OBJECTIVETo systematically review the effectiveness of bone substitute augmentation combined with internal fixation versus internal fixation alone in treating proximal femoral fractures in the elderly.

METHODSSubject term and keywords were searched from Pubmed, Cochrane databases and CNKI from database foundation to August 2015. Randomized controlled studies and qusi-randomized controlled studies on bone substitutes augmentation combined with internal fixation versus internal fixation alone for the treatment of proximal femoral fractures in the elderly were chosen. Postoperative re-displacement, re-operation rate, complications (infection and bone ununion), functional outcome, quality of life scores and muscle strength were seen as outcome indicators. Enumeration data were statistical analyzed by risk difference and 95% confidence interval. Measurement data were analyzed by standardized mean difference and 95% confidence interval. If the same measurement data were evaluated by different standards in different studies, standardized mean differences and 95% confidence interval were used. The methods of statistical analysis were used by Cochrane databases.

RESULTSEleven RCTs (677 patients) were included. Meta-analysis results indicated that bone substitutes augmentation combined with internal fixation occurred fewer re-displacement [SMD = -0.75, 95% CI (-1.03, -0.47)] and obtained better function [SMD = 0.40, 95% CI (0.20, 0.59)]. While there were no significant differences in reoperation rate [RD = 0.02, 95% CI (-0.05, -0.09)], pain at 1 week after operation [MD = -1.79, 95% CI (-13.55, -9.96)], pain ranged from 6 to 8 weeks [MD = -7.24, 95% CI (-20.07, -5.59)], postoperative pain at 12 weeks [MD = -0.32, 95% CI (-4.9, -3.55)], muscle strength [MD = 1.25, 95% CI (-6.98, -9.48)], bone ununion [RD = 0.02, 95% CI (-0.01, -0.05)] and postoperative complications [MD = 0.01, 95% CI (-0.03, -0.04)].

CONCLUSIONCompared with single internal fixation, bone substitutes augmentation combined with internal fixation for the treatment of proximal femoral fractures in the elderly less occur re-displacement and could obtain better functional recovery.

Aged ; Aged, 80 and over ; Bone Substitutes ; administration & dosage ; Female ; Femoral Fractures ; surgery ; therapy ; Fracture Fixation, Internal ; Humans ; Male ; Middle Aged ; Randomized Controlled Trials as Topic ; Treatment Outcome

Objective To investigate the clinical states of enuresis children companied with spina bifida occulta(SBO)and study the efficient way of treatment.Methods The children with SBO were check out by X ray from a total of 121 children with bedwetting.Their parents were asked to complete the enuresis questionnaires.Urine routine test and B-ultrasound examination about kidney,bladder and ureter were also asked to be done.The clinic data of the 49 children were attained and analyzed.They were randomly divided into 2 groups,and given the controlled treatment.Group A[used 1-deamino-8-D-arginine vas-opressin(DDAVP)only] and group B(used DDAVP plus oxybutynin plus bladder training)treated for 12 weeks.Results There were totally 49 bedwetting children companied with SBO,and most of them(44 cases,89.8%)were severe type(bedwetting times≥7 times/week).Some of them coexisted with frequency,urgency,gentle urgency incontinence and microscopic hematuria(22 cases).Thirty cases were found the functional bladder capacity(FBC)decrease by B-ultrasound.The cure rates were 58.3%(group A)and 88.0%(group B)respectively.The relapse rates were 36.8%(group A)and 12.5%(group B)respectively after stopping treatment for 3 months.Conclusions SBO accounts for considerably higher rate in enuretic children.It might cause the disability of bladder function.The treatment plan with DDAVP plus oxybutynin plus bladder training can not only increase the cure rate but also lower the relapse rate.

Adult ; Female ; Humans ; Middle Aged ; Myxoma ; pathology ; surgery ; Vulvar Neoplasms ; pathology ; surgery

OBJECTIVETo evaluate the effects of Bevacizumab on the tumor growth, proliferation and apoptosis of gastric cancer xenograft, and the impacts on the VEGF and Sp1 expression.

METHODSGastric cancer xenografts in nude mice were established using SGC-7901 gastric cancer cell line. The nude mice were randomly divided into two groups, Bevacizumab treatment group and PBS group. The tumor sizes were measured for tumor growth curve. The proliferation and angiogenesis were evaluated by immunohistochemistry (IHC) staining of Ki67 and CD34. TUNEL assay was used for apoptosis evaluation. The expression of VEGF and Sp1 in tumor cells were detected by IHC and Western blot.

RESULTSCompared to the PBS group, the tumor growth decreased significantly (P<0.05), the proliferation of tumor cells and angiogenesis decreased, and apoptosis index increased significantly [(5.3 ± 1.8)% vs. (16.7 ± 6.7)%, P<0.01] in Bevacizumab group. The results of IHC and Western blot demonstrated that the expression of VEGF and the microvessel density (MVD) was decreased (4.0 ± 1.0 vs. 16.3 ± 1.5, P<0.001) in Bevacizumab treatment group. No obvious changes of Sp1 expression were observed in Bevacizumab treatment group.

CONCLUSIONSBevacizumab can inhibit the growth of gastric cancer xenografts in nude mice, decrease the VEGF expression and MVD. However, the compensatory up-regulation of transcription factor Sp1 is not affected by Bevacizumab.

Animals ; Antibodies, Monoclonal, Humanized ; pharmacology ; Apoptosis ; Bevacizumab ; Gene Expression Regulation, Neoplastic ; drug effects ; Humans ; Mice ; Mice, Nude ; Sp1 Transcription Factor ; metabolism ; Stomach Neoplasms ; metabolism ; pathology ; Vascular Endothelial Growth Factor A ; metabolism ; Xenograft Model Antitumor Assays

OBJECTIVETo observe the therapeutic effects of beta-elemene combined DC/Dribble vaccine in treating mice with hepatic cancer, thus exploring their anti-tumor mechanisms.

METHODSDentritic cells were derived from Balb/c mice's spleen and their phenotypes were identified. Using hepatic cancer cell line BNL1MEA.7R.1 (abbreviated as BNL) originated from Balb/c mice as target cell, DC/Dribble vaccine was prepared via raising the antigen representing carrier autophagosomes (DRips in Blebs, DRibbles), which were rich in tumor antigen information. The mice previously immunized were divided into 4 groups, i.e., the control group, the beta-elemene group, the vaccine group, and the combined group. The PBS was subcutaneously and intraperitoneally injected to mice in the control group. The beta-elemene was intraperitoneally injected at the daily dose of 50 mg/kg to mice in the beta-elemene group and the combined group for 7 successive days. DC/Dribble vaccine was injected into the lymph node of mice in the vaccine group and the combined group on the 1st day, and DC/Dribble vaccine was subcutaneously injected on the 3rd day and the 5th day. All the mice were sacrificed on the 10th day. Their spleens were obtained sterilely, and the suspension was incubated with or without Dribble. The cells were inoculated for 72 h. The contents of IFN-gamma in the supernatant were measured by ELISA. In addition, the spleen cells obtained from the combined group were incubated with different stimulations for 72 h, which were then divided into the control group, the DRibble group, the DC group, and the DC/Dribble vaccine group. The supernatant of cultured cells were collected and the contents of IFN-gamma were measured by ELISA. The liver tumor-bearing mouse model was established, and then the BNL bearing mice were randomly divided into 4 groups, i.e., the control group, the beta-elemene group, the vaccine group, and the combined group. The treatment ways were the same as the immune ways. The tumor size and the survival period were observed in each group. On the 23rd day the mice were sacrificed. The tumor tissue was stripped and stained by HE staining. The pathomorphological manifestations of the tumor tissue were observed by light microscope.

RESULTSIn vitro detection of mice immunized previously by different ways showed that the secretion of IFN-gamma was significantly higher in the combined group than in the rest groups (P < 0.01). The secretion of IFN-gamma was significantly higher in the beta-elemene group and the vaccine group than in the control group (P < 0.01). The spleen cells could be stimulated to secrete a large amount of IFN-gamma in the vaccine group and the Dribble group (P < 0.01). When the beta-elemene was 10 microg/mL as the stimulating dose, the secretion of IFN-gamma obviously increased (P < 0.01). In vivo observation showed that the growth velocity of tumors in mice of the combined group was slowed down. There was statistical difference in the tumor area or the survival period of mice in the combined group, when compared with the other groups (P < 0.01). In HE staining, the surrounding connective tissues of the tumor were wrapped tightly and compactedly, with infiltration of a large amount of inflammatory cells.

CONCLUSIONSbeta-elemene combined DC/Dribble vaccine could induce specific immune cells to secrete secretory cells, thus exerting its anti-tumor effect. Its immunological effects might be associated with enhancing the DC antigen presenting function.

Animals ; Cancer Vaccines ; immunology ; Cell Line, Tumor ; Dendritic Cells ; drug effects ; immunology ; Female ; Liver Neoplasms ; drug therapy ; immunology ; Mice ; Mice, Inbred BALB C ; Sesquiterpenes ; pharmacology

Objective To investigate the influence of diabetes liaisons on the practicing skills of nurses and life quality of patients in neurology department.Methods Diabetes liaisons were established in 2009 in neurology department.40 nurses' practicing skills of diabetes nursing were compared 3 months before with 3 months after the establishment,and 120 diabetes patients' knowledge 3 months before and 112 diabetes patients' knowledge 3 months after the establishment were compared.Results The correct rates of 40 nurses' practicing skills of diabetes nursing in blood sugar monitoring,insulin pen injection and hypoglycemic emergency measures were 70％,75％ and 60％ 3 months before the establishment of diabetes liaisons and 100％,100％,and 100％ 3 months after the establishment of diabetes liaisons.And the differences were statistically significant (x2 =69.83,72.57,60.28,respectively;P ＜0.01).The rates of diabetes patients' knowledge in the field of reasonable diets,drug knowledge,regular exercises,skin care and self management were respectively 76.79％,64.07％,59.82％,58.04％ and 82.14％ 3 months after and 29.17％,20.83％,33.33％,20.00％ and33.33％ 3 months before the establishment.And differences were statistically significant (x2 =44.68,46.28,13.33,27.73,47.64,respectively; P ＜ 0.01).Conclusions Diabetes liaisons in the department of neurology can improve nurse' s practicing skills and both nurse' s and patient' s knowledge of diabetes,so as to improve nurse' s nursing quality as well as patient' s life quality.

OBJECTIVETo observe the therapeutic effect of moxibustion and exercise comprehensive scheme intervention for children with short stature of deficience of the kidney essence.

METHODSTwenty four cases of children in 12 to 14 years old were selected, 12 male and 12 female, they were treated with comprehensive therapy of exercise therapy and moxibustion. Running and jumping were selected as main exercise therapy, it became a suitable exercise amount when the heart rate reach to 150 to 170 times per minute, thrice each week, 35 to 45 minutes each time. After exercises they were treated with moxibustion, Qihai (CV 6), Guanyuan (CV 4), Zusanli (ST 36), Dazhu (BL 11), Xuanzhong (GB 39), Geshu (BL 17) etc. were selected. After treatment for half a year, the changes of the body height, body weight, bone age(BA), growth hormone (GH), testosterone (T) and estradiol (E2) were compared before and after treatment.

RESULTSThe body height and bone age of the boys and girls were significantly higher than those before treatment (all P<0.05), the growth of body height was more than 4 cm, the growth of bone age was more than 0.5 years old in half a year; the testosterone of all children was significantly increased (all P<0.05), and there were no significant differences in body weight, GH and E2 compared to those before treatment (all P>0.05).

CONCLUSIONMoxbustion and exercise comprehensive scheme can effectively improve the children with short stature of deficience of the kidney essence, the mechanism is related to the improving of the testosterone level.

Adolescent ; Body Height ; Child ; Estradiol ; metabolism ; Exercise Therapy ; Female ; Growth Disorders ; metabolism ; physiopathology ; therapy ; Human Growth Hormone ; metabolism ; Humans ; Kidney ; physiopathology ; Male ; Moxibustion ; Testosterone ; metabolism ; Treatment Outcome

Objective To observe the expression and distribution the low affinity receptor p75 of nerve growth factor in the traumatic neuroma and investigate its significance and relationship with the growth of peripheral nerve and the formation of the traumatic neuroma.Methods Fifty-one cases of traumatic neuro- ma were collected and were divided into four groups according to its course,i.e,groupⅠ(less than one month),groupⅡ(1～3 months),groupⅢ(3～6 months) and groupⅣ(more than six months).Fifteen cases of normal nerve samples were harvested as the control group(n=15).Immunohistochemical studies were performed to observe the expression of p75.the expression level was detected by the computer graph analysis system.Results There was no significant expression of p75 in the normal nerve while in the four studied groups,significant expression of p75 waspositively observed.The level of p75 was weak in the early time and achieved its peak in three months,but the high level state was maintained even after six months.The one-way ANOVA statistic analysis manifests that there were no significant differences of the expression of p75 among the groupⅡ,ⅢandⅣ(P＞0.05),but the differences among the groupⅠand the latter three groups were signifi- cant (P＜0.05).p75 was mainly distributed in the Schwans cell.Conclusion p75 is expressed in the traumatic neuroma and may play an important role in the modulation progress of the formation of traumatic neu- roma with an unknown mechanism.

AIM:To investigate the effects of evodiamine on the growth and apoptosis of human hepatocellular carcinoma Huh7 cells,and to illustrate the molecular mechanism that evodiamine enhances antitumor activity of tumors nec -rosis factor-related apoptosis-inducing ligand(TRAIL)in Huh7 cells.METHODS: The cell viability was measured by MTT assay.The cell cycle distribution was analyzed by flow cytometry.The apoptosis rate was determined by TUNEL stai-ning.The protein levels of cell cycle-and apoptosis-related proteins were detected by Western blot analysis.RESULTS:Treatment of Huh7 cells with evodiamine reduced the cell viability(P<0.05).Evodiamine induced cell cycle arrest in G2/M phase by upregulation of p27,cyclin B1, cell division cycle protein 2(Cdc2)and p-Cdc2.Evodiamine triggered apoptosis accompanied by cleavage of caspase-3 and poly(ADP-ribose)polymerase(PARP).Combination of evodiamine with TRAIL significantly reduced the cell viability and increased cleavage of caspase -3 and PARP as compared with the use of each agent alone.Moreover,evodiamine increased the expression of death receptor 5(DR5)in the Huh7 cells.CON-CLUSION:Evodiamine inhibits the cell growth by reducing the cell viability and inducing cell cycle arrest.Evodiamine also triggers cell apoptosis and enhances the sensitivity of Huh 7 cells to TRAIL by upregulating the expression of DR5.

Objective:To investigate the effect of moxibustion at Shenque (CV 8) on the immune system in rats with different levels of exhaustive exercise.Methods:Fifty-six male Sprague-Dawley (SD) rats were randomly divided into a blank group (n=8),an exhaustive group (n=24),and a moxibustion group (n=24).The exhaustive group was randomly divided into a 1-time exhaustive group,a 4-time exhaustive group and a 7-time exhaustive group,with 8 rats in each group.According to the treatment time,the moxibustion group was randomly divided into a 1-time moxibustion group,a 4-time moxibustion group and a 7-time moxibustion group,with 8 rats in each group.Rats in the exhaustive groups and the moxibustion groups were subjected to replicating the exhaustive swimming models.Rats in each moxibustion group received mild moxibustion for 15 min immediately after the exhaustive modeling,once every other day.Twenty-four hours after the corresponding exhaustive exercise,the rats in each group were tested for the levels of serum immunoglobulin (Ig) G,IgA,IgM and acid phosphatase (ACP),and the morphological changes of spleen tissues were observed.The level of IgA was detected by immunoturbidimetric assay,and the levels of IgG,IgM and ACP were detected by enzyme-linked immunosorbent assay (ELISA).Results:Compared with the 1-time exhaustive group,swimming time of rats in the 4-time exhaustive group was significantly prolonged (P＜0.01),and swimming time of rats in the 7-time exhaustive group was significantly shortened (P＜0.01).Compared with the 7-time exhaustive group,exhaustive swimming time of rats in the 7-time moxibustion group was significantly prolonged (P＜0.01).Compared with the blank group,the IgG level in the 1-time exhaustive group was significantly decreased (P＜0.01),and the levels of IgG,IgA and IgM in the 4-time exhaustive group and the 7-time exhaustive group were all significantly decreased (P＜0.05 or P＜0.01),while the ACP level was increased significantly (both P＜0.01).Microscopically,the number of splenic corpuscles in the 1-time exhaustive group was reduced;the center of some splenic corpuscles in the 4-time exhaustive group was damaged;the number of splenic corpuscles in the 7-time exhaustive group was reduced,and there was no obvious germinal center.Compared with the 4-time exhaustive group,the IgA level in the 4-time moxibustion group was significantly increased (P＜0.01),and the ACP level was significantly decreased (P＜0.01).Compared with the 7-time exhaustive group,the levels of IgG,IgA and IgM in the 7-time moxibustion group were significantly increased (all P＜0.01),and the ACP level was significantly decreased (P＜0.01).Microscopically,the number of splenic corpuscles in the 1-time moxibustion group was reduced;the center of some splenic corpuscles in the 4-time moxibustion group was damaged together with hyperplasia of some splenic corpuscles;blast cells were proliferated in the center of some splenic corpuscles in the 7-time moxibustion group.Conclusion:Moxibustion at Shenque (CV 8) can improve the levels of igG,igA and igM,reduce the ACP level,repair damaged spleen tissues,and enhance the immunity of the body to some extent in the long-term fatigue rats.