Objective To retrospectively analyze the results of treatment with Asian proximal femoral nail anti rotation intramedullary nail (PFNA Ⅱ) in senile patients with unstable intertrochanteric femoral fractures. Methods 1 06 cases of unstable intertrochanteric femoral fracture with internal fixation of PFNAⅡ were analyzed retrospectively,and the treatment effect was observed.Results 1 06 cases were followed -up(mean 1 3.5 months, ranged 1 0 -22 months).Bone union occurred in all cases,average fracture healing time was 3.8 months.The average operation time was 48 minutes,the average volume of blood loss was 1 06mL.The hip functions were analyzed using Harrison score.And found 80 excellent cases,1 4 good cases,1 2 fair cases,with 88.7% of excellent and good rate. Conclusion For the senile patients of unstable intertrochanteric femoral fractures,PFNAⅡ has the biomechanical advantages of intramedullary fixation,small trauma,short operation time,reliable internal fixation,early functional exercise,low incidence of complications,significant functional recovery,and is a preferred treatment option.

Objective To study the prevalence and associated factors of loneliness in individuals with speech disability.Methods Using multi-stage stratified random cluster sampling method,170 community-residing ver-bally disabled persons were selected and administered with a general information questionnaire,one single -item loneliness self-rating question and social support scale.A total of 204 study questionnaires were distributed to the subjects;170 subjects(mean age:43.1±13.7 years)completed the survey.Results As high as 46.47% (79/170)of these verbally disabled individuals reported to feel lonely often.Females (OR=2.45),unemployment (OR=2.95), first and second degrees of disability (OR=4.35),co-existence of chronic illnesses (OR=6.50)and low utiliza-tion of social support (OR=2.58)were significantly associated with the increased risk of loneliness in persons with speech disability (P =0.002~0.046).Conclusion Loneliness is highly prevalent in individuals with speech disabili-ty.Verbally disabled persons,who are female,unemployed,severely disabled,and chronically ill and have a low use of social support,are the target population of mental health services.

Objective:To study factors influencing postoperative pancreatic fistula rates with a view to prevent postoperation pancreatic fistula from happening.Methods:This is a retrospective study on 281 patients who underwent distal pancreatectomy at the First Affiliated Hospital of China Medical University from March 2011 to April 2018. There were 89 males and 192 females, with the age of (51.01±13.65) years. Univariate and multivariate logistic regression analyses were used to analyze the following factors on the occurrence of pancreatic fistula after operation: gender, age, body mass index(BMI), tumor characteristics, preoperative fasting blood glucose, blood biochemistry, liver function and surgical indications.Results:Of the 281 patients who underwent distal pancreatectomy in this study, 245 (87.2%) did not develop pancreatic fistula / biochemical leakage, while 36(12.8%) patients developed clinically significant pancreatic fistula (B/C grade). Univariate analysis showed the factors which affected the incidence of pancreatic fistula after surgery to include: BMI, preoperative fasting blood glucose, and whether the main pancreatic duct was ligated (all P<0.05). Multivariate logistic regression analysis showed that the independent factors affecting pancreatic fistula incidence after surgery were BMI≥25 kg/m 2 ( OR=2.354, 95% CI: 1.137-4.873, P<0.05), and main pancreatic duct was not ligated ( OR=4.067, 95% CI: 1.191-13.885, P<0.05). Conclusions:A high BMI increased the risk of postoperative pancreatic fistula, while ligation of main pancreatic duct during surgery reduced the risk.

Objective To establish a patient-derived xenografts (PDX) mouse model of liver cancer (LC) and to explore its role in precision medicine.Methods PDX model was established by subcutaneous implantation of tumor tissues in NCG mice.The morphological structure of tumor tissue was exaimed using HE staining.Fifteen BALB/c nude mice were subcutaneously inoculated with tumor cell suspension from the PDX models.The xenograft mice were randomly divided into 5-fluorouracil (5-FU) group, sorafenib group and negative control group.The tumor volume and body weight of the tumor-bearing mice were measured regularly, the tumor inhibition rate was calculated and the curative effect was evaluated.Results The success rate was 33.3% (6/18) in the establishment of liver cancer PDX mouse model, and the model well retained the characteristics of the primary tumor.In one case of PDX mouse model, the tumor inhibition rates of 5-FU and sorafenib group were 63.7% and 29.6%, with a statistically significant differece between them (P< 0.05), and there was no significant difference between the sorafenib group and negative control group, consistent with clinical observation.Conclusions The PDX mouse model of liver cancer can maintain the histological structure of primary tumor, and can be applied to precision medicine for patients with liver cancer.

Objective:To study the impact of anticoagulant therapy starting at different platelet levels on the incidences of portal vein thrombosis (PVT) after splenectomy and devascularization.Methods:From January 2014 to January 2017, 125 patients with liver cirrhosis and portal hypertension underwent splenectomy and pericardial devascularization in Beijing Ditan Hospital, Capital Medical University. All patients routinely received anticoagulant therapy. There were 85 patients who had a platelet count greater than >100×10 9/L (the study group) and 40 patients who had a platelet count greater than >300×10 9/L (the control group). The incidence of PVT was compared between the two groups. Results:A total of 125 patients were included in the study, including 91 males and 34 females, aged 20-59 years. Age, gender, preoperative platelet level, preoperative splenic vein and portal vein width, preoperative coagulation function, preoperative liver function (Child classification), preoperative esophageal and gastric varices, operation time, preoperative bleeding time, preoperative venous blood flow velocity, coagulation function 1 week and 2 weeks after operation between the two groups were not significantly different (all P>0.05). Of 125 patients undergoing splenectomy and pericardial devascularization, PVT was not found in all patients before operation. The incidence of PVT was 39.2% (49/125) within one month after operation. Among the 85 patients in the study group, 28 patients developed PVT, and the incidence of thrombosis was 32.9% (28/85). In the control group, 21 patients developed PVT, and the thrombosis rate was 52.5% (21/40). The difference was significant (χ 2=4.366, P=0.037). After anticoagulant therapy, the incidence of bleeding in the study group was 4.7% (4/85), and that in the control group was 5.0% (2/40), the difference was no significant ( P>0.05). Conclusion:Early anticoagulation (platelet >100×10 9/L) does not increase the risk of postoperative bleeding, but can reduce the incidence of PVT.

Objective:To investigate the anti-fatigue phenomenon induced by forced swimming in the mice,and to explore the anti-fatigue effect of argininyl fructoyl glucose (AFG) from red ginseng in the mice and its mechanism.Methods:The AFG was extracted from red ginseng.The ICR mice were divided into blank control group,low dose of AFG group (100 mg · kg-1),middle dose of AFG group (200 mg · kg-1) and high dose of AFG group (400 mg · kg-1) (n=20).The mice mere given a forced swimming test after continuous gavage for 28 d.The weights,organ indexes,time of forced swimming,contents of lactic acid (LD),blood urea nitrogen (BUN),hepatic glycogen (Gly) and expressing levels of PGC-1α in gastrocnemius of the mice in various groups were detected.Results:Compared with blank control group,the weights and organ indexes of the mice in low,middle and high doses of AFG groups had no significant differences (P＞ 0.05).Compared with blank control group,the time of forced swimming,contents of Gly and expressing levels of PGC-1α of the mice in low,middle and high doses of AFG groups were significantly increased (P＜0.05 or P＜0.01) in a dose-dependent manner.Compared with blank control group,The contents of LD and BUN in serum of the mice in low,middle and high doses of AFG groups were significantly decreased (P＜0.01).Conclusion:AFG has anti-fatigue effect in mice,and its mechanism may be related to energy metabolism.

Objective:To explore the classification and treatment strategy of femoral neck fracture combined with ipsilateral intertrochanteric fracture.Methods:A retrospective analysis was performed of the 44 patients who had been admitted to Department of Orthopedics, Liangxiang Teaching Hospital, Capital Medical University from March 2003 to March 2019 for femoral neck fracture combined with ipsilateral intertrochanteric fracture. They were 19 males and 25 females, aged from 37 to 93 years (average, 77.9 years). According to the anatomical location and displacement severity, the femoral neck fractures were divided into 3 types while the intertrochanteric fractures were classified as stable or unstable ones. There were 3 cases of type Ⅰ which were completely extracapsular ones, 31 cases of type Ⅱ which were intracapsular stable ones, and 10 cases of type Ⅲ which were intracapsular unstable ones. Types Ⅰ and Ⅱ fractures were treated with intramedullary fixation, and type Ⅲ fractures with cemented hip hemi-replacement+reduction and fixation of the intertrochanteric fracture with Kirschner wires and steel cables. Recorded were fracture healing time, function of the affected hip and complications.Results:The 44 patients were followed up for at least 2 years. The fracture healing time for the 3 patients with type I fracture averaged 5.6 months (from 4.4 to 6.8 months); their hip function at the last follow-up, evaluated by the Harris scoring system, was excellent in 2 cases and good in one case. For 30 of the 31 patients with type Ⅱ fracture, the fracture healing time averaged 7.2 months (from 5.1 to 9.3 months); their hip function at the last follow-up, evaluated by the Harris scoring system, was excellent in 18 cases, good in 6 cases, fair in 5 cases, and poor in 2 cases, giving an excellent and good rate of 77.4% (24/31). As for complications, withdrawal or cutting-out of the head screw happened in 6 cases, infection in one case and nonunion in one case. In 10 patients with type Ⅲ fracture, the hip function at the last follow-up was excellent in 7 cases, good in 2 cases and poor in one case.Conclusions:For type Ⅰ and type Ⅱ femoral neck fractures combined with ipsilateral intertrochanteric fracture, intramedullary fixation with angulation stability may be a proper choice. For type Ⅲ ones, hip joint replacement should be the first choice.