BACKGROUND:Conventional dynamic hip screw or artificial joint replacement can be used to treat unstable intertrochanteric fracture in aged patients. It remains unclear whether we should select one-stage replacement or remedial joint replacement after failture, and there is no unified standard globaly. OBJECTIVE: To observe the outcomes and prognosis of one-stage artificial joint replacement for unstable intertrochanteric fracture in aged patients. METHODS:From April 2008 to October 2011, 21 patients with unstable intertrochanteric fracture in aged patients were repaired with one-stage artificial joint replacement at the Second Department of Orthopedics, Changji Prefecture People’s Hospital. Among 21 patients, 1 patient previously combined with avascular necrosis of the femoral head and traumatic arthritis received biological artificial total hip replacement. Three cases were subjected to standard bone cement bipolar artificial femoral head replacement. 17 cases underwent biological bipolar artificial femoral head prosthesis replacement. Al artificial joint, internal fixation material and accessory joint replacement surgical instruments were purchased outside China. Al patients were folowed up regularly. Hip joint function was assessed by Harris hip score. RESULTS AND CONCLUSION: Al operations were completed by the same group of physicians. Operation time was 30-60 minutes, averagely 42 minutes. Incision length was 8 to 15 cm, averagely 11 cm. Average intraoperative blood loss was 50-300 mL, averagely 150 mL. The number of transfusion cases was 13. 1.5 U blood was transfused averagely in each patient during hospital stay. One 76-year-old patient combined with hypertension, coronary heart disease and diabetes suffered from sudden death due to acute myocardial infarction at 9 days after replacement. B ultrasound revealed venous thrombosis of calf muscle of double lower extremities at 3 days after replacement. No complications such as prosthetic loosening, sinking, infections and thrombosis were detected. Except 1 case died, the other 20 cases received folow-up for 6-49 months. Harris hip score was 73±4 before discharge and 82±6 during last folow-up. These data confirm that effects of one-stage artificial joint replacement for unstable intertrochanteric fracture in aged patients are affirmative, but the number of case is stil less, and deserves further investigations. We suggest that in patients with conformed indication, one-stage artificial joint replacement can be the first choice.

BACKGROUND:Autologous peroneus brevis and alogeneic tendon are often used for reconstruction of lateral colateral ligament of the ankle joint, but these two kinds of materials have different histological and biomechanical properties. OBJECTIVE:To compare the clinical effects of autologous peroneus brevis and alogeneic tendon to reconstruct lateral colateral ligament of the ankle joint. METHODS: Sixty-six patients with chronic external ankle instability caused by old injury to lateral colateral ligament of the ankle joint were enroled, aged 15-63 years. The 34 of 66 patients underwent lateral ligament reconstruction using autologous peroneus brevis and the rest 32 patients received lateral ligament reconstruction using alogeneic tendon. After reconstruction, reaction time of the peroneous brevis, talar tilt angle and anterior talar translation, visual analog scale score and the American Orthopaedic Foot and Ankle Society (AOFAS) score were compared between the two groups. RESULTS AND CONCLUSION:At the last folow-up, the visual analog scale score, tilt angle and anterior talar translation were lowered in the two groups compared with the previous (P < 0.05), and the AOFAS scores were increased significantly in the two groups (P < 0.05); the reaction time of the peroneous brevis was increased inthe autologous peroneus brevis group (P < 0.05) and decreased in the alogeneic tendon group (P < 0.05); the above-mentioned indexes had no difference between the two groups. These findings indicate that autologous peroneus brevis and alogeneic tendon have similar effects on the lateral ligament reconstruction in terms of postoperative ankle function, stability and activity levels, but the alogeneic tendon shows advantages on less trauma and shorter operation time.

Objective To optimize the extraction process of the compound herba lysimachiae by orthogonal experiment and response surface method. Methods The sum of the peak areas of multiple representative components in the compound herba lysimachiae was used as the evaluation index. The ultrasonic extraction time, ultrasonic temperature and ethanol ratio were analyzed to optimize the extraction process conditions by orthogonal experiment and Box-Behnken response surface analysis method. Results Ultrasonic extraction time and ethanol ratio are important factors in the extraction process of the compound herba lysimachiae. The effect of ultrasonic temperature in the extraction process is not significant. The optimal extraction condition for compound herba lysimachiaeare is 10 min ultrasonic extraction time at 55 ℃ with 55% ethanol. Conclusion The optimal extraction process parameters obtained by combining orthogonal experiment and Box-Behnken response surface method can be used for the extraction of representative components from the compound herba lysimachiae and pharmaceutical research in the future.

The clinical treatment of severe trauma with sternoclavicular joint injury is challenging, primarily due to the irregular shape of the bones surrounding the sternoclavicular joint, as well as the posterior clavicle being close to the aorta and mediastinal organs.[1] These patients not only suffer direct injuries to the sternoclavicular joint, but also frequently experience severe injuries to other body parts. The systemic physiological disorders and multi-organ dysfunction caused by severe trauma increase the surgery difficulty and mortality risk.[2]

Cell-free protein expression system is a new method to express target protein in vitro and has been widely applied to the study of protein structure, protein function and other related fields. Preparation of cell extract is one of the key factors that affect the efficiency of the cell-free system. To improve the efficiency and economical feasibility of cell-free protein synthesis, we discussed the parameters during the preparation of the cell extract. These parameters include centrifugation speed, pre-incubation, and dialysis. We used the green fluorescent protein as the reporter protein, and obtained a simple procedure for the preparation of Escherichia coli cell extract. A simple centrifugation step (12 000 x g, 10 min) followed by a brief incubation was sufficient for the preparation of an active cell extract to support protein expression with higher productivity (209 microg/mL). Compared to the traditional E. coli S30 procedure, the processing time was reduced by 62%, and the productivity was increased by 2.6 times. The new procedure will make the advantage of cell-free technology more obvious, and promote its wider application.
Cell Fractionation ; methods ; Cell-Free System ; Escherichia coli ; cytology ; genetics ; metabolism ; Escherichia coli Proteins ; biosynthesis ; chemistry ; isolation & purification ; Green Fluorescent Proteins ; metabolism

Objective To explore the influencing factors of poor prognosis after clipping in patients with ruptured intracranial aneurysm and hematoma,and to construct a clinical prediction model.Methods A total of 151 patients with aneurysmal intracranial hematoma in Dongyang People's Hospital were selected from September 2017 to October 2023.3 months after operation,the patients were grouped by modified Rankin scale(mRS),with 93 cases in good prognosis group and 58 cases in poor prognosis group.Univariate analysis and multivariate Logistic regression analysis were used to explore the risk factors affecting the poor prognosis of patients with postoperative prognosis,and a poor prognostic prediction model for patients with intracranial aneurysm rupture and hematoma clamping was constructed,the discriminant validity of the area under the curve(AUC)was evaluated,and the fit of the model was established using the Hosmer-Lemeshow test.Results The Hunt-Hess gradeⅣ-Ⅴ(OR=5.339),modified Fisher grade Ⅲ-Ⅳ(OR=5.145),hematoma volume≥ 50ml(OR=7.426),hematoma clearance rate was≤50％(OR=8.381),size of the responsible aneurysm＞5mm(OR=3.053),operation time window＞5h(OR=2.659),and intraoperative vascular operation time＞3h(OR=2.305)were independent risk factors for poor prognosis after clipping in patients with intracranial aneurysm ruptured and intracranial hematoma(P＜0.05).The AUC of the poor prognosis prediction model of patients with intracranial aneurysm rupture with hematoma after clipping was 0.863(95％CI:0.781-0.946,P＜0.001),the specificity was 79.6％,the sensitivity was 86.2％,and the prediction accuracy was 82.1％.Hosmer-Lemeshow testx2=5.778,P=0.679,and there was no significant difference between the predicted value of the model and the actual observed value.Conclusion Hunt-Hess grade Ⅳ-Ⅴ,the modified Fisher grade Ⅲ-Ⅳ,hematoma volume≥50ml,hematoma clearance rate≤50％,responsible aneurysm size＞5mm,operation time window＞5h,and intraoperative vascular operation time＞3h were independent risk factors for poor prognosis after clipping in patients with intracranial aneurysm ruptured.The model constructed in this study has high predictive performance and can provide guidance for the treatment and postoperative recovery of patients undergoing craniotomy and clipping surgery in clinical practice.