老年粗隆间骨折的临床护理

老年人粗隆间骨折较为常见，无论用手术或非手术治疗，均需长期卧床。长期卧床制动不仅能引起肌肉、骨骼的废用性改变，而且可能发生多种并发症。因此做好老年粗隆间骨折病人的临床护理和康复指导至关重要。近年来，我科共收治老年粗隆间骨折54例，随访50例，平均随访时间为1年零6个月，效果满意。     

股骨颈骨折疗法综述

股骨颈骨折疗法综述附院骨科彭维波股骨颈骨折多见于老年人，病人年老体弱。骨折后长期卧床容易引起一些危及生命的并发症，由于老年人骨质疏松，股骨头位置根深，活动性很大，股骨颈又比较细，骨折后局部不受很大的剪刀作用。骨折不易固定，易造成骨折不愈合，另外．骨折...     

临床常见老年骨折病人的护理

股骨颈、粗隆间骨折是临床上常见的老年疾病,我院骨伤科 2006年至2008年共收治了27例老年股骨颈、粗隆间骨折病人,由于老年人体质原因,我们均采用了骨牵引术.我们根据患者年老体弱的特殊体质对需长期卧床易引发并发症等情况,设计出一整套护理方案,取得了满意效果.     

高龄髋部骨折合并糖尿病患者健康教育体会

老年人由于骨质疏松、关节部位骨质增生、肌肉萎缩等原因,极易因各种因素造成骨折,以髋部骨折多发[1],使人丧失行走能力,长期卧床易出现多种并发症;手术可以使此类病人避免长期卧床,尽早恢复功能。     

老年骨折病人的护理要点

随着社会人口老龄化的迅速发展，老年骨折病人数在逐年上升，骨科老年病人大多需要长期卧床，相应的护理内容很多，难度大、要求高，护理工作显得更为重要。2006年1月～2007年12月我科共收治老年骨折病人520例，现将其护理体会总结如下：     

老年股骨粗隆间骨折的治疗进展

股骨粗隆间骨折多见于老年人,约占全身骨折的1.4%[1]。但由于老年患者常并存潜在的内科疾患,伤后若长期卧床易产生褥疮、肺部感染、泌尿道感染、深静脉血栓形成、脑梗塞等并发症而威胁患者的生命。     

高龄股骨颈骨折患者人工关节置换术后护理体会

老年人股骨颈骨折，人工股骨头、人工髋关节置换术为一种公认的有效治疗方法，我院2004年1月～2005年12月实施人工股骨头、人工髋关节置换治疗老年股骨颈骨折病人43例，针对骨折病人长期卧床、恢复缓慢、易出现并发症等特点，通过护理人员手术前后有计划的护理，加强病人对基本知识的了解，积极配合治疗，有效地预防并发症的发生，取得良好的效果。现将其护理体会介绍如下。     

股骨颈骨折人工髋关节置换术102例围术期护理

股骨颈骨折是一种常见的老年性疾病,由于老年人骨质疏松,外伤后约90%以上的病人会发生股骨颈骨折,部分病人伤后合并各种心、肝、肾、脑等全身性疾病,加上患者长期卧床极易发生各种并发症,这是导致病人死亡的原因之一。人工髋关节置换术大大缩短了病人卧床时间,降低病死率[1]。因此,     

老年骨折患者术后便秘的原因及预防措施

便秘是骨折长期卧床病人常见的并发症之一,尤其是老年人发病更高,骨科卧床病人发生便秘的占90.7%。由于创伤及手术打击大,卧床时间长,伤口疼痛,老年人生理机能下降,各种消化液分泌减少,胃肠蠕动减慢,结肠、直肠及肛门括约肌松弛,易产生便秘。我科对108例老年骨折患者采取有效的护理干预,取得满意的效果,现报告如下。     

老年股骨颈骨折术后的护理与康复指导

股骨颈骨折是老年人常见的骨折之一，多发病，髋部骨折对老年人的健康影响很大，骨折后多需手术治疗，且出院后康复期长，长期卧床易出现并发症，为此，我们对老年股骨颈骨折的患者实施康复指导，效果很好。     

Postoperative Disc Wedging in Adolescent Idiopathic Thoracolumbar/Lumbar Scoliosis: a Comparison of Anterior and Posterior Approaches

Objective To evaluate the different influences of anterior and posterior correction and fusion approaches upon disc wedging in adolescent idiopathic thoracolumbar/lumbar scoliosis. Methods The retrospective study was conducted with the medical records and radiographs of adolescent idiopathic thoracolumbar/lumbar scoliosis patients that underwent anterior （group A） or posterior （group B） correction and fusion surgery from December 1998 to May 2008. The correction of the main curve and changes of the disc wedging were analyzed. Results Fifty-three patients were included, 26 in group A and 27 in group B. The mean coronal Cobb angles of the main curve in group A and group B were significantly corrected after surgery （P〈0.05）, with an average correction rate of 75.2% and 88.2%, respectively. Upon final follow-up, the coronal Cobb angles of the two groups were 18.9°± 11.1 ° and 7.7°±5.6°, respectively, with an average correction loss of 6.8°±6.5° and 2.7°±3.3°, respectively. The coronal Cobb angle after operation and at final follow-up, and the correction rate were significantly better in group B than those in group A （P〈0.05）, while the coronal Cobb angle loss in group A was greater than that in group B （P〈0.05）. The disc wedging before operation, after operation, and at final follow-up were 3.2°±3.0° 5.7°±3.0% and 8.6°±4.4° in group A, and 2.4°±3.2° , 3.3°± 3.4°, and 3.7°± 3.6° in group B, respectively. Postoperative disc wedging was significantly larger compared with preoperative measurements in group A （P〈0.05）, but not in group B （P〉0.05）. The difference between disc wedging at final follow-up and that after surgery was significant in group A （P〈0.05）, but not in group B （P〉0.05）. Between the two groups, group A had larger disc angles after operation and at final follow-up （P〈0.05）, and a greater loss of disc angle （P〈0.05）. Conclusion For adolescent idiopathic thoracolumbar/lumbar scoliosis, posterior approach using all pedicle screws might produce a better result in terms of disc wedging compared with anterior approach.     

Posterior Selective Thoracic Fusion in Adolescent Idiopathic Scoliosis Patients： a Comparison of All Pedicle Screws versus Hybrid Instrumentation

Objective To analyze the influence of segmental pedicle screws versus hybrid instrumentation on the correction results in adolescent idiopathic scoliosis patients undergoing posterior selective thoracic fusion. Methods By reviewing the medical records and roentgenograms of adolescent idiopathic scoliosis patients who underwent selective thoracic fusion from February 2000 to January 2007 in our hospital, the patients were divided into 2 groups according to different instrumentation fashions： Group A was hook-screw-rod （hybrid） internal fixation type, Group B was screw-rod （all pedicle screws） internal fixation type, and the screws were used in every segment on the concave side of the thoracic curve. The parameters of the scoliosis were measured and the correction results were analyzed. Results Totally, 48 patients （7 males, 41 females） were included, with an average age of 14.4 years old and a mean follow-up time of 12.3 months. Thirty and 18 patients were assigned to group A and group B, respectively. The mean preoperative coronal Cobb angles of the thoracic curve were 48.8° and 47.4°, respectively. After surgery, they were corrected to 13.7° and 6.8°, respectively. At final follow-up, they were 17.0° and 9.5°, with an average correction rate of 64.6% and 79.0%, respectively, and the correction rate of group B was significantly higher than that of group A （P=0.003）. The mean preoperative coronal Cobb angles of the lumbar curve were 32.6° and 35.2°, respectively. After surgery, they were corrected to 8.6° and 8.3°, respectively. At final follow-up, they were 10.3° and 11.1°, with an average correction rate of 66.8% and 69.9%, respectively, and the correction rate of group B was significantly higher than that of group A （P=0.003）. The correction loss of the thoracic curve and lumbar curve in the 2 groups were 3.1° and 1.8°, 2.4° and 2.4°, respectively. No significant difference was noted （both P〉0.05）. The decompensation rate at final follow-up in these 2 groups were 4% （1/25） and 7.1% （1/14） respectively, with no significant difference （P〉0.05）.     

Chinese herbal medicine Xinfeng Capsule in treatment of rheumatoid arthritis： study protocol of a multicenter randomized controlled trial

BACKGROUND： Rheumatoid arthritis （RA）, as a common systemic inflammatory autoimmune disease, affects approximately 1 in 100 individuals. Effective treatment for RA is not yet available because current research does not have a clear understanding of the etiology and pathogenesis of RA. Xinfeng Capsule, a patent Chinese herbal medicine, has been used in the treatment of RA in recent years. Despite its reported clinical efficacy, there are no large-sample, multicenter, randomized trials that support the use of Xinfeng Capsule for RA. Therefore, we designed a randomized, double-blind, multicenter, placebo-controlled trial to assess the efficacy and safety of Xinfeng Capsule in the treatment of RA. METHODS AND DESIGN： This is a 12-week, randomized, placebo-controlled, double-blind, multicenter trial on the treatment of RA. The participants will be randomly assigned to the experimental group and the control group at a ratio of 1：1. Participants in the experimental group will receive Xinfeng Capsule and a pharmaceutical placebo （imitation leflunomide）. The control group will receive leflunomide and an herbal placebo （imitation Xinfeng Capsule）. The American College of Rheumatology （ACR） Criteria for RA will be used to measure the efficacy of the Xinfeng Capsule. The primary outcome measure will be the percentage of study participants who achieve an ACR 20% response rate （ACR20）, which will be measured every 4 weeks after randomization. Secondary outcomes will include the ACR50 and ACR70 responses, the side effects of the medications, the Disease Activity Score 28, RA biomarkers, quality of life, and X-rays of the hands and wrists. The first four of the secondary outcomes will be measured every 4 weeks and the others will be measured at baseline and after 12 weeks of treatment. DISCUSSION： The result of this trial will help to evaluate whether Xinfeng Capsule is effective and safe in the treatment of RA. TRIAL REGISTRATION： This trial has been registered in ClinicalTrials.gov. The identifier is N CT01774877.     

Modulating Effects of Chlorogenic Acid on Lipids and Glucose Metabolism and Expression of Hepatic Peroxisome Proliferator-activated Receptor-α in Golden Hamsters Fed on High Fat Diet

Objective To examine the effects of chlorogenic acid （CGA） on lipid and glucose metabolism under a high dietary fat burden and to explore the possible role of peroxisome proliferator-activated receptor-α （PPAR-α） in these effects. Methods Twenty male golden hamsters were randomly divided into CGA treatment group （n=10, given peritoneal injection of CGA solution prepared with PBS, 80 mg CGA/kg body weight daily）, and control group （n=10, given PBS i.p. at the average volume of the treatment group）. Animals in both groups were given 15% high fat diet. Eight weeks after treatment with CGA, the level of biochemical parameters in fasting serum and tissues and the expression of hepatic mRNA and protein PPAR-α were determined. Results Eight weeks after treatment with CGA, the levels of fasting serum triglyceride （TG）, free fatty acid （FFA）, total cholesterol （TC）, low density lipoprotein cholesterol （LDL-C）, high density lipoprotein cholesterol （HDL-C）, glucose （FSG）, and insulin （FSI） were significantly lower in the GGA treatment group than in the control group. CGA also led to higher activity of hepatic lipase （HL） lower contents of TG and FFA in liver, and lower activity of lipoprotein lipase （LPL） in skeletal muscle. Furthermore, CGA significantly elevated significantly elevated the expression level of mRNA and protein expression in hepatic PPAR-α. Conclusion CGA can modify lipids and glucose metabolism, which may be attributed to PPAR-α facilitated lipid clearance in liver and improved insulin sensitivity.     

The role of central nervous system on hypoglycemia and the feasibility of the brain theory in traditional Chinese medicine on treatment of diabetes mellitus

The central nervous system （CNS） plays a key regulatory role in glucose homeostasis. In particular, the brain is important in initiating and coordinating protective counterregulatory responses when blood glucose levels fall. This may due to the metabolic dependency of the CNS on glucose, and protection of food supply to the brain. In healthy subjects, blood glucose is normally maintained within a relatively narrow range. Hypoglycemia in diabetic patients can increase the risk of complications, such as heart disease and diabetic peripheral neuropathy. The clinical research finds that the use of traditional Chinese medicine （TCM） has a positive effect on the treatment of hypoglycemia. Here the authors reviewed the current understanding of sensing and counterregulatory responses to hypoglycemia, and discuss combining traditional Chinese and Western medicine and the theory of iatrogenic hypoglycemia in diabetes treatment. Furthermore, the authors clarify the feasibility of treating hypoglycemia on the basis of TCM theory and CNS and have an insight on its clinical practice.     

Integrative techniques using acupuncture,Chinese herbal medicine,diet, and supplements for polycystic ovary syndrome： a case report

Patients with a diagnosis of polycystic ovary syndrome （PCOS） are on the rise. About 4%-12% of women are currently estimated to have this condition. It is hypothesized that PCOS appears in women who have long-standing insulin resistance （1R）, which leads to high androgen and testosterone levels; this ultimately disrupts their menstrual cycles. Some researchers attribute IR to genetic factors, although there have been only minute changes in the human genome in the past 20 000 years. However, even with a stable gene pool, genes can be turned on and offby the environment, food and air quality and toxin exposure.     

WHO西太区与世界中医药学会联合会中医名词术语国际标准比较研究:津液辨证(英文)

Intraditional Chinese medicine (TCM),the so-called津液refers to all the fluid and liquid flowingand maintaining inside the human body.In Chineselanguage,津液is a phrase composed of twoChinese characters which describes two differentkinds of fluid or liquid in the human body .According to the theory of TCM,津refers to thepart of fluid that is thin in texture and flowss moothly inside the body while液refers to thepart of fluid that is thick in texture and mainlymaintains in the joints of the body to nourish andlubr...     

TGF-β1 Precursor and CD8 Are Potential Prognostic and Predictive Markers in Operated Breast Cancer简

The transforming growth factor β1（TGF-β1） and CD8-positive T cells are two important immune factors that function at opposite directions. The purpose of this study was to verify the relationship between the two factors and their associations with long-term effects of adjuvant chemotherapy or endocrine therapy in breast cancer. Expression of TGF-β1 precursor and CD8 was immunohistochemically detected on surgically-obtained tumor samples of 130（stageⅠ–Ⅲ） invasive breast carcinomas from Chinese subjects, who were followed up for a mean time of 112 months. Interstitial CD8-positive cells and TGF-β1 precursor-positive cells adjacent to tumor nests were counted. Infiltration of CD8-positive lymphocytes into tumor nests and TGF-β1 precursor expression in tumor cells were observed and survival analysis was performed. Our results showed that density of interstitial CD8-positive lymphocytes was an independent adverse prognostic factor for distant disease-free survival（DDFS）（HR=8.416, 95% CI=1.636–43.292, P=0.011） in hormone receptor-positive patients who were on adjuvant endocrine therapy. For breast cancer patients who did not receive adjuvant chemotherapy, those without infiltration of CD8-positive cells into tumor nests had a shorter overall survival（OS） than their counterparts with CD8-positive cell infiltration into tumor nests（Log-Rank, P=0.003）. But OS of patients without infiltration of CD8-positive cells into tumor nests was significantly prolonged by adjuvant chemotherapy（Log-Rank, P=0.013） and paralleled that of patients with CD8-positive cell infiltration. Although OS was shorter in the tumor cell TGF-β1 precursor（t-TGF-β1-pre）-positive patients than in the negative patients in patients without recieiving chemotherapy（P=0.053）, OS of t-TGF-β1-pre-positive patients was significantly prolonged by adjuvant chemotherapy（P=0.035） and was longer than that of t-TGF-β1-pre-negative patients. Analysis showed that t-TGF-β1-pre was an independent positive prognostic factor for DDFS（HR=0.392 95% CI=0.157–0.978, P=0.045） in patients who received adjuvant chemotherapy. This study suggested that density of interstitial CD8-positive lymphocytes was of prognostic value in hormone receptor-positive patients who received adjuvant endocrine therapy. Our study verified that adverse immunologic signatures consisting of absence of CD8-positive cells in tumor nests or expression of TGF-β1 precursor in tumor cells in breast cancer were associated with worse prognosis and significantly improved long-term survival with adjuvant chemotherapy, respectively.