Objective To assess the clinical outcome of retrograde intramedullary interlocking nail in the treatment of femoral suplracondylar or intercondylar fracture with femoral shaft fracture.Methods 3 cases of femoral supracondylar fracture with femoral shaft fracture and 6 cases of intercondylar femoral fracture with femoral shaft fracture experienced the fixation with retrograde intramedullary interlocking nail.Results The patients were followed up for 7～ 20 months,on an average of 10 months.All the patients recovered in an average time of 6 months,with excellent knee joint movement.Conclusion Retrograde intramedullary interlocking nail has obvious advantages in the treatment of femoral supracondylar or intercondylar fracture with femoral shaft fracture and the clinical outcome is satisfactory.

Objectives To elucidate the molecular changes of bone collagen during the development of postmenopausal osteoporosis and to investigate the molecular effects of estrogen replacement.Methods An adult ovariotomy rat model was used. Type-Ⅰ collagen and matrix metalloproteinase-9 (MMP-9) expressions in bone tissues of rats treated by sham surgery (SH), bilateral ovariotomy (OVX) and OVX with estradiol (OVX-E2) were analysed at mRNA level by using dot blot technique. The distribution of mRNA of these two genes in bone tissues was studied by in situ hybridization.Results The expression levels of both type-Ⅰ collagen and MMP-9 in bone tissues of OVX rats were higher than those of SH group, while treated with estradiol, the expression of both genes declined to some degree. In situ hybridization showed that type-Ⅰ collagen mRNA located in osteoblasts, whereas MMP-9 was mainly expressed in osteoclasts, some lining cells on bone surface, and some mononuclear cells in bone marrow.Conclusions The reduction of high bone turnover in osteoporotic bone tissues induced by estrogen replacement may result from alterations in gene expression related to bone formation and bone resorption. These alterations are consistent with the changes observed previously by histomorphometry and biochemical markers of bone metabolism on OVX animals and postmenopausal osteoporosis.

Objective To explore the effect of oral-muscle biofeedback system training on the rehabilitation of cognitive dysfunction in patients with obstructive sleep apnea (OSA) after ischemic stroke.Methods A total of 60 cases of poststroke OSA patients with cognitive dysfunction admitted to the rehabilitation center of deAn hospital in changzhou city from June 2017 to March 2018 were selected.On the basis of routine rehabilitation treatment,the control group was given positive pressure ventilation treatment,and the observation group was given oral muscle biofeedback system training.The changes of polysomnography (PSG) parameters,Montreal cognitive assessment (MoCA) score,serum matrix metalloproteinase-9 (MMP-9) and plasma homcysteinemia (Hcy) expression levels in the two groups before and after treatment were compared.Results Apnea hypopnea index and maximum apnea time of the two groups were significantly decreased after treatment compared with those before treatment,and the lowest SpO2 and average SpO2 were significantly higher than those before treatment(P＜0.05).After treatment,MoCA total score and the dimensions score of patients in the observation group were significantly higher than those in the control group at the same time (P＜0.05).After treatment,the levels of Hcy((12.38±4.54) μmol/L) and MMP-9((124.52± 12.94) μg/L) in the observation group were significantly lower than those in the control group at the same time(Hcy(17.52±6.27) μmol/L,MMP-9(268.25±20.5 7)μg/L),and the difference was statistically significant (Hcy:t=3.637,P＜0.05;MMP-9:t =32.395,P＜0.05).Conclusions Positive pressure ventilation and oral muscle biofeedback system training have the same effect on OSA after stroke,but oral muscle biofeedback system training can also effectively improve patients' cognitive function.