Objective To investigate the correlation between TNF-β NcoⅠpolymorphism and PDR.Methods PCR-RFLP analysis of frequencies of allele in each group.Results The frequency of allele TNF-β2 was significantly higher in patients with PDR than that without PDR（P<0.05）.Conclusion This polymorphism of TNF-β can be served as a susceptible genetic marker of PDR.

Objective To investigate the correlation between TNF-? NcoⅠpolymorphism and PDR.Methods PCR-RFLP analysis of frequencies of allele in each group.Results The frequency of allele TNF-?_2 was significantly higher in patients with PDR than that without PDR(P

Objective To investigate the relationship between vascular cognitive impairment(VCI) and the angiotensinogen(AGT) gene ( G-6A and M235T) polymorphism. Methods Randomnized controled study was ap- plied in the study. AGT gene G-6A and M235T genotypes of 67 cases with VCI and 71 normal controls were deter- mined by polymerase chain reaction (PCR). Results For the location of M235T, the frequencies of T allele(0.73 I and TT genotype ( 0.52 ) were observed in VCI compared with control group ( 0.68,0.45, P > 0.05 ). The odds ratio associated with TT/MM genotype was 0.544 ( 95% CI 0.208～1. 424 ,P > 0.05 ). For the location of G-6A ,the fre- quencies of A allele(0.69) and AA genotype (0.48) were observed in VCI compared with control subjects (0.63, 0.39,P > 0.05). The odds ratio associated with AA/GG genotype was 0.602 ( 95% CI 0.252～1. 738, P > 0.05 ). There was no difference in allele distribution between 67 VCI patients and the controls. Conclusion There is no correlation between vascular cognitive impairment and AGT gene polymorphisms of M235T and G-6A. AGT gene pol- ymorphism is not included in the risk factors for development vascular cognitive impairment.

Objective To investigate the relationship between polymorphism in methylenetetra-hydrofolate reductase (MTHFR ) and acute cerebral infarction (CI), observe the variation regular of fasting plasma homocysteine (Hcy) level.Methods Using Homocysteine Microplate STE Assay to examine the fasting plasma homocysteine level of 28 CI patients during their initial stage (flaring up between 1 to 3 days) and later stage (flaring up 10 to 15 days) of acute period and 27 healthy controls. The presence of the MTHFR genetic type was determined by polymerase chain reaction (PCR) assay and subsequent restriction enzyme digestion.Results There was no significant difference among the three MTHFR genotypes in distributed frequency of the CI group, normal controls and the 677 allelic gene (P>0.05). The discrepancy of Hcy level in various kinds of genotypes: heterozygote mutation and homozygoto mutation were much higher than wild type (P<0.01). Homozygoto mutation was higher than heterozygote mutation, but there was no significant difference between them (P>0.05). The high homocysteine of group CI during the acute early stage were found out more frequent than normal control (P<0.05). There was no significant difference of fasting plasma Hcy level between the initial stage and later stage of CI group which were in acute period (P>0.05), both of the Results were higher than normal control (P<0.01). There was no significant difference among the Hcy level of various genetypes in CI group during the initial stage and later stage of acute period (P<0.05).Conclusion MTHFR gene C677T mutation is one of the cause of high homocystinemia, while it dose not lead to CI directly. High Hcy level is the independent risk factor of CI, but has no concern to the course of acute CI.

BACKGROUND:StageIorIIKummel’s diseaseisusualy suggested to be treated with percutaneous vertebroplasty (PVP) orpercutaneous kyphoplasty (PKP). Stage IIIKummel’s diseasewith neurologic deficit is treated with open decompression, cement-augmented combined with internalfixation. However, surgical options for stage IIIKummel’s diseasewithdural saccompression butwithnonervous symptoms arein disputeand rarely reported. OBJECTIVE:To investigatethesurgical options of Kummel’s disease with vertebral posterior walcolapse. METHODS:Fourteen patients with Kummel’s disease with vertebral posterior wal colapse wereenroled as experimental groupandtreated with PVP or PKP based on the degree of postural reduction.Another28 patients with osteoporotic vertebral fracture as control group were treated with PKP. Thenalpatients were folowed up to observe vertebralheight, Cobb angle, visual analog scale and the Oswestry disability index. RESULTS AND CONCLUSION:After folowed up for 10 to 42 months, therestoredvertebralheight, Cobb angle, visual analog scale and Oswestry disability index were significantly improved inthetwo groups (P<0.05). Thepostoperativevertebralheight intheexperimental group was significantly higher than thatinthe control group(P< 0.05).Butno significant differencesin Cobb angle, visual analog scalescoresand Oswestry disability indexwere found between thetwo groups after operation (P> 0.05). These data suggest that based on the degree of postural reduction, individualizedPVP or PKP for Kummel’s disease with vertebral posterior wal colapsecanattain satisfactoryoutcomes.

Objective To investigate the correlation of incident pneumonia and serum 25-hydroxyvitamin D[25(OH)D] levels in elderly patients with fragility hip fractures.Methods 132 patients with fragility hip fractures were divided into the pneumonia group [n=43,14 males and 29 females,aged 63-97 years,a mean age of (83.8±7.1) years] and the non-pneumonia group [n=89,28 males and 61 females,aged 60-93 years,a mean age of (77.1±8.1) years].Fasting venous blood samples were taken on the second day after admission.Serum 25 (OH)D levels were measured by radioimmunoassay.Results Vitamin D deficiency was found in 90.7％ of the patients in the pneumonia group,52.8％ in the non-pneumonia group (x2=24.953,P＜0.05).The age and smoking rate were higher in the pneumonia group than in the non-pneumonia group (t=4.661,P＜ 0.05;x2 =4.459,P=0.035).Logistic regression analysis showed that serum 25(OH)D levels,age and smoking were independent impact factors for pneumonia.When serum 25(OH)D levels were less than or equal to 20 g/L,the incidence of pneumonia was increased and the risk of pneumonia was 8.66 times higher than that for patients with normal 25 (OH)D levels.Conclusions The risk of pneumonia in patients with brittle hip fractures is correlated with age,smoking and the serum 25-hydroxyvitamin D level,with the latter as a major risk factor.Patients with brittle hip fractures should be supplemented with vitamin D as early as possible in order to reduce the risk of incident of pneumonia.

Objective: To observe the effect of balancing yin-yang needling manipulation on post-stroke upper limb spasticity and changes of electromyography (EMG) after treatment.
Methods: A total of 60 eligible cases were randomly allocated into an observation group and a control group, 30 in each group. Based on routine medication, cases in the control group were treated with conventional needling manipulation, whereas cases in the observation group were treated with balancing yin-yang manipulation. After the courses of treatment were completed, the therapeutic efficacies were evaluated using modified Ashworth scale and clinical spasticity index (CSI), coupled with the integrated electromyography (IEMG) and root mean square (RMS) value of biceps in passive flexion of the elbow joint during isokinetic testing recorded with the surface EMG.
Results: The total effective rate in the observation group was 86.7%, versus 53.3% in the control group, showing a statistical significance (P < 0.05). After treatment, there was between-group statistical significance in severity of elbow spasticity (P<0.05); there were intra-group (P<0.01, P<0.05) and inter-group (P<0.05) statistical significances in CSI index;and there were intra-group (P<0.01, P<0.05) and inter-group (P<0.01, P<0.05) statistical significances in IEMG and RMS values.
Conclusion:Balancing yin-yang and conventional needling manipulations can both improve upper limb spasm and reduce CSI as well as IEMG and RMS values in stroke patients;however, balancing yin-yang manipulation is better than conventional manipulation in clinical effect.

Objective To observe the mortality of fragile hip fractures and evaluate the death-associated risk factors.Methods 100 men and 186 women aged 50 to 97 (mean,77.09± 10.65) years old who had fragile hip fracture over 50 years old from 2010 to 2012 were followed up,and the clinical data were retrospectively analyzed.Three months,one year and the total mortality of following time were calculated.Mortality-related risk factors were evaluated including age,gender,and surgery,duration from injury to operation,pulmonary infection,number and kind of complications.Results The 286 patients were followed up between 6 months and 42 months,with 21.42±9.88 months in average.The three month mortality was 7.69％,the patients who were followed up over one year were 231 cases,the one year mortality was 16.02％,and the total mortality of following time was 17.48％.The mortality was associated with age,gender,surgery,duration from injury to operation,number of complications,pre-injury cardiovascular disease and respiratory system diseases,and pulmonary infection.A Binary Logistic Regression analysis revealed that the independent risk factors affecting the mortality included age (OR=5.385,P=0.003),surgery (OR=21.217,P=0.000),number of complications (OR=9.038,P=0.000),pre-injury cardiovascular disease (OR=3.201,P=0.041).Conclusion The early mortality of fragile hip fractures was high and was associated with many risk factors.Age,surgery,number of complications and pre-injury cardiovascular disease were the independent risk factors affecting the mortality of fragile hip fractures.The positive treatment with complications,early surgery in condition allowed,can lower the early mortality.

Objective To study the changes of bone mineral density (BMD) and structural parameters of femoral neck in fragile femoral neckfracture,and to investigate the relationship between the changes and occurrence of fragile fracture of femoral neck.Methods 102 patients were divided into fracture group (n=59) and non-fracture group (n=43).There were 18 males and 41 females [[mean age (74.0±9.3) yrs,ranged 53-88 yrs] in fracture group and 16 males and 27 females [mean age (64.3±9.9)] yrs,ranged 50-82 yrs in non-fracture group.CT scan and BMD in the femoral neck were collected in all patients.The structural parameters of the femoral neck in CT scan were measured with medical image analysis software.Results BMD was lower,cortical thickness of femoral neck (FNCT) was thinner and the ratio (FNCT/FNW) of cortical thickness (FNCT) over femoral neck width (FNW) was lower in fracture group than in non-fracture group (all P＜0.001),but there were no statistically significant differences in femoral neck width (FNW) and femoral medullary cavity width (FMCW) between the two groups (both P＞0.05).The BMD of femoral neck was markedly decreased in the fracture group as compared with the non-fracture group in patients aged 50-64 yrs (P ＜0.05),and there were no statistically significant differences in the changes of the femoral neck BMD between the two groups in patients aged over 65 yrs (P＜0.05).In both of patients aged 50-64 yrs and more than 65 yrs,FNCT was thinner and ratio of FNCT/FNW was lower in the fracture group than in the non-fracture group (both P＜0.05).The patients with osteopenia and osteoporosis had thinner FNCT and lower ratio of FNCT/FNW in the fracture group than in the non-fracture group of the patients with osteopenia and osteoporosis (both P＜ 0.01).Conclusions Lower BMD and thinner cortical thickness of femoral neck are closely related to the fragile fracture of femoral neck.The phase of femoral neck BMD rapid decline is mainly in the age of 50-65 yrs,which is consistent with the risk assessment for fragile fracture in femoral neck.The decrease of cortical thickness of femoral neck on FNCT is the main factor for the decreased femoral neck strength in patients aged over 65 yrs,which is also an important factor for the fragile fracture of femoral neck in the elderly aged over 65 yrs.

BACKGROUND:The prevalence of osteoporosis is high in the patients undergoing total hip arthroplasty. Osteoporosis is associated with the survival of prostheses. Both canal flare index and bone mineral density are aged-related.
OBJECTIVE:To study the cxorrelation between canal flare index of the proximal femur and bone mineral density of femoral neck, and to pay more attention to osteoporosis.
METHODS:A retrospective study of the correlation between canal flare index of the proximal femur on pelvic radiograph and bone mineral density of femoral neck was made in 57 patients undergoing total hip arthroplasty.
RESULTS AND CONCLUSION:The canal flare index were ranged 1.8-4.8 (3.1±0.7) in 57 patients. There were 23 patients in canal flare index<3 (chimney-type medul ary cavity), 33 in canal flare index between 3 and 4.7 (normal-type medul ary cavity), and one in canal flare index>4.7 (funnel-type medul ary cavity). The age had an impact on the type of medul ary cavity. The prevalence of chimney-type medul ary cavity were significantly higher in>60 years old group than≤60 years old group, and bone mineral density of femoral neck in the group of canal flare index≥3 was significantly higher than the group of canal flare index<3. The bone mineral density of femoral neck was gradual y reduced with age, and were significantly higher in≤60 years old group than in>60 years old group [(0.751±0.235) g/cm2, (0.590±0.092) g/cm2, P=0.000]. As bone mineral density reduced, canal flare index was also decreased. Experimental findings indicate that, the bone mineral density of femoral neck is significantly correlated with canal flare index.