Objective To investigate the outcomes of the treatments for the patients with Vancouver type B 1 periprosthetic femur fractures.Methods Seventeen patients with periprosthetic femoral fractures (5 males and 12 females;average age,70.4 years,range from 37 to 86 years) who underwent revision arthroplasty or open reduction and internal fixation between December 2006 and June 2016 were retrospectively reviewed.Periprosthetic femoral fractures occurred at the mean time of 65.1 months after arthroplasty.Twelve patients underwent open reduction and internal fixation and five cases underwent total hip or stem revision with Solution from Depuy,Wagner from Zimmer,Echelon from Smith & Nephew or Secur-Fit Max from Stryker due to primary bone loss,acetabular component wear or long-time prosthesis use respectively.Data were collected at 1,3,6 and 12 months and then each year postoperatively.All patients were followed up,and the results of X-ray,postoperative Harris hip score,stability of prosthesis and complications were also evaluated.Results A total of 5 patients underwent revision arthroplasty,and 12 patients underwent open reduction and internal fixation.The mean follow-up duration was 56 months (range from 7 to 120 months).Total blood loss in the open reduction and internal fixation group and in revision group was 385± 129 ml and 531± 113 ml respectively.The operation duration in the open reduction and internal fixation group was 72±36 min while it was 126±48 min in the revision group.The postoperative Harris hip score in the open reduction and internal fixation group was significantly increased compared with preoperative Harris hip score (68.8±18.4 vs.46.2±9.6),as well as in the revision group (75.0±8.9 vs.57.4±13.0).For the incidence of complications,in the open reduction and internal fixation group,one patient suffer with delayed fracture union,one patient complained about persistent pain and one suffered a secondary fracture,while in the revision group one suffered from blood loss and one with long-term pain.Conclusion Open reduction and internal fixation is an optimal intervention for Vancouver B 1 fracture,and revision arthroplasty can be considered as a safe alternative in patients with primary bone loss,implant of short survival time,severe liner wear or long-term prosthesis use.

Objective To evaluate the prevalence and risk factors of human papillomaviruses (HPV)infection among human immunodeficiency virus(HIV)-positive women.Methods Totally 178HIV-positive and 122 HIV-negative women were enrolled.Structured interviews,peripheral CD4 + T cells counts and cervical specimens were obtained.Polymerase chain reaction(PCR)assay was used to identify HPV types. SPSS 16.0 was used for statistical analysis,and logistic regression was used to identify independent prognostic factors for high-risk HPV infection. Results HPV positive rate,high-risk and multiple HPV infection rates were 38.2% vs.12.3% ,35.4% vs.8.2% ,and 13.5% vs.3.3% in HIVpositive women and HIV-negative women,respectively,and the differences were of statistical significance (x2 =24.77,29.08 and 8.91,P ＜0.05).The common types of high-risk HPV were similar between HIV-positive and HIV-negative women(HPV16,52,58 and 18).CD4 + T count ＜ 350/pL,HIV-positive in husband,and HIV infection through sexual contact were risk factors for high-risk HPV infection in HIV-positive women.Conclusion sThe prevalence of HPV infection in HIV-infected women is high,especially for high-risk HPV infection and multiple infection.High-risk HPV infection usually occurs in HIV-positive women with low immune status,HIV infection through sexual contact and HIV-positive husband.

BackgroundRetinal pigment epithelial(RPE) cells can secrete platelet-derived growth factor (PDGF) and PDGF receptor(PDGFR).Studies have shown that PDGF plays a key role in the formation of proliferative vitreous retinopathy(PVR). ObjectiveThis study was to investigate the proliferation and apoptosis changes of RPE after blockage of the PDGFR-α expression by antisense oligonucleotide ( ASODN ) in vitro. Methods Human RPE cells strain was cultured in low glucose DMEM with 10％ fetal bovine serum.Logarithmic phase cells were collected and incubated in 96-well plate at the density of 5 × 105 cells/hole.PDGFR-α ASODN was transfected into RPE cells at different concentrations for 48 hours.The cells of the blank control group were regularly cultured without any transfection.The changes of PDGFR-α expression were detected by reverse transcription-polymerase chain reaction(RT-PCR),and the proliferation of RPE was detected by MTT as the A490 value.Hoechst 33258 fluorescence staining was used to determine the apoptosis of RPE.Flow cytometry method (FCM) was applied to detect the change of cell cycle and apoptosis rate of RPE cells. ResultsThe A490 values of RPE cells were 1.45±0.12,1.07±0.06,0.65±0.05 in blank control group,1.0 μmol/L Lipo-ASODN group and 2.0 μmol/L Lipo-ASODN group with the significant difference(P=0.00 ),and that of 1.0 μmol/L Lipo-ASODN group and 2.0 μ mol/L Lipo-ASODN group were significantly lower than the blank control group ( P =0.00,0.00).Hoechst 33258 staining showed that the apoptosis cells were obviously more in Lipo-ASODN group compared with blank control group.PDGFR-α ASODN transfection induced an increase of percentage of RPE cells in G0/G1 phase( F =206.70,P =0.00),and the apoptosis rates in 1.0 μmol/L Lipo-ASODN group and 2.0 μmol/L Lipo-ASODN group were significantly enhanced in comparison with blank control group ( 37.8 ± 1.3 vs 10.5 ± 0.1,61.2 ± 1.9 vs 10.5 ± 0.1 ) ( F =1808.90,P =0.00 ).Expression intensity of PDGFR-α mRNA in RPE cells in Lipo-ASODN groups was lower. ConclusionsBlocking the PDGFR-α expression with ASODN technology can suppress proliferation and induce apoptosis of RPE cells.Intensity of PDGFR-α mRNA expression in RPE cells is ASODN dose-dependent.ASODN targeted to PDGFR-α offers an experimental basis of the gene therapy for PVR.

Objective To investigate the effect of insulin and gliclazide therapy on endoplasmic reticulum (ER) stress and insulin sensitivity in the liver of type 2 diabetic rats.Methods A high fat diet plus a low-dose of streptozotocin was implemented to create a type 2 diabetic rats which were randomly divided into diabetes mellitus (DM) group,insulin treatment (INS) group and gliclazide treatment (GT)group; and healthy rats were as normal control group.Diabetic rats in INS and GT groups were given neutral protamine hagedorn (NPH) insulin and gliclazide respectively for 3 weeks.Protein expression levels of immunoglobulin binding protein (Bip),spliced X-box binding protein 1 (XBP-ls),phosphorylated c-Jun on serine 73 (p-c-Jun),phosphorylated insulin receptor substrate 1 on serine 307 (p-IRS-1),and glucose-6-phosphatase (G6Pase) in liver homogenate were detected by Western blotting.Results Compared with the normal rats,Bip and XBP-Is in the DM group were up-regulated (0.28 ±0.07 vs 0.90 ±0.10 for Bip;0.41 ± 0.07 vs 0.95 ±0.07 for XBP-1 s; both P ＜ 0.01 ) ; p-c-Jun (0.59 ± 0.18 vs 1.94 ± 0.03 ),p-IRS-1( 1.73 ± 0.18 vs 5.32 ± 0.22) and G6Pase (0.11 ± 0.01 vs 0.45 ± 0.01 ) were increased ( all P values ＜0.01 ).In the INS group,all of aforementioned changes were reversed (0.90 ± 0.10 vs 0.25 ± 0.04 for Bip; 0.95 ±0.07 vs 0.47 ±0.01 for XBP-1s; 1.94 ± 0.03 vs 0.50 ±0.10 for p-c-Jun; 5.32 ± 0.22 vs 1.59 ±0.32 for p-IRS-1 ; 0.45 ±0.01 vs 0.15 ±0.02 for G6Pase,all P values ＜0.01 ).In the GT group,all of aforementioned changes were also attenuated ( 0.90 ± 0.10 vs 0.53 ± 00.02 for Bip ; 0.95 ± 0.07 vs 0.78±0.02 for XBP-1s; 1.94 ±0.03 vs 1.33 ±0.11 for p-c-Jun; 5.32 ±0.22 vs 3.13 ±0.02 for p-IRS-1; 0.45 ± 0.01 vs 0.25 ± 0.01 for G6Pase,all P values ＜ 0.05).Furthermore,all of aforementioned protein levels were down-regulated more obviously in the INS group comparing to the GT group ( all P values ＜ 0.01 ).Conclusions Both insulin and gliclazide therapy could relieve ER stress and e-Jun N-terminal kinase activity and improved insulin sensitivity.The effect of insulin on Bip,XBP-1s,p-c-Jun,p-IRS-1 and G6Pase protein expressions is more obvious than that of glilcazide,which indicates besides lowering glucose,insulin might have protective effects of anti-inflammation,anti-oxidative stress or stimulation of lipid redistribution.

Objective To investigate the antibacterial effect of grape peel residue procyanidins on common clinical bacteria ,inclu‐ding E .coli ,Pseudomonas aeruginosa ,Acinetobacter baumannii ,Enterococcus and methicillin‐resistant Staphylococcus aureus (M R‐SA) .Methods By the means of agar plate method ,we detected the minimum inhibitory concentration (MIC) of 30 strains of E .co‐li ,28 strains of Pseudomonas aeruginosa ,15 strains of Acinetobacter baumannii ,32 strains of Feces Enterococcus ,25 strains of E . faecalis and 70 strains of MRSA ,then calculate the MIC50 and MIC90 .The result was analyzed with SPSS software 16 .0 .Results The concentration of procyanidins at 3 -8 mg/mL had no inhibitory effect on E .coli ,Pseudomonas aeruginosa and Acinetobacter baumannii;there was no inhibitory effect on E .faecalis at 3-8 mg/mL ,but the inhibition rate to Feces Enterococcus was 6 .3% .By measuring the inhibitory effect of procyanidins on 70 MRSA ,the inhibition rate at 4 mg/mL was 65 .7% ,at 8 mg/mL was 95 .7% , MIC50 was 4 .221 mg/mL and MIC90 was 6 .260 mg/mL .Conclusion There are no inhibitory effects of grape peel residue procya‐nidins on Gram‐negative bacilli such as E .coli ,Pseudomonas aeruginosa ,Acinetobacter baumannii ,and there are certain inhibitory effects on Gram‐positive bacteria such as MRSA ,enterococci ,especially on MRSA (P<0 .05) .

ABSTRACT:Objective To establish a rapid molecular method for the detection of aldehyde dehydrogenase-2 (ALDH2)and investigate the gene polymorphisms of ALDH2?2 and determine whether the polymorphic ALDH2 gene is associated with drinking behavior in a Chinese population.Methods The gene polymorphisms of ALDH2?2 were detected using pyrosequencing,TaqMan Real-time PCR and GeneChip microarray technologies;genotyping of 302 volunteers was performed to assess their genetic associations with alcohol use behavior.Results We developed pyrosequencing,TaqMan Real-time PCR and GeneChip microarray methods to identify ALDH2? 2 polymorphisms.The allele frequency of ALDH2?2 was 20.36% in the Chinese population:16.33% in the alcoholic group and 27.83% in non-drinkers (P=0.001).In contrast,the genotype frequency of heterozygous ALDH2?1/?2 plus homozygous ALDH2?2/?2 was 45.28% in non-drinkers and 32.65% in the alcoholics group (P=0.030). Allele frequency of ALDH2 genotypes differed significantly between our Chinese sample and other ethnic groups in Asia,and it was significantly higher than that in European and American countries.Conclusion The developed pyrosequencing,TaqMan Real-time PCR and GeneChip microarray methods are rapid,accurate,high-throughput, convenient,and reliable for detecting ALDH2 polymorphisms.ALDH2?2 gene can protect against the development of alcoholism.The allele frequency of ALDH2 in this Chinese population differs from that in other ethnic groups.

Objective:To explore the traits of functional connectivity of resting-state networks in patients of schizophrenia with auditory verbal hallucinations (AVH) by using independent component analysis (ICA).Methods:All patients were met the Diagnostic and Statistical Mannal of Mental Disorders,Fourth Edition,Text Revision (DSM-IV-TR) diagnostic criteria for schizophrenia.Thirty schizophrenia patients with frequent AVH (AVH),24 schizophrenia patients without AVH (non-AVH) and 60 healthy controls (HC) matching with age and gender were analyzed by resting functional magnetic resonance imaging.The AVH were assessed by using Hoffman auditory hallucination scale.By using ICA,auditory network (AUN),language network (LAN),salience network (SAN),right front-parietal network (RFP) and default mode network (DMN) were selected as interesting networks for further analyses.Covariance analysis was used to compare the activity and functional connectivity of multiple resting state networks between three groups,and correlation analysis was used to evaluate the relations between abnormalities of brain and the severity of hallucination.Results:Compared to non-AVH,AVH group showed increased activity in left superior temporal gyrus (STG) and left postcentral gyrus (LPG) in the AUN,and showed decreased activity in right anterior cingulate cortex (ACC) in the SAN (P ＜ 0.05,FDR corrected).The severity of AVH group was associated with activity of the left STG (r =0.43,P ＜0.05) and the right ACC (r =-0.48,P ＜0.01).Furthermore,compared to non-AVH group,there were decreased connectivity between LAN and AUN [(-0.29 ±0.21) vs.(-0.16 ± 0.17),P ＜ 0.05,uncorrected],decreased connectivity between SAN and LAN [(-0.09 ± 0.22) vs.(-0.06 ± 0.18),P ＜ 0.05,uncorrected],increased connectivity between SAN and AUN [(0.30 ± 0.18) vs.(0.15 ± 0.24),P ＜ 0.05,uncorrected] in AVH group.Conclusion:There may be aberrant functional connectivities of AUN,LAN and SAN in schizophrenia patients with frequent AVH,and the occurrence of AVH seems to be related to brain areas involved in language production,speech perception and self-monitoring.

ObjectiveTo assess the effects of rehmannia and storesin on minimal hepatic encephalopathy(MHE) in rat model.MethodsMHE rat model was induced by carbon tetrachloride (CCl4) intragastric administration. The effects of rehmannia and storesin on spontaneous movement and learning and memory function of model animals were evaluated with open field test and Morris water maze in 3 dose groups. Lactulose was used in the positive group.ResultsThe spontaneous movement and the spatial learning and memory ability of the model rats both improved significantly in the high dose group. Meanwhile, the serum level of alanine transarninase(ALT) and ammonia(Amm) also decreased in the high dose group.ConclusionRehmannia and storesin has therapeutical effect on MHE rat model.

OBJECTIVETo observe the efficacy and the adverse effects of erlotinib in the treatment for advanced non-small cell lung cancer (NSCLC) in Chinese patients.

METHODSFrom November 2005 to March 2009, a total of 519 patients with unresectable, local advanced, relapsed or metastatic NSCLC were enrolled in the trial. All the patients were treated with erlotinib 150 mg/day until disease progression or intolerable toxicity or for other reasons. The response rate, time to disease progression, overall survival and toxicity were analyzed.

RESULTSOf these 519 patients, 1 case had complete response, 127 cases had partial response and 263 cases had stable disease, resulting in an overall response rate (CR + PR) of 26.7%, disease stable rate of 54.9% and disease control rate (CR + PR + SD) of 81.6%. The median time to progression was 6.44 months and median overall survival was 15.37 months. The major erlotinib treatment-related adverse events (AE) were mild (CTC AE 1/2), only 3 cases had severe adverse effect, 1 case had interstitial lung disease and died of respiratory failure.

CONCLUSIONThe study presents excellent response rates, time to progression and overall survival of erlotinib treatment for advanced NSCLC in Chinese patients, and its adverse events are tolerable.

Asian Continental Ancestry Group ; Carcinoma, Non-Small-Cell Lung ; drug therapy ; pathology ; Diarrhea ; chemically induced ; Disease Progression ; Erlotinib Hydrochloride ; Exanthema ; chemically induced ; Female ; Follow-Up Studies ; Humans ; Lung Diseases, Interstitial ; chemically induced ; Lung Neoplasms ; drug therapy ; pathology ; Male ; Middle Aged ; Neoplasm Staging ; Protein Kinase Inhibitors ; adverse effects ; therapeutic use ; Quinazolines ; adverse effects ; therapeutic use ; Receptor, Epidermal Growth Factor ; adverse effects ; antagonists & inhibitors ; therapeutic use ; Remission Induction ; Survival Rate

OBJECTIVETo explore the curative effects and complications of elastic intramedullary nail in treating children's bilateral femoral shaft fractures.

METHODSForm February 2005 to March 2008, 7 patients with bilateral femoral shaft fractures were treated by closed reduction and internal fixation with elastic intramedullary nail. There were 5 males and 2 females. The age ranged from 3 to 13 years with the mean of 8.3 years. Six injuries caused by road accident and 1 injury caused by fall from high. Two cases associated with pulmonary contusion, 3 cases brain injuries, 1 case fracture of calcaneus and 1 case bladder injuries. All the cases were closed fractures without nerve and blood vessel injury. A cast external fixation had been used after operation for a month in two cases.

RESULTSAll the patients were followed up for 21-37 months with an average of 30.3 months. No infecton of incisional wound, displacement fracture, internal fixation fail, delayedunion and malunion were found. All fracture obtained healing for 7-12 weeks with an average of 8.7 weeks. Inequality of lower limb was found in 1 case (length differences was 5 mm). According to Flynn scoring,all fractures were excellent.

CONCLUSIONTreatment of femoral shaft fractures in children with elastic intramedullary nail according with biological principle. The method has little trauma, less complication, outstanding effect and it is a good way to treat bilateral femoral shaft fractures result from high-energy injuries.

Adolescent ; Bone Nails ; Child ; Child, Preschool ; Elasticity ; Female ; Femoral Fractures ; surgery ; Fracture Fixation, Intramedullary ; adverse effects ; methods ; Humans ; Male