Objective To analyze the causes for failed treatments of proximal femoral fractures and to evaluate the curative results of total hip replacement(THR)to salvage the failures.Methods A retrospective study was conducted for 23 consecutive cases of THR to salvage failed treatments of proximal femoral fractures from February 2002 to April 2005.There were 17 cases of femoral neck fracture,five cases of intertrochanteric frac- ture,and one case of femoral head fracture.Results Inadequate reduction after inadequate fixation,incorrect materials or technical errors in internal fixation were the most significant reasons for the failure of early treatment. Twenty-one of the 23 patients were available for fullow-up that ranged from 8 to 46 months(mean,32 months). No such complications as wound infection,hip dislocation,prosthesis breakage or deep venous thrombosis were found.Their mean Harris score increased from 48.3 preoperatively to 87.6 postoperatively.Condusions Re- duction,internal fixation,and fixation technique are very important to treatments of proximal femoral fractures. High energy trauma in young patients and osteoporosis in old patients make treatment of proximal femoral fractures even more difficult.THR is a satisfactory and safe way to salvage a failed treatment of proximal femoral fracture.

Objective To investigate effects of different doses of recombinant human bone morphogenetic protein-2 (rhBMP-2) on vascular endothelial growth factor (VEGF) expression in fetal mouse osteoblasts.Methods Calvaria osteoblasts of fetal mice of 19 days were cultured.The effects of rhBMP-2 at different doses and different action times on VEGF expression patterns in fetal mouse osteoblasts were observed with reverse transcrip- tion-polymerase chain reaction (RT-PCR) and Western blot staining.Results In the present study,RT-PCR detected a steady expression of VEGF mRNA in the control fetal mouse osteoblasts.The levels of VEGF mRNA increased in an apparent biphasic manner with a maximum stimulation (about 2-fold above the control,P＜0.05 ) in both VEGF mRNA species observed at 300 ng/mL of rbBMP-2.After 48 h of rhBMP-2 treatment,the VEGF mRNA levels approached those in the control.The VEGF mRNA levels appeared to be biphasic in rhBMP-2-treated cultures,showing peak induction at 3 and 24 h and remaining elevated at 48 b.Compared with the individual control value at each time point,an apparent maximum increase (about 2.5-fold above the control,P＜0.05) occurred at 6 h.The second peak induction,about 2-fold above that in the control,occurred at about 36 h.Conclusions The expression of VEGF mRNA is steady in the control fetal mouse osteoblasts.RhBMP-2 can promote the expression of VEGF in dose-dependent and time-dependent manners.

Objective To investigate the injury of the brain, lung and liver of the pups after maternal infection of human eytomegalovirus (HCMV) 3 days before pregnancy. Methods Thirty kunming mice aged 10-12 weeks were mated and divided into infection group and control group. The female mice in the infection group were given intraperitonealty 1×106 50% tissue culture infective dose of HCMV suspension 0. 5 ml 3 days before pregnancy, while those in the control group were given intraperitoncally supernatant of human fibroblasts. At 19 days of gestation, cesarean sections were performed. Pathology and HCMV DNA of the brain, lung and liver tissue of the fetus were tested through microscope and PCR. Kai-square test was used to compared the positive rates of HCMV DNA and viral isolation between these two groups. Results The positive rates of HCMV viral isolation and DNA in the fetal mice of infection group were as follow: brain (73.3% and 93.3%), liver (53.3% and 93.3%)and lung (60. 0% and 86.7%), while HCMV DNA and viral isolation was not detected in the control group (P<0.05). Under microscope, viromicrosome and tissue injury including necrosis, degeneration and bleeding were found in the tissues of brain, lung and liver in the infection group. Conclusions Maternal mice HCMV infection before pregnancy might vertically transmitted to the fetus and cause multi-organ injury.

Objective To observe the difference in treament of thoracolumbar vertebral bodies fractures be- tween AF nail and Dick nail.Methods From March 1998 to March 2007,85 cases of thoracolumbar vertebral bod- ies fractures were followed up.20 cases were fixed with Dick nail,and 65 cases with AF nail.Results The mean,fol- low-up period was 12 months.By comparison of the operating rime,bleeding amount,the recovery rate of vertebral height,the reduction of Cobb angle and capacity of vertebral canal,AF nail was much better than Dick nail.But there was no marked difference in the recover of nerve function.Conclusion AF nail has more power to reduce vertebral height and is easier to set than Dick nail.It will be worthy of more and wider application in basic level hospitals.

Objective To investigate the serum C-reactive protein (CRP) level in patients with acute cerebral infarction and acute massive cerebral infarction with multiple organ dysfunction syndrome (MODS),and analyze the clinical value of CRP. Methods The serum CRP level of 50 patients of control group and 50 patients of cerebral infarction admitted to hospital within 7 days (30 patients were admitted into acute cerebral infarction group and 20 patients into acute massive cerebral infarction with MODS group) were determined by immune scatter turbidimetry. Results (1)In cerebral infarction patients,serum CRP level in 48 cases(96%) was equal and over 5 mg/L.In control group,serum CRP level in 3 cases(6%) was equal and over 5 mg/L(P＜0.0 5).(2)The level of serum CRP acute in cerebral infarction group and in acute massive cerebral infarction with MODS group increased significantly than that in control group (P＜0.01).The level of serum CRP in acute massive cerebral infarction with MODS group increased significantly than that in acute cerebral infarction group.(3)When the level of CRP＜25 mg/L,the incidence of MODS in patients with acute cerebral infarction was zero.When the level of CRP≥25 mg/L,the incidence of MODS increased gradually with the rise of CRP. Conclusions There is positive correlation between the serum level of CRP and the severity of acute cerebral infarction and the incidence of MODS.CRP is a useful marker in predicting the prognosis of acute massive cerebral infarction with MODS.

OBJECTIVETo observe the differences of the expression of Cx43 in rats' acupoints and sham-acupoint when needled blocks, and explore the relatively specificity of acupoints.

METHODTwenty Wistar rats were randomly divided into two groups: an acupuncture group and a control group, ten in each group. The rats in the control group were not treated and sacrificed directly to by air embolism; the rats in the acupuncture group were needled at "Neiguan (PC 6)", "Zusanli (ST 36)", "Dazhui (GV 14)" and "Guanyuan (CV 4)", Sham-acupoints were on 1 cm next to each of the above acupoints and "Yongquan (KI 1)" were needled by hand manipulation, retented needles for 30 min, then all the rats were sacrificed by air embolism. With the rats fixed, the tissue blocks at the acupoints and sham-acupoints were collected, then quick-frozen and cut into sections. The sections were stained by immunohistochemical method (Cx43).

RESULTSThe expression of the rats' Cx43 at the acupoints was significantly higher than that at the non-points in both groups (all P < 0.01). The expression of Cx43 at the acupoints in the acupuncture group was significantly higher than that in the control group (all P < 0.01).

CONCLUSIONThe expression of Cx43 at acupoints and non-points is significantly different, which indicates that the acupoints are actually existed and have relatively specificity.

Acupuncture Points ; Acupuncture Therapy ; Animals ; Connexin 43 ; genetics ; metabolism ; Gene Expression Regulation ; Humans ; Male ; Rats ; Rats, Wistar

We use Z type skin flap to repair face slant diastema by combining nasal bottom and infraorbital border. The therapeutic efficacy was satisfactory. The dislocated nostril, eversioned eyelid and lowered eyeball was resettled.
Diastema ; Face ; Female ; Humans ; Nose ; Surgical Flaps

OBJECTIVETo explore the functions of phospholipase C (PLC)-independent protein kinase C signaling pathway (PTH/nonPLC/PKC) of parathyroid hormone (PTH) and its role in bone metabolism.

METHODSOsteoblasts isolated from the calvaria of 2- or 3-day-old C57BL mice, identified by alkaline phosphatase staining and Alizarin red staining, were treated for 4 h with 100 nmol/L [Gly(1), Arg(19)]hPTH(1-28) plus 10 nmol/L RP-cAMP, 10 nmol/L [Gly(1), Arg(19)]hPTH(1-34) plus 10 nmol/L RP-cAMP , 10 nmol/L PTH(1-34), or and 0.1% trifluoroacetic acid (TFA). The total RNA was then isolated for screening differentially expressed genes related to PTH/nonPLC/PKC pathway using Affymetrix mouse 12x135K gene expression profile microarray, and the identified genes were confirmed by real-time quantitative PCR. MC3T3-E1 cells treated with [Gly(1), Arg(19)]hPTH(1-28)+RP-cAMP, [Gly(1), Arg(19)]hPTH(1-34)+RP-cAMP, [Gly(1), Arg(19)]hPTH(1-34)+ RP-cAMP +100 nmol/L Go6983, or 0.1% TFA were also examined for GR(1-28)- or GR(1-34)-mediated gene expression changes using real-time quantitative PCR.

RESULTSAlizarin red staining visualized red mineralized nodules in the osteoblasts at 28 days of culture. According to the genechip results, we selected 56 target genes related to PTH/nonPLC/PKC pathway, among which CITED1 showed higher expressions in [Gly(1), Arg(19)]hPTH(1-34)+ RP-cAMP group than in both the control group and [Gly(1), Arg(19)]hPTH(1-28)+RP-cAMP group (P<0.05), and its expression was the highest in PTH(1-34) group (P<0.05). RT-PCR of MC3T3-E1 cells yielded consist results with those in the primary osteoblasts, and the cells treated with Go6983 (a PKC inhibitor) did not show GR(1-28)- or GR(1-34)-mediated differential expression of CITED1.

CONCLUSIONThe activation of PLC-independent protein kinase C signaling pathway of PTH enhances the expression of CITED1 in mouse osteoblasts to mediate the effect of PTH on bone metabolism, and this pathway is not dependent on the activation of PLC or PKA signaling.

Animals ; Cells, Cultured ; Indoles ; Maleimides ; Mice ; Mice, Inbred C57BL ; Nuclear Proteins ; physiology ; Osteoblasts ; physiology ; Parathyroid Hormone ; physiology ; Protein Kinase C ; physiology ; Signal Transduction ; Skull ; Trans-Activators ; physiology ; Type C Phospholipases

OBJECTIVETo compare the effect and safety of the no-flip method versus the external method in Shang Ring circumcision.

METHODSWe searched relevant randomized controlled trials published in China and abroad comparing the no-flip method and external method of Shang Ring circumcision. Based on the Cochrane Handbook for systematic review, two reviewers independently eval- uated the quality of the included studies and abstracted relevant data, followed by a meta-analysis using the statistical software Review Manager 5.1.0.

RESULTSTotally 7 studies with 1 200 cases were included. Compared with the external method, the no-flip method was associated with a lower total rate of complications (RR = 0.40, 95% CI: 0.18, 0.87, P = 0.02), a lower incidence of postop- erative edema (RR = 0.28, 95% CI: 0.09, 0.81, P = 0.02), and a lower 24 h postoperative pain score (MD = -0.35, 95% CI: -0.55, -0.14, P < 0.001).

CONCLUSIONThe no-flip method of Shang Ring circumcision was superior to the external method for its advantages of fewer complications, lower incidence of postoperative edema, and mild postoperative pain. However, our findings need further support by more high-quality randomized controlled trials.

China ; Circumcision, Male ; adverse effects ; instrumentation ; methods ; Edema ; epidemiology ; Humans ; Male ; Pain Measurement ; Pain, Postoperative ; epidemiology ; Randomized Controlled Trials as Topic

Objective To investigate the effect of mangiferin on the apoptosis of rat primary cardiomyocytes induced by hypoxia. Methods Rat primary cardiomyocytes were separated and cultured under aseptic condition. Cardiomyocytes were treated with hypoxia of 2, 4, 8 and 12 h, and then the time of hypoxia of cardiomyocyte apoptosis model was determined according to the apoptosis outcome.The cardiomyocytes were divided into normal group, hypoxia group and mangiferin intervention group, each group was subjected to 3 batches in parallel, and 3 holes were done in parallel with each batch. After the experiment, cardiomyocytes apoptosis was deteced by flow cytometry;apoptosis protease caspase-3 and caspase-9 activity in cell lysates was detected by spectrophotometry;the protein expression of Bax and Bcl-2 was detected by Western blot. Results After treated with hypoxia for 12 h, the cardio-myocytes apoptosis rate was significantly increased (P < 0.05), the apoptosis protease caspase-3 and caspase-9 activity was increased markedly (P＜0.05), the protein expression of proapoptotic protease Bax was increased notablely (P＜ 0.05 ) , and the protein expression of anti apoptotic protease Bcl-2 was decrease memorably (P＜0.05) in hypoxia group as compared with those in the control group. After mangiferin intervention, above indexes in mangiferin group can be significantly relieved as compared with those in the hypoxia group. Conclusions Mangiferin can significantly inhibit the apoptosis of rat primary cardiomyocytes induced by hypoxia.