[Objective]To discuss the feasibility and efficacy of the treatment of low subtrochanteric femoral fracture(LSFF) by using general interlocking intramedullary nail(GIIN).[Method]Between March.2000 and January.2006,47 cases(38 males,9 females) of LSFF were treated with limited incision and 6IIN.The mean age of the patients were 41.2 years(range 25 to 78 years).29 of them were injured in a traffic accident,7 in falling,6 in crush by a heavy object and 5 in pedestrain injury.According to Seinsheimer classification,11 cases were type IA,10 cases were type lB,19 cases were type ⅢB,and 7 cases were type Ⅳ(8 combined with other fractures)6 of these were open fractures(4 cases of Gustilo-Anderson type Ⅰ and 2 cases of type Ⅱ).The procedure included following step: all patients were treated with limited open reduction.The pyriform sinus entry point were localized with retrograde reamed;then,intramedullary nail was performed through the anterograde approach after limited reamed.All fractures were fixed statically.The operation time were from 50 minutes to 130 minutes(averaging 90 minutes).[Result]All the cases,were followed up for 11 to 34 months,with an average time of 33 months.The alignment of fracture was good.The bone union time were 2.5～6 months,the average 3.9 months.Fracture union rate was 100%.The functional evaluation was done by Sanders traumatic hip rating scale.of the 47 cases,31 were excellent,14 good and 11 fair.The excellent and good rate was 95.7%.There were no infection,implant breakage,limb shortening and varus deformity.[Conclusion]In treatment of LSFF,the GIIN is worth to recommend because it is simple for use,no need of X-ray monitoring during the operation,reliable,high union rate,rare complications,and good effects.Reasonable application of GIIN,better fracture reduction and early active functional rehabilitation(earlier activities and later weight bearing) are the keys to obtain a good clinical result.

Objective To observe the role of baicalin on the expression of phosphorylated protein of signal transduc-ers and activators of transcription signaling proteins (STATs) during the process that neural stem cells (NSCs) differentiating into neurons. Methods NSCs were isolated from the embryonic cerebral cortex of the 14-15-day pregnant SD rats, which were cultured and passaged in vitro. The 3rd generation of NSCs was used in the experiment. NSCs were randomized into nat-ural differentiation control group, three different doses of baicalin groups (7.5μmol/L, 15μmol/L and 30μmol/L), leukemia inhibitory factor (LIF)+basic fibroblast growth factor (bFGF) group and baicalin+LIF+bFGF group. After 6 d culture in vi-tro, the immunohistochemical method was used to observe the expressions of microtubule-associated protein 2(MAP-2) and glial fibrillary acidic protein (GFAP) in different groups. The expression levels of phosphorylation protein of STAT 3 in NSCs were detected by Western blotting method after 2 h and 6 d of culture. Results The expression of MAP-2 in NSCs was in-creased by baicalin, but the expression of GFAP in NSCs decreased. The expression of GFAP in NSCs was enhanced in LIF+bFGF group, which was inhibited by baicalin+LIF+bFGF. The phosphorylation level of STAT3 in NSCs was downregulat-ed by baicalin, but the phosphorylation level of STAT3 was upregulated in LIF+bFGF group. The upregulated phosphoryla-tion level of STAT3 was inhibited in baicalin+LIF+bFGF group(P＜0.05). Conclusion Baicalin can induce NSCs to dif-ferentiate into neurons, which may be caused by the downregulation of the phosphorylation level of STAT3 in NSCs.

Objective To compare the efficacy of percutaneous compression plate (PCCP) and dynamic hip screw (DHS) on intertrochanteric fractures in elderly patients. Methods A literature search was performed in the Cochrane Li-brary, Mdiline, EMbase, CNKI, Wanfang database and other databases. The controlled clinical trials were retrieved, which in-cluded PCCP and DHS treatment for intertrochanteric fractures in elderly patients. A meta-analysis was performed to ana-lyze the efficacy of PCCP and DHS on this kind of fractures in elderly patients. Results In 231 citations initially identified, 11 eligible papers were included in this study, which consisted of a total of 1 100 patients. Results showed that there were shorter operative time (WMD=-12.83,Z=2.54,P=0.01), smaller incision(WMD=-7.43,Z=3.35,P＜0.001), low blood loss during surgery(WMD =-211.41,Z=9.07,P＜ 0.001) and better prognosis in PCCP group than those of DHS group. There was no significant difference in the length of postoperative hospital stay between PCCP and DHS group(WMD=-1.28, Z=0.89, P=0.37). Conclusion The current analysis suggests that the PCCP is better for intertrochanteric fractures in elderly patients.

BACKGROUND:On the basis of thorough debridement, homochronous anterior or staging posterior fixation has been a standard scheme for spinal tuberculosis. Numerous studies confirmed that above approach has obtained good effects, but the anterior approach has some disadvantages, such as complex anatomic structure, great trauma, relatively more complications, and difficult operation and fixator implantation. OBJECTIVE:To observe spinal stabilization and deformity correction in patients with single-segment thoracic/lumbar spinal tuberculosis after posterior debridement and interbody fusion. METHODS:Clinical data of 36 patients with single-segment thoracic/lumbar spinal tuberculosis undergoing one-stage posterior debridement and interbody fusion in the Guangxi Yulin Orthopedics Hospital of Integrated Traditional Chinese and Western Medicine from January 2008 to January 2012 were retrospectively analyzed. There were 2 cases in single T11/12 segment, 4 in T12/L1 segments, 6 in L3/4 segments, 22 in L4/5segments and 2 in L5/S1 segments. Of them, 24 patients suffered from different degrees of spinal nerve injury. At 6, 12 and 24 months after surgery, al patients were folowed up. Bone graft fusion, kyphosis correction, functional recovery of the spinal cord and complications were observed. RESULTS AND CONCLUSION:Al patients were folowed up for 24-38 months. Cobb angle of kyphosis and spinal stenosis rate were significantly improved at 2 years after treatment (P < 0.05). The lumbar back pain symptoms were significantly improved in final folow-up (P < 0.05), with an intervertebral fusion rate of 100%. No lesion residue and recurrence, correction loss, fixation loosening or displacement was found. These results demonstrated that in patients with single-segment thoracic/lumbar spinal tuberculosis, posterior debridement and interbody fusion can effectively reconstruct spinal stabilization, correct deformity, and promote the functional recovery of spinal nerves.

Objective:To explore the mechanism of B10 cell involved in cardiomyocyte hypertrophy following myocarditis, and to develop potential therapeutic strategies.Methods:BALB/c mice infected with Coxsackie virus B3 induced viral myocarditis model. The expression of angiotensin (ANG)Ⅱ and its receptor in myocarditis mice was detected. The changes of B10 cells in the hearts of control mice and myocarditis mice were analyzed by flow cytometry. After losartan was administered to myocarditis mice, the degree of myocardial inflammation was detected by HE staining, the expression of inflammatory factors was detected by ELISA, the myocardial hypertrophy was detected by wheat germ agglutinin (WGA) staining, and the changes of B10 cells in the heart were analyzed by flow cytometry. The levels of cardiac troponin T (C-TNT) and high mobility group box 1 (HMGB1) protein in neonatal mouse cardiomyocytes treated with ANGⅡ and ANGⅡ+ IL-10 were detected. Cardiomyocytes were treated with ANGⅡ, ANGⅡ+ B10 cells, ANGⅡ+ B10 cells + IL-10 receptor antibody and ANGⅡ+ B cells to detect C-TNT protein levels, and Annexin-V/PI was used to detect the apoptosis of cardiomyocytes. Cardiomyocytes were treated with oxidized HMGB1, reduced HMGB1 and disulfide HMGB1, and C-TNT expression was detected.Results:Coxsackievirus B3 infection caused cardiac hypertrophy, high expression of ANGⅡ and its receptor, and transient increase of B10 cells in mice. Losartan treatment blocked the angiotensin receptor, reduced expansion of B10 cells. B10 cells alleviated apoptosis of cardiomyocytes and inhibited the production of HMGB1 induced by ANGⅡ patch by producing IL-10, thus alleviating viral myocarditis and cardiac hypertrophy.Conclusions:B10 cells may play an important role in myocardial protection in myocarditis.

Objective:To investigate the effects of standardized treatment combined with medical nutrition intervention on blood glucose level, body mass management and glucose metabolism at 3 months postpartum in patients with gestational diabetes mellitus (GDM).Methods:A total of 114 patients with GDM who received treatment in Shunyi District Hospital of Beijing from June 2017 to October 2019 were included in this study. They were randomly divided into observation group ( n = 57) and control group ( n = 57). The control group was treated with standardized therapy, and the observation group was treated with standardized therapy combined with medical nutrition intervention. Blood glucose level, body mass management, glucose metabolism outcomes at 3 months postpartum, pregnancy outcome, and neonatal outcome were compared between the two groups. Results:After treatment, hemoglobin A1c (HbA1c), fasting blood glucose, 2-hour plasma glucose (2hPG) after breakfast, and 2hPG after dinner in the observation group were (5.20 ± 0.34)%, (4.69 ± 0.31) mmol/L, (7.32 ± 2.13) mmol/L, and (7.54 ± 2.36) mmol/L, respectively, which were significantly lower than those in the control group [(6.38 ± 0.42)%, (6.34 ± 0.45) mmol/L, (9.01 ± 2.27) mmol/L, (9.35 ± 2.47) mmol/L, t = 16.48, 22.79, 4.09, 4.00, all P < 0.001]. The increases in body mass and body mass index during pregnancy in the observation groups were (12.19 ± 2.35) kg and (4.52 ± 1.13) kg/m 2, respectively, which were significantly lower than those in the control group [(16.21 ± 2.64) kg, (6.11 ± 1.25) kg/m 2, t = 8.58, 7.12, both P < 0.001]. The abnormal rate of glucose metabolism at 3 months postpartum in the observation group was significantly lower than that in the control group [5.3% (3/57) vs. 8.8% (5/57), χ2 = 0.53, P = 0.462]. The incidences of premature rupture of membranes, polyhydramnios, and cesarean section in the observation group were 5.3% (3/57), 14.0% (8/57) and 15.8% (9/57), which were significantly lower than those in the control group [22.8% (13/57), 35.1% (20/57), 40.4% (23/57), χ2 = 7.27, 6.81, 8.51, all P < 0.05]. There were no significant differences in the incidences of pregnancy-induced hypertension and postpartum hemorrhage between the two groups (both P > 0.05). The incidences of premature births, macrosomia, respiratory distress, neonatal hypoglycemia and hyperbilirubinemia in the observation groups were 5.3% (3/57), 3.5% (2/57), 7.0% (4/57), 3.5% (2/57), 5.3% (3/57), respectively, which were significantly lower than those in the control group [22.8% (13/57), 17.5% (10/57), 21.1% (12/57), 15.8% (9/57), 19.3% (11/57), χ2 = 7.27, 5.96, 5.60, 4.93, 5.21, all P < 0.05). Conclusion:Standardized treatment combined with medical nutrition intervention can effectively reduce blood glucose level in patients with GMD, control body mass, and improve glucose metabolism at 3 months after delivery.

AIM: To evaluate the safety and efficacy of oral oxycodone /acetaminophen or tramadol in early postoperative patients undergoing laparoscopic gynecological operations. METHODS: 120 gynecologic patients receiving laparoscopy operation were enrolled in a randomized,double blind, placebo controlled, multi center clinical trial with early oral analgesics if the vasual analgesia scores (VAS) was scored higher than 3.0. All patients were randomly received a single dose of oral analgesic: oxycodone/acetaminophen, tramadol or placebo, respectively. For rescue medication, PCA pump was provided in all three groups with a dose of 1 mg morphine and lockout of 5 minutes. The VAS scores, pain relief, PCA morphine consumption and side effects were evaluated at the following occasions of 0.25 , 0.5 , 0.75 , 1, 2, 4, 6, 8, 12 and 24 h throughout the study. RESULTS: The VAS scores and pain relief were significantly different in three groups at 0.75 , 1, 2, 4, 6, 8 and 12 h. The VAS scores and PCA morphine consumption was significantly lower in oxycodone/acetaminophen and tramadol groups than those in placebo group. Pain relief in oxycodone/acetaminophen and tramadol groups was better than those in placebo group. The incidence of side effects such as nausea and vomiting significantly increased in tramadol group at 24 h compared with those in the other two groups. CONCLUSION: Early oral administration of oxycodone /acetaminophen or tramadol can provide surgical patients with good and safe postoperative analgesia after laparoscopy gynecologic operation. The incidence of side effects in oxycodone /acetaminophen group is lower than that in tramadol group in this clinical trial.

Background Arsenic exposure is a common and important environmental and occupational hazardous factor in China, and arsenic-induced insulin resistance (IR) has attracted widespread attention as a negative health outcome to the population. Objective To explore part of the mechanism of hepatic IR induced by arsenic exposure based on the peroxisome proliferators-activated receptors γ (PPARγ)/ glucose transporter 4 (GLUT4) pathway, and to investigate potential effects of Ginkgo biloba extract (GBE) on hepatic IR induced by arsenic exposure and associated mechanism of action. Methods The target of drug action was predicted by network pharmacology and verified by in vivo and in vitro experiments. In vivo experiments: 48 SPF C57BL/6J male mice were divided into 4 groups, including control group, 50 mg·L⁻¹ NaAsO₂ model group (NaAsO₂), 50 mg·L⁻¹ NaAsO₂+10 mg·kg⁻¹ GBE intervene group (NaAsO₂+GBE), and 10 mg·kg⁻¹ GBE group (GBE), 12 mice in each group. The animals were given free access to purified water containing 50 mg·L⁻¹ NaAsO₂, or given intraperitoneal injection of normal saline containing 10 mg·kg⁻¹ GBE once per week. After 6 months of exposure, blood glucose detection, intraperitoneal glucose tolerance test (IPGTT), and insulin tolerance test (ITT) were performed. Serum and liver tissues were collected after the mice were neutralized, liver histopathological sections were obtained, serum insulin levels, liver tissue glycogen content, glucose content were detected by enzyme linked immunosorbent assay (ELISA), and the expression of PPARγ and GLUT4 proteins was detected by Western blot (WB). In vitro experiments: HepG2 cells were divided into 4 groups, including control group, 8 μmol·L⁻¹ NaAsO₂ group (NaAsO₂), 8 μmol·L⁻¹ NaAsO₂ + 200 mg·L⁻¹ GBE intervene group (NaAsO₂+GBE), and 200 mg·L⁻¹ GBE group (GBE). The levels of glycogen and glucose were detected by ELISA, and the expression of PPARγ and GLUT4 proteins was detected by WB. Results A strong binding effect between GBE and PPARγ was revealed by network pharmacology. In in vivo experiments, the NaAsO₂ group exhibited an elevated blood glucose compared to the control group, and the NaAsO₂+GBE group showed a decreased blood glucose compared to the NaAsO₂ group (P<0.01). The histopathological sections indicated severe liver structural damage in the arsenic exposure groups (NaAsO₂ group and NaAsO₂+GBE group), with varying staining intensity, partial liver cell necrosis, and diffuse red blood cell appearance. Both results of in vitro and in vivo experiments showed a decrease in glycogen synthesis and glucose uptake in the NaAsO₂ groups compared to the control groups, which was alleviated in the NaAsO₂+GBE group (P<0.01). The results of WB revealed inhibited PPARγ expression and reduced GLUT4 levels on the cell membrane, and all these changes were alleviated in the NaAsO₂+GBE group (P<0.01). Conclusion This study findings suggest that GBE antagonizes arsenic exposure-induced hepatic IR by regulating the PPARγ/GLUT4 pathway, indicating that GBE has a protective effect on arsenic exposure-induced hepatic IR, and PPARγ may be a potential therapeutic target for arsenic exposure-induced hepatic IR.

Aphids are major agricultural pests that cause significant yield losses of crops each year. (E)-β-farnesene (EβF), as the main component of the aphid alarm pheromones, can interrupt aphid feeding and cause other conspecies in the vicinity to become agitated or disperse from their host plant. Furthermore, EβF can function as a kairomone in attracting aphid predators. EβF synthase genes, which encode enzymes that convert farnesyl diphosphate (FPP) to the acyclic sesquiterpene EβF, have been isolated and characterized from peppermint (Mentha × piperita and Mentha asiatica), Yuzu (Citrus junos), Douglas fir (Pseudotsuga menziesii), sweet wormwood (Artemisia annua) and chamomile (Matricaria recutita), respectively. Transgenic plant overexpressing EβF synthase genes has been one of the most efficient strategies for aphid management. In this review, the current statuses of transgenic plants engineered for aphid resistance were summarized. The plant-derived EβF synthase genes with their potential roles in aphid management via genetic-modified (GM) approaches were reviewed. The existing problem in GM plants with EβF synthase gene, such as low EβF emission was usually detected in the transgenic plant, was discussed and the development direction in this area was proposed.