The coming of an aged society in China will surely greatly affect the chief concerns of health care. The Chinese orthopaedists should be prepared for the tasks imposed by the new situation. Once a fracture happens due to osteoporosis in a senile person, a series of problems will follow. This paper discusses the diagnosis and prevention of osteoporosis, preoperative assessment of the patient, proper application of internal fixation and combined treatment of fracture and osteoporosis. The critical point is how to improve the therapeutic effects and to reduce the operative risks.

Background Insulin-like growth factor-1 (IGF-1) participates in the regulation of the biological activity of cells.Researches showed that the serum IGF-1 level is significantly raised in the patients with Graves diseases.Thyroid associated ophthalmopathy (TAO) is one of Graves diseases,and orbital adipose cells are the target cells of thyroid autoantigens.However,whether IGF-1 is associated with TAO is still unclear.Objective This study was to investigate the expressions of IGF-1 in both circulating blood and orbital adipose tissue in TAO patients.Methods A retrospective cohort study was performed.Eighty-six TAO patients were enrolled in West China Hospital of Sichuan University from August 2009 to February 2014.According to the clinical activity score criteria(CAS) ,the patients were divided into active stage (CAS ≥ 4,35 patients) and inactive stage (CAS ＜4,51 patients).Eighty-six health adult persons were enrolled as the controls.The periphery blood of 3 ml was collected from each subject to detect the serum IGF-1 level by ELISA.Orbital adipose tissues were obtained during the surgery from 35 TAO patients and 35 patients with benign orbital tumor or orbital adipose prolapse from August 2009 to February 2014.The histopathological examination of orbital adipose tissue was carried out to evaluate the pathological characteristics, and the expression of IGF-1 in orbital adipose tissue was assessed by immunochemistry.This study protocol was approved by Ethic Committee of West China Hospital of Sichuan University, and informed consent was obtained from each subject before entering the cohort.Results The mean serum IGF-1 level was (0.862±0.026)ng/ml in the TAO patients,and that in the normal controls was (0.767 ± 0.480) ng/ml, without significant difference between them (P=0.281).The mean serum IGF-1 level was (0.877±0.355) ng/ml and (0.803±0.031) ng/ml in active stage and inactive stage of patients, respectively, and no significant difference was found between them (P =0.834).IGF-1 expression located in cellular membrane and cytoplasm.The expressing intensity of IGF-1 in orbital adipocytes was significantly enhanced in the TAO patients with the positive rate of 74.29% , and that in the controls was 45.46％ ,showing a statistical difference between the two groups (x2=5.289,P=0.021).Conclusions Serum IGF-1 level dose not rise in TAO patients, but the expression of IGF-1 in orbital adipocytes up-regulates, indicating that mature orbital adipocytes of TAO are regulated mainly by IGF-1.

This paper firstly discusses the concept and manifestation of subhealth state,and reveals that the subhealth state is a low constitutional one between morbid state and health state.The manifestations of subhealth state include two cases,namely symptoms without positive lab or instrument examination results and tiny positive lab or instrument examination results without symptoms.In the diagnosis of subhealth state,traditional Chinese medicine comes down the traditional four diagnostic methods of which tongue-inspection,pulse-taking and complexion-inspection are particularly significant,and mainly makes use of etiological syndrome differentiation and differentiation of syndromes by zang-fu viscera.Traditional Chinese medicine has multifarious and effective therapeutic methods in the treatment of subhealth state,including Chinese herbs as well as acupuncture,massage,leading of Qi,food treatment and Qigong.Adjustment of emotion,regard of living,moderate work and rest,reasonable diet are important in the auxiliary treatment of subhealth state.In the new era,we should actively utilize the advantages of traditional Chinese medicine in the diagnosis and therapy of subhealth so as to contribute more to the health of people.

29 virgin female Wistar rats were divided into experimental and control groupson the 5th day of pseudopregnancy.The experimental animals were injected with200 ?g.of LH-RH-A subcutaneously daily in 5th-8th day,while in the controlgroup physiological saline was used instead.Both experimental and control animalswere killed on 9th,11th,13th days of pseudopregnancy.Histochemical techniques were applied to cryostat sections to show the activityof the following enzymes:SDH,LDH,NE,~5△A-3?-HSD,G6Pase,TPPase,AlPand AcP;PAS,Oil red O,and gallocyanin-chromalum staining methods were usedto show carbohydrates,fats and RNA respectively.The above enzymatic reactions of the decidual cells of the experimental animalswere negative,while those of the stromal cells were positive on 9th day.Incomparison,the results of the decidua of the control group on 13th day are verysimilar to the decidua of the experimental group on the 9th day.The resultssuggest that a high dosage of LH-RH-A only advances degeneration of thedecidua.

On the basis of the bioluminescent detection technology of the lux gene being a kind of new and progressing environmental detection technology,in this paper,the constitution,function,expression and regulation of the lux gene were introduced,moreover,the recent advance of its application in the study of environmental detection was reviewed

Objective To discuss the treatment effect of doctor-nurse cooperation in multi-plane operation of obstructive sleep apnea hypopnea syndrome.Methods 73 patients with multi-planar surgery due to OSAHS were divided into the observation group (38 cases) and the control group(35 cases) in our department from January 2008 to December 2012.Health care was strengthened throughout the course of treatment in the observation group and traditional treatment and care were adopted in the control group.Short-term and long-term efficacy,intraoperative and postoperative complications were compared between two groups.Results The operation of short-term effective rate was 100％,and significant differences were found in the long-term efficacy between the two groups.There were significant differences in nasal bleeding during surgery,one-time intubation success rate and the significances were found in postoperative pain,extubation time,lung infection and soft palate regurgitation between two groups.Conclusions The implementation of the multi-plane surgery for patients with OSAHS can effectively improve the short-term efficacy of the patients throughout the course of treatment.Strengthening doctor-nurse cooperation effectively improve the patients' long-term efficacy,reducing the patients' intraoperative and postoperative complications.

Objective To observe the effect of Tongsaimai Tablets on the leptomeningeal collateral circulation established after acute cerebral infarction by TCD.Methods 50 patients with acute cerebral infarction were randomly divided into control group (received conventional treatment) and treatment group (received Tongsainai Tablets three times a day,1.75g each time,on the basis of conventional treatment).The leptomeningeal collateral circulation of the two groups were observed after 6 months.Results The factors which may affect the leptomeningeal collateral circulation,such as age,the prevalence of hypertension and hyperlipidemia,original compensatory status of cerebral artery between the two groups had no statistically significant differences.The open rate of leptomeningeal collateral circulation in the treatment group was 64.00％,which was significantly higher than that of the control group(32.00％)(P =0.024).Conclusion Tongsaimai Tablets can promote the formation of leptomeningeal collateral circulation in patients with acute cerebral infarction.

OBJECTIVE: To study the classification of common symptoms and the laws of syndrome element combination in 251 cases of stable angina pectoris (SAP) by using cluster analysis and corresponding-correlation analysis. METHODS: A total of 251 SAP cases were selected and their information from four diagnosis in traditional Chinese medicine was recorded. The classification of common symptom and the laws of syndrome element combination were investigated by cluster analysis and corresponding-correlation analysis. RESULTS: Twenty-five symptoms found in 251 SAP cases were divided into four types by cluster analysis: deficiency of heart qi, deficiency of spleen qi, deficiency of qi and yin, and phlegm accumulation and blood stasis. The deficiency of heart qi had the closest relation to phlegm accumulation and blood stasis. By corresponding-correlation analysis, the deficiency of qi had the closest relation to blood stasis, next was turbid phlegm and heat stagnation, and then deficiency of qi and deficiency of yin. CONCLUSION: Blood stasis due to deficient qi is the key factor in pathogenesis of SAP. Deficiency of qi plus blood stasis, deficiency of qi plus deficiency of yin, blood stasis plus turbid phlegm, deficiency of heart qi plus blood stasis plus turbid phlegm are common syndrome element combinations of SAP. It is proved that cluster analysis and corresponding-correlation analysis are the proper methods for studying laws of syndrome element combination.

ObjectiveTo study the way of famous TCM doctors to success in modern times. MethodsTotally 96 famous TCM doctors and 30 TCM masters (122 in total, and 4 overlapping) recorded in the book ofThe Way of Distinguished Veteran Doctors of TCM were set as samples in the study. Their learning life was employed as evidence, and the following information was analyzed and concluded:the provinces they come from, their approaches to success, the ages when they became useful, learning time before they became useful, the most influential books, whether they started with classical prescription.ResultsDistinguished veteran doctors of TCM mainly come from Jiangsu Province (21.31%) and Zhejiang Province (11.48%). Learning from other TCM maters (40.98%) and inheriting the family’s TCM knowledge (22.95%) were their main approaches to becoming useful. The learning years before they became useful were 10-15 years (32.81%) and 6-10 years (26.56%). They became useful mainly at the ages of 21-30 (57.58%). 65.98% (64/122) of them treatedTreatise on Febrile Diseases as the most influential book. ConclusionThe study will provide beneficial reference for talent cultivation of TCM colleges and universities.

Objective To observe the evolution process of cerebral blood flow spectrum in brain death by transcranial doppler ultrasound.Methods To detect the blood flow of bilateral middle cerebral artery in brain dead patients by transcranial doppler ultrasound.Results Twenty brain dead patients were collected in the study.The blood flow velocity of middle cerebral artery ranged s from 6 to 37cm/s,and the mean velocity was (12.13 ± 3.15)cm/s.There were three characteristic spectrums which include oscillatory wave (reverse wave in diastolic),nails wave (tip small wave in systolic),no blood flow sign,and they appeared in turn accoerding to worsen of the disease.The heartbeat irreversibly stopped within 8 days after the appearing of oscillatory wave,and ninty percent of the cases had the regular blood flow spectrums of oscillatory wave-nails wave-no blood flow sign.Conclusion The three regularly characteristic transcranial doppler ultrasound blood flow spectrums,which include oscillatory wave,nails wave and no blood flow sign could facilitate the diagnosis of brain death.