BACKGROUND:Less Invasive Stabilization System (LISS) has been shown to hold the same biomechanical strength to proximal femoral nail anti-rotation.OBEJCTIVE:To investigate the safety and effectiveness of the reversed LISS plates for senile femoral intertrochanteric fractures.METHODS:Thirty elderly patients with femoral intertrochanteric fractures were treated with reversed LISS plates.The operation time,incision length and total blood loss (intraoperative plus volume of drainage 1 day postoperative) were recorded.Physiologic and Operative Severity Score for the Enumeration of Mortality and Morbidity (POSSUM) and modified POSSUM scoring systems were used to predict the incidence of complications and mortality,and then the real incidence of complication and mortality was compared to evaluate the safety of reversed LISS plates.The clinical effectiveness was evaluated by fracture healing time and Harris scores at the last follow-up.RESULTS AND CONCLUSION:(1) The incidence of complications showed significant difference between predicted (46.05％) and real (13.3％) results (P=0.05),but the mortality did not differ significantly between predicted (3.93％) and real (0％) results (P=1).(2) The fracture healing time was 21-32 weeks,and the excellent and good rate in Harris scores at the last follow-up was 83.3％.(3) These results indicate that the reversed LISS plates are easy to operate,safe and obtain good efficacy in the treatment of senile femoral intertrochanteric fractures.

Objective:To investigate the influential factors of mental health in rural high-school students by structural equation modeling.Methods:447 rural high-school students were tested by Mental Health test,Adolescent Self-rating Life Events Check list,Social Support Scale and Trait Coping Style questionnaire,then theoretical model were established and confirmed for the relationships of life events,social support,coping styles and mental health of rural high-school students.Results:The structural equation modeling fitted the data very well(?2/df=3.56,GFI=0.940,AGFI=0.902,NFI= 0.913,CFI=0.901,RMSEA=0.048),the theoretical model suppose was supported by the use of structural equation modeling.Conclusion:Social supports and coping styles have direct influence on mental health of rural high-school students.Life events have indirect influence on mental health through social supports and coping styles.

ObjectiveTo evaluate the intraoperative neuromonitoring of the external branch of the superior laryngeal nerve (EBSLN) during Micooli's endoscopic thyroidectomy in order to avoid nerve injury.MethodsIn this study,36 patients with 56 nerves at risk were enrolled from February 2011 to September 2011.A positive signal is determined by observing contractions of the cricothyroid muscle to locate the EBSLN.The relationship between EBSLN and the upper pole of the thyroid or the inferior constrictor muscle was studied.The VHI-10 table was used for evaluation pre- and postoperatively. ResultsAll 56 nerves were located successfully,26 nerves(46.4％ ) crossed the superior thyroid artery more than 1 cm apart from the upper pole of the thyroid gland,while the other 30 nerves(53.6％ ) did less than 1 cm.In cases where the diameter was longer than 5 cm,the nerves crossed the artery at less than 1.0 cm from the upper pole in 73％ cases(P =0.006).There was no significant difference between VHI-10 results before and after surgery (P ＞ 0.05). ConclusionsIntraoperative neuromonitoring is useful and helpful in avoiding nerve injury by locating EBSLN.

ObjectiveTo investigate the affection of Shujinxi external granule on the knee joints function after meniscus suture.Methods60 patients who undertook meniscus suture were randomly recruited into two groups,30 cases in each group.The control group accepted conventional rehabilitation training,while the treatment group received Shujinxi external granule on the basis of the conventional rehabilitation training.Both groups were treated for two weeks for a therapeutic course,and statistics analysis was made after 3～4therapeutic courses.ResultsThe average postoperative knee activity after 8 weeks and 12 weeks was [ (114.1 ±18.6)° and [(129.6±10.3)° ],in thetreatment group,comparing to [(89.7±t2.5 )° and (112.7±16.6)° ]in the control group,the difference was statistically significant (P＜0.05).the IKDC score and the Lysholm score of treatment group after 12 weeks was [(84.76±5.21) and (92.54±3.22)],while the control group was [(79.63±4.67) and (85.61±4.92)],the difference was significant (P＜0.05).ConclusionShujinxi external granule can promote the recovery of knee joints function after the operation of meniscus suture.

Objective: To establish an animal model for research of maxillary protraction. Methods: 16 pubertal rabbits were assigned randomly to 2 groups. Titanium bone markers were fixed on each side of mucogingival junction, 1 cm above incisor teeth. The experimental group underwent maxillary protraction by self-made distraction devices. A down and forward elastic force (about 3.43 N) was exerted for 30 days. Results: In 30 d, the distance of premaxilla movement in the experimental group was 1.89 mm averagely, while that in the control group was only 0.11 mm. Cephalometric analysis indicated that the maxilla of rabbits was moved forward obviously by appliance in the experimental group, and maxilla was not rotated. There was no obvious difference between the control and the experimental groups. Conclusion: Animal model used in this experiment for maxillary protraction is reliable. The appliance can move the rabbits maxilla forward obviously during the maxillary protraction.

Objective:To investigate the feasibility and safety of fetal intravascular transfusion via the intrahepatic vein in the treatment of fetal anemia.Methods:This was a retrospective analysis of all fetuses requiring intrauterine transfusion (IUT) in the Shanghai First Maternity and Infant Hospital between January 2010 and December 2019. According to the different ways of IUT, they were divided into intrahepatic venous transfusion group and umbilical venous transfusion group, fetal outcomes and the incidence of procedure-related complications between the two groups were compared.Results:A total of 97 IUTs were performed on 48 fetuses. Among them, 16 cases were performed in the intrahepatic vein (31 transfusions), 32 cases were performed in the cord of the umbilical vein (66 transfusions).There were no significant differences between the two groups in age, labor history and the proportion of fetal hydrops before the first transfusion. In the intrahepatic venous transfusion group, the posterior placenta was 14/16, which was significantly higher than 78% (25/32) in the umbilical venous transfusion group ( P<0.01). The live-birth rates of the two groups were 13/16 and 75% (24/32). There was no significant difference between the two groups ( P>0.05). Before intrahepatic venous transfusion, the proportion of fetal hydrops was significantly higher than that of umbilical venous transfusion [55% (17/31) vs 24% (16/66), P<0.05]. Puncture success rate of intrahepatic venous transfusion and umbilical venous transfusion were both 100%. In the umbilical venous transfasion group, the incidence of needle slippage (5%, 3/66) and the abnormality of fetal heart rate (11%, 7/66) were higher than those in the intrahepatic venous transfasion group [0 and 3% (1/31)], but there were no significant differences between the two groups (all P>0.05). There were no cases of fetal loss within 24 hours, premature rupture of membranes, infection within 7 days and emergency cesarean section after IUT in both groups. Conclusions:Fetal intravascular transfusion via the intrahepatic vein is safe and feasible in the treatment of fetal anemia. But the requirements of puncture technique are relatively high, so it is recommended to be carried out in experienced fetal treatment center.

Aim: To construct a prokaryotic expression vector carrying NuBCP-9-tumstatin(74-98) (abbreviated as NT) gene and to obtain the fusion peptide with antitumor activity. Methods: Nucleotide sequences of antitumor peptides, NuBCP-9 and Tumstatin( 74-98), were connected via a linker(G_4S)_3 based on biased codons of E. coli the fused NT gene was reconstructed using SOE PCR, and inserted into pET32a(+) vector, and transformed in E. coli BL21(DE3). After expression, the novel fusion peptide was purified through nickel-affinity chromatogra-phy, Factor Xa digestion and ultrafiltration. Biological activity of the fusion peptide on ECV304 and A549 cells was evaluated by MTT assay. Results: A prokaryotic expression system with NT gene was successfully constructed. The soluble fusion peptide was accounted for approximately 25% when induced by 0. 5 mmol/L IPTG at 30 ℃ for 4 h. The purified fusion peptide could inhibit cell growth of ECV304 and A549 with inhibition rates of 60. 8% and 65. 2% at 20 μmol/L, respectively. Conclusion: A novel fusion peptide with antitumor activity was cloned, expressed and purified.

To lay a foundation for the type selection of the ambulance helicopter. The type selection was explored from the aspects of platform selection, rescue environment and service requirements, analyzing the rescue in the helicopter and the tendency of the ambulance helicopter in foreign countries and China. The types of the am-bulance helicopter were determined as the specific and modified ambulances, with the considerations such as operation environment, flight performance, cabin structure, onboard equipment, cabin configuration, fixation device and protection. Specific ambulance helicopter is supposed to be based on small- or mediate-sized platform, while the modi-fied ambulance helicopter is supposed to be based on large or heavy platform.

Objective To observe the therapeutically effect of kangnao liquid on Pi3k mRNA and Aktm RNA ex-pressions in rats with focal cerebral ischemia-reperfusion (I/R) injury. Methods 180 male SD rats were randomly divided into 6 groups:sham operated group, model group, three kangnao liquid groups (high-dose, medium-dose and low-dose) and nimodipine group. Rats in kangnao liquid groups were administrated with kangnao liquid of 24 g/(kg · d), 12 g/(kg · d) and 6 g/(kg · d), orally once a day. Rats in nimodipine group were given nimodipine 1 mg/(kg · d). Rats in model group and sham group were treated with the same volume of distilled water for 7 days. The animal model of middle cerebral artery occlusion (MCAO) was established by a monofilament method from right internal carotid artery. The neurological evaluation was per-formed 24 h after reperfusion. The in situ hybridization was used to investigate the expression levels of Pi3k mRNA and Akt mRNA in rats on 12 h, 24 h, 48 h, 72 h and 168 h after ischemia for 2 h. Results Compared with model group, neurological functions were improved significantly in kangnao liquid groups. The expression levels of Pi3k mRNA and Akt mRNA were al-so significantly higher in kangnao liquid groups than those of model group. The expression levels of Pi3k mRNA and Akt mRNA were significantly higher in nimodipine group than those of model group, but which were lower compared with those of high-dose and medium-dose kangnao liquid groups. Conclusion Kangnao liquid can protect nerve cells by enhancing the expressions of Pi3k mRNA and Akt mRNA in rats with cerebral ischemia-reprefusion injury.

Objective To explore whether PERK is involved in the regulation of arsenite-induced autophagy.Methods Human hepatoma cells HepG2 were cultured and treated with arsenite.The expression level of autophagic hallmarks and the activation status of PERK were detected by Western blotting.The transactivation of p53 and the induction of its downstream target genes expression were also detected by Western blotting after knockdown of PERK expression.Transactivity of p53 was detected by dual luciferase reporter assay after knockdown of PERK expression.Results An increase in the LC3BII:I ratio,the induction of Beclin-1 expression and the degradation of p62 were readily observed in arsenite-treated HepG2 cells,but the effects were abolished after knockdown of PERK expression.Furthermore,phosphorylation of p53 at Ser15 and Ser392,transactivation of p53 and the induction of its downstream target gene DAPK1 expression were effectively inhibited under the same PERK knockdown conditions.Conclusion PERK regulates arsenite-induced autophagy by activating p53-dependent DAPK1 upregulation.