Analysis on conformance with the standardized construction requirements in vaccination outpatient services in Huangpu District of Shanghai in 2019 / 上海预防医学

Objective To fully understand the actual situation and existing problems in vaccination outpatient services, which will provide information to support and improve the standardized construction of vaccination outpatient service and the whole-process vaccination management. Methods Cross-sectional study was conducted among all the vaccination outpatient services in Huangpu District of Shanghai.Data were collected by self-examination and health supervision.Analysis was focused on the conformance with the six aspects of management requirements, which included institution and personnel management, layout of facilities, vaccine and cold-chain management, vaccination management, disinfection and isolation management and medical waste management. Results Twenty-one vaccination clinics were included in the study.There were significant differences for conformance between self-examination and health supervision, public and private medical institutions (P < 0.05).There was no significant difference in the overall compliance rate among six aspects of management requirement (P > 0.05), indicating that they were relatively balanced.On analysis within the 6 aspects, there were significant differences in the indicator compliance rate for 4 aspects of management requirement, including institution and personnel management, layout of facilities, vaccine and cold-chain management, disinfection and isolation management (P < 0.05). Conclusion The standardized construction of vaccination outpatient service should be strengthened with the emphasis on the following: implementation and consolidation of management requirements, enhancement of responsibility consciousness in vaccination outpatient service, construction of special-need vaccination outpatient service in private medical institutions, and improvement of publicity and guidance education.

Effects of Zuogui Pill () and Yougui Pill () on the expression of brain-derived neurotrophic factor and cyclic adenosine monophosphate/protein kinase A signaling transduction pathways of axonal regeneration in model rats with experimental autoimmune encephalomyelitis / 中国结合医学杂志

<p><b>OBJECTIVE</b>To study the effects of Zuogui Pill (, ZGP) and Yougui Pill (, YGP) on the expressions of brain-derived neurotrophic factor (BDNF) and cyclic adenosine monophosphate (cAMP)/protein kinase A (PKA) signaling of axonal regeneration in the Lewis rats with experimental autoimmune encephalomyelitis (EAE), in order to explore the possible mechanism of ZGP and YGP on promoting axonal regeneration.</p><p><b>METHODS</b>The rats were randomly divided into normal control (NC), model (MO), prednisone acetate (PA), ZGP and YGP groups. The EAE model of rat was established by injecting antigen containing myelin basic protein (MBP)68-86. The brain and spinal cord were harvested on the 14th and 28th day post-immunization (PI), the protein and mRNA expression of BDNF and PKA in the brain and spinal cord of rats were detected by Western blot analysis and real-time quantitative polymerase chain reaction (PCR), and the cAMP levels were detected by using enzyme-immunoassay method.</p><p><b>RESULTS</b>(1) On the 28th day PI, the mRNA expression of BDNF in brain white matter and spinal cord of rats in ZGP and YGP groups were up-regulated, especially in YGP group (P<0.05 or P<0.01). (2) On the 14th day PI, the cAMP levels in brain white matters significantly increased in PA and YGP groups compared with MO group (P<0.05 or P<0.01), and the cAMP level in YGP group was higher than that in ZGP group (P<0.05). The cAMP level in spinal cord also significantly increased in YGP group compared with MO, PA and ZGP groups, respectively (P<0.01). (3) On the 14th day PI, the PKA expression in spinal cord of rats in ZGP group was significantly decreased compared with MO and YGP groups, respectively (P<0.05). (4) On the 28th day PI, there was a positive correlation between cAMP and PKA expression in the brain white matter of YGP rats.</p><p><b>CONCLUSIONS</b>The results suggest that ZGP and YGP may promote axonal regeneration by modulating cAMP/PKA signal transduction pathway, but the targets of molecular mechanism of ZGP may be different from those of YGP.</p>

Complications of surgical treatment for femoral intertrochanteric fractures using dynamic hip screw / 中国骨伤

<p><b>OBJECTIVE</b>To investigate the complications of surgical treatments for femoral intertrochateric fractures using dynamic hip screw (DHS).</p><p><b>METHODS</b>From Jan. 2002 to Dec. 2007, sixty-nine patients with intertrochanteric fractures were treated by dynamic hip screw fixation included 27 males and 42 females,with an average age of 72.9 years ranging from 53 to 96 years. According to Evans classification there were 10 cases in type I ,21 in type II, 22 in type III, and 16 in type IV, of which 51 patients (73.9%) suffered from systematic diseases preoperatively.</p><p><b>RESULTS</b>Fifty-seven patients were followed up for 8 to 70 months (41 months on average). Four patients died, 17 cases occurrenced systematic complications postoperatively. Internal fixation related complications occurred in 12 patients. There were 8 cases with mechanical failure of DHS including 4 of screw loosen,3 of cutting-out of device through femoral head and neck and 1 of plate breakage. Five patients had a coxa vara, and delayed union occurred in 4 patients.</p><p><b>CONCLUSION</b>Unstable fracture pattern produced high percentage of mechanical failure. In such cases DHS should not be the first choice for treatment. The appropriate treatment should be in relation to pre-operative fracture stability and osteoporosis.</p>