Objective To compare the clinical effects of 2 common installation positions of the helical blade in the treatment of senile intertrochanteric fractures with proximal femoral nail antirotation (PFNA).Methods From January 2010 to December 2012,166 old patients with intertrochanteric fracture were treated by PFNA.According to the installation position of the helical blade in the femoral head on the postoperative X-ray films,they were divided into a C/C group (87 cases) where the helical blade was at the center of the femoral head in both anteroposterior and lateral views and an I/C group (79 cases) where the helical blade was at the inferior one-third of the femoral head in anteroposterior view and at the center in lateral view.There were no significant differences between the 2 groups in general data preoperation (P ＞ 0.05).The 2 groups were compared in terms of reduction quality,tip-apex distance (TAD),full weight bearing time,fracture healing time,and Harris Hip Score(HHS) at the last follow-up.Results C/C group had 83 patients followed for an average of 13.6 months and I/C group had 76 patients followed for an average of 13.3 months.There were no significant differences between the 2 groups regarding the good-to-excellent reduction rate [94.0％ (78/83) versus 94.7％ (72/76)],full weight bearing time (9.4 ± 1.5 weeks versus 9.3 ± 1.3 weeks),fracture healing time (17.8 ±2.3 weeks versus 17.2 ±2.3 weeks),or HHS (89.6 ±4.6 points versus 89.3 ±4.7 points) (P ＞ 0.05).There was a significant difference in TAD (21.14 ± 3.17 mm versus 24.96 ± 3.48 mm) between the 2 groups(t =-7.242,P =0.000).No infection or cut-out or other related complications of the helical blade occurred in either group.Conclusion The helical blade may lead to satisfactory clinical effects in the treatment of senile intertrochanteric fractures with PFNA no matter at which of the 2 positions it is installed.

Objective To assess the value of embolization of intracranial aneurysms with GDC.Methods 17 patients with 18 intrtacranial aneurysms were treated with GDC.15 patients presented SAH with the following classifications of Hunt and Hess grading:grade Ⅰ and Ⅱ with 10 patients respectively,Ⅲ with 3,Ⅳ with 2.Results 13 patients had excellent clinical outcomes,and 3 patients suffered from transient parlysis after embolization,but recovered following medical treatment medical treatment and one patient died.Conclusion Endovascular treatment of intracranial aneurysms with GDC is a better alternative but a long-term follow-up is necessary.

To construct a recombinant adenovirus containing CDglyES fusion gene, which can directly inhibit human ovarian cancer cell and indirectly inhibit vascular endothelial cell growth. Methods:We constructed prAdCDglyES using a homolo-gous recombination method in bacteria. The prAdCDglyES was transfected to 293 packaging cells using liposome, in which rAdCDgly-ES was packaged and amplified. MTT was used to observe the proliferation inhibition effect of rAdCDglyES on human ovarian cancer cells and the growth inhibition effect of expressing products of rAdCDglyES on ECV-304. Results:The titer of rAdCDglyES was 1 × 1013.3 TCID50/L, whereas the inhibition rate on human ovarian cancer cell SKOV-3 was (83.1±6.3)%. This result is significantly different from the control rAd-LacZ, which had an inhibition rate of (24.1 ± 13.2)% (P<0.01). The concentrated culture supernatant from cells transfected with rAdCDglyES can inhibit ECV-304 cell proliferation at a rate of (78.7 ± 1.6)%. This rate is significantly different com-pared with that of the control with the same concentration of culture supernatant from cells transfected with rAd-CD, with an effect on ECV-304 cell shown by an inhibition rate of (23.9 ± 9.7)%(P<0.01). Conclusion:The results showed that the recombinant adenovirus rAdCDglyES could inhibit human ovarian cancer cells directly and indirectly.

Objective To explore the clinical characteristics of pancreas damage in children with Henoch-Sch(o)nlein purpura (HSP).Methods The clinical data of 206 HSP patients was analyzed from February 2008 to July 2013.The serum and urine example was detected by the automatic biochemical analyzer and the clinical characteristics of them was analyzed.The pancreatic morphology of patients was observed by type-B ultrasonic,and the clinical feature of skin,joints,digestive tract and kidney damage were observed.The relationship between pancreas damage and other systems damage was analyzed.Results There was 58 cases suffering from pancreas damage in 206 HSP children:31 cases were male,27 cases were female.There was no patients with pancreatic edema and deformation of structure in 58 patients.The incidence of pancreas damage with HSP combined with abdominalgia patients was 39.7％ (50/126),which was obviously higher than that in the patients without abdominalgia 10.0％ (8/80) (x2 =14.355,P ＜ 0.01).The incidence of pancreas damage in mixed type of HSP [31.8 ％ (55/173)] was significantly higher than that in simple type of HSP [9.1％ (3/33)] (x2 =18.292,P ＜ 0.01).The mean hospital stay of the HSP patients with pancreas damage was 6-38 (10.39± 6.80) d,while without pancreas damage was 4-18 (8.51 ± 3.42) d,and there was no significant difference (t =5.790,P ＞ 0.05).Conclusions The HSP children usually combine with pancreas damage.If they have abdominalgia and multi-system damage,they are more likely to be accompanied with pancreas damage,which should be paid more attention.

Adolescent ; Child ; Child, Preschool ; Female ; Humans ; Infant ; Longitudinal Studies ; Male ; Neoplasm Staging ; Neuroblastoma ; diagnosis ; pathology ; therapy ; Treatment Outcome

Objective To explore the related risk factors of central lymph node metastasis ( CLNM) of papillary thyroid microcarcinoma ( PTMC) and the application value of central lymph node dissection ( CLND) . Methods Totally 251 patients who were confirmed as PTMC by pathological biopsy were selected as the research object, and they were divided into the metastasis group (n=42) and the non-metastasis group (n=209) according to the status of lymph node metastasis. The general datum of the two groups were retrospectively analyzed, and the indexes with significant differences after univariate analysis were analyzed by non-conditional Logistic regression analysis. Treated the patients with lymph node metastasis through CLND, and the occurrence rate and recurrence rate of related complications were recorded during the 1 to 3 years of follow-up. Results The comparison of the location of the tumor, complicated adenoma, Hashimoto’ s thyroiditis, nodular goiter, and hyperthyroidism between the two groups was not statistically significant (P>0. 05). In the metastasis group, the rate of patients aged less than 45 years old and the percentage of male patients were both significantly higher than the non-metastasis group, and the difference was of statistical significance (P<0. 05). There were 25 cases (59. 5%) whose tumor diameter were 5~10 mm, 12 cases (28. 6%) with multiple lesions, and 22 cases (52. 4%) breaking through the envelope in the metastasis group, which were significantly higher than 70 cases (33. 5%), 23 cases (11. 0%) and 67 cases (32. 1%) in the non-metastasis group, and the differences were statistically significant (P<0. 05). In the metastasis group after operation, there was 1 cases (2. 3%) of hoarseness, 6 cases (14. 3%) of local numbness, 1 case (2. 3%) of nerve invasion, and 2 cases (4. 8%) of vascular invasion, and there was no choking cough report. During the period of 1 to 3 years of follow-up, there were only 2 cases of recurrence and the recurrence rate was 4. 8%. Conclusion Central lymph node metastasis mostly occurs in the male patients with PTMC who are less than 45 years old. And the main characteristics are diameter of tumor over 5 mm, multifocal lesions, with envelope penetration symptom and so on. In clinic, patients who meet the above-mentioned condition should be taken as the primary concern and given related prevention measures to reduce the occurrence risk of central lymph node metastasis. To treat patients with papillary thyroid microcarcinoma through central lymph node dissection can receive good curative effect and effectively improve the prog-nosis quality, and it is worthy of clinical promotion.

[Objective]To investigate the therapy of human enbryonic olfactory ensheathing cells(hOECs) transplantation on adult rats' transected spinal cord.[Method]Separated,cultured hOECS from abortus were obtained and percent age of P75 positive cells was calculated.Twenty-four Wistar rats were choosen and divided into experimental group and control group randomly.All rats of two goups were transected at the T_(10) segment of spinal cord.Nine to ten days later 5 ul(2.5?10~5) hOECs(labled by Hoechst 33342) were injected in the contusion area of lesion site in transplantation group.In control group same volume of DMEM-F12 were transplanted.1,2,4,6,8 and 10 weeks later all rats were estimated by system of the BBB locomotion score respectively.Then part of them were killed.The tissue section of spinal cords were separated and inspected by fluorescence microscope or the methods of immunohistochemical staining.Data were processed with statistical tools in double-blinded condition.[Result]Transplanted hOECs can survive for at least ten weeks and even migrated from the injuried area in spinal cord.From 4 weeks to 10 weeks the BBB locomotion scores of experimental group were improved significantly contrasting to that of control group(P

Objective:To explore the efficacy and safety of Certolizumab pegol in patients with rheumatoid arthritis. Methods:Such databases as Pubmed, Medline, Embase, The Cochrane Library, WANFANG, CNKI, Science, CBM and VIP were searched from their establishment to March 2015 for collecting the randomized controlled trials comparing Certolizumab pegol and placebo in the treatment of RA. The meta-analysis was undertaken using RevMan5. 3 for Windows. Results:Ten publications and eight researches met the inclusion criteria with high quality. The results revealed CZP significantly improved the ACR20,ACR50,ACR70 response rates,and physical function. CZP was associated with a statistically significant reduction in Disease Activity Score in 28 joints-Erythrocyte sedimentation rate, arthritis pain, and fatigue. There were no significant differences of incidence of treatment-related adverse events between CZP group and placebo group. Conclusion:CZP significantly reduced the RA signs and symptoms,improved physical function and life quality as compared with the placebo in the treatment of RA. More large-scale RCTs are needed to evaluate the long-term efficacy and safety of CZP in the treatment of RA.

Objective To investigate the clinical effect of salmon calcitonin in the treatment of senile osteoporosis , and to observe the effect of salmon calcitonin on bone mineral density ( BMD ) and pain.Methods 180 cases of patients diagnosed as osteoporosis from September 2015 to September 2016 in our hospital were retrospectively analyzed, the patients were divided into control group and treatment group according to the random number table method.The clinical efficacy and side effects of the two groups were evaluated.The bone mineral density (BMD) of the lumbar vertebrae, femur and radius were measured by dual energy X-ray absorptiometry.The VAS was used to evaluate the two groups before and after the treatment.( ODI) were used to evaluate the functional status of the patients before and after treatment.The self-made questionnaire was used to evaluate the quality of life of the patients before and after treatment.Results The total effective rate of treatment group was 94.44%, significantly higher than the control group 75.56%(P<0.05).After treatment, the treatment group of lumbar spine bone mineral density, bone mineral density and radial bone mineral density was significantly higher than the control group (P<0.05).After treatment, spontaneous low back pain, flexion extension pain, turn over pain and weight pain were significantly lower in the treatment group than in the control group (P<0.05).The ODI index of the treatment group was significantly lower than that of the control group (P<0.05).After treatment, the quality of life scores in the two groups were significantly higher than those before treatment, and the treatment group was higher than the control group(P<0.05).No significant adverse reactions occurred in two groups during the treatment.Conclusion Salmon calcitonin treatment of osteoporosis in elderly patients with a significant effect, help to improve bone mineral density, reduce pain and improve its dysfunction, and has high security.

Objectives To review the experience of surgical treatment of univentricule.Methods 26 patients with univentricule underwent surgical treatment were retrospectively analyzed. There were 17 cases of total cavopulmonary connection, 8 cases of bi-directional Glenn shunt and one case of pulmonary artery banding.Results Followed-up for 6～30 monthes(mean 11 months) showed 4 early postoperative death,there was mortality of 15 4%,no advanced death.Conclusions The result of this study suggests that surgical outcome is related to the selection of proper surgical indicators,perioperative management and complete correction of cardiac deformity.