[Objective]To study the pertinency of position of the lesser trochanter and lateral shaft of femur for internal fixation of fracture of the lesser trochanter.[Method]One hundred and twenty thigh bones were taken X-ray films on normotopia and lateral position,anatomical observation and measurement of the the lesser trochanter were completed with angel and length relative to lateral shaft of femur.[Result]Vertical axis length of the lesser trochanter was 26.38?2.44 mm and transverse diameter was 15.61?1.49mm.Its retroverted angle was 17.66??10.56?and uptilted angle was 26.33??3.33?.[Conclusion]The appropriate position in fixation of the fracture of the lesser trochanter is the point on the besctor of the lateral cortex of the femur on level of the lower of the lesser trochanter.Its retroverted angle is 10?-15?and uptilted angle is 25?-30?.The length of the screw is 45-50 mm,it is beneficial to design the plate in femur with the data.

Objective To explore the possibility of polymethyl methacrylate (PMMA) bone cement as the carrier for lipophilic drugs through in vitro cytotoxicity study and molecular modeling with PMMA and 17-allylamino-17-demethoxy-geldanamycin (17-AAG) loaded PMMA bone cement.Methods The 17-AAG loaded bone cement was made by mixing method.In vitro antitumor activity with MTT assay for PMMA,17-AAG,the 24 h and 48 h released solution of 17-AAG loaded PMMA bone cement were evaluated.Through Material Studio 5.0,the interaction between 17-AAG and PMMA through the model of Amorphous Cell and energy optimization of Forcite was explored.Results The inhibition ratio of MMA for tumor cells is 9.21％±0.06％ with 50 μmol/L.The 24 h released solution of 17-AAG loaded PMMA bone cement (17-AAG∶ PMMA=1∶ 4 000) inhibits the tumor cells 66.15％±0.43％ which has a quick released influence on 17-AAG.The inhibition of 24 h released solution of 17-AAG-loaded PMMA bone cement (17-AAG∶PMMA=1 ∶ 1 000,1∶2 000) shows no significance compared with PMMA released solution (P＜0.05).The 48 h released solution of 17-AAG-PMMA (17-AAG∶ PMMA=1∶ 1 000,1∶2 000,1∶4 000) inhibits U26630.25％±4.47％,30.24％±3.42％,50.52％±5.20％,with a significant difference with PMMA.The molecular model showed that the interaction between 17-AAG and PMMA was van der Waalz bonds,which drove 17-AAG inside or on the surface of PMMA bone cement.Conclusion PMMA bone cement can be used as a carrier for lipophilic drugs.It has antitumor activity and influences the release of 17-AAG with different ratio,for example it has a sustained-released influence on 17-AAG in 17-AAG-PMMA (17-AAG∶PMMA=1 ∶ 1 000,1∶2 000).Molecular model implies that 17-AAG exists inside or on the surface the PMMA bone cement through van der Waalz bonds.

OBJECTIVE:To provide reference for standardized management of skin test of cephalosporin injection in our hos-pital. METHODS:In retrospective analysis,skin test of 8 kinds of cephalosporin [cefotaxime(1.0 g),cefotaxime(0.5 g),cefoti-am (1.0 g),cefotiam (0.5 g),ceftazidime (0.5 g),cefminox (0.5 g),cefminox (1.0 g),ceftriaxone (1.0 g)] and the cost of skin test, related cost of allergic reaction induced by cephalosporin injection were analyzed statistically during Sept. 1st, 2015-Aug. 31th,2016. The cost of skin test of cephalosporin injection was compared with allergic reaction cost reduced by skin test. RESULTS:The positive rate of 100330 patients who used above 8 kinds of cephalosporin injections was 6.27%;the rate of skin test was 82.49%;the direct cost of skin test was 3434411.72 yuan;the indirect cost was 141985.12 yuan;the cost of pa-tient was 3162901.44 yuan;the cost of medical insurance was 259096.28 yuan;the cost of the whole society was 3576396.84 yuan. From the perspective of the whole society,the cost of skin test of cephalosporin injections was(447049.61±247395.07)yuan, and allergic reaction cost reduced by skin test was (316075.48 ± 260600.49)yuan. The cost of skin test was significantly higher than allergic reaction cost reduced by skin test,with statistical significance(P<0.05). CONCLUSIONS:Skin test of cephalosporin injection is low in positive rate,has high expense. The government standardizes the management of skin test of cephalosporin injec-tion and reduces the economic burden of patients under the premise of ensuring the safety of drug use.

Objective To establish a qualitative and quantitative determination of glyphosate in serum using ultraviolet spectro-photometry(UV) to provide basis for clinical diagnosing and treating glyphosate poisoning .Methods The mixture of 0 .5 mL serum and 0 .2 mL 10% methanol solution of perchloric acid was shocked and centrifuged with 10 000 r/min for 5 min .A nitrosyla-tion reaction conducted on supernatant and 50 μL serum nitrosylation liquid was detected by UV scanning .Results The results of serum theophylline absorption maxima was(243 ± l) nm and the concentration of 10 .0-60 .0 μg/mL range linear regression equa-tion was Y=0 .0173 8X+0 .036 3(r= 0 .999 8) .The recovery rate was from 85 .5% to 102 .4% and the relative standard deviation (RSD) was from 3 .50% to 4 .90% .The intra-day and inter-day RSD were 3 .79% -5 .10% and 3 .88% -4 .55% .The minimum de-tectable concentration was 5μg/mL .Conclusion This method is simple ,rapid and accurate results for detecting glyphosate poison-ing .

Objective To investigate the selection of operative method and peri operative managements for osteoporotic femoral intertrochanteric fracture in elderly patients aged over 75 years.Methods A total of 132 consecutive patients aged 75-91 years with osteoporotic intertrochanteric fractures from July 2009 to July 2012 were retrospectively analyzed.47 patients were treated with dynamic hip screw (DHS group),44 patients with proximal femoral nail anti-rotation (PFNA group) and 41 patients with Gamma Ⅲ nail (Gamma Ⅲ group).The peri-operative managements,operation circumstance,the time for fracture union,postoperative complications and the degree of functional recovery were analyzed and compared between the 3 groups.Results The mean surgical time was shorter in Gamma Ⅲ nail and PFNA groups than in DHS group [(68.7±9.1) min,(80.5±11.3) min vs (112.2±18.4) min,both P＜0.01].The mean blood loss was less in the Gamma Ⅲ nail and PFNA groups than in DHS group[(156.9±18.5) ml,(183.4±21.3) ml vs (296.2±29.6) ml,both P＜0.01].The mean time for fracture healing was shorter in Gamma [Ⅲ nail and PFNA groups than inDHSgroup [(12.6±2.4) weeks,(13.1±2.4) weeks vs (15.3±3.2) weeks,both P＜ 0.05],and it has no obvious difference between Gamma Ⅲ nail and PFNA groups (P＞0.05).There were significant differences in postoperative complications between Gamma Ⅲ nail,PFNA groups and DHS group (2 cases,3 cases vv 11 cases,P＜0.05,respectively).The mean Harris hip score had no significantly difference among DHS,Gamma Ⅲ nail and PFNA groups (87.4±11.6,90.2±13.0 vs 88.9±12.3,both P＞0.05).Conclusions The 3 operative methods for stable intertrochanteric fracture are feasible and effective in elderly patients,but for unstable intertrochanteric fractures,the treatment with Gamma Ⅲ nail and PFNA has advantages.

Objective To study the effect of tissue plasminogen activator (t-PA) on p57NTR ,inflammatory reaction ,immune regulation and oxidative stress and its effect on intimal hyperplasia .Methods The vascular injury treatment was performed in the diabetic rabbit model with carotid arterial adventitia stripping ,meanwhile t-PA controlled release microspheres were given ,the nerve distribution in the local blood vessels was observed by immunohistochemical staining .The change of nerve remodeling in the control group and treatment group was observed ,meanwhile the effect of giving t-PA controlled release microspheres on the release of ace-tylcholine and norepinephrine was detected .RT-PCR was used to detect local vascular tissue inflammation ,immune effects and oxi-dative stress .The sympathetic neurons and smooth muscle cell co-culture was adopted ,then giving glyoxal treatment as the athero-sclerosis cell model .With the t-PA treatment group as the intervention group ,the effect of t-PA on the number of cholinergic neu-ron ,and synaptic connections between the smooth muscle cells and acetylcholine secretion was observed .The change of t-PA-MMP-p75NTR and NF-kappa B signaling pathway were detected by RT-PCR .Results The vascular injury treatment was performed in the diabetic rabbit model with carotid arterial adventitia stripping ,meanwhile t-PA controlled release microspheres were given ,the nerve distribution in the local blood vessels was observed by immunohistochemical staining .The change of nerve remodeling in the control group and treatment group was observed ,meanwhile the effect of giving t-PA controlled release microspheres on the release of acetylcholine and norepinephrine was detected .RT-PCR was used to detect local vascular tissue inflammation ,immune effects and oxidative stress .The sympathetic neurons and smooth muscle cell co-culture was adopted ,then giving glyoxal treatment as the ath-erosclerosis cell model .With the t-PA treatment group as the intervention group ,the effect of t-PA on the number of cholinergic neuron ,and synaptic connections between the smooth muscle cells and acetylcholine secretion was observed .The change of t-PA-MMP-p75NTR and NF-kappa B signaling pathway were detected by RT-PCR .Conclusion t-PA activates MMPs and feedback in-hibits p75NTR-NF-kappa B signaling pathway to increase vascular adventitia autonomic nerve reconstruction and delay the occur-rence and development of atherosclerosis disease .

Periodontal pathogens are the main pathogenic factor of periodontitis. Periodontal pathogens have a large variety of virulence factors such as lipopolysaccharide, fimbriae and proteases, which enables the pathogens to infect periodontal tissues and stimulate the secretion of inflammatory cytokines, causing chronic systemic inflammation. Periodontal pathogens may invade multiple systems such as the circulatory system, immune system, respiratory system and digestive system to cause systematic diseases. Recent studies have shown that periodontal pathogens may have close relations with systemic diseases such as cardiovascular disease, diabetes, rheumatoid arthritis, and cancer. Among the periodontal pathogens, can be found in atherosclerotic plaques to impairing the function of the vascular endothelium; may also increase the level of inflammatory factors such as TNF-α to promote insulin resistance and diabetes. Many of the periodontal pathogens such as , and can be detected in the synovial fluid of rheumatoid arthritis patients, suggesting their involvement in the pathogenesis of rheumatoid arthritis. may cause alterations in the intestinal microbiome in mice and promote the occurrence of intestinal tumors. Herein we review the recent progresses in the relationship between periodontal pathogens and systemic diseases.
Aggregatibacter actinomycetemcomitans ; Animals ; Fusobacterium nucleatum ; Humans ; Insulin Resistance ; Periodontitis ; Porphyromonas gingivalis ; Prevotella intermedia

BACKGROUND:Diabetic foot patients with wound infections constitute a large patient population,and there is currently no satisfactory treatment approach. OBJECTIVE:To investigate the clinical efficacy of a modified tibial cortex transverse transport combined with antibiotic-loaded bone cement for treating refractory diabetic foot ulcers. METHODS:A total of 46 diabetic foot ulcers patients,27 males and 19 females,with an average age of 64.37 years,were selected from Beijing Chaoyang Hospital,Capital Medical University and Beijing Chaoyang Integrative Medicine Rescue and First Aid Hospital from January 2020 to January 2023.All of them underwent the modified tibial cortex transverse transport combined with antibiotic-loaded bone cement treatment.Ankle-brachial index,WIFi(Wound/Ischemia/Foot infection)classification,pain visual analog scale score,and ulcer area were recorded before and 3 months after surgery. RESULTS AND CONCLUSION:(1)The mean ulcer healing time for the 46 patients was(58.07±24.82)days.At 3 months postoperatively,there were significant improvements in ankle-brachial index,pain visual analog scale score,ulcer area,and WIFi classification in 46 patients,as compared to the preoperative values,with statistically significant differences(P<0.05).Two patients experienced pin-tract infections,without infection or ulcer recurrence during the follow-up period.(2)These findings indicate that the modified tibial cortex transverse transport combined with antibiotic-loaded bone cement effectively alleviates patients'pain,improves lower limb circulation,controls infections,and promotes ulcer healing.

Objective:To analyze the risk factors of radiation-based sarcopenia in patients with multiple myeloma (MM).Methods:A total of 185 clinical and imaging data of patients with MM admitted to Beijing Chaoyang Hospital from September 2009 to October 2019 were retrospectively analyzed. The area of the erector spinae muscle and the area of fatty infiltration (FI) in the fascial compartment were measured by Image-pro Ρlus software, and the area of the fat-free erector spinae muscle and the fat infiltration rate (FI%) were calculated. Sarcopenia was defined as an erector spinae area of less than 3 197 mm 2 in males and 2 895 mm 2 in females. The differences in gender, age, body mass index, disease duration, hemoglobin, leukocytes, platelets, albumin, serum calcium, lactate dehydrogenase, serum creatinine, alkaline phosphatase, M-protein, serum β 2-microglobulin, bortezomib chemotherapy, receipt of stem cell transplantation, osteopathy, stage, recurrence and progression of MM between the sarcopenia group and the normal muscle group were compared. Binary logistic regression was used to analyze the independent risk factors of sarcopenia in MM patients. Kaplan-Meier curves were drawn to compare the survival rates between the two groups. Results:53.0% (98/185) of MM patients were complicated with sarcopenia: there were 30 males, whose fat-free erector spinae area was 25.0±6.0 cm 2, the FI of erector spinae was 12.0±4.8 cm 2, and the FI% was 31.5%±12.0%, while there were 68 females, whose fat-free erector spinae area was 22.7±4.2 cm 2, the FI of erector spinae was 10.7±4.1 cm 2, and the FI% was 30.2%±9.8%. 47.0% (87/185) of MM patients had normal muscle mass: there were 62 males, whose fat-free erector spinae area was 40.6±6.5 cm 2, the FI of erector spinae was 9.3±4.8 cm 2, and the FI% was 17.9%±7.4%, while there were 25 females, whose fat-free erector spinae area was 33.6±5.1 cm 2, the FI of erector spinae was 9.9±3.0 cm 2, and the FI% was 21.9%±5.7%. There were statistically significant differences in the gender composition ratio (χ 2=30.47, P<0.001), hemoglobin ( t=-2.73, P=0.007), serum creatinine ( Z=-2.26, P=0.024), receipt of stem cell transplantation (χ 2=4.32, P=0.038), and MM recurrence and progression (χ 2=3.85, P=0.050) between the two groups. However, there were no significant differences in age, body mass index, course of disease, leukocytes, platelets, albumin, alkaline phosphatase, lactate dehydrogenase, serum calcium, M-protein, serum β 2-microglobulin, bortezomib chemotherapy, osteopathy or MM stage ( P>0.05). Binary logistic regression analysis showed that female was an independent risk factor for sarcopenia in MM patients. The survival rates at 2, 3, 4, and 5 years were 87.9%, 71.8%, 64.4%, and 53.7% in the sarcopenia group, and 92.1%, 75.8%, 66.8%, and 66.8% in the normal muscle group, respectively, with no statistically significant differences ( HR=0.71, P=0.364). Conclusion:The incidence of radiation-based sarcopenia in MM patients is 53.0%. Low hemoglobin and blood creatinine levels, not receiving stem cell transplantation, and recurrence or progression of MM are associated with sarcopenia in MM patients, and female is an independent risk factor for sarcopenia in MM patients.

Objective To assess the effectiveness of enhanced tibial transverse transport(TTT)in con-junction with vacuum-assisted closure(VAC)therapy for managing recalcitrant diabetic foot ulcers.Methods A retrospective analysis was conducted on data from diabetic foot patients with Wagner grade≥2 who were treated at Beijing Chaoyang Hospital and Beijing Chaoyang Hospital of Integrated Traditional Chinese and Western Medicine between July 2020 and December 2022.The patients were categorized into three groups based on their treatment regimen:VSD treatment(VSD group),modified TTT treatment(TTT group),and combined application of TTT and VSD(combined group).A one-year follow-up was performed to assess general data,ulcer area before and three months after surgery,ankle brachial index,visual analog pain score,as well as adverse events within one year post-surgery among the three groups.Results The VSD group consisted of 43 patients,while the TTT group consisted of 43 patients,and the combined group consisted of 42 patients.There were no statistically significant differences in baseline characteristics among the three groups(P＞0.05).Patients in the VSD group had longer ulcer healing time,higher pain scores,lower ankle brachial index(P＜0.05),larger ulcer area(P=0.029),and higher one-year ulcer recurrence rate compared to those in the TTT group.On the other hand,patients in the combined group had shorter ulcer healing time compared to those in the TTT group(P=0.046).However,there were no significant differences observed between these two groups regarding ulcer area(P=0.362),pain scores(P=0.932),ankle brachial index(P=0.671),and one-year ulcer recurrence rate(P=0.710).Conclusions The efficacy of modified TTT surpasses that of VSD in promoting ulcer healing,alleviating pain,and enhancing lower limb circulation.Furthermore,the combination of VSD with modified TTT demonstrates a potential to further expedite wound healing time.