Objective Unstable intertrochanteric hip fractures are characterized by comminution of the posteromedial cortex and a fragment of variable size containing the lesser trochanter. This paper is to discuss whether it is necessary to perform reduction and fixation for this fragment. Methods 67 cases of intertrochanteric fractures were treated by dynamic hip screw (DHS) fixation between March 2001 and September 2002 and followed up for a minimum of 1 year. Their treatment results were retrospectively analyzed. Results No nonunion, coxa vara or failure of internal fixation occurred in all these patients. Conclusion If DHS provides stability, screw fixation of the lesser trochanteric fragment is unnecessary.

OBJECTIVETo study the pathological characteristics of severe acute respiratory syndrome (SARS) and its relationship to clinical manifestation.

METHODSTissue specimens from 3 autopsies of probable SARS cases were studied by microscope, and the clinical data was reviewed.

RESULTSThe typical pathological changes of lungs were diffuse hemorrhaging on the surface. A combination of serous, fibrinous and hemorrhagic inflammation was seen in most of the pulmonary alveoli with the engorgement of capillaries and detection of micro-thrombosis in some of these capillaries. Pulmonary alveoli thickened with interstitial mononuclear inflammatory infiltrates, suffered diffuse alveolar damage, experienced desquamation of pneumocytes and had hyaline-membrane formation, fibrinoid materials, and erythrocytes in alveolar spaces. There were thromboembolisms in some bronchial arteries. Furthermore, hemorrhagic necrosis was also evident in lymph nodes and spleen with the attenuation of lymphocytes. Other atypical pathological changes, such as hydropic degeneration, fatty degeneration, interstitial cell proliferation and lesions having existed before hospitalization were observed in the liver, heart, kidney and pancreas.

CONCLUSIONSevere damage to the pulmonary and immunological systems is responsible for the clinical features of SARS and may lead to the death of patients.

Aged ; Humans ; Lung ; pathology ; Lymph Nodes ; pathology ; Male ; Middle Aged ; Severe Acute Respiratory Syndrome ; pathology ; Spleen ; pathology

Objective:To explore the relationship between mild cognition impairment(MCI) and components of metabolic syndrome in the elderly.Methods:A total of 293 patients aged 65 years and older with an average age of (78.8 ± 7.5) years who met the inclusion criteria were included.The Montreal Cognitive Assessment Scale(MoCA)was used to evaluate cognitive function.The components of the metabolic syndrome were compared between the MCI and the normal cognitive function(NC) groups.Binary Logistic regression analysis was used to analyze the relationship between cognitive function and components of the metabolic syndrome.Results:The levels of body mass index(BMI)and tryglicerides(TG)were lower in the MCI group than in the NC group[BMI, (22.9±3.7)kg/m 2vs.(25.3±3.3)kg/m 2, t=3.124, P=0.002; TG, 1.2±0.6 mmol/L vs. 1.4±0.7 mmol/L, t=2.615, P=0.009]. The differences in proportions of hypertension and diabetes and in levels of fasting blood glucose and high-density lipoprotein cholesterol had no statistically significance between the MCI group and the NC group(all P>0.05). Binary multivariate Logistic regression analysis showed that after adjusting for age and education, BMI was independently associated with MCI, and as BMI increased, the risk of MCI decreased( OR=0.901, 95% CI: 0.838-0.968, P=0.004). In elderly men, after adjusting for age, education level and smoking history, TG was independently associated with MCI, and as TG increased, the risk of MCI decreased( OR=0.446, 95% CI: 0.249-0.874, P=0.017). While in elderly women, no independent correlation between TG and MCI was observed. Conclusions:BMI is independently associated with MCI.Screening for cognitive function among low-level BMI elderly is helpful to identify MCI.The relationship between TG and MCI is different between different genders, and different standards might be adopted for the management of TG in elderly MCI patients with different genders.

Objective: To investigate the genetic characteristics of Lamivudine-resistant mutation patterns and HBV S gene mutants in patients with chronic hepatitis disease of different disease progression. Methods: Blood samples of LAM-resistant patients with chronic hepatitis disease were collected. HBV RT gene nucleotide sequences were obtained, and then differences in drug-resistant mutation patterns, drug susceptibility and HBV S gene mutants characteristics between the two groups were analyzed. Results: Forty-seven chronic hepatitis B (CHB) patients and 16 HBV-related liver cirrhosis (LC)/HBV-related hepatocellular carcinoma (HCC) patients were included in this study. M204I single point mutation and L180M+ M204I/V were the most common pattern during patients with chronic hepatitis disease (35/63, 55.56%). The numbers of resistant to three nucleos(t)ide analogues in LC/HCC group was higher than CHB group’s (62.50% vs 34.04%, P=0.046). In HBV S gene, more immune associated HBsAg-escape mutations were detected in LC/HCC group than that in CHB group (62.50% vs 31.91%, P=0.031). I126T/V and G145A (for LCC/HCC group, 60%), I126S/T and S117T (for CHB group, 46.67%) were showed as the most common form for HBsAg escape mutations in the two groups. The two groups both detected RT mutations concomitantly with stop codon mutations in S gene (rtA181T/sW172* and rtM204I/sW196*). Conclusions Different characteristics in Lamivudine-resistant mutations and associated HBV S gene mutants were found in patients with chronic hepatitis disease of different disease progression, and LC/HCC patients exhibit more multi-drug resistant variants and immune associated HBsAg-escape mutants than CHB patients.

Objective To study the effect of plaque eccentricity on stent performance and stress distributions of artery and plaque during stent implantation in stenotic vessels. Methods The stent and idealized stenotic vessels were constructed, and 4 different eccentricities (0%, 20%, 40%, 60%) were attributed to the plaque. Then the stent recoil, stent foreshortening, and stress distributions of artery and plaque when the stent was expanded to the target displacement were analyzed by the finite element method. Results Along with the increase of plaque eccentricity, both stent recoil and stent foreshortening gradually grew. At the same time, the stress of artery and plaque also showed an increasing tread, and high-stress areas gradually approached the narrow side. The maximum von Mises stress of the plaque was much greater than that of the artery. Conclusions Plaque eccentricity had a certain effect on performance of the stent and stress distributions of stenotic vessels. In stent design, the geometry of the plaque should be considered to improve clinical effect of the stent in interventional treatment.