[Objective]To analyze the clinical effect of intertrochanteric fractures treated with percutaneous proximal femoral nails(PFN).[Method]From January 2004 to May 2009,PFN using percutaneous technique was performed in 180 elderly patients of femoral intertrochanteric fractures(180 hips,80 males and 98 females),with mean age of 76 years(range from 57-99 years).According to Evans classification,12 cases were type Ⅰ,28 were type Ⅱ,62 were Ⅲa,20 were Ⅲb,49 were Ⅳ,9 were Ⅴ.Traction table and C-arm fluroscopic intensifier were used with close reduction and interlocking during the course of operation.[Result]One hundred and seventy two cases in 180 patients were followed up for 8 to 21 months with a mean of 13.5 months.Other 8 patients were lost to follow up after discharge.Of 172 patients followed up,166 cases' radiographs showed the callus during 6-8 weeks postoperatively,while they had a full range of hip motion as the original level.Partial weight bearing exercises were carried out since the 8th postoperative week.The time of clinical fracture healing was from 12 to 16 weeks,the rate of healing was 98.8%.In the function assessment of 172 patients the satisfactory rate reached to 87.8 percents.[Conclusion]Percutaneous proximal femoral nails is an ideal way for the treatment of intertrochanteric fractures in aged because of its simple procedure,minimal invasion,less fluoroscopy exposures,less complications,stable fixation,early fracture healing and satisfied functional outcomes.

BACKGROUND: Electromagnetic pulse (EMP) radiation can affect the learning and memory function of experimental rats and induce injury of hippocampal issues and change of ultrastructure of rats.OBJECTIVE: To observe the effects of EMP on injury of hippocampal neurons cultured in vitro and [Ca2+]i, and analyze deeply possible mechanism of cerebral injury induced by EMP.DESIGN: Randomized controlled animal experiment.SETTING: Department of Pathology, Chengde Medical College.MATERIALS: Several Wistar neonate rats, of either sex (half and half),were selected. Source of EMP radiation was high intensity EMP dummy source.METHODS: The experiment was performed from March to December 2004 at the Academy of Military Medical Science and Chengde Medical College, respectively. Several Wistar neonate rats were decapitated to take out the brains under narcotization. Hippocampal tissues were isolated. The cell suspension was adjusted to 5×108 L-1 for inoculation. Grouping: ①Cultured cells were assigned into control group and radiation group. Cells were collected immediately after radiation to perform observation of morphology and determination of free calcium ion concentration. ②Other cultured cells were divided into control group, 0-hour radiation group and 12-hour radiation group. Cell apoptosis rate and necrosis rate were determined. (Dosage of cultured cells: one culture flask of each group was checked in each item for 3 times). EMP radiation was in 6×104 V/m, with pulse rise time of 20 ns,pulse width of 30 μs, frequency of 2.5 pulses/min, totally for 2 minutes.EMP radiation was performed in primary cultured hippocampal neurons,and then morphological change of neurons was observed under inverted phase contrast microscope before and after radiation. Cell apoptosis and necrosis were measured with FACS method; Free [Ca2+]i concentration in neurons was measured with Fluo-3-AM fluorescent probe loading and laser confocal microscopy scanning.MAIN OUTCOME MEASURES: Morphological change of neuron, cell apoptosis rate and necrosis rate and free [Ca2+]i concentration.RESULTS: ①Immediately after EMP radiation, the onset of colliquation appeared in nerval cells gradually, and neurite was recovery and degeneration. ②Apoptosis rate after 12-hour EMP radiation recovered as compared with that at hour 0 after radiation, but significantly increased as compared with the control group [(59.27±1.27)%, (72.17±6.21)%, (17.45±5.63)%,P＜0.05]. ③Necrosis rate at hour 0 and hour 12 after radiation increased as compared with the control group, but there was no statistical significant difference [(13.71±2.31)%, ( 11.96±1.04)%, (8.45±0.67)% ,P ＞ 0.05].④[Ca2+]i fluorescence intensity at hour 0 after EMP radiation was higher obviously than that in the control group (107.34±26.14,54.93±16.08,P ＜ 0.05).CONCLUSION: EMP induces morphological injury, necrosis and increase of apoptosis rate in hippocampal neurons, and Ca2+ fluorescence intensity increases markedly in neurons.

Objective To evaluate the clinical effect of CEREC chairside on atypical porcelain inlay restoring class [[cavity.Methods 30 patients that required re-treatment because of resin restoration failure and early posterior proximal caries were selected randomly.The original fillings,secondary carious tissues and undercut parts were removed.The clear and round edge lines were prepared.With Sirona CEREC Blocs,35 atypical ceramic inlays were produced in accordance with CEREC AC CAD/CAM standard procedures.After clinical trial and modification,the inlays were bonded with 3M Veneer resin adhesive cement.Evaluation was done immediately and 3,6,12 and 24 months after restoration.Two senior prosthodontists did the evaluation according to the modified USPHS criteria.Results The evaluation results were all A when estimated immediately after restoration.None inlay falled off during the first two years.However,3 inlay were found to be damaged when reviewed at the 24th month.There exsited two patients having mild symptoms of dentine hypersensitivity which appeared at the beginning and died out gradually.Generally speaking,more than 90％ of inlay restorations had reached the USPHS criteria A.Color match and retention represented better effects.Conclusions CEREC atypical ceramic inlays can effectively restore Class Ⅱ cavity,short-term effect is good,but long-term effect still needs further observations.

Objective To systematically evaluate the effectiveness and safety of resuscitation-inducing acupuncture for post-stroke dysphasia. Methods The randomized controlled trials ( RCTs) of resuscitation-inducing acupuncture for post-stroke dysphasia were searched in the domestic and overseas databases such as CBM, CNKI, Weipu VIP, Wanfang Data, PubMed, Web of Science, EMbase and the Cochrane Library ( from the founded date to December of 2014) . Literature screening, information extracting and literature quality assessment were done by 2 reviewers independently. RevMan5.3.0 software was used for Meta analysis. Results A total of 8 RCTs were included into the analysis, involving in 766 cases. The results of Meta analysis showed:( 1) for patients in the recovery stage of stroke, 4-week resuscitation-inducing acupuncture combined with routine treatment including internal medicine plus swallowing function training or not had better efficiency than the control group without resuscitation-inducing acupuncture (P<0.001) ; (2) for patients in the acute stage, the difference of efficiency between the combination group and the control group was insignificant (P=0.05); (3) The efficiency of resuscitation-inducing acupuncture combined with routine treatment for the complication of pulmonary infection stayed uncertain. Conclusion Resuscitation-inducing acupuncture combined with routine treatment is recommended to the patients with dysphasia in the recovery stage of recovery. But the cure time window, treatment course and effectiveness evaluation still need to be confirmed by more large-scale, high-quality randomized controlled trials.

Objective To investigate the relationship between serum uric acid (SUA) and metabolism syndrome (MS) in community-based elderly population in Beijing.Methods A community-based and cross-sectional survey on 1821 elderly person was performed in Beijing in 2000.Questionnaire survey,physical examination and blood biochemical tests were conducted.Relationship of MS and its components with SUA was analyzed.Results Among 1821 subjects,there were 365 cases with MS (20.0％) and 1456 cases without MS (80.0％).SUA level was higher in MS group than in non-MS group [(5.20±2.27) μmol/L vs.(4.50±1.44) μmol/L,t=-7.34,P=0.000].All subjects were divided into 4 groups according SUA level:goup 1 (≤3.5μmol/L,n=443),group 2 (3.6 μmol/L-4.4 μmol/L,n=465),group 3 (4.5 μmol/L-5.4 μmol/L,n=446) and group 4 (≥5.5 μmol/L,n=467).SUA level was increased along with the increased BMI,TG,TC,LDL-C levels,and decreased along with the decreased HDL-C level,which had significant differences (F=43.07,9.32,22.36,8.19,9.39,all P＜0.001).There were significant distribution differences in MS components numbers in the 4 groups (x2=73.62,P=0.000).After adjusting for age,sex,residential,education level,marriage,smoking,drinking and exercise habits,logistic regression analysis showed that MS was related with SUA level,and the risk of MS was increased along with the increased SUA level.Conclusions MS is correlated with SUA level in elderly people.SUA level should be observed and controlled effectively in the elderly.

OBJECTIVE:To optimize the ethanol mixed-extraction technology of Red ginseng and Salvia miltiorrhiza in Xin-likang granules. METHODS:L9(34)orthogonal test was adopted to optimize ethanol mixed-extraction technology with ethanol vol-ume fraction,amount of ethanol and extraction times as factors using weighting coefficient comprehensive score of the contents of ginsenoside Rg1,Re and Rb1 in R. ginseng and the contents of tanshinone ⅡA and salvianolic acid B in S. miltiorrhiza as index;and the verification test was detected. RESULTS:Optimal mixed-ethanol extraction technology was as follows as 6-fold 70% etha-nol,reflux extracting for 3 times,2 h each time. In verification test,average contents of ginsenosides Rg1,Re,Rb1 in R. ginseng and those of tanshinone ⅡA and salvianolic acid B in S. miltiorrhiza were 3.963 8,0.757 3,4.986 2,0.964 7,27.662 5 mg/g,re-spectively,and comprehensive score was 0.96 (RSD=1.26%,n=3). CONCLUSIONS:Ethanol extraction technology of R. gin-seng and S. miltiorrhiza in Xinlikang granules optimized by multiple indexes comprehensive score combined with orthogonal test is stable,reasonable and feasible.

objective To analyze the causes of defective nonunion of femoral shaft and to evaluate interlocking intramedullary nails in treatment of shortened limb deformity following nonunion of femoral shaft. Methods 12 patients with shortened limb deformity following nonunion of femoral shaft were treated with autograft of ilium to fill up the defects and fixation by interlocking intramedullary nails. The patients were followed up for an average of 20 months. Results All the 12 patients healed by first intention after an average of 22 months. The limbs were lengthened averagely by 3.2cm. No failure occurred due to bent or broken major nails or intramedullary nails. Conclusions The main cause of shortened limb deformity following femoral shaft nonunion is bone resorption due to unreliable fixation. Interlocking intramedullary nails are an ideal device for shortened limb deformity following femoral shaft nonunion, though the union process is slow. In bone graft, care should be taken to avoid the complication of bone defect and weight bearing should be carried out some time later.

Objective To analyze the effect of stroke duration on the cognitive function in the elderly population in Beijing.Methods Based on the Research Project of Beijing Chronic Disease Combined with Common Elderly Syndrome Community Management Practices,a cross-sectional study was used.From July 2013 to December 2014,the old population in 4 districts and a county (Xicheng District,Fangshan District,Tongzhou District and Yanqing County) in Beijing were sampled with the multi-stage,randomized and stratified sampling.A total of 3 024 subjects were enrolled in the study.The data were obtained from the questionnaires and clinical examinations.Mini-Mental State Examination (MMSE) was used as the evaluation index of cognitive function.The subjects were divided into either a normal cognitive function group (MMSE>26,n=1 878) or a cognitive impairment group (MMSE≤26,n=1 146) according to the MMSE scores.A multiple logistic regression model was used to analyze the effects of hemorrhagic stroke,ischemic stroke,and asymptomatic stroke,as well as disease duration on cognitive function.Results After adjusting for the confounding factors,such as sex,age,educational level,marriage,smoking,and alcohol consumption,the risks of occurring cognitive impairment in patients with hemorrhagic stroke in stroke duration for 1-3,4-10 and >10 years were OR 3.019 (95％CI 0.974-9.361,P=0.056),8.652 (95％CI 2.924-25.601,P<0.01) and 1.104 (95％CI 0.311-3.920,P=0.879) times of those without occurring stroke population;the risks of occurring cognitive impairment in patients with ischemic stroke in stroke duration for 1-3,4-10 and >10 years were 1.000 (95％CI 0.636-1.571,P=1.000),1.874 (95％CI 1.231-2.853,P=0.003),2.439 (95％CI 1.386-4.291,P=0.002) times of those without occurring stroke population.Stroke duration for 4-10 years in patients with hemorrhagic stroke and stroke duration for 4-10 and >10 years in patients with ischemic stroke were all the risk factors for occurring cognitive dysfunction.Conclusion For patients with stroke,stroke duration or long-term effects has a certain impact on cognitive function.

Objective To study the association of prevalence of cardio-cerebro vascular diseases (CCVD) with metabolic syndrome (MS) defined by different criteria in middle and aged people.Methods A cross-section survey was conducted among 1458 people aged 55 years and over in urban and rural areas of Beijing in 2009.MS definitions by World Health Organization (WHO),National Cholesterol Education Program-Adult Treatment Panel Ⅲ (NCEP-ATP Ⅲ ) revised,international diabetes mellitus (IDF) and Chinese Diabetes Society (CDS) were applied to analyze the association MS with the prevalence of CCVD.Results The risks of CCVD were all significantly higher in patients with MS than with non-MS using 4 definitions of MS.The definitions of WHO and CDS showed well agreement with the prevalence of CCVD.OR values of MS for CCVD were 2.14 folds (95％ CI:1.59-2.87) for WHO definition and 1.91 folds (95％ CI:1.43-2.55) for CDS definition,while OR values of MS for CCVD were 1.68 folds (95％ CI:1.32-2.15) for NCEP-ATPⅢ definition and 1.64 folds (95％ CI:1.26-2.13) for IDF definition as compared to non-MS,respectively.After adjustment for age,sex,region,history of smoking and alcohol drinking,the OR values in above four definitions were 1.91,1.88,1.67 and 1.80,respectively.The OR value of MS was highest for stroke by CDS definition and highest for coronary heart disease by WHO definition.Conclusions MS values defined by WHO and CDS are the optimal index of prevalence for CCVD in middle and aged people.

Objective To investigate the prevalence characters of peripheral artery disease (PAD) and associated factors among people aged 35 and above in Beijing. Methods This was a cross?sectional study. A total of 5 208 community?based individuals aged equal and above 35 in Beijing were chosen with stratified multistage random sampling method. Structure questionnaire was used to collected the information of demographic factors, habits and chronic disease history. Ankle brachial blood pressure was detected and ankle brachial index (ABI) was calculated. ABI was used to diagnose PAD (ABI≤0.90). Based on the 2010 Beijing Municipal Population Census, the age?and gender?specific weight?adjusted sample was acquired to estimate the prevalence of PAD and corresponding 95% confidence intervals ( CI ). Multivariate logistic regression analysis was performed to estimate the associated factors of PAD. Results The age?and sex?standardized prevalence of PAD was 3.84% (200/5 208, 95%CI 3.32%-4.36%). There was no significant difference between male and female (3.83%(102/2 664 ,95%CI 3.10%-4.56%) vs. 3.85% (98/2 544,95% CI 3.10%-4.60%), P=0.965). The prevalence of PAD in urban was higher than that in rural (4.34% (163/3 755,95%CI 3.69%-4.99%) vs. 2.55% (37/1 453,95%CI 1.74%-3.36%), P=0.001). Furthermore, the prevalence of PAD increased with age (Ptrend<0.01), and the difference between genders did not change with ageing (all P>0.05). In addition, age (OR=1.03, 95%CI 1.01-1.04), urban (OR=1.52, 95%CI 1.08-2.12), smoking ( OR=1.83, 95%CI 1.29-2.59), hypertension ( OR=1.61, 95%CI 1.17-2.22) and diabetes (OR=1.44, 95%CI 1.08-1.93) were related with increased risk of PAD in logistic regression analysis models. Conclusions The prevalence of PAD increases with age in Beijing and there are significant difference between urban and rural on prevalence of PAD. Age, urban, smoking, hypertension and diabetes are related with increased risk of PAD.