Objective:To investigate the efficacy of an additional augmentative locking compression plate combined with bone graft for aseptic subtrochanteric fracture nonunion after intramedullary nailing.Methods:From October 2016 to October 2019, 32 patients (25 males and 7 females) were treated at Department of Orthopedics, The Sixth People's Hospital Affiliated to Shanghai Jiaotong University for aseptic subtrochanteric fracture nonunion after intramedullary nailing. Their ages ranged from 27 to 68 years (average, 50.5 years) and their nonunion time from 9 to 24 months (average, 12.2 months). According to the Weber-Cech classification for nonunions, 9 cases belonged to the highly vascular type and 23 to the ischemic type. With the original intramedullary nails retained, all patients were fixated with an additional augmentative locking compression plate before simultaneous autologous iliac bone grafting. All patients were followed up regularly for fracture union, function of the affected hip and complications.Results:The 32 patients were followed up for 6 to 24 months (average, 12.9 months). All nonunions obtained clinical and imaging union. The clinical union time ranged from 3 to 8 months (average, 5.2 months), and the imaging union time from 6 to 10 months (average, 7.4 months). At the last follow-up, the therapeutic efficacy was evaluated as excellent in 28 cases and as good in 4, giving a good to excellent rate of 100%(32/32), according to the Sanders scoring for post-traumatic hip joint; the efficacy was evaluated as excellent in 21 cases, as good in 10 cases and as fair in one, giving a good to excellent rate of 96.9%(31/32), according to the Harris hip scoring. No such complications occurred as infection or loosening or breakage of internal fixation.Conclusion:An additional augmentative locking compression plate combined with bone graft is a reliable and effective treatment for aseptic subtrochanteric fracture nonunion after intramedullary nailing.

Objective:To assess the implementation of injection-related risk management based on WeChat platform for type 2 diabetic patients with the insulin self-injection.Methods:A total of 124 diabetic patients, who would receive insulin therapy by self-injection at home after discharge from the PLA 903 hospital during April 2017 to July 2018, were divided into the control group( n=62)and the study group( n=62). All patients were given routine education on insulin injection during the hospitalization,while the study group( n=62)received additional video and text education based on WeChat platform after discharge. The skill of self-injection and the status of blood glucose control were evaluated in both groups 4 weeks and 8 weeks after discharge, respectively. Results:The insulin injection skill, including skin disinfection [36(58%) vs. 11(18%),χ 2=21.42, P<0.01], exhaust before injection [62(100%) vs. 51(82%),χ 2=12.07, P<0.01], stay 10s after injection [60 (97%) vs. 47(76%),χ 2=11.52, P<0.01], disposal of used needle[49(79%) vs. 18(29%),χ 2=31.20, P<0.01], rotation of injection site [48(77%) vs. 35(56%),χ 2=6.16, P=0.01], insulin storage [62(100%) vs. 57(92%),χ 2=5.21, P=0.02], and the ability of correctly dealing with hypoglycemia [52(84%) vs. 38(61%),χ 2=7.94, P=0.01] in the study group were significantly better than those in the control group after 4 weeks of injection-related risk management. The fasting plasma glucose [(6.41±0.76) vs.(7.19±0.81)mmol/L, t=5.61, P<0.01], glycosylated hemoglobin A1c [(6.71±0.64)% vs. (7.37±0.78)%, t=5.18, P<0.01], incidence of hypoglycemia [6(10%) vs. 15(24%),χ 2=4.64, P=0.03] in the study group were significantly lower than those in the control group after 12 weeks of the management. Conclusion:The risk management based on WeChat platform can improve insulin self-injection skill and the ability of dealing with hypoglycemia,also promote effective blood glucose control for diabetes patients.

Objective To evaluate the value of indirect hemagglutination test(IHA)in schistosomiasis diagnosis. Meth?ods The literature concerned schistosomiasis diagnosis with IHA in the databases of Medline,CNKI,VIP and Wanfang Data from 1982 to 2014 was collected and evaluated. Results Totally 21 articles which were satisfied with the research criteria were analyzed with the Meta?analysis method. The IHA method had high value in schistosomiasis diagnosis,the AUCSROC of IHA in laboratory evaluation was 0.990 6,while in filed evaluation was 0.832 9,and the difference between them was significant(Z=4.50,P<0.05). Conclusion The diagnosis value of IHA in field evaluation is less than that in laboratory. In the process of the elimination of schistosomiasis,developing a new and higher sensitive reagent in schistosomiasis diagnosis is needed.

Objective　To study the effects of Fuyuansan(Chinese herbal medicine) on microcirculation of steroid-induced necrosis of femoral head.Methods　40 male adult New Zealand rabbits were randomly divided into three groups:model group(n=15),Fuyuansan group(n=15) and control group(n=10).Hydroprednisone acetate was injected into the rabbits of the model group using intragluteal injection to produce necrosis models of bone cells of femoral head.The rabbits of Fuyuansan group were injected the same agent using the same methods as model group.Meanwhile,the animals of Fuyuansan group were given Fuyuansan daily.The whole-blood viscosity,triglyceride,serum total cholesterol and intraosseous pressure of each group were determined every two weeks.Results　The whole-blood viscosity,triglyceride,serum total cholesterol and intraosseous pressure of model group remarkably increased,but those of Fuyuansan group increased lightly(P<0.01).Conclusion　Fuyuansan can improve microcirculation of femoral head,change ischemia conditions and prevent the development of necrosis of femoral head.

Objective To evaluate the effects of the chronic Keshan disease's self-management in Liangshan Prefecture of Sichuan Province. Methods According to "The Serf Management Program of Chronic Keshan Disease in Liangshen Prefecture of Sichuan Province", 56 chronic Keshan disease patients were selected in the personalized self-manngemant evaluation under the instructions by endemic disease specialists and the rural doctors. Evaluation was based on changes of indexes such as the clinical symptoms, general health conditions, the electrocardiogram, X-ray, the heart function, etc, before treatment and 3 and 6 months following the treatment. Results Clinical signs and symptoms of the patients were significantly improved 3 and 6 months after the treatment, and the improvement was more obvious 6 months than 3 months following the treatment(P<0.05 or< 0.01). After treatment for 3 months, the patients'electrocardingram and heart function did not show obvious change (X2=0.05,039, P0.05); hut obvious improvements Eexcept X ray results(X2=0.61 ,P0.05)] were seen 6 months after treatment (X2=4.36,16.84, P<0.05 or<0.01). Altogether, among the 56 patients evaluated after treatment for 6 months, none achieved the clinical cure standard, 26 cases(46.3%) showed significant improvement, 17 cases (30.4%) were stable, 5 cases (8.9%) were aggravated,one case (1.8%) lost contact, and 6 cases (10.6%) died. Conclusion The project of the chronic Keshan disease's self-management is suitable for the present situati,on of the endemic regions and can he introduced to many places in our country.

Objective To investigate the clinical effect of preoperative neoadjuvant chemotherapy by thalidomide combined with gefitinib for non-small cell lung cancer (NSCLC) patients and provide clinical basis for NSCLC therapy.Methods From 2011/1 to 2013/1,we collected 160 NSCLC cases in our hospital and divided them into 2 groups randomly,80 cases in control group and 80 cases in observation group.The patients in the control group were treated with conventional surgical treatment and patients in the observation group were treated with preoperative neoadjuvant chemotherapy by thalidomide combined with gefitinib before surgery.The clinical effects,the 6 months and 1 year survival rates,and the toxicity effects were observed,and the clinical effects and survival rates between the 2 groups were compared.Results The observation group had a therapeutic efficiency ratio (TER) of 80.0％ which was significantly higher than the control group (50.0％),and the difference was statistically significant (P＜0.05).The 6 months survival rate and 1 year survival rate were 97.5％ and 92.5％,which were both significantly higher than those of control group (87.5％ and 77.5％),and all differences were statistically significant (P＜0.05).The toxicity effects of observation group were lower.Conclusions Preoperative neoadjuvant chemotherapy by thalidomide combined with gefitinib for NSCLC therapy is effective and safe,which is worthy of study and further application in clinical treatment..

PURPOSE: The characteristic expression of DNA damage response proteins in familial breast cancers with BRCA1, BRCA2, or non-BRCA1/2 mutations has not been analyzed in Chinese patients. Our study aimed to assess the differential expression of microcephalin 1 (BRIT1), ATM serine/threonine kinase (ATM), checkpoint kinase 2 (CHEK2), BRCA1, RAD51 recombinase (RAD51), and poly (ADP-ribose) polymerase 1 (PARP-1) and establish the profile of Chinese familial breast cancers with different mutation status. METHODS: We constructed five tissue microarrays from 183 familial breast cancer patients (31 with BRCA1 mutations; 14 with BRCA2 mutations, and 138 with non-BRCA1/2 mutations). The DNA response and repair markers used for immunohistochemistry analysis included BRIT1, ATM, CHEK2, BRCA1, RAD51, and PARP-1. The expressions of these proteins were analyzed in BRCA1/2 mutated tumors. The association between pathologic characteristics with BRCA1/2 mutation status was also analyzed. RESULTS: In familial breast cancer patients, BRCA1 mutated tumors were more frequent with high nuclear grade, estrogen receptor/progesterone receptor/human epidermal growth factor receptor 2 negative, low Ki-67, and positive CK5/6. BRCA1 mutated tumors had lower CHEK2 and higher cytoplasmic BRIT1 expression than BRCA2 and non-BRCA1/2 mutation tumors. BRCA2-associated tumors showed higher CHEK2 and cytoplasmic RAD51 expression than those in other groups. Nuclear PARP-1 expression in BRCA1/2-associated tumors was significantly higher than in non-BRCA1/2 mutation tumors. Moreover, we found quite a few of negative PARP-1 expression cases in BRCA1/2 mutated groups. CONCLUSION: The clinicopathologic findings of BRCA1-associated Chinese familial breast cancers were similar to the results of other studies. Chinese familial breast cancer patients with BRCA1/2 mutations might have distinctive expression of different DNA damage response proteins. The reduced expression of PARP-1 in Chinese BRCA1/2 mutated breast cancer patients could influence the therapeutic outcome of PARP-1 inhibitors.
Asian Continental Ancestry Group* ; Breast Neoplasms* ; Breast* ; Checkpoint Kinase 2 ; Cytoplasm ; DNA Damage* ; DNA Repair ; DNA* ; Estrogens ; Genes, BRCA1 ; Genes, BRCA2 ; Humans ; Immunohistochemistry ; Phosphotransferases ; Rad51 Recombinase ; Receptor, Epidermal Growth Factor

Objective:To investigate the clinical effects and indications of tibial condylar valgus osteotomy (TCVO) in treating varus unicompartmental knee osteoarthritis.Methods:A retrospective analysis was conducted in 32 patients (45 knees) who suffered from varus unicompartmental knee osteoarthritis and underwent TCVO from June 2016 to June 2018. These patients were aged 65.8±8.3 (range from 52 to 79) years, including 12 males (18 knees) and 20 females (27 knees). All enrolled individuals presented obvious expansion of the lateral joint space with joint line convergence angle (JLCA) of 7.19°±2.69°. Based on the full-length standing X-ray imaging of the lower limbs at before and 2 years after surgery, the percentage of mechanical axis (%MA), femorotibial angle (FTA), hip-knee-ankle angle (HKA), lateral distal femoral angle (LDFA) and medial proximal tibial angle (MPTA) were measured and analyzed to evaluate the improvements of lower extremity alignments. The medial tibial plateau depression (MTPD), posterior proximal tibial angle (PPTA), JLCA and joint space width (JSW) were measured and analyzed to evaluate the congruency of the knee joint and shape of the tibial plateau based on positive and lateral radiographs of knee joint. In addition, visual analogue scale (VAS) and Western Ontario and McMaster Universities (WOMAC) score were evaluated to assess the clinical effects of TCVO pre-operatively and at 1 year or 2 years after surgery.Results:All patients were followed up for 33.4±7.4 (range from 25 to 40) months. Comparing to the preoperative radiological data, %MA at 2 years after surgery increased from 3.78%± 14.34% to 66.16%±9.90%, FTA from 185.41°±4.45° to 170.81°±2.87°, HKA from 169.69°±1.70° to 181.16°±2.39°, MPTA from 83.03°±3.20° to 90.84°±3.67° all with statistical significance ( P<0.05). There was no significant difference for PPTA between before (89.22°±1.52°) and 2 years (88.97°±1.57°) after surgery ( t=0.638, P=0.526). MTPD improved from -7.81°±3.27° to 5.78°±2.19° ( t=19.218, P<0.001). However, there was no significant difference for PPTA between before (81.63°±3.28°) and 2 years (82.25°± 2.21°) after surgery ( t=0.881, P=0.382). JLCA reduced from 7.19°±2.69° to 0.22°±2.09°. The medial and lateral JSW were corrected from 2.45±0.23 mm and 5.86±0.25 mm to 3.73±0.27 mm and 4.68±0.34 mm ( P<0.05), respectively. Additionally, VAS and WOMAC scores improved from 6.46±2.21 and 52.66±16.69 preoperatively to 2.94±1.72 and 19.31±14.87 at 1 year after surgery, and to 1.39±1.45 and 13.66±15.44 at 2 years after surgery, respectively ( P<0.05). Conclusion:Satisfactory early therapeutic outcomes could be achieved by TCVO in varus unicompartmental knee osteoarthritis with subluxated lateral joint and increased JLCA. TCVO can correct intra-articular varus deformity, adjust mechanical axis and relieve knee joint pain and dysfunction.

OBJECTIVETo assess the effect of tea consumption on the risk of endometrial cancer.

METHODSIn a population based case-control study conducted in urban Shanghai, face-to-face interviews were completed for 995 incidence cases aged 30 - 69 from January 1997 to December 2002 and 1087 controls that frequency-matched to cases on age. Unconditional logistic model was used for analysis.

RESULTSAn inverse association was observed in tea drinking and endometrial cancer risk. Compared to non-tea drinkers, regular tea drinkers had reduced risk of endometrial cancer (OR = 0.74; 95% CI: 0.54 - 1.01) in premenopausal women. Green tea had a protective effect on endometrial cancer among non-smoking or non-alcohol drinking women (OR = 0.77, P = 0.0199) and the ORs reduced with the increasing concentration of tea being served (P for trend = 0.0493). The multivariate ORs for drinking green tea < 7 times/week and >or= 7 times/week were 0.90 (95% CI: 0.53 - 1.54) and 0.76 (95% CI: 0.60 - 0.95) with the trend test of P = 0.0163.

CONCLUSIONTea drinking, with green tea in particurlar, seemed to have weak but inverse association with endometrial cancer risk, but this effect of protection might only limit to premenopausal women.

Adult ; Aged ; Case-Control Studies ; China ; epidemiology ; Endometrial Neoplasms ; epidemiology ; prevention & control ; Female ; Humans ; Logistic Models ; Middle Aged ; Risk Factors ; Surveys and Questionnaires ; Tea ; Urban Health