Objective To analyze the risk factors of failure of internal fixation of unstable femoral intertrochanteric fractures treated with proximal femoral nail anti-rotation (PFNA) in elderly patients,and to provide reference for clinical treatment.Methods Collected the clinical data of 251 aged and unstable femoral intertrochanteric fracture patients who have recieved PFNA treatment from January 2012 to December 2016.Preoperative clinical general data and intraoperative clinical factors were used as analysis variable to analyze the high risk factors and risk factors of internal fixation failure in PFNA treatment by χ2 test ,Wilcoxon rank sum test and Logistic regression.Results Through the analysis of 78 aged patients with internal fixation failure after PFNA treatment,the χ2 test and Wilcoxon rank sum test showed that,type of fractures,osteoporosis Singh index grade, tip-apex distance,application of hormone,basic diseases were risk factors for internal fixation failure after PFNA treatment (P<0.05).Among thses factors,type of fractures,osteoporosis Singh index grade, tip-apex distance were independent high risk factors for internal fixation failure after PFNA treatment(P<0.05).Conclusion Severe type of fractures (type Ⅲ and Ⅳ),osteoporosis of grade 4 to 6,and tip-apex distance greater than 25 mm are high risk factors of failure of internal fixation of unstable femoral intertrochanteric fractures treated with PFNA,and it is better to give more attention and effective intervention or other treatment.

BACKGROUND:Olfactory ensheathing cells can promote the repair of the central nervous system. Composite engineering materials prepared by the combination of chitosan and col agen have been widely used in the construction of tissue-engineered nerve conduits.
OBJECTIVE:To explore the repair effect of olfactory ensheathing cells and chitosan in the treatment of sciatic nerve injury in rats.
METHODS:Rat models of sciatic nerve injury were prepared. Olfactory ensheathing cells combined with chitosan scaffold were used to connect the injured sciatic nerve. In the chitosan scaffold group, only the chitosan scaffold was utilized. In the control group, no treatment was done.
RESULTS AND CONCLUSION:At 1-4 weeks fol owing surgery, sciatic functional index and motion evoked potential were monitored and histological examination was performed. Sciatic functional index was significantly improved in the olfactory ensheathing cells+chitosan scaffold group (P<0.05). Motion evoked potential was significantly lower in the olfactory ensheathing cells+chitosan scaffold group compared with other groups (P<0.001). Histological examinations showed new nerve fibers and rare inflammatory reaction in the olfactory ensheathing cells+chitosan scaffold group. These findings indicate that autologous olfactory ensheathing cells combined with chitosan scaffold exerts good repair effects on treatment of sciatic nerve injury, and can be considered as an ideal tissue engineering material.

ObjectiveTo observe the effect of moxibustion with medicine cake on mRNA expression of matrix metalloproteinases-2,9 (MMP-2，MMP-9)in artherosclerosis (AS) plaques of rabbits, and to explore the effect of moxibustion with medicine cake to the stability of artherosclerosis plaques of rabbits.MethodsAS rabbit models were established by feeding high-fat diet. 75 New Zealand big-eared rabbits were divided into 5 groups, blank group (blank control group), model group (AS model group), direct moxibustion group (AS model + moxa cone direct moxibustion), moxibustion on medicine cake group (AS model + moxibustion on medicine cake), western medicine group (AS model + atorvastatin), 15 rabbits in each group. Then the mRNA expression of MMP-2, MMP-9 was detected in the atherosclerotic plaques of rabbits with in situ hybridization.ResultsThe expressions of MMP-2, MMP-9 in the atherosclerotic plaques of rabbits were all be controlled in direct moxibustion group, moxibustion on medicine cake group, western medicine group (P<0.01 or P<0.05). The expressions of MMP-2 and MMP-9 in the moxibustion on medicine cake group and western medicine group were obviously lower than those of the direct moxibustion group.ConclusionThe expression of MMP-2, MMP-9 in the atherosclerotic plaques of rabbits can all be controlled in direct moxibustion group, moxibustion on medicine cake group, and western medicine group; as well as the plaques can all be made stable. The efficacy in the moxibustion on medicine cake group and western medicine group is superior to that of the direct moxibustion group.

The many-banded krait, Bungarus multicinctus, has been recorded as the animal resource of JinQianBaiHuaShe in the Chinese Pharmacopoeia. Characterization of its venoms classified chief phyla of modern animal neurotoxins. However, the evolutionary origin and diversification of its neurotoxins as well as biosynthesis of its active compounds remain largely unknown due to the lack of its high-quality genome. Here, we present the 1.58 Gbp genome of B. multicinctus assembled into 18 chromosomes with contig/scaffold N50 of 7.53 Mbp/149.8 Mbp. Major bungarotoxin-coding genes were clustered within genome by family and found to be associated with ancient local duplications. The truncation of glycosylphosphatidylinositol anchor in the 3'-terminal of a LY6E paralog released modern three-finger toxins (3FTxs) from membrane tethering before the Colubroidea divergence. Subsequent expansion and mutations diversified and recruited these 3FTxs. After the cobra/krait divergence, the modern unit-B of β-bungarotoxin emerged with an extra cysteine residue. A subsequent point substitution in unit-A enabled the β-bungarotoxin covalent linkage. The B. multicinctus gene expression, chromatin topological organization, and histone modification characteristics were featured by transcriptome, proteome, chromatin conformation capture sequencing, and ChIP-seq. The results highlighted that venom production was under a sophisticated regulation. Our findings provide new insights into snake neurotoxin research, meanwhile will facilitate antivenom development, toxin-driven drug discovery and the quality control of JinQianBaiHuaShe.