Objective To explore the clinical curative effect of locking plate in elderly patients with proximal humeral fractures. Methods Seventy elderly patients with proximal humeral fractures were selected, and all patients were treated with surgical treatment. Among them, application of locking plate was in 35 cases (locking plate group), and application of ordinary steel plate was in 35 cases (ordinary steel plate group). The operation time, intraoperative blood loss, fracture healing time and curative effect between 2 groups were compared. Results The operation time, intraoperative blood loss and fracture healing time in locking plate group were significantly lower than those in ordinary steel plate group: (61.3 ± 5.6) min vs. (78.3 ± 4.2) min, (190.5 ± 11.5) ml vs. (268.5 ± 21.2) ml and (12.6 ± 1.8) weeks vs. (16.5 ± 1.5) weeks, the excellent and good rate was significantly higher than that in ordinary steel plate group: 94.29% (33/35) vs. 74.98% (26/35), and there were statistical differences (P<0.05). Conclusions The curative effect of locking plate in elderly patients with proximal humeral fractures is accurate. Locking plate can be fixed firmly, and it is conducive to early recovery after surgery.

Juvenile idiopathic arthritis(JIA)is the most common rheumatology disease in childhood period with poor prognosis.The biological agents are newly developed drugs with features of clear therapeutic targets and fast effects.But its use in JIA is still limited,so this article focuses on the clinical use experience,timming and sideffects of the biological agents on JIA.

In this study, a combination of metabolomics and network pharmacology was used to study the pharmacodynamic substances and mechanism of action of Yiyi Fuzi powder (YYFZ) on rheumatoid arthritis (RA) rats. The animal experiments were conducted in accordance with the requirements of the Experimental Animal Ethics Committee of Tianjin University of Traditional Chinese Medicine (approval number: TCM-LAEC2021241). The metabolomic analysis using UPLC-Q-TOF/MS technique identified 22 metabolites, including arachidonic acid, tryptophan, linoleic acid, phenylalanine, as significant biomarkers for the treatment of RA with YYFZ, and they were significantly regressed after YYFZ treatment. The analysis of YYFZ blood components also revealed that 11 blood components, including hypaconitine, benzoylhypaconitine, and deoxyaconitine, may be the components that exert direct pharmacological effects in YYFZ in vivo, and further network pharmacological analysis of blood components obtained that YYFZ may exhibit anti-inflammatory effects through acting on PI3K/Akt signaling pathway, estrogen signaling pathway, vascular endothelial growth factor (VEGF) signaling pathway. The results of this study provide implications for the clinical application of YYFZ.

Objective To study the effects of alpinetin on apoptosis of Hep3B cells and explore the related mechanism.Methods Hep3B cells were cultured in vitro,treated with alpinetin; RT-PCR and Western blot was used to detect the mRNA and protein levels of Bcl-2; MTT assay was used to detect the cellular growth inhibitory rate; Annexin V-FITC/PI double staining was used to detect the apoptosis rate of cells; Mitochondrial membrane potential was analyzed by flow cytometry; Western blot was used to detect protein expression of Caspase-3,9 and Cytochrome C ; the experiment was carried out in four groups:control group,high dosage of alpinetin group,middle dosage of alpinetin group and low dosage of alpinetin group.Results The expression of Bcl-2 in Hep3B cells were decreased by alpinetin.After treated with different dosages of alpinetin (40,80,120 μmol/L),the apoptotic inhibitory rate detected by MTT were 6.38％ ± 1.32％,21.58％ ± 1.97％ and 43.18％ ± 3.89％,significantly higher than those in control group (tlowdose =13.01,tmiddle dose =15.12,thighdose =14.79,average P ＜ 0.01) ; the expression of mitochondrial membrane potential green fluorescence protein (GFP) were 18.93％ ± 2.3％,31.11％ ± 2.67％ and46.06％ ± 2.95％,significantly higher than those in control group (tlow dose =16.70,tmiddle dose =31.38,thigh dose =48.15,average P ＜ 0.01).Western blot analysis showed that the expression of Caspase-3,9 andCytochrome C in cytoplasm significantly was higher than those in control group(Caspase-3:llow dose =11.94,tmiddle dose =10.18,thigh dose =18.82,average P ＜0.01; Caspase-9:tlow dose =15.11,tmiddle dose =20.41,thish dose =21.25,average P ＜0.01; Cytochrome C:tlow dose =15.11,tmiddle dose =28.47,thigh dose =16.01,average P ＜ 0.01).while that Cytochrome C in mitochondria significantly lower than those in control group (tlow dose =16.70,tmiddle dose =12.00,thighdose =27.61,average P ＜ 0.01).Conclusions Alpinetin promotes apoptosis of human hepatic cancer cells Hep3B by down-regulating Bcl-2,probably through mitochondrial pathway.

OBJECTIVETo retrospectivly compare the clinical efficacy of dynamic hip screw (DHS) with proximal femoral nail anti-rotation (PFNA) for the treatment of unstable intertrochanteric fractures in the elderly.

METHODSTotally 92 elderly patients with unstable intertrochanteric fractures were treated with DHS [including 27 males and 23 females with a mean age of (72.5 +/- 5.3) years old] and PFNA [including 22 males and 20 females with a mean age of (72.8 +/- 5.8) years old] from August 2008 to August 2012. The data of operation time,blood loss (obvious and hidden blood loss), bedridden time, down load time, postoperative complications and Harris hip function score were recorded and compared.

RESULTSBoth of two groups were followed-up for 10 to 18 months with an average of 13.5 months. PFNA was implanted with a significantly smaller incision and shorter clinical healing time, less blood loss,while hidden blood loss were more. Postoperative complications, therapeutic effects and Harris score in PFNA group were better than that of DHS group.

CONCLUSIONFor treatment of senile patients with unstable intertrochanteric fractures, PFNA was superior to DHS in reducing complication rates, recovering hip joint, while DHS could reduce perioperative blood loss in treating type II a, II b and III fracture.

Aged ; Aged, 80 and over ; Bone Nails ; Bone Screws ; Case-Control Studies ; Female ; Femur ; surgery ; Fracture Fixation, Internal ; instrumentation ; Hip Fractures ; surgery ; Humans ; Internal Fixators ; Male ; Middle Aged ; Retrospective Studies ; Treatment Outcome

Four salts of ticagrelor, ticagrelor-3,5-dinitrobenzoic acid, ticagrelor-pyrazinamide, ticagrelor-D-proline and ticagrelor-L-proline were prepared by solvent suspension and liquid-assisted grinding to improve the solubility of ticagrelor. The compounds were characterized by powder X-ray diffraction, Fourier transform infrared spectroscopy, differential scanning calorimetry, nuclear magnetic resonance spectroscopy, elemental analysis, and the intermolecular salt-bonding forces were analyzed. The equilibrium solubility of salts and pure drug in hydrochloride buffer pH 1.2 and phosphate buffer pH 6.8 were measured by high-performance liquid chromatography. Ticagrelor was salted with 3,5-dinitrobenzoic acid, pyrazinamide, D-proline, L-proline all in a stoichiometric ratio of 1∶1; with the exception of ticagrelor-D-proline, the solubility of the other three salts provided significantly improved solubility in hydrochloride buffer pH 1.2, and the equilibrium solubility of ticagrelor-3,5-dinitrobenzoic acid was increased by approximately 1.7 folds as compared to pure drug. Salt-forming technology is convenient and can improve the solubility of ticagrelor.

Objective To investigate the effects of Kinesio taping on function of knees in girls. Methods 20 female students were tested the peak torque of centripedal and eccentric contraction of knee flexion and extension with Biodex isokinetic testing at 60°/s angular velocity, with Kinesio taping, placebo taping and without taping. Their amplitude root of mean square (RMS) of surface electromyography of vastus medialis (VM), rectus femoris (RM) and vastus lateralis (VL) were also recorded. Results For centripedal isokinetic contraction, the relative extensors peak torque was the most as Kinesio taping (P<0.01). There was no significant difference in relative flexor peak torque (P> 0.05). Standardized RMS of VM and VL were the least as Kinesio taping (P<0.01), but not significantly different of RF among all the conditions (P>0.05). For eccentric isokinetic contraction, the relative extensor peak torque of both extensors and flexors were the most as Kinesio taping (P<0.01), while the Standardized RMS of VM and VL were the least (P<0.01), but no significant difference was observed in RF (P> 0.05). Conclusion Kinesio taping may enhance the strength of centripedal, eccentric contractions of quadriceps and eccentric contractions of hamstring, and increase the muscle fibers recruitment of VM and VL.

Objective To compare the efficacy of arterial stenting with that of traditional B -T shunt for neo-natal pulmonary atresia with intact ventricular septum.Methods Twenty -six cases of neonatal pulmonary atresia with intact ventricular septum were treated at Children′s Hospital of Zhengzhou from December 2005 to December 201 5,aged 3 to 23 days[(8.20 ±4.80)days],and weighted 2.80 -3.88 (3.41 ±0.27)kg.Accompanied with pulmonary hypo-plasia,all these patients were combined with PDA and ASD or PFO.Before operation,the peripheral oxygen saturation was kept in 61 % -75%,averaged at 67%.Among them,1 2 cases underwent arterial catheter stenting,and 1 4 cases re-ceived B -T shunt (including modified B -T shunt and central shunt)ductus ligation.After operation,the oxygen satu-ration in these children was observed,and they were examined by echocardiography and true lateral chest X -ray,blood flow situations in stents and shunts were assessed,and follow -up examinations were conducted in 1 ,3,6 and 1 2 months postoperatively.Results Stents were successfully inserted into these 1 2 cases.After traditional pulmonary shunt,pa-tients′peripheral oxygen saturation was (82.73 ±5.59)%,compared with that of patients after arterial catheter sten-ting (86.1 8 ±3.1 9)%,there was significant difference(t =1 0.71 ,P <0.05).In pulmonary shunt group,2 cases died,1 case died of postoperative heart failure,and the other case was complicated with pulmonary infection and died of respiratory failure;in catheter stent group,1 case was complicated with postoperative supraventricular tachycardia and recovered after drug intervention.For the follow -up examinations 1 ,3,6 and 1 2 months after the operation,1 case of B -T shunt in pulmonary shunt group was improved by central shunt due to slow blood flow,less shunt volume,and ox-ygen saturation decreased to 69%.For the catheter stent group,1 case was improved by stent balloon dilatation due to declined peripheral oxygen saturation 2 months postoperatively,and after the operation,transcutaneous oxygen saturation was improved.No patients died in the catheter stent group.Conclusions In traditional B -T shunts,the operation is extensive,and complications are common,and the recovery turns slowly.Arterial catheter stenting can be used as the preferred method of treatment for one -stage surgical pulmonary atresia with intact ventricular septum to reduce the weakness feasibly and effectively.

Objective To explore the safety and clinical effect of the human acellular nerve allograft (hANG) for repairing peripheral nerve defects.Methods During November,2009 to October,2010,6 patients with 3 digital nerve defects and 3 radial nerve defects were repaired with hANG.During postoperation period,safety was evaluated by local wound response and laboratory testing,while the efficacy was evaluated by British Medical Research Council sensory function assessment standards,static 2-point discrimination (2PD) and Semmes-Weinstein monofilament testing.Results Three patients with 6 digital nerve defects received hANG transplant.The length of nerve graft was 20-50 mm(mean 30.8 mm).After followed up for 31-40 months,the excellent rate of 2PD was 66.7％.Two of 3 patients rahabilited as well as the normal.Three patients with radial nerve defects,whose length of nerve graft was 35-60 mm(mean 48.3 mm).The strength of extensor carpiradialis longus muscle had restored Ⅲ in 1 case,and other 2 cases had no restoration.Conclusion hANG is safe and effective for repairing peripheral nerve defects,especially for digital nerve defects.