Objective To investigate the clinical outcomes of proximal femoral nail antirotation (PFNA) Ⅱ in the treatment of femoral intertrochanteric fractures.Methods From January 2011 to June 2016,240 patients with intertrochanteric fracture were treated at our department.They were 132 males and 108 females,aged from 30 to 106 years (average,71.4 years).Of them,168 cases were older than 70 years.According to AO classification,21 patients were of type 31-A1.1,15 of type 31-A1.2,27 of type 31-A1.3,39 of type 3 1-A2.1,51 of type 3 1-A2.2,32 of type 3 1-A2.3,12 of type 3 1-A3.1,23 of type 3 1-A3.2 and 20 of type 31-A3.3.The time from injury to surgery in this series ranged from 38 to 140 hours,averaging 52 hours.All the patients were treated by fixation with PFNA Ⅱ.Results The average operating time was 45 min,average operation incision 5 cm,and average blood loss during operation 85 mL.Primary wound healing was achieved in 239 patients,and one patient developed postoperative incision infection which was cured after implants were taken out and debridement was carried out 8 weeks after operation.This group obtained an average follow-up of 31.5 months (from 6 to 51 months).Primary fracture healing was achieved in 235 patients after 6 to 23 weeks (average,12.6 weeks);fracture healing was delayed in 5 patients after 36 to 96 weeks (average,56 weeks).There was no in-hospital mortality,and the survival rate 6 months after operation was 98.8％ (237/240).One year after operation,132 patients obtained an average Harris hip score of 85.2 (from 72 to 94).No implant-related complications or implant failure happened.Conclusions Internal fixation with PFNA Ⅱ is an effective treatment for different types of femoral intertrochanteric fractures,because it is simple and less invasive,and leads to limited complications,especially for senile patients.

Objective: To evaluate the fixation with proximal femoral nail antirotation-Ⅱ (PFNAⅡ) for femoral intertrochanteric fractures involving the lateral wall. Methods: A retrospective study was conducted of the 491 patients with femoral intertrochanteric fracture who had been treated from January 2013 to December 2017 at Department of Hip Surgery, Orthopedic Hospital, Affiliated Hospital to Panzhihua University. Of them, the lateral wall was involved in 104 (group A), 43 males and 61 females with an age of 72.3±2.1 years; their later wall fractures were classified as type Ⅰ (simple lateral wall fracture) in 45 cases, as type Ⅱ (fragmental lateral wall fracture) in 23 cases and as type Ⅲ (combined fracture of lateral wall and subtrochanter) in 36 cases. In the other 387 cases (group B), the lateral wall was not involved. They were 186 males and 201 females with an age of 74.7±1.5 years. The 2 groups were compared in terms of incision length, operating time, intraoperative blood loss, fracture healing time, postoperative weight-bearing time, Harris scores at the last follow-up and complications. Results: There were no significant differences between the 2 groups of patients in their preoperative general data, indicating they were compatible(P>0.05). All the 491 patients obtained an average follow-up of 25.5 months (from 12 to 50 months). The fracture healing time in group A (27.2±12.1 weeks) was significantly longer than in group B (13.1±2.2 weeks) and the rate of delayed union in the former (16.4%, 17/104) was significantly higher than that in the latter (2.3%, 9/387) (both P<0.05). There were no significant differences between the 2 groups in incision length (7.1±1.2 cm versus 6.5±2.2 cm), operating time (60.8±1.2 min versus 56.5±1.5 min), intraoperative blood loss (96.2±2.1 mL versus 92.1±2.4 mL), postoperative weight-baring time (2.5±2.1 d versus 2.1±2.9 d), the Harris scores at the last follow-up (83.3±2.3 versus 85.1±3.4) or incidence of other complications [5.8% (6/104) versus 4.7%(18/387)] (all P>0.05). Conclusion Femoral intertrochanteric fractures involving the lateral wall can be effectively treated by PFNA Ⅱ fixation, but they usually take longer time to get united than those without lateral wall fracture.

OBJECTIVETo observe the effect and mechanism of ginsenoside Rg1 in inducing senescence human leukemia K562 cell line.

METHODProliferation of K562 cell line induced by Rg1 was detected by MTT colorimetric test for the purpose to screen optimal active concentration and time (20 micromol x L(-1) , 48 h). Impact of Rg1 on cell cycle was analyzed using flow cytometry. The percentage of staining positive cells was detected by SA-beta-Gal staining. The expressions of senescence-related genes such as p16, p53, p21, Rb, were detected by RT-PCR and the changes in ultramicro-morphology were observed by transmission electron microscopy.

RESULTRg1 can significantly inhibit the proliferation of K562 cells in vitro and arrest the cells in G2/M phase. The percentage of positive cells stained by SA-beta-Gal was dramatically increased (P < 0.05) and the expression of cell senescence-related genes were up-regulated. The observation of ultrastructure showed that cell volume increase, heterochromatin condensation and fragmentation, mitochondrial volume increase, lysosomes increase in size and number.

CONCLUSIONRg1 can induce the senescence of leukemia cell line K562 and play an important role in regulating p53-p21-Rb, p16-Rb cell signaling pathway.

Apoptosis ; drug effects ; Cell Cycle ; drug effects ; Cellular Senescence ; drug effects ; Ginsenosides ; pharmacology ; Humans ; K562 Cells ; Leukemia ; drug therapy ; metabolism ; physiopathology ; Signal Transduction ; drug effects

OBJECTIVETo investigate the roles of telomere and telomerase in the effect of ginsenoside Rg1 to delay hematopoietic stem cell senescence.

METHODSca-1(+) HSC was isolated by magnetic cell sorting(MACS) and divided into five groups: the control group, the aged model group, the Rg1 group, the Rg1 treated aged group and the Rg1 delayed aged group. The changes of cells were observed by senescence-associated beta-Galactosidase (SA-beta-Gal) staining. Cell cycle assay and culture of mixed hematopoietic progenitor cell were used to investigate the effect of ginsenoside Rg1 to delay Sca-1(+) HSC senescence. Telomere length and telomerase activity were detected by southern blotting and TRAP-PCR-SYBR Green staining.

RESULTCompared with aged model group, the percentage of positive cells expressed SA-beta-Gal and the number of cells entered G1 phase were decreased and the number of colony of mixed hematopoietic progenitor was increased. It showed markedly decreased in the shortening of telomere length and reinforcing in the telomerase activity to Rg1 treated aged group and Rg1 delayed aged group. The change of Rg1 delayed aged group was significantly higher than Rg1 treated aged group.

CONCLUSIONActivation of telomerase and prolonging of telomere length might be involved in the process of ginsenoside Rg1 to delay and treat the senescence of Sca-1(+) HSC.

Cellular Senescence ; drug effects ; Ginsenosides ; pharmacology ; Hematopoietic Stem Cells ; drug effects ; physiology ; Telomerase ; metabolism ; Telomere ; drug effects

BACKGROUND:Resection of femoral neck in the conventional total hip replacement greatly influences the equilibrium of forces jn the proximal fetour and causes disequilibrium of bone reconstruction,easily resulting in bone absorption,prosthesis loosening and dislocation.OBJECTIVE:To investigate the biocompatibility between materials and host in the total hip replacement with femoral neck preserved.DESIGN,TIME AND SETTING:A retrospective case analysis was performed in the Department of Orthopedics,the 180 Hospital of Chinese PLA between September 2000 and December 2006.PARTICIPANTS:Twenty-five patients.10 males,15 females,aged 47 years old(range 31-56 years old)were recruited for this study.Twelve patients suffered from femoral head necrosis-caused hip joint disease and osteoarthrosis(bilaterally affected in 5 patients),eight femoral head necrosis(femoral head necrosis subsequent to femoral neck fracture healing in 2 patients),three acetabular dysplasia necrosis of femoral head,and two infra-head femoral neck fracture nonunion.The course of disease averaged 6 years old ranging from 2-10 years.METHODS:Modified hip ioint posterior approach was used to expose the hip joint.Femoral head was resected from the femoral head-neck iuncture.Cartilago acetabularis was stripped and then artificial acetabulum was installed.Femoral proximal medullary cavity was expanded.Artificial femoral head was installed.Finally,all artificial joints were reduced.MAIN OUTCOME MEASURES:(1)Biocompatibility between prosthesis and host.(2)Function recovery of hip joint.RESULTS:All wounds were primarily healed.Patients were followed up for 0.5-6 years on average.Follow-up results demonstrated good hip joint motion and normal walking gait.X-ray showed well-positioned artificial hip joint,absence of prosthesis loosening and dislocation,as well as good femoral neck sclerotin.CONCLUSl0N:The preservation of femoral neck in total hip replacement is fit to the physiological compliance of proximal femar and prevents osteoporosis-induced prosthesis loosening and dislocation in the proximal femur.

Objective To explore the effect of Tianma Gouteng Yin combined with butylphthalein(NBP)on symptom improvement and vascular elasticity in patients with acute cerebral infarction(ACI).Methods Eighty-two ACI patients admitted to Lu'an Hospital of Traditional Chinese Medicine were included in this study,and they were randomly separated into the single group and the combination group,with 41 cases in each group.The single group was given intravenous infusion of NBP sodium chloride injection,and the combination group was given treatment with Tianma Gouteng Yin on the basis of the single group.Cerebrovascular reserve function,endothelial function,neurological function,independent living ability,hemodynamic indicators,vascular elasticity,clinical efficacy and incidence of adverse reactions were compared between the two groups of patients at 1 day after admission(T0)and 14 days after treatment(T1).Results There were no significant differences in cerebrovascular reserve function,endothelial function,National Institutes of Health Stroke Scale(NIHSS)scores,independent living ability scores,hemodynamic indicators and vascular elasticity indicators at T0 between the two groups(P＞0.05).At T1,levels of cerebrovascular reactivity(CVR),nitric oxide(NO),nitric oxide synthase(NOS),large artery elasticity index(C1)and small artery elasticity index(C2)were significantly increased in both groups,and levels were higher in the combined group than those of the single group(P＜0.05).At T1 moment,levels of ET-1,vascular endothelial growth factor(VEGF),NIHSS score,MRS score,red blood cell count,whole blood viscosity,platelet adhesion rate and arterial pressure were reduced in both groups,and levels were lower in the combined group than those of the single group(P＜0.05).The total effective rate was higher in the combination group(80.5%)than that of the single group(46.3%).The overall incidence of adverse reactions was lower in the combined group than that in the single group(P＜0.05).Conclusion Tianma Gouteng Yin combined with NBP can effectively improve the cerebral vascular reserve function,endothelial function and neurological damage in ACI patients,increase vascular elasticity and improve hemodynamic levels.

Objective To explore the interaction between family history of diabetes and hyperlipidemia on the risk of diabetes in population with normotension.Methods A multistage stratified probability random sampling was conducted to select a representative sample of urban residents aged 20-74 years in Harbin.A total of 376 diabetes patients with normotension and 3 692 residents with normal blood pressure,normal fasting glucose,and normal 2 hours glucose from OGTT were surveyed.The interaction was evaluated by using crossover analysis and additive model.Results Multivariate logistic regression analysis indicated that there was a possible additive interaction between family history of diabetes and hyperlipidemia on the risk of diabetes.The relative excess risk due to the interaction,the attributable proportion due to the interaction,and the synergy index were 1.97 (95％CI:-0.32-4.26),0.30 (95％CI:0.03-0.57),and 1.54 (95％CI:0.96-2.47),respectively.There were significant combination effects between family history of diabetes and high both total cholesterol and triglyceride,isolated high total cholesterol,and isolated high triglyceride levels;the ORs were 10.55 (95％CI:5.62-19.80),7.81 (95％CI:3.65-16.71) and 5.13 (95％CI:3.22-8.16),respectively.Conclusion There might be synergistic effect between family history of diabetes and hyperlipidemia on the risk of diabetes in population with normotension.