The coming of an aged society in China will surely greatly affect the chief concerns of health care. The Chinese orthopaedists should be prepared for the tasks imposed by the new situation. Once a fracture happens due to osteoporosis in a senile person, a series of problems will follow. This paper discusses the diagnosis and prevention of osteoporosis, preoperative assessment of the patient, proper application of internal fixation and combined treatment of fracture and osteoporosis. The critical point is how to improve the therapeutic effects and to reduce the operative risks.

Objective To assess the predictive value of cerebral arteriosclerosis to acute cerebral infarction evaluated by transcranial doppler ultrasound .Methods 170 cases suspected cerebral arteriosclerosis consecutively enrolled were given transcranial doppler ultrasound and were followed up for 6 months,then we assessed the correla-tion between the levels of cerebral arteriosclerosis and acute cerebral infarction within 6 months.Results By Spearman rank correlation analysis ,there was positive correlation between the severity of cerebral arteriosclerosis de-tected by transcranial doppler ultrasound and acute cerebral infarction within 6 months,the correlation coefficient was 0.575(P<0.05).Conclusion Through the detection of transcranial doppler ultrasound ,the higher levels of cere-bral arteriosclerosis,the greater probability of acute cerebral infarction within 6 months.

BACKGROUND:Currently the ultrasound-guided continuous femoral nerve block has been widely used as a postoperative analgesia method after knee replacement surgery, but there are stil some technical and practical details issues to be studied. OBJECTIVE:To evaluate the effect of ultrasound-guided imaging and safety evaluation of different puncture techniques and needle choice in the ultrasound-guided continuous femoral nerve block after total knee arthroplasty.METHODS:One hundred and sixty patients undergoing total knee arthroplasty were randomly divided into four groups, with 40 cases in each group. Continuous femoral nerve block was done after general anesthesia induction. Patients in each group were respectively punctured using 20 G needle (diameter 1.1 mm) out-of-plane approach, 20 G needle (diameter 1.1 mm) in-plane approach, 18 G needle (diameter 1.3 mm) out-of-plane approach, and 18 G needle (diameter 1.3 mm) in-plane approach. Patient-control ed analgesia pump was used 30 minutes before the end of surgery. The operating time of continuous femoral nerve block was recorded. The visual analogue scale scores at rest, active functional exercise and continuous passive movement state on 6, 24, 48, 72 hours after total knee arthroplasty were estimated. The presses of the pump, time of first walk, daily walk times and complication of continuous femoral nerve block were observed. RESULTS AND CONCLUSION:The operating time of continuous femoral nerve block in group D was shorter than that in other groups (P<0.05). There was no difference of visual analogue scale scores, the presses of the pump, time of first walk, and daily walk times among each group. The incidence of puncture site pain in group C was higher than that in other groups (P<0.05). The best ultrasound imaging was obtained by using 18 G needle in-plane approach for ultrasound-guided continuous femoral nerve block after total knee arthroplasty, and the complication incidence was not increased.

Apoptin,a chicken anemia virus-derived protein.selectively induces apoptosis in trans-formed or tumor cells but not in normal cells.The tumor specificity of apoptin is thought to be related to its cel-lular localization.The apoptin-induced apoptosis is p53-independent and can not be blocked by overexpressionof Bcl-2.But activation of Caspase-3 is essential for apoptin-induced apoptosis.These features make apoptin a potential candidate as a novel therapeutic and diagnostic tool in cancer treatment.

Objective: To analyze the published domestic documents of the clinical trial for treatment of anal fissure in past 10 years, to evaluate the quality of literatures about anal fissure randomized controlled clinical trials, and to provide references of clinical studies for the treatments of anal fissure in Traditional Chinese Medicine (TCM). Methods: In term of principles of evidence-based medicine, we evaluate the published domestic literatures of the randomized controlled clinical trial for treatments of anal f issure in past 10 years. Results: We analyze 52 literatures which are in the method of randomized controlled clinical studies. 28 literatures (accounting for 53.85%) record diagnostic criteria, 38 literatures (accounting for 73.08%) make sure standards of evaluating the effect and 18 literatures (accounting for 34.62%) mention comparability between groups without describing the baseline statistics. Only 5 are marked as a funded research projects. Conclusion: in current published literatures of randomized controlled study for treatments of anal fi ssure, the problems are focused on: ① Experimental idea is unclear and design is unreasonable, ② The description of implemented process in randomized control is unspecif ic, ③ Signifi cant parameters in statistical data are missed and with less credibility, ④ Criteria of diagnosis and effi cacy are different, ⑤ Evaluation indicators are fuzzy. All above clue to the quality of clinical research needs to be improved rapidly, and standardized evaluation of eff icacy also needs to be created urgently.

Objective To clone the full-length cDNA of rat B cell lymphoma-2(bcl-2) gene,then construct and identify the cytomegavirus-mediated lentiviral expression vector of bcl-2 gene,and assess the gene expression in 293T cell,which is a human embryonic kidney cell line.Methods The full-length bcl-2-cDNA fragment was amplified by reverse transcription polymerase chain reaction(RT-PCR) from the kidney tissue of a Wistar rat.The double-stranded oligonucleotides(dsOligoe) were then cloned into the pMD18-T plasmid.After confirmation of a correct construction by sequencing,the positive clone was subcloned into pGC-FU vector with enhanced green fluorescent protein(EGFP),and then transformed into DH5a competent cells.The restricted endonuclease and T4 DNA ligase were used to construct the lentiviral expression vector plasmid pGC-FU-bcl-2 which,combined with the lentiviral packing materials(pHelper 1.0,pHelper 2.0),was then transfected into 293T cell line to form the recombinant lentivirus pGC-FU-bcl-2,and it was used to transfect the 293T cells.The expression of pGC-FU-bcl-2 was further verified by detecting EGFP and bcl-2.Results 1) It was verified by DNA sequencing that the sequence of rat bcl-2 gene was consistent with reported sequence in GenBank.2) The bcl-2 gene was successfully combined in pGC-FU-bcl-2 recombinant plasmid which could be transfected into human embryonic kidney cells.3) The recombinant virus pGC-FU-bcl-2 could be obtained from the 293T cells by co-transfection of pGC-FU-bcl-2 and packing plasmids.4) Targeting gene could be cloned into 293T cells by the recombinant lentivirus with steady expression.The fluorescent protein could be observed under microscope and the expression of bcl-2 protein was detected by Western blotting.Conclusions The lentiviral expression vector containing EGFP and bcl-2 gene has been successfully constructed,with which the transfected 293 T cells can lead to a steady expression of bcl-2 protein.The present study provides a basis for the further study of the function of bcl-2 gene and a potential therapy for the diseases relating to apoptosis.

To observe the therapeutic e ects of Fufangbiejiasan on patients with hepatocirrhosis of Child-Pugh B.Methods:Eighty-eight patients with hepatocirrhosis of Child-Pugh B,Chronic Hepatitis B were enrolled,and divided into two groups,treated with Fufangbiejiasan and Binglian Jianganlin capsule respectively.The therapeutic course was 3 years for both groups.Liver function,HBV.DNA,AFP and CT/MRI were examined at 6th,12th,24th and 36th month after treatment.Results:Levels of blood albumin were markedly increased in Fufangbiejiasan group after treatment at 6th,12th,36th month(38.5?2.1),(39.1 ?3.9),(40.8?3.4)g/L while those in Binglian Jianganlin group were reduced(28.9?1.6),(28.8?1.7),(25.6?1.5)g/L.Level of PTA in Fufangbiejiasan group was signi cantly higher than those in controls;Compared with controls,Fufangbiejiasan treatment was more e ective :34(77.3),41(93.2),42(95.5) and 0(0),0(0),0(0)(P

Transdermal drug delivery is an administration route which can avoid the first-pass effect,maintain steady plasma concentrations and enhance bioavailability. Drug transporting through the skin by passage through the stratum corneum leads to the viable epidermis and the dermis.With the development of the computer technology,many mathematical models for predic-ting the absorption of drugs have been built according to physical and chemical properties of drugs and physiological characteristics of each skin layer.This article presented provides a summary of the progress of mathematical models for predicting percutaneous absorption of drugs.

Objective To investigate the effect of ATP-binding cassette protein E 1 (ABCE1) gene silencing by electroporation on the survival,cell cycle and invasion of human glioma cells line U87MG.Methods The siRNA against ABCE1 was constructed and transfected into U87MG cells by electroporation.The expression of ABCE1 was detected by real time-polymerase chain reaction (RT-PCR) and Western blot.Flow cytometry was used to detect the cell cycle distribution and apoptosis.The effects of ABCE1 gene silencing by electroporation on proliferation,migration and invasion of U87MG cell line were evaluated by cell counting kit-8 (CCK-8) assay,wound closure assay,chemotactic migration,and cell invasive experiments,respectively.Results Compared to the control and blank groups,the mRNA and protein levels were significantly decreased in the experimental group when ABCE1 gene silencing by electroporation.The cell cycle was arrested at G0/G1 phase,and cell number in S phase was decreased in U87MG cell line (P ＜ 0.05).The cell growth inhibition ratio in the experimental group was significantly higher than that in the control and blank groups (P ＜0.01).Compared to the control and blank groups,the experimental group U87MG cell proliferation was inhibited significantly (P ＜ 0.05).Scratch healing experiments showed the experimental group migration ability was decreased significantly (P ＜ 0.05).Transwell chamber method showed the experimental group U87MG cell invasion ability was decreased significantly (P ＜ 0.05).Conclusions ABCE1 is involved in the progression of human glioma cells,and inhibiting the expression of ABCE1 by electroporation can decrease migration,invasion,and proliferation ability of tumor cells in vitro.

The fluid status variate sharply in patients after operation. Appropriate fluid therapy is essential to reduce perioperative complications, shorten hospitalization days and improve prognosis of postoperative patients. In this article, we reviewed the relevant issues about fluid therapy strategy for postoperative patients such as the variation of body fluid in patients after operation, the assessment of fluid status, the establishment of the goal of fluid therapy and the selection of strategy or fluid for fluid therapy in patients after operation.