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 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 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 variation in the position of conus medullaris in Chinese adult population in order to avoid hitting conus during spinal puncture. Methods Eight hundred patients suffering from back pain, aged 18-91 yr, were enrolled in this study. The position of conus medullaris was determined using Siemens 1.5 T magnetic resonance imaging system. According to the method described by Reimann, the vertebral body was used as mark of reference to the level of the end of conus. Results There were 190 patients in whom the position of the end of conus medullaris was lower than L1,2 . The incidence of the position of the end of conus medullaris lower than L1,2 was higher in patients 30-60 or older than in those under 30, and in those over the age of 60 than in those 30-60 (P ＜ 0.05). Conclusion Spinal puncture should be performed cautiously at L2,3. CT or MRI is recommended before operation for the patients to locate the position of conus medullaris and avoid injury to the spinal cord.

Objective To investigate the effect of norepinephrine infusion at 0.03-0.3 μg·kg-1 ·min-1 on renal function in patients undergoing kidney transplantation. Methods Thirty-two ASA Ⅲ or Ⅳ patients aged 22-64 yr weighing 44-88 kg undergoing kidney transplantation were studied. Dialysis was performed within 36 h before operation. Blood pressure was fairly stable. Combined spinal-epidural anesthesia (CSEA) was performed. Spinal anesthesia was performed at L2,3 interspace and hyperbaric 0.5% bupivacaine 10-15 mg was injected into the subarachnoid space. The upper level of sensory block measured by pin-prick reached T6. Epidural catheter was placed at T11,12 interspace and 1% ropivacaine was given intermittently. The patients were randomly allocated into preoperative baseline level (increase or decrease amplitude ＜ 10% of baseline level) by dopamine or norepinephrine infusion during operation. Venous blood samples and urine samples were obtained at the end of operation and 12 h after operation for determination of serum concentrations of cystatin C and β2-microglobulin and urine α1- and β2-microglobulin concentrations. Urine was collected and the volume was recorded. Meanwhile the consumption of furosemide administration during the 12 h after operation was recorded. Results The two groups were comparable with respect to age, M/F sex ratio, body weight, the volume of urine and fluid infused, and the consumption of furosemide. There was no significant difference in serum cystatin C and β2-microgiobulin and urine α1- and β2-microglobulin concentratious, urine volume and consumption of furosemide administration between the transplantation without adverse effect on kidney allograft function.

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.