Objective To evaluate the curative effect of percutaneous compression plating system in treatment of intertrochanteric fractures of the elderly patients.Methods The clinical data of 18 elderly patients(aged 68-89 years)with intertrochanteric fractures were retrospectively analyzed.According to Evans classification,there were seven patients with type Ⅰ fractures,nine with type Ⅱ fractures and two with type Ⅲa fractures.Percutaneous compression plating system was applied to all patients from June 2007 to June 2009,and the therapeutic effect was evaluated by Harris hip function evaluation criteria.Results All the fractures were healed,with excellent results in 15 patients and good results in the rest three patients.Conclusions The percutaneous compression plating system is easy to manipulate with minimal invasion,has minor side effect and is beneficial to reducing surgical complications in the elderly patients with intertrochanteric fractures.

BACKGROUND:FGF2,TGFβ/activin/nodal and IGF signal pathways are necessary for keeping functions of human embryonic stem calls,but there was no report concerning whether addition of exogenous basic fibroblast growth factor,transforming growth factor β and insulin can maintain self-renewal of human embryonic stern cells.OBJECTIVE:To establish a feeder layer-and serum-free culture system of human embryonic stem cells.DESIGN,TIME AND SETTING:The cytological in vitro study was performed at the Kunming Animal Institute of Chinese Academy of Sciences from September 2007 to February 2009.MATERIALS:Pregnancy 12.5 or 13.5-day ICR strain mica (clean grade) were provided by the Animal Center of Kunming Medical College.Human embryonic stem cell line BG02 was purchased from Bresagen,USA.METHODS:BG02 cells were digested,centrifuged,resuspended in feeder layer-free medium,and then incubated for 5-7 days.Differentiated human embryonic stem cells were removed.Dispase was added for digestion.Samples were cut into blocks,centrifuged,resuspended,and then incubated at 1:3 in a 4-well plate coated with laminin in feeder layer-free and serum-free medium,supplemented with 80% DMEM/F12,20% KSR,2 mmol/L glutamine,1% non-essential amino acid,0.1 mmol/L β-mercaptoethanol,insulin-transferrin-selenium (ITS) (×1),10~6 U/L penicillin,100 mg/L streptomycin,4 μg/L basic fibroblast growth factor (bFGF) and 0.12 μg/L transforming growth factor-β1 (TGF-β1).ICR fetus mica were sterilely obtained to culture mouse embryonic flbroblasts by tissue pancreatin digestion method.These cells were incubated in a 6-well plate coated with 0.1% gelatin.Human embryonic stem cell line BG02 cultured on mouse embryonic fibroblasts feeder layers was transferred to laminin-coated plates in serum-free medium containing bFGF,TGFβ1 and ITS.MAIN OUTCOME MEASURES:The morphology of BG02 cells in feeder layer-and serum-free condition was observed.The specific molecular markers of human embryonic stem cells were determined by immunohistochemical staining.The karyotype and differentiation ability in vitro of BG02 cells were analyzed.The differences in the proliferation and the differentiated rate of BG02 clumps in feeder layer-and serum-free condition or mouse embryonic fibroblast feeder layer condition were compared.RESULTS:BG02 calls had been continuously cultured for at least 20 passages in feeder layer-and serum-free culture condition.BG02 clones in this culture system had typical human embryonic stem cell morphology.BG02 cells all expressed SSEA-4,SSEA-3,TRA-1-60,TRA-1-81,Oct-4,but did not express SSEA-1.After 20 days of culture,BG02 cells had the capacity to differentiate into derivatives of embryonic endoderm,mesoderm,and ectoderm.Differentiated cells could express alpha-fetoprotein,nestin,α-actin.At passage 20,call karyotype was normal (46XY).The growth of BG02 cells cultured in feeder layer-and serum-free condition was more slowly compared with mouse embryonic fibroblast feeder,and doubling time was significantly prolonged (P ＜ 0.05).Differentiation rate of the colonies was significantly increased (P ＜ 0.05).CONCLUSION:A feeder layer-and serum-free condition for culture of BG02 cells has been established.The addition of bFGF,TGFβ1 and ITS can maintain the self-renewal of BG02 cells.

BACKGROUND: Expectant treatment for intertrochanteric fractures in elderly patients with osteoporosis and other chronic diseases can easily lead to complications of lying in bed.OBJECTIVE: To evaluate the results of percutaneous compression plating system (PCCP) for intertrochanteric fractures in elderly patients. METHODS: Thirty-two cases of elderly intertrochanteric fractures treated with PCCP admitted from June 2007 to June 2009 and 40 cases of elderly intertrochanteric fractures treated with dynamic hip screw system (DHS) were reviewed. The operative bleeding, operative time and curative effect were compared.RESULTS AND CONCLUSION: The operative bleeding and operative time in the patients receiving PCCP were significantly lower than those in the patients receiving DHS. There was not statistical significance between the curative effects about the two methods. PCCP applied in elderly patients with intertrochanteric fracture can get satisfactory effects, and the system is operated simply with minimally invasive surgery, which is beneficial to reduce surgical complications.

Objective To investigate the protective effect of hepatocyte growth factor (HGF) on cultured Sprague-Dawley rat cortical neurons injured through hypoxia/reoxygenation.Methods Primary cultured cerebral cortical neurons were isolated from newborn rots.Neurons were pre-incubated with different concentrations (15,30 and 60 μg/L) of HGF.The cell viability was detected by MTT.Apoptosis was measured by Hoechst 33258 staining and flow cytometer.Lactate dehydrogenase (LDH) and caspase-3 activity were determined by colorimetry.Results Compared with normal group,hypoxia/reoxygenation treatment significantly decreased cell viability,increased LDH activity and the percentage of apoptotic cells.Pretreatment of HGF for 12 h could remarkably reverse the decrease of cell viability and the increase of apoptosis rate in neurons induced by hypoxia/reoxygenation treatment.HGF pre-treatment also attenuated the activity of LDH and caspase-3 in a dose-dependent manner.The effects of HGF could be inhibited by a special PI3K/Akt pathway inhibitor,LY294002.Condusion HGF could attenuate rat cortical neuron injury induced by hypoxia/reoxygenation.The neuroprotective effect of HGF may be related to activating PI3K/Akt pathway,and further suppressing the expression of caspase-3.

Objeetive To investigate the clinical efficacy of inverted intmmedullary nail combined with medial minimally invasive plate in treatment of type C2 and C3 distal femoral fractures.Methods A retrospective case control study was conducted on 38 patients with complex distal fractures of the femur treated from January 2015 to January 2017.There were 22 males and 16 females,aged 24-72 years [(45.6 ± 2.5)years].AO fracture classification was type C2 in 24 patients and type C3 in 14.All of them were fresh closed fractures.The time duration from injury to operation was 4-16 days (average,7.5 days).Based on the different surgical methods,the patients were divided into lateral single plate fixation group (single plate group,20 patients) and inverted intramedullary nail combined with medial minimally invasive locked plate fixation group (locked plate group,18 patients).The two groups were compared in terms of operation condition,early weight bearing time,fracture healing time,postoperative complications,postoperative knee function and activity of living.Hospital for Special Surgery (HSS) score was used for evaluating postoperative knee function and Barthel index for activity of living.Results The patients were followed up for 10-24 months [(12.2 ± 1.8) months].The operation duration was (110.5 ± 35.4) min for single plate group and (116.7 ± 42.3) min min for locked plate group(P ＞0.05).Intraoperative blood loss in single plate group was [(450.5 ± 120.7)ml] and [(455.2 ± 130.4) ml] in locked plate group (P ＞ 0.05).The early weight bearing time in single plate group was (28.5 ± 8.6)days and 18.7 ± 4.9 (P ＜ 0.01)days in the locked plate group.The fracture healing time in single plate group was (8.5 ± 2.2) months,and [(6.5 ± 1.6) months] in locked plate group (P ＜ 0.01).After 3 weeks,6 months and 12 months,HSS scores of knee joint function of the locked plate group was significantly better than that of single plate group (P ＜ 0.01).At 6 months and 12 months after operation,Barthel index score of locked plate group was significantly better than that of single plate group (P ＜ 0.01).No infection occurred in two groups after operation.There were no complications such as internal fixation failure,knee valgus,external rotation deformity or fat embolism in locked plate group.There were two cases of internal fixation failure,one knee eversion,and two knee varus in single plate group (P ＜ 0.01).Conclusion Compared with single plate fixation,the therapeutic method of inverted intramedullary nail combined with medial minimally invasive locked plate has the advantages of early weight bearing time,quick recovery,better function restoration and fewer complications,and hence is a preferable choice for treatment of type C2 and C3 complex distal femoral fractures.