective To study the effects of different dose 6 MV and 10 MV photons for classic conformal radiotherapy on cervical cancer patients with different height and weight,in order to provide guidance for clinical irradiation energy choosing for different patients.Methods Twenty-one recruited patients were divided into obese and non-obese group according to the body mass index (BMI).The 4-field classic conformal radiotherapy plans was designed and applied in both groups and the results were compared.Statistical analysis was carried out on the dosimetric parameters.Results The treatment plan of 10 MV photons could both reduce the maximum and minimum dose (Dmax and Dmin) of the target area PTV and increase the conformal and heterogeneity index (CI and HI),and change the median dose (D50) for non-obese patients,while it could not reduce the mean dose (Dmeen) for two groups.It was more effective in reducing Dmax and increasing HI for obese patients.The plan could also reduce the dose of organs at risk (OAR) near the PTV.Using 10 MV photons plan could more effectively reduce the low isodose volume of the patients and machine hops.Conclusions The 10 MV photons plan has many advantages in classic conformal radiotherapy for obese cervical cancer treatment.

Objective The purpose of this study is to compare the most comfortable levels and neural re-sponse imaging threshold between children of cochlear implants with large vestibular aqueduct syndrome and normal inner ears. Methods Thirty-eight implanted children participated in this study and were divided into two groups. Group A consisted of 32 patients with normal inner ears and group B 6 patients with radiographically proven large vestibular aqueduct syndrome. All of the patients were the recipients of the cochlear implants by Advanced Bionics. The initial time for the first programming session was approximately one month after surgery. The psychophysical tests included M- level tests. Programming techniques used in the test were suitable for the age of patients. Sound-Wave 1.4 software was used to test tNRI. Results Using the rank sum test, M-level and tNRI of electrode 3,7,11 and 15 did not differ significantly between group A and B(P>0. 05). Conclusion The parameters of mapping are not significantly different between the implanted children with large vestibular aqueduct syndrome and normal inner ear. The management and procedures of mapping used to the subjects with normal inner ear can be applied to the children with large vestibular aqueduct syndrome.