Objective To explore the clinical results of minimally invasive therapy for femoral intertrochanteric fractures with proximal femoral nail anti-rotation(PFNA) in 25 elderly patients.Methods A total of 25 patients with intertrochanteric fractures were treated by PFNA in our hospital from February 2007 to June 2008.The patients received close reduction and minimal invasive operation.Based upon the Tronzo-Evans classification,type Ⅰ fractures were diagnosed in 2 cases,type Ⅱ fractures in 2 cases,type Ⅲ in 16,and type Ⅳ in 5.Results The mean operation time in this series was 50.3 min(30-70 min),an the mean intraoperative blood loss was 100.2 ml(70-200 ml).All the 25 patients completed a follow-up of 3 to 12 months(average time 7.1 months),during which all the fractures healed in 10 to 14 weeks with a mean of 11 weeks,without occurrence of varus deformity,hardware loosening or hardware cutting.According to the Harris Hip Score,20 cases achieved excellent results,4 were good,and 1 was fair. Conclusions It is a reliable and ideal method to treat intertrochanteric fractures with PFNA in elderly patients,for the procedure is convenient and minimally invasive,resulting in firm fixation,less blood loss,short operation time,and high healing rate.

Objective: To evaluate the efficacy of postoperative radiotherapy in the treatment of parotid gland carcinoma. Methods: Eighty-six postoperated patients with parotid gland carcinoma( 7 in stage Ⅰ, 28 in stage Ⅱ, 33 in stage Ⅲ and 18 in stage Ⅳ) were radiated by 60Co ?-ray or linear accelerator X-ray combined with electron beam. All patients were diagnosed by pathology and followed up for more than 5 years. Results: The five year survival rate and the local control rate were 73.3% and 87.2% respectively. Poor prognosis was observed in the cases with the neoplastic classification of undifferentiated carcinoma, sequamous cell carcinoma and malignant pleomorphic adenoma, but the better prognosis was obtained in the cases with acinic cell carcinoma and mucoepidermoid carcinoma. Poor prognosis was observed in the cases with stage Ⅲ and Ⅳ of clinical stage. Radiotherapy undertaken in 2 weeks after surgical operation gave higher 5- year survival ratio( 83.8%). The group given 51～60 Gy radiation showed 82.9% of five- year survival rate. Conclusion: The combination of surgery with radiation is effective in the treatment of parotid gland carcinoma.Radiation of 51～60 Gy 2 weeks after operation may result in better prognosis. Neoplastic type and clinical stage are important factors for prognosis.

Objective Primary renal mucosa associated lymphoid tissue lymphoma (MALT lymphoma)is very rare,here dis-cuss the clinical pathological characteristics and diagnosis,differential diagnosis of primary renal MALT lymphoma.Methods A case of primary renal MALT lymphoma was assayed for clinical and histopathological morphology,an well as immuno-histochemical staining,then reviewed the relevant literature.Results The clinical and imaging characteristics of renal lym-phoma lack of specific performance,the tissue section of the kidney biopsy showed diffuse infiltration of small lymphocytes. The small lymphocytes were centrocytes-like,monocytes-like,and plasma cell differentiation was recognized.Lymphoepithe-lial lesions were scattered.Follicular implanted phenomenon could been seen.Immunohistochemically result:the tumor cells were positive for CD20,PAX-5,CD79αand MUM-1,but negative for CD3,CD5,CD45RO,bcl-2,CD10,bcl-6 and CyclinD1. CD2 1 showed damage FDC network,positive for Kappa,negative for lambda,and it showed monoclonal phenotype,the Ki-6 7 index was about 35%.Final pathology diagnosis was primary renal MALT lymphoma.Conclusion Primary renal MALT lymphoma is very rare,the clinical manifestations and imaging characteristic of renal lymphoma are non-specific and misdiag-nosis frequently occurs in clinical practice,definite diagnosis depends on pathological examination,immunohistochemical stai-ning is helpful to differential diagnosis.

Objective To explore CT and HRCT manifestations of Swyer-James syndrome(SJS).Methods CT and HRCT were performed in 19 patients,3 of them underwent inspiratory and expiratory HRCT,1 patient surgically proved with bronchiolitis obliterans and bronchiectasis.Results CT demonstrated 37 lobes were involved appearing as hyperlucent and with decreased vascularity ,the volume of lobes decreased in 35(95%) ; CT showed 19 patients with brochiectasis , 2 patients with pulmonary tuberculosis , 6 patients with brochiolitis , and 3 with segmental atelectasis.Conclusion CT and HRCT are very useful for the diagnosis of SJS.

Objective To explore the distribution of specific allergens for children in Sichuan Province and provide the evidences of clinical diagnosis and treatment.Methods Totally 451 cases in West China Second University Hospital,from April to August of 2016,were detected for 20 kinds of allergen-specific immunoglobulin E (IgE) by a new reverse enzyme-allergosorbent test,SPSS 18.0 statistical analysis was used to evaluate allergen-specific IgE levels in different groups of age,gender and diverse population distribution of disease.Results A total of 282 cases among 451 subjects were detected as IgE positive and the positive rate was 62.53%,among which 248 cases were positive for inhaled allergen-specific IgE,and the positive rate was 54.99%.There were 261 positive cases in food allergen-specific IgE,and the positive rate was 57.87%.For inhaled allergens,the highest positive rate was dermatophagoides pteronyssinus (n=111,24.61%),then dermatophagoides farina (n=110,24.39%),and house dust (n=108,23.95%);For food allergens,the highest positive rate was milk (n=159,35.25%),then egg (n=111,24.61%),and house dust (n=108,23.95%).Conclusions Both Inhaled allergens and food allergens were the important cause of allergic disease for children in Sichuan area.Serum allergen specific IgE determination was helpful to understand the patient′s allergy status,and diagnose the allergic disease.

OBJECTIVE:To systematically review the efficacy and safety of Calf spleen extract injection combined with chemo-therapy in the treatment of cancer,and provide evidence-based reference for clinical treatment. METHODS:Retrieved from Co-chrane Library,PubMed,Medline,EMBase,CJFD,Wanfang and VIP Database,randomized controlled trials(RCT)of the effica-cy and safety about Calf spleen extract injection combined with chemotherapy in the treatment of cancer were collected. Meta-analy-sis was performed by using Rev Man 5.0 software after data extract and quality evaluation by Cochrane 5.0. RESULTS:Totally 23 RCT were enrolled,including 1 682 patients. Results of Meta-analysis showed Calf spleen extract injection combined with chemo-therapy in the treatment of cancer can significantly improve the effective rate [OR=2.17,95%CI(1.68,2.81),P<0.001] and im-provement rate of life quality [OR=4.26,95%CI(2.47,7.32),P<0.001] and also reduce the degree rate of WBC and PLT,the inci-dence rate of nausea and emesis,the differences were statistically significant. CONCLUSIONS:Calf spleen extraction injection combined with chemotherapy has good efficacy and safety in the treatment of cancer.

Objective:To explore the roles of the caudal ventrolateral medulla(CVLM) in the central anti-hypertensive mechanism. Methods : In 20 urethane-anesthetized SD rats, the effects of I1-imidazoline receptor and ?2-adrenceptor antagonists (microinjection into the CVLM) on the cardiovascular responses induced by intravenous clonidine were observed. Results: Prior bilateral microinjection of mixed antagonist idazoxan (I1-imidazoline receptor and a2-adrenceptor) into the CVLM not only decreased the mean arterial pressure [(-17. 3 ? 6. 9) mmHg, 1 mmHg = 0. 133 kPa, P

Objective : To examine the association between dietary patterns during pregnancy and gestational diabetes mellitus (GDM), so as to provide the evidence for guiding the establishment of healthy and balanced dietary patterns and reducing the prevalence of GDM. Methods: Pregnant women who underwent oral glucose tolerance tests in Hangzhou Obstetrics and Gynecological Hospital from 2020 to 2021 were enrolled, and their demographic information were collected using questionnaires. Pregnant women's diets during the past three months were collected using Food Frequency Questionnaires (FFQs), and dietary patterns were extracted using principal component analysis. In addition, the association between dietary patterns and risk of GDM was examined using a multivariable logistic regression model. Results: A total of 1 689 pregnant women were included, with a median age of 28.53 (interquartile range, 2.47) years and a median gestational age of 26.00 (interquartile range, 2.00) weeks. Five dietary patterns were identified according to pregnant women's types of diets, including meat-based diets, dessert-fruit-refined grain diets, plant-based diets, eggs-milk-nut diets and whole-grain diets, with a cumulative contribution rate of 58.76%. The prevalence of GDM was 24.57% (415 cases) among the study subjects. Multivariable logistic regression analysis showed that pregnant women with scores in the highest quartile (Q4) of the meat-based diets had an increased risk of GDM (OR=1.372, 95%CI: 1.043-2.055) relative to those with scores in the lowest quartile (Q1), and pregnant women with Q4 scores of the dessert-fruit-refined grain diets had an increased risk of GDM (OR=1.743, 95%CI: 1.397-2.432) relative to those with Q1 scores, while pregnant women with Q4 scores of the plant-based diets had a reduced risk of GDM (OR=0.382, 95%CI: 0.346-0.613) relative to those with Q1 scores. Conclusion A plant-based dietary pattern may reduce the risk of GDM, while meat-based and dessert-fruit-refined grain dietary patterns may increase the risk of GDM.

Objective To explore the vascular endothelial function in individuals with normal glucose tolerance (NGT),impaired glucose tolerance (IGT),and type 2 diabetes mellitus,and to study the role played by PPARγcoactivator 1 α (PGC-1 α) in diabetic macrovascular function.Methods A total of 94 subjects with NGT,87with IGT,and 306 with type 2 diabetes mellitus were recruited in the study.Carotid flow-mediated vasodilatation (FMD),glyceryl trinitrate dilatation (GTN),and carotid intima-media thickness (CIMT) were assessed by highresolution B-mode color vascular Doppler instrument.Finally,correlation analysis was conducted.NO,Akt-Ser473phosphorylation levels,IL-β,and PGC-1 α mRNA expression levels were measured by means of nitrate reductase,western blot,and reverse transcriptase real-time fluorescence quantitative PCR assay methods in peripheral blood mononuclear cells respectively.Results FMD in newly-diagnosed type 2 diabetic group was significantly lower than that in NGT and IGT groups(P＜0.01).GTN and CIMT showed no difference.PGC-1 α mRNA transcription level in diabetic group was significantly lower than that in non-diabetic groups (P＜0.01).Correlation analysis showed that PGC-1 α was positively correlated with FMD and GTN (P＜0.05 or P＜0.01).Logistic regression analysis revealed that PGC-1 α was independently associated with FMD (P ＜ 0.01) after adjusting other influencing factors.Conclusion FMD is a more sensitive early warning indicator of endothelial function than CIMT and GTN.As indices of atherosclerosis,CIMT and GTN are more or less focused on the progression of macrovascular complications.PGC-1 α is a protective factor of macro-vasculature in diabetes mellitus,and its effect may be achieved through the protection of the vascular endothelium.

Objective To investigate the effects of protocadherin 20 (PCDH20) in the spinal cord in the development of bone cancer pain (BCP) in rats.Methods Thirty-six SPF female Sprague-Dawley rats,weighing 180-200 g,were randomly divided into 4 groups (n =9 each):sham operation group (group S),BCP group,lentivirus control group (group LC) and PCDH20 siRNA lentivirus group (group P).Control lentivirus and lentivirus containing PCDH20 siRNA 4 μl were injected into the ipsilateral spinal cord in groups LC and P,respectively.One week later,BCP was induced by injection of Walker 256 breast cancer cells into the upper segment of bone marrow of right tibia.The mechanical paw withdrawal threshold (MWT) was measured at 1 day before injection of lentivirus (T1),1 day before BCP (T2),and 7,14 and 21 days after BCP (T3-5).Three rats in each group were sacrificed after measurement of the MWT at 21 day after BCP and the tibia on the operated side was obtained for examination of invasion of the cancer cells with light microscope.The spinal cord was removed for determination of the expression of PCDH20 and postsynaptic density 95 (PSD95) protein (by Western blot) and mRNA (by RTPCR).Results In groups BCP,LC and P,the cancer cells grew out of the bone and destroyed the cortical bone seriously.Compared with group S,the MWT was significantly decreased at T3-5 in groups BCP,LC and P,the expression of PCDH20 and PSD95 protein and mRNA was up-regulated in groups BCP and LC,and the expression of PCDH20 was up-regulated in group P (P ＜ 0.05).Compared with BCP group,no significant change was found in the MWT and expression of PCDH20 and PSD95 protein and mRNA in group LC (P ＞ 0.05),and the MWT was significantly increased at T4,5 and the expression of PCDH20 and PSD95 protein and mRNA was down-regulated in group P (P ＜ 0.05).Conclusion PCDH20 is involved in the development of BCP through regulating the expression of PSD95 in the spinal cord and adjusting the function of excitatory synapse in rats.