Objective: To compare and observe the clinical efficacy of ALP and PFNA in treatment of intertrochanteric fractures, to provide clinical evidence for such patients. Methods:The clinical data of 122 cases patients with intertrochanteric fractures admitted to our department from January, 2012 to January, 2013 was analyzed retrospectively. 72 patients treated with PFNA were regarded as the study group and 50 patients with ALP as controls group. Two groups were compared with surgical incision, blood loss, operative time, healing time, hip functional recovery and postoperative complications. Results: The incision length, blood loss, operative time, postoperative weight-bearing activity time, fracture healing time, Harris score and complications of study group were significantly better than the control group (P<0.05), with statistical significance. Conclusion: The long-term efficacy of PFNA and ALP has no difference, but PFNA has smaller wound, less bleeding, sooner fracture healing time and weight-bearing activities and better early results.

Fractures, Bone ; Humans ; Paralysis ; Parietal Bone/diagnostic imaging* ; Superior Sagittal Sinus ; Tomography, X-Ray Computed

Objective To investigate the early intervention to improve calcium and phosphorus metabolism in chronic kidney disease patients left ventricular hypertrophy. Methods 116 cases of non-dialysis patients with chronic kidney disease were randomly divided into 3,4-intervention group and control group, intervention group patients with calcium and phosphorus metabolism in early intervention were observed in patients with calcium, phosphorus, and left ventricular mass index changes. Results Patients in the intervention group after the intervention of phosphorus,calcium and phosphorus product,serum parathyroid hormone were significantly lower than the control group,the difference was all statistically significant (all P＜0.05 );intervention group of LVMI was significantly lower than before the intervention, but also significantly lower than the control group, the difference was statistically significant (P＜0.05). Conclusion Patients with chronic renal calcium and phosphorus metabolism of early intervention can improve symptoms in patients with left ventricular hypertrophy is beneficial to the improvement of patients with the disease.

Objective To explore the relationship of the levels of adhesion molecules and cytokines with vascular disease in patients with type 2 diabetes (T2DM).Methods Ninety-six T2DM patients were selected as case group and divided into non-vascular group (28 cases),micro-vascular group (33 cases) and major vascular group(35 cases) according to vascular disease.Meanwhile,30 healthy persons were selected as control group.Serum levels of serum soluble intercellular adhesion molecule-1 (ICAM-1),vascular cell adhesion molecule-1 (VCAM-1),interleukin-6 (IL-6),tumor necrosis factor-α (TNF-α) and yon willebrand factor (vWF) were determined by Enzyme-Linked Immuno Sorbent Assay (ELISA),and the expression of adhesion molecule and cytokines of patients with T2MD at 2 weeks after treatment.Results Compared with control group,the levels of ICAM-1,VCAM-1,TNF-α and IL-6 in all subgroup of T2DM patients were significantly elevated(P ＜ 0.05),and the levels showed an increasing trend with function deterioration (P ＜ 0.05).The levels of ICAM-1,VCAM-1,IL-6 and TNF-α in case group before treatment were (505.34 ± 56.42) μg/L,(570.85 ±59.54) μg/L,(94.51 ± 18.04) ng/L,(70.57 ± 18.34) ng/L respectively,significant different from those of after treatment ((390.53 ±45.23) μg/L,(482.93 ± 69.85) μg/L,(77.31 ± 15.49) ng/L,(50.45 ± 12.66) ng/L; t =16.281,8.712,7.697,8.445; P ＜ 0.05).There were significant positive correlation between ICAM-1,VCAM-1,IL-6,TNF-α and vWF in the case group(r =0.482,0.453,0.576,0.534 respectively,P ＜ 0.05).Conclusion Adhesion molecules and cytokines are take part in the process of the deterioration of T2DM and the occurrence of vascular disease.

Objective:To investigate the different techniques and wave characteristic of applying non-invasive stimulation in blink reflex.Methods:Thirty volunteers participated in this study.Using the electrodiagnostic techniques,the orbital nerve and mental nerve were stimulated and the waves were respectively recorded at orbicularis oculi and levator labli superioris,then concluded the latency and amplitude of R1,R2,R2'.Results:The results of blink reflex were basically identical with the normative criteria.The wave of stimulating the orbital nerve and recording at levator labli superioris resembled BR.The images were steady and repeatable.The waves of stimulating mental nerve and recording at orbicularis oculi and levator labli superioris were unstable and partial R1 absent.Conclusion:The techniques of stimulating orbital nerve and recording at orbicularis oculi and levator labli superioris are valuable in the initial investigation of trigemino-facial reflex.The techniques of stimulating mental nerve and recording at orbicularis oculi and levator labli superioris can be used to examine assistantly.

Objective To investigate the expression of secretagogin(SCGN) and chromogranin A(CgA) in pancreatic neuroen‐docrine tumors (PNETs) .Methods Totally 54 cases of PNETs hospitalized in our hospital from October 2007 to October 2013 were enrolled in our study .Immunohistochemical detection was used to determine secretagogin and CgA .Results Secretagogin and CgA were highly expressed in all PNETs specimens .Compared with CgA ,secretagogin were highly expressed in the non‐functional PNETs ,tumor volume>30 cm3 ,the enveloped ,vascular invasion and lymph node metastasis (P<0 .05) .There were no statistically significant difference between SCGN and CgA in functional PNETs tumor volume ≤30 cm3 ,no enveloped ,no vascular invasion and lymph node metastasis(P>0 .05) .Conclusion The expression of secretagogin and CgA in tumor combined with PNETs pathologi‐cal characteristics can predict the severity of PNETs .

Objective To investigate and compare the effects of minimally invasive percutaneous nephrolithotomy for renal upper calyceal stones with approaches through upper edge of the 1 lth rib and lower edge of the 11th fib.Methods Two hundred and sixteen cases of kidney stones in our hospital from July 2008 to July 2010 were reviewed.Of which 66 patients were renal calyceal stones.Thirty-two patients underwent the approach through upper edge of the 11th rib (group A),with 15 males and 17 females,with a mean age of 42 years.Ten cases with stone were located on the left side,right 21 cases,and bilateral 1 case,with calculi average maximum diameter of 1.9 cm.Thirty-four cases underwent the approach through lower edge of the 11th path (B group),with 14 males and 20 females,with a mean age of 44 years.Thirteen cases with stone were located on the left side,right 21 cases,with calculi average maximum diameter of 1.7 cm.The two groups underwent minimally invasive percutaneous nephrolithotomy holmium laser lithotripsy lithotomy.The average puncture time,one-time success rate of puncture and disposable stone-free rate were compared.Results Puncture time of group A was 3.0-14.0 min,with an average of 5.8 min,and group B was 3.0-17.0 min with an average of 6.4 min.The disposable puncture success rate of the two groups was 100％.Disposable stone-free rate was 100％ in group A (32/32),and 88％ in group B (30/34) (P ＜ 0.05).There were no pneumothorax,hemothorax,abdominal viscera injury in two groups.Conclusions The minimally invasive percutaneous nephrolithotomy through the approach of upper edge of the llth fib was better than through the approach of conventional lower edge of 11 subcostal margin,with shorter percutaneous renal access distance,and higher stone-free rate.

Objective To investigate the aged-related changes of biochemical mark and bone histomorphology in rats and to explore the effects ofαD3 on aged rats. Methods Sixty male Wistar rats with different age were divided into four groups, including group A (6-week-old male wistar rat), group B (6-month-old male wistar rat), group C (24-month-old male wistar rat) and group D (24-month-old male wistar rat +αD3). Group D was treated with αD3 three times per week for 10 weeks at a does of 0.05μg/(kgrameters. The left femur and mandible were collected for histomorphology. Results Compared with group A, ALP (alkaline phosphatase) and BGP in group B, C and D were decreased with age increased [(87.30 ±12.22)mmol/L VS (257.20 ±92.26) mmol/L, (55.23 ± 18. 18 ) mmol/L VS (257.20 ±92. 26) mmol/L,(46.17 ± 16. 6) mmol/L VS (257. 20 ±92. 26 mmol/L); (4. 37 ± 1.46) ng/L VS (9. 03 ±2. 04) ng/L,(3.80±1.00) ng/L VS (9.03 ±2.04) ng/L, (3.59 ±0.64) ng/L VS( 9.03±2.04) ng/L, P <0. 05]. TRACP5b in group C and D increased more than that in group B [( 15.69 ± 1.62 ) pg/L VS ( 7. 26 ±2.13) pg/L, ( 14.16 ± 1.88 ) pg/L VS ( 7. 26 ± 2. 13 ) pg/L, P < 0. 05]. Testosterone decreased significantly with age increased, but no significant difference was found among four groups. Testosterone was positive related with trabecular area of mandible. Bone gla protein was positive related with alkaline phosphatase and negative related with tartrate - resistant acid phosphatase 5b. Trabecular areas of femur increased in group C and D were greater than that in group B[(220310. 6 ±76360. 50) μm2 VS ( 105093.5 ±73242. 2) μm2, (293085.9 ±68230. 78) μm2 VS ( 105093.5 ±73242. 2) μm2, P <0. 05]. Compared with group B,the trabecular thickness of group C was increased by 53%, while trabecular separation was increased 123%. Trabecular area of group D was increased by 33% compared with group C. Conclusions Theresults showed that bone formation was decreased and absorption was increased with age increased. Testosterone was positive related with trabecular area of mandible. Alfacalcidol had the effects to promote the bone mass of mandible.

Objective To investigate the effect of high pressure distention on the expression of stenosis-related genes of saphenous vein graft(SVG) during the coronary artery bypass grafting(CABG).Methods The biopsy specimens of saphenous vein collected from 10 patients who have undergone CABG,were divided into expansion group and no-expansion group.Real-time PCR and immunohistochemical staining were performed for examination of mRNA and protein expression of VE-cad,Egr-1,VCAN respectively.Student's t and Chi-square test were used to do statistic analysis.Results The results of RT-PCR showed that the mRNA transcription of Egr-1,VCAN in the expansion group were statistically significantly higher than those in no-expansion group(P<0.05).The mRNA transcription VE-cad in expansion group was statistically significantly lower than that in the no-expansion group(P<0.05).The immunohistochemical staining results showed that the expression of Egr-1 and VCAN in expansion group were significantly stronger than those in no-expansion group,while the expression of VE-cad was significantly lower than no-expansion group.Conclusion The intraoperative expansion of SVG can increase the expression of stenosis-related genes Egr-1 and Versican,and decrease the expression of stenosis-related gene VE-cad,which may be related with the SVG stenosis after CABG.

Objective To investigate the value of ionic-contrast esophagogram in diagnosis of intrathoracic anastomotic leakage after oesophagectomy.Methods The data of 728 patients suffered esophagectomy were retrospectively collected.723 patients without clinical manifestations of anastomotic leakage were divided into group A(esophagogram before eating,n=465) and group B(non-esophagogram before eating,n=258).The incidence of anastomotic leakage was compared between the two groups.Results The discovery rates of anastomotic leakage in group A and B were 0.43%(2/465) and 0.78%(2/258),respectively,the difference was no statistically significant between the two group(P=0.55).The total incidence rates of anastomotic leakage in group A and B were 0.65%(3/465) and 0.78%(2/258),respectively,the difference was no statistically significant between the two groups(P=0.84).5 patients with clinically suspected anastomotic leakage,all had loculated pleural effusion,4 cases had fever,and 2 cases had abnormal chest drainage.Finally,4 cases(80%) were confirmed to be anastomotic leak by esophagogram.Conclusion Routine ionic-contrast esophagogram before eating do not improve intrathoracic anastomotic leakage detection rate after esophagectomy,but when patients have fever,loculated pleural effusion and abnormal chest drainage,esophagogram is necessary and can improve the detection rate of esophageal anastomotic leak.CT radiography may detect smaller anastomotic leakage than conventional esophagogram.