BACKGROUND: Now, the current study has not yet confirmed two treatment methods of the proximal femoral nail antirotation and total hip arthroplasty for treating intertrochanteric fractures in the elderly, which method has more advantages, and there is no clear conclusion at present. OBJECTIVE: To systematical y compare the repair effect of proximal femoral nail antirotation and total hip arthroplasty for treatment of intertrochanteric fractures in the elderly. METHODS: We searched the related literatures from 2011 to 2015 on Wanfang database, PubMed, MEDLINE and Embase database by computer. We retrieved the journals in China by hand and col ected randomized control ed trials on proximal femoral nail antirotation and total hip arthroplasty in the treatment of intertrochanteric fractures in the elderly. Intraoperative blood loss, operation time, hospitalization time, ambulation time after operation, and Harris score were selected as evaluation indexes. Data were analyzed using RevMan 5.2 software. RESULTS AND CONCLUSION: Final y, 7 Chinese literatures were included, with 811 patients. The results of meta analysis showed that the hospitalization time and ambulation time after operation were significantly shorter in the total hip arthroplasty group than in the proximal femoral nail antirotation group (P < 0.000 01), which reduced the pain of patients. Operation time and intraoperative blood loss were poorer in the total hip arthroplasty group than in the proximal femoral nail antirotation group (P < 0.000 01). No significant difference in Harris hip score was detected between the two groups (P > 0.05). These results confirmed that the internal fixation of proximal femoral nail antirotation in minimal y invasive therapy when reducing operation time and blood loss has a certain advantage. The total hip arthroplasty can make the recovery of hip function earlier, al ow early weight-bearing walking, reduce the patients’ bedridden time and reduce the complications in bed. Thus, the clinicians in the practical work should choose the appropriate therapy with considering the patient’s condition, damage degree, fracture type, and financial capability.

OJECTIVETo explore whether different acupuncture signals were afferent to the cerebellar fastigial nucleus (FN) neuron and to find out their corresponding effect features through observing the effect of spontaneous discharge of cerebellar FN neuron by needling at different acupoints.

METHODSTotally 120 male SD rats were anesthetized by 20% urethane and their right cerebellar FN were positioned (AP 11. 6 mm, RL 1. 0 mm, H 5. 6 mm). Extracelluar discharge was recorded by glass microelectrode (AP: -11. 6 mm, R: 1. 0 mm, H: 5.7 -7. 0 mm), using extracellular microelectrode recording method, recording the spontaneous discharge of cerebellar FN neurons as a baseline. Random order of needling at zusanli (ST36), quchi (Lil1), weishu (BL21), and zhongwan (CV12) were compared with the baseline before each acupuncture. Their effects on the discharge of cerebellar FN neurons were observed and compared with baselines.

RESULTSThe frequency of FN neuronal discharge could be elevated by needling at zusanli (ST36), quchi (LiI), weishu (BL21), and zhongwan (CV12) (P <0. 01, P <0. 05). The response rate of needling at Zhongwan (CV12, 56. 00%) was higher than that of needling at Zusanli (ST36), Quchi (Ll1), and Weishu (BL21) (35. 00%, 34. 62%, 36. 63%, respectively) with statistical difference (P <0. 05). The response rate of needling at zhongwan (CV12) was obviously higher than that of needing at other points (F = 2. 101, P < 0. 05).

CONCLUSIONSNeedling at zusanli (ST36 ), quchi (Lil), weishu (BL21), and zhongwan (CV12) could elevate the spontaneous discharge frequency of cerebellar FN neurons. Needling at Zhongwan (CV12) had advantageous roles in regulating cerebellar FN.

Acupuncture Points ; Acupuncture Therapy ; Animals ; Cerebellar Nuclei ; physiology ; Male ; Microelectrodes ; Neurons ; Rats ; Rats, Sprague-Dawley

Objective To investigate the role of p38MAPK in the differentiation of murine osteoblasts, and to observe the expressions of receptor activator of nuclear factor-κB ligand (RANKL) and osteoprotegerin (OPG). Methods The calvarial osteoblasts of newborn BALB/c mice were cultured in MEM medium containing 10% NCS. Raloxifene (10~(-7) mol/L) and 17β-estradiol (10~(-8) mol/L) were added respectively when cells reached 70%-80% confluence combined with or without 5 μmol/L SB202190, an inhibitor of p38MAPK. The osteoblasts alkaline phosphatase activity assays were performed 72 hours later using PNPP method, and mRNA levels of alkaliphosphatase (ALP), OPG and RANKL were determined by RT-PCR. Results 17β-estradiol and raloxifene increased ALP activity and ALP mRNA level in osteoblasts in vitro which were blocked by p38MAPK inhibitor.The mRNA levels of RANKL and OPG were up-regulated by 17β-estradiol and raloxifene while the ratio of OPG/RANKL kept constant. SB202190 (5 μmol/L) inhibited the highly expressed RANKL and OPG in osteoblasts, and obviously decreased the ratio of OPG/RANKL. Conclusions p38MAPK inhibition blocked the differentiation of osteoblasts and decreased the up-regulated OPG and RANKL expressions in osteoblasts significantly (P<0.05).

Aim To evaluate the reversal effect of 2-deoxy-D-glucose ( 2-DG ) on multidrug resistance ( MDR) by observing the uptake change of 99m Tc-MIBI in HNE-1/DDP cells, and to explore its mechanism. Methods The uptake of 99m Tc-MIBI in HNE-1/DDP cells under different concentrations of 2-DG was detec-ted by γ-counter, and the clearance rates of 99m Tc-MI-BI in HNE-1 cells and HNE-1/DDP cells after treated with 2-DG (10 mmol·L-1 ) were compared. The con-tent of ATP in HNE-1/DDP cells was detected after treated with 2-DG. P-glycoprotein ( P-gp ) and multi-drug resistance-associated proteins ( MRP ) expression were measured by Western blot. Apoptotic HNE-1/DDP cells treated with DDP alone or combined with 2-DG (10 mmol·L-1 ) were detected by propidium io-dide ( PI ) staining. Results The clearance rate of 99m Tc-MIBI in HNE-1/DDP cells was 54. 8%, which was significantly higher than that ( - 41. 3%) in HNE-1 cells (P<0. 01). The clearance rate of 99mTc-MIBI in HNE-1/DDP cells was -203. 7% after treat-ment with 2-DG ( 10 mmol · L-1 ) , which could be significantly reduced compared with the control group ( P<0. 01 ) . The level of ATP was 55 . 69% compared with the negative control group and the expression of P-gp and MRP protein decreased dramatically in HNE-1/DDP. With the combination of 2-DG and DDP, the ap-optotic rate of HNE-1/DDP cells reached 49 . 4%which was significantly higher than DDP treated group (22. 5%) . Conclusion Multidrug resistance and the reversal effect of 2-DG on multidrug resistance could be evaluated effectively by detecting the uptake change of 99m Tc-MIBI in HNE-1/DDP cells. The mechanism may be related with the inhibition of ATP level and the re-duced expression of P-gp and MRP protein in cancer cells.

Objective To determine the contents of four fiavonoids(trifolirhizin,nor-kurarinone,xanthonumal and kuraridin)in 25 samples of Sophora flavescens Air.in the market.Methods The determination was carried out on Phe- nomenex Luna C_(18)column(250 mm?4.6 mm,5?m),using Acetonitrile-H_2O as mobile phase,at a flow rate of 1.0 mL/min and detected at the wavelength of 310 nm for trifolirhizin,294 nm for nor-kurarinone and,365 nm for xan- thonumal and kuraridin,and column temperature at 35℃.Results The contents of 4 flavonoids in 25 samples of Sophora flavescens Air.in market were in the ranges of 0.05 %～0.32 % for trifolirhizin,0.05 %～0.51% for nor- kurarinone,0.55?10~(-3)%～4.87?10~(-3)% for xanthonumal and 0.06 %～0.23 % for kuraridin.Conclusion The contents of 4 flavonoids in the samples from the market vary notably,and this should be taken into the quality control of Sophora flavescens Ait.

Objective To establish the canine model of esophageal variees caused by portal hyper-tension. Methods The model was established in 12 dogs with a side-to-side portacaval shunt, an ameroid constrictor around the portal vein and double ligation and cross suture of the cephalic part of the inferior vena cava (IVC), and the development of esophageal varices was confirmed 6 weeks later by endoscopy and portal vein angiography. Results The mean pre- and postoperative portal pressure were (11.0 ± 1.1) mm Hg and (22. 9 ± 1.2) nun Hg, respectively (P =0. 010). Endoscopy detected mild to moderate esophageal varices in all dogs, which was confirmed by portal vein angiography, and varices was also seen in abdominal wall. Conclusion Canine model of esophageal varices induced by portal hypertension can be established with the procedure.

BACKGROUND:Over-expression of serum interleukin-6 and interleukin-8 may be involved in tourniquet-induced limb ischemia-reperfusion injury to the lung ventilation function. OBJECTIVE:To evaluate the tourniquet effect on serum interleukin-6 and interleukin-8 levels of the rat limb within the safety time limit. METHODS: Sixty rats were randomly divided into control and experimental groups, 30 rats in each group. Rats in the control group had no ischemic preconditioning and were directly subjected to stop bleeding for 2, 3, 4 hours; rats in the experimental group were subjected to ischemic preconditioning (short-time hemostasis for several times within 1 day before ischemia-reperfusion injury), and then underwent 2-, 3-, 4-hour hemostasis at the 2nd day. At 1, 3, 7, 14 days after the recovery of limb blood flow, blood samples were extracted to detect serum interleukin-6 and interleukin-8 levels using ELISA method. RESULTS AND CONCLUSION:The levels of interleukin-6 interleukin-8 showed an increasing and decreasing trend in the two groups, which both reached the peak at the 3rd day (P< 0.05). The levels of interleukin-6 in the experimental group was significantly higher than that in the control group at 1, 3, 7, 14 days (P < 0.05), and only at 7 days, the level of interleukin-6 in the rats undergoing 3-hour hemostasis was significantly lower than that in the control group (P< 0.05). At 7 days, the level of interleukin-8 in the rats undergoing 3-hour hemostasis was lower than that in the control group, but there was no significant difference (P > 0.05), and at 3, 7, 14 days, the level of interleukin-8 in the rats undergoing 4-hour hemostasis was significantly higher than that in the control group (P< 0.05). At 1 and 3 days, the levels of interleukin-6 and interleukin-8 in the experimental group had an increasing trend with the bleeding time and ranked as folows: 2-hour hemostasis < 3-hour hemostasis < 4-hour hemostasis, and there was a significant difference; while in the control group, there was also an increasing trend in the levels of interleukin-6 and interleukin-8, but there was no statistical difference. These findings indicate that the tourniquet preconditioning treatment is preferred at 3 days after limb ischemia-reperfusion injury, when the inflammatory response was the most obvious in rats, and this treatment can dramaticaly reduce inflammatory response. Additionaly, the inflammatory become more obvious with the bleeding time.

OBJECTIVETo compare the effect,safety,and advantage of flexible fixation with paperboard and pad versus short leg plaster in treating the fifth metatarsal base fracture,and establish the standard of diagnosis and treatment of the fifth metatarsal base fractures in flexible fixation with paperboard and pad.

METHODSFrom June 2010 to March 2013,59 patients with the fifth metatarsal base fracture were treated with paperboard and pad fixation or short leg plaster. Patients were enrolled and divided into paperboard and pad treatment group (paperboard group) and short leg plaster treatment group (plaster group) randomly according to the random number table. In paperboard group,there were 29 cases including 9 males and 20 females with an average age of (51.79±11.40) years old; the average course of injury was (11.59±6.58) hours. In plaster group, there were 30 cases including 9 males and 21 females with an average age of (52.13+17.34) years old ;the average course of injury was (11.03±7.06) hours. According to whether the fracture line across the articular surface, in paperboard group there were 14 cases of type A,15 of type B; in plaster group,16 of type A, 14 of type B. According to the degree of dislocation,in paperboard group there were 16 cases of degree I ,13 of degree II ; in plaster group,20 were degree I ,10 were degree II. Fracture was restored according to the type in manual. Patients in paperboard group were treated with paperboard and pad, and patients in plaster group were treated with short leg plaster. Fracture was fixed for 4 to 6 weeks according to fracture healing. On the 2nd, 4th,6th, 8th week and 3rd, 6th month after fixation, patients were followed up, and the foot function score was used to evaluate the function of injured foot. X-ray of injured foot was taken on the 2nd, 4th, 6th and 8th week were used to assess fracture healing.

RESULTSAll patients got complete follow-up. The X-ray result showed that all fracture reached at clinical healing on the 8th week after fixation without skin ulcer,nonunion and displacement of fracture. From the 4th to 8th week after fixation, paperboard group had a higher X-ray score than plaster group, but the difference between two groups had no statistically significance. Repeated analysis result showed that there was interact at different time point and between groups,the difference had statistically significance (P<0.01). The foot function score showed that at all time point, paperboard group had a higher score than plaster group, and on the 2nd, 4th, and 6th week, it had statistically significant difference(P<0.01) between two groups. On the 6th months after fixation,the excellent and good rate of paperboard group was 93.10%, higher than that of plaster group, which was 86.67%. But it had no statistically difference(P=0.483) between two groups.

CONCLUSIONUsing paperboard and pad fixation to treat the fifth metatarsal base fracture has the advantage of simplicity operating,reliable fixation, satisfactory effects, easily obtainable material.

Adult ; Aged ; Casts, Surgical ; Female ; Foot Injuries ; physiopathology ; surgery ; Fracture Fixation ; instrumentation ; methods ; Fracture Healing ; Fractures, Bone ; physiopathology ; surgery ; Humans ; Male ; Metatarsal Bones ; injuries ; physiopathology ; surgery ; Middle Aged

Heparinase II (Hep II) from Flavobacterium heparinum is an enzyme that could specifically cleave certain sequence of heparin and heparan sulfate. In this work, fermentation conditions of recombinant heparinase II (His-Hep II) producing bacteria were optimized, including initial induction time, inducer (IPTG) concentration, induction temperature and induction time. The optimum conditions were as follows: cultivating recombinant bacteria to exponential prophase under 37 degrees C, then adding IPTG to a final concentration of 0.3 g/L, finally cultivating recombinant bacteria under 20 degrees C for 10 h. The total crude enzyme activity reached 570 U/L. Based on these results, high cell density fermentation of recombinant bacteria was studied. The final OD600 could reach 98 and the total crude enzyme activity of His-Hep II increased to 9 436 U/L.
Fermentation ; Flavobacterium ; metabolism ; Microbiological Techniques ; Polysaccharide-Lyases ; biosynthesis ; Recombinant Proteins ; biosynthesis

Objective To investigate the effect of nCPAP as pre-emptive ventilatory support strategy in severe bronchiolitis. Methods A retrospective analysis was made on cases with nCPAP as pre-emptive ventilatory support strategy for severe bronchiolitis in PICU of our hospital from August 2012 to September 2014. Results Seventy-nine children received nCPAP therapy in our PICU. Overall, nCPAP was successful performed in 69 children, 10 patients required intubations. PaO2 and PaO2/FiO2 in patients received intubations were lower than those in patients received only nCPAP before treatment (P < 0.05). There were significant improvements in PaCO2, PaO2, PaO2/FiO2, respiratory rate and heart rate in the patients received only nCPAP at 12 hours and 24 hours post-treatment (P < 0.05). For the 69 patients with hypercapnia received only nCPAP, PaCO2 was significantly reduced at 2 hours, 12 hours and 24 hours post-treatment (P < 0.01). Conclusion Clinically, nCPAP could improve the oxygenation and hypercapnia of patients with severe bronchiolitis. However, these patients, who suffered from severe bronchiolitis with minor PaO2 or PaO2/FiO2, appeared to require intubation as soon as possible.