Objective To investigate the clinical effect of hyperbaric oxygen combined with Xianling Gubao capsule in delayed union of elderly proximal femoral fractures.Methods 64 elder patients with proximal femoral fracture form May 2013 to December 2015 in our hospital were selected and divided into two groups.32 cases in the control group were treated with routine clinical treatment, and 32 cases in the experimental group were treated on the basis of the control group with Xianling Gubao capsule combined with hyperbaric oxygen.Fracture healing time and clinical efficacy were compared after the treatment.Results The fracture healing time of experimental group was shorter than that in control group ( P<0.05 ) .The pain degree in experimental group was lower than that in control group ( P<0.05 ) .The efficacy in experimental group was higher than that in control group ( Z =-2.144,P<0.05).There was no significant difference in total adverse reactions between experimental group and control group (χ2 =0.474, P>0.05).Conclusion Xianling Gubao capsule combined with hyperbaric oxygen in the treatment of delayed union of proximal femoral fractures in elderly patients has better clinical curative effect and high safety.

This article explains the purpose of setting up the sperm bank, the role of the sperm bank in auxiliary reproduction technology, and exhaustively clarifies the ethical problems in the various aspects of the social life that are caused by the sperm bank, and finally it also proposes some relevant suggestions to these problems.

BACKGROUND:Matrix metal oproteinases (MMPs) have been shown to break the balance between the production and degradation of extracel ular matrix by degrading col agen, gelatin, elastin and other macromolecules, which is the leading cause of bone and cartilage damage in rheumatic arthritis.
OBJECTIVE:To determine the expression levels of MMP-2 and MM-9 in the rabbit knee osteoarthritis cartilage, and to analyze whether they are related to the early MRI performance.
METHODS:Fifty healthy Japanese white rabbits free from osteoarthritis were enrol ed and randomly divided into control group (n=10) and model group (n=40). The anterior and posterior cruciate ligament amputation was adopted to establish the model of osteoarthritis. Subsequently, MRI examination and the expression levels of MMP-2 and MMP-9 were detected at 1, 3, 5 and 7 weeks (n=10 at each time point), respectively.
RESULTS AND CONCLUSION:MRI examination showed that more damaged cartilage appeared with time in the rabbit model of osteoarthritis, and significantly different from MRI classification (P<0.05). The expression levels of MMP-2 and MMP-9 mRNA in the model group were always significantly higher than those in the control group (P<0.05);MMP-2 level reached the highest at 3 weeks after modeling (P<0.01), and then presented a slight decline;MMP-9 level peaked at 5 weeks after modeling (P<0.01) and slightly decreased at 7 weeks. MRI classification of cartage injury and expressions of MMP-2 (R2=0.119, P=0.119) and MMP-9 (R2=0.466, P=0.466) were shown to have the correlation. These results il ustrate that the serum levels of MMP-2 and MMP-9 are related to the early destruction of articular cartilage in patients with osteoarthritis, and can be used as predictors for early osteoarthritis.

Objective To explore the feasibility of low dose in MSCT thoracic angiography using Z-axis modulation. Methods The consecutive 60 patients were averagely divided into 3 groups and underwent thoracic angiography with a Toshiba Aquilion 16 scanner. The whole chest acquisition was commenced in automatic exposure control with Z-axis modulation 20-25 seconds after the contrast material was administered at the rate of 3.5-4. 0 ml/s. With the noise index (SD) as the variable, three study groups were classified as A (SD = 12) , B (SD = 15 ), and C (SD = 18 ). The mAs value per slice and the number of slices were recorded. The noises and artifacts of the axial images and the acceptability of CT angiogram were evaluated. The difference among the groups was compared by using ANOVA or nonparametric Kruskal-Wallis test. The threshold of the P value was 0. 05. Results The mean mAs value (46. 4 ± 15.6) mAs in group A was the highest but the SD value (21.6 ±7.7) was the lowest. The mean mAs value ( 37. 0 ± 13.5 ) and the SD value ( 24. 0 t 5.4 ) in group B were the mediate. The mean mAs value ( 20. 7 ±6.3) mAs in group C was the lowe(s)t but the SD value ( 30. 7 ± 6.9) was the highest ( H = 31. 390, P =0. 000). The middle slice images in all patients had the smallest mAs (40. 9,31.3,17. 1 for group A,B,C,respectively; F =9. 578, H =22. 230, F =21. 180,P =0. 000) and SD values( 16. 3, 20. 0,25.4 for group A,B,C, respectively; H = 28. 982, H = 20. 824, H = 24. 396, P = 0. 000). The acceptability of CT angiogram in all patients was excellent. The CT value of descending aorta in group A, B, and C was ( 335 ± 85 ) HU,(334 ±56)HU, and (427 ± 63 )HU, respectively. Conclusion Low dose in MSCT thoracic angiography using Z-axis modulation is feasible. We can use low dose (20 mAs, etc. ) for CT angiography when the contrast is significant.

Objective To investigate the factors correlated to coronary artery calcification (CAC) in maintenance hemodialysis (MHD) patients.Methods This study included 132 patients(54 females,78 males),aged 26-94 years,who were on hemodialysis for 10-204 months(median dialysis duration 51.00 months).The parameters including calcium,phosphorus,parathyroid hormone,total cholesterol,low density lipoprotein,triglycerides,C-reactive protein (CRP),klotho,and so on were assessed.Quantification of CAC was determined by multi-slice spiral computed tomography (MSCT),known as the coronary artery calcification score (CACs).Results Ninety-two patients (69.70％) had CAC,with CACs ranging from 0 to 13 450.20.More than 30％ patients experienced one even a variety of cardiovascular and cerebrovascular diseases.A positive correlation was observed between the degree of CAC and the incidence of cardiovascular and cerebrovascular diseases.Whereas a positive correlation existed between CACs and age (r=0.347,P=0.000),duration of hemodialysis (r=0.245,P=0.005),systolic blood pressure (r=0.184,P=0.034),diabetes history (r=0.211,P=0.015),phosphorus (r=0.262,P=0.002),calcium-phosphorus product (r=0.247,P=0.004);and a negative correlation between CACs and klotho level (r=-0.294,P=0.001).Multivariate logistic regression analysis showed that the main factor influencing the degree of CAC in MHD patients was age.Conclusions CAC is common and widespread in hemodialysis patients,who are often accompanied by cardiovascular and cerebrovascular diseases.The prevalence rate of cardiovascular and cerebrovascular diseases increases with the aggravation of CAC degree.Age,duration of hemodialysis,systolic blood pressure,diabetes history,disturbance of calcium and phosphorus metabolism and klotho are correlated with the severity of CAC.Age is an independent risk factor of CAC degree.

Objective To develop a fluorescence signal activatable multifunctional molecular probe with theranostics function through combining ultrasmall gold nanorods(UGNRs) with fluorescein,and to evaluate its therapeutic effect on photothermal therapy (PTT) in breast cancer cells.Methods The UGNRs were synthesized by the one-pot seedless method,then the functionalized modification of UGNRs were conducted using cysteamine.Finally,the activatable ultrasmall gold nanorods (AUGNRs) were synthesized by amide condensation of —NH2 of cysteamine and —COOH of carboxylated fluorescein CyS.The cell uptake ability and GSH-mediated imaging ability of AUGNRs were studied using breast cancer 4T1 cells.4T1 cells co-cultured with AUGNRs were irradiated with 808 nm excitation light,and the PTT effects were assessed by MTT colorimetric staining and calcein-AM/PI staining.Results The AUGNRs were synthesized successfully,which could be uptaken by 4T1 cells quickly and efficiently,and could achieve intracellular glutathione (GSH) triggered fluorescence recovery.No obvious cytotoxicity of AUGNRs to 4T1 cells was observed in the co-cultivation.Moreover,obvious PTT effects could be induced by 808 nm laser,which could effectively kill 4T1 cancer cells.Conclusion The fluorescence signals of AUGNRs can be induced by intracellular GSH,and tumor cell destruction can be achieved by 808 laser-excitated PTT effects.

Objective To study the safety and feasibility of laparoscopic total splenectomy (LTS) and laparoscopic partial splenectomy (LPS) in the diagnosis and treatment of benign splenic tumors by comparing the perioperative and follow-up data between these two operative approaches.Methods We retrospectively analyzed the clinical data of 57 patients who underwent laparoscopic surgery for benign splenic tumors from December 2009 to April 2016.These patients were divided into the LTS and the LPS groups.The clinical data including the preoperative,intraoperative,postoperative and follow-up data were analyzed.Results When compared with the LPS group,the LTS group had shorter operation time [(97.0 ± 22.1)min vs.(135.0 ± 24.6) min,P ＜ 0.05] and less blood loss [(33.3 ± 19.5) min vs.(90.6 ± 55.1)min,P ＜ 0.05],but there were no significant differences between the two groups in the length of hospital stay,the duration of drainage tube placement,the amount of postoperative analgesics as well as the incidences of pulmonary infection,postoperative pancreatic fistula and other complications after surgery.These incidences were low in the two groups.Conclusion Laparoscopic surgery,including LTS and LPS,were safe and feasible in treating benign splenic tumors.

BACKGROUND: Bone morphogenetic protein in combination with hol ow porous titanium al oy can improve the affinity with surrounding bone tissues. OBJECTIVE: To observe the effects of bone morphogenetic protein 2 on growth and osteogenic differentiation of bone marrow mesenchymal stem cel s cuftured on a hol ow porous metal prosthesis scaffold. METHODS: Passage 3 Sprague-Dawley rat bone marrow mesenchymal stem cel s were directly inoculated onto a hol ow porous metal prosthesis, and then the scaffold was cultured in DMEM medium containing 0, 0.001, 0.01, 0.06 and 0.1 g/L bone morphogenetic protein 2, respectively. At 6, 12, 24 and 48 hours after inoculation, cel adhesion was detected by MTT assay. Cel osteogenic differentiation was detected by alizarin red staining at 18 days. Besides, Transwel culture was put on the scaffold, and 5x108/L bone marrow mesenchymal stem cel s were added into the upper chamber, and DMEM medium containing 0, 0.001, 0.01, 0.06 and 0.1 g/L bone morphogenetic protein 2 were added into the lower chamber to observe cel migration capability after 0, 6, 12, 24 and 48 hours culture. RESULTS AND CONCLUSION: After 6-48 hours of inoculation, different mass concentrations of bone morphogenetic protein 2 promoted adhesion of bone marrow mesenchymal stem cells in a time-dependent manner. After 18 days of inoculation, bone marrow mesenchymal stem cells induced by different mass concentrations of bone morphogenetic protein 2 changed from fusiform to polygon, and arranged in a multilayer and overlapped form. Numerous calcified nodules could be found, which were stained red by alizarin red. Additionally, within 6-48 hours of culture, bone morphogenetic protein 2 could promote the migration of bone marrow mesenchymal stem cells in a concentration-and time-dependent manner. In conclusion, bone morphogenetic protein 2 can enhance the adhesion, osteogenic differentiation and migration of bone marrow mesenchymal stem cells cultured on the hollow porous metal prosthesis.

Objective To investigate the image quality and radiation dosage of the prospective ECG-triggered 256 multi-slice computer tomography (MSCT) angiography in accessing coronary artery (CA) on children.Methods Coronary arteries of ninety-three children were evaluated using prospective ECG-triggered 256-MSCT with the same system setting.Seventy-four patients had the heart rate records and a four-point scoring system was applied to study the capability of MSCT in detecting CA.The signal,noise and contrast-to-noise ratio (CNR) were analyzed to investigate the association of image quality with age (n =74).Then volumetric CT dose index (CTDIvol),dose-length product (DLP) and effective dose (E) were utilized to study the association of radiation dosage with age (n =93).Results On 74 patients with heart records,the detection rate for original,proximal,middle,distal and all 11 segments of CA was 100％,97％,92％,78％ and 91％,respectively.No influence of age was found on their detection (all P＞0.05).E of group A,B,C and D were 1.8,1.3,0.8 and 0.7 mSv,respectively.A strong negative correlation was found between E and age (r =-0.803,P ＜ 0.01).Higher DLP was found on elder patients,though no correlation was found between ages vs.DLP(r =0.124,P ＞ 0.05).No correlation was found between noise vs.age (r =0.041,P ＞ 0.05).Significantly larger signals,CNR and E(t =3.386,2.073,3.825,P ＜ 0.05) were found on younger patients (age ＜ 3 years).Conclusions Prospective ECG-triggered 256-MSCT has considerable performance for the evaluation of coronary arteries on children.However,children under the age of 3 are not recommended for this examinary,but for examination on children ≥ 8-year old,the tube current could be further needed.

Objective To examine the correlation of serum neutrophil gelatinase-associated lipocalin (NGAL) with dialysis adequacy,microinflammatory state and iron metabolism,and to assess the value of NGAL in identifying the dialysis adequacy in maintenance hemodialysis (MHD) patients.Methods A total of 150 MHD patients and 50 healthy control people were enrolled in the study.Clinical data were collected and serum NGAL,CRP,transferrin saturation,serum ferritin were measured.MHD patients were divided into adequacy group and non-adequacy group according to spKt/V value.Serum NGAL between two groups was compared and correlation of NGAL with spKt/V,inflammatory factors,and other clinical indexes was examined by Pearson,multivariate regression Logistic model and area under curve (AUC) of ROC.MHD patients were followed up for 3 months.Similar correlation analysis was carried out before and after follow up between two groups.Results Serum NGAL of MHD patients was higher compared to healthy people [(445.45±50.34) μg/L vs (50.02 ±6.45) μg/L].Among 150 MHD patients,95 were classified into adequacy group,while 55 into non-adequacy group according to spKt/V value.Serum NGAL was significantly higher in adequacy group as compared to non-adequacy group [(589.14±56.34) μg/L vs (360.13±46.23) μg/L,P＜0.05].Serum NGAL was positively correlated to spKt/V,CRP,TSAT [r=0.652,0.825,0.785,all P＜0.05],but not to serum ferritin.Serum NGAL was also correlated to spKt/V,CRP,TSAT by multivariate regression Logistic model.AUC showed that NGAL level could reflex the condition of dialysis adequacy.During the follow up,all adequacy patients remained the same adequacy status.Thirty-eight out of 55 non-adequacy patients were qualified for complete adequacy after intervention.The serum NGAL before and after intervention was (368.14±56.21) μg/L and (360.56±46.23) μg/L respectively without significant difference.Conclusions Serum NGAL is obviously higher in MHD patients with dialysis adequacy compared to those without dialysis adequacy.Serum NGAL is positively correlated to spKt/V,CRP,TSAT.NGAL can reflex the condition of dialysis adequate in MHD patients.