Objective To summarize and analyze the failure reason of internal fixation operation in peritrochanteric fractures and propose appropriate prevention measures.Methods The clinical data of 229 patients with peritrochanteric fractures were retrospectively analyzed,the failure reason of internal fixation was analyzed by the univariate and multivariate Logistic regression analysis.Results The univariate analysis showed that the patients' age,gender composition,types of internal fixation had no significantly correlated with the failure of internal fixation (P ＞ 0.05) ; the Garden reset index,bone quality,fracture type and load time had significantly correlated with the failure of internal fixation (P ＜ 0.05).The multivariate Logistic analysis showed that load time was the independent risk factors for fixation failure (OR =13.515).Conclusion The weight-bearing time points should be selected according to the bone quality,fracture type,and degree of intraoperative reset,thereby reducing the risk of surgery failure.

Objective To observe the effect of different methods such as combined treatment of traditional Chinese and western medi-cine, the simple excision and expanded resection for the treatment of granulomatous lobular mastitis. Methods 60 cases of patients treated in our hospital from Jan. 2010 to Jan. 2013 were enrolled in this study, and they were confirmed the diagnosis of granulomatous lobular mas-titis by pathology examination. According to randomly number table, they were divided into three groups and they were given the treatment of combined treatment of traditional Chinese medicine and Western medicine, the simple excision, and expanded resection respectively. Where-after, the therapeutic effect of the three groups were observed. Results There were 9 cases (45. 0%) were of cure and 11 cases (55. 0%) of recurrence in the combined treatment group. There were 16 cases (80. 0%) of cure and 4 cases (20. 0%) of recurrence in the simple ex-cision group. There were 8 cases (90. 0%) of cure and 2 cases (10. 0%) of recurrence in the combined treatment group. It shows that the recurrence rate of combined treatment group was higher than the other two groups (P<0. 05). The satisfactory rate of breast appearance after treatment were 17 (85%), 15 (75%) and 16 (80%) respctively, and there is no significant difference (P>0. 05). Conclusion The effect of extended resectionin for the treatment of granulomatous is better and it has important clinical value.

AIM: To investigate the relationships between antiproliferative mechanisms of probucol and protein expressions of signaling molecules ERK1/2, MKP-1, HO-1 and Trx-1 in rat aortic smooth muscle cells (RASMCs) stimulated with ox-LDL. METHODS: The effects of probucol on cell cycle, cell proliferation and the expressions of ERK1/2, MKP-1, HO-1 and Trx-1 in the presence of ox-LDL were observed by means of MTT test, FCM and Western blotting. RESULTS: (1) Probucol significantly inhibited the proliferation of RASMCs stimulated with ox-LDL. A value in 100 μmol/L probucol+35 mg/L ox-LDL group was reduced by 34.9% as compared to ox-LDL group (P<0.01). (2) Probucol protected against ox-LDL-induced RASMCs proliferation through inducing cell growth arrest at G_0/G_1 phase and cell apoptosis. (3) ox-LDL increased the expression of p-ERK1/2 by 34.7% (P<0.01) and decreased MKP-1 by 60.0% (P<0.01), respectively, as compared to control. Probucol attenuated the increase in ox-LDL-stimulated p-ERK1/2 level by 15.7%, but increased MKP-1 expression by 2 times (P<0.01). (4)ox-LDL at concentration of 35 mg/L decreased the intracellular Trx-1 expression by 28.9% (P<0.05), and slightly increased the level of HO-1 expression as compared to control (P<0.05). Probucol enhanced the expression of Trx-1 by 91.6% (P<0.01) and HO-1 by 31.9% (P<0.01), respectively as compared to ox-LDL group. CONCLUSION: Probucol inhibits ox-LDL-stimulated the proliferation of RASMCs through increases in MKP-1/HO-1 expression, suppression of cell cycle progression and induction of cell apoptosis.

Objective To investigate the situation of urine albumin measurement of clinical laboratory in Tianjin.Methods Control materials from patient mixed urine samples were made to validate precision in the clinical laboratories in Tianjin.Reference Material ERM-DA470K was prepared as the first external quality assessment ( EQA) sample, and the bias between laboratories was calculated.Then we give some advice about the methods of routine maintenance, calibration, standardized operation, internal quality assessment and so on to the laboratories which were not qualified in the first EQA.Then the second EQA was carried out and CV and bias were culculated.Results 52 clinical laboratories has 12 series of instruments and 17 series of reagents.The precision research showed that most laboratories ( 93.55%) had good precision for urine albumin measurement, while CV of inter-laboratory was great:the range of low level of control sample was 8.91 -43.95 mg/L, 34.46% for CV; and the high level was 36.32 -281 mg/L, 28.51% for CV.Only 36.5% laboratories were qualified in the first EQA. The qualified rate for nephelometry and turbidimetry was higher (55.6%, 42.9%).The qualified rate of trueness verification was 58.6%in the second EQA, and the CV between laboratories was significantly decreased, Inter-laboratory CV of the five samples were:19.83%, 13.57%, 13.41%, 13.08%, 11.37%. The qudified rate for nephelomety and turbidimetry was 71.4% and 56.3%.Conclusions There are a mide variety of measurement systems of urine albumin in Tianjin, and the CV between these systems is great.Clinical laboratory should strengthen the laboratory standardization operation and upgrade calibration testing to improve the testing consistency.

Objective To indentify Streptobacillus moniliformis isolated from the knee joint pus by 16S rRNA gene sequencing and biochemical reactions and explore the clinical value of the method. Methods The bacterial 16S rRNA gene sequence-based identification, bacterial morphology, VITEK 2 automate systems, API 20NE strips, API 20E strips and API 50CH were performed to identify the rare bacteria. Results The bacteria grew slow on blood agar and chocolate agar and were inhibited on Maconkey agar. The bacterial colony on blood agar tookes the form of 1~2 mmomelette, which was translucent and moist with circular protrusion and smooth edges. They were Gram-staining negative and in catenation, its thalli 1~3μm, round, oval or fusiform. Vitek 2 GN-13, API 20NE and API 20E were unable to reach the identification of the bacteria. 16S rRNA gene sequencing showed the bacteria were similar to streptobacillus moniliformis by 100%. Conclusion The rare bacteria isolated from left knee joint are streptobacillus moniliformis. 16S rRNA gene sequences combined with the biochemical reactions is accurate in the identification of these bacteria.

AIM:To analyze the correlation between serum angiotensin-converting enzyme 2 (ACE2) levels and different stages of coronary heart disease (CHD), and to explore the change of serum ACE2 level during the development of CHD.METHODS:The control group included 85 non-CHD samples, and 174 CHD samples were divided into light stenosis (ls-CHD, stenosis degree <50%) group, moderate stenosis (ms-CHD, stenosis degree 50%~75%) group and severe stenosis (ss-CHD, stenosis degree ≥75%) group.The ACE2 level in each serum sample was detected by ELISA.The relationship between the ACE2 level and the development of coronary heart disease was explored by statistical analysis of serum ACE2 levels in different stages of CHD.RESULTS:The serum ACE2 levels in ls-CHD group, ms-CHD group and ss-CHD group were all higher than that in control group.The more severe the coronary artery stenosis existed, the higher the ACE2 level was observed.The serum ACE2 level in the males was higher than that in the females.In a single sex, the serum ACE2 levels in ls-CHD group, ms-CHD group and ss-CHD group were higher than that in control group with significant differences.Regression analysis found that sex, diabetes and CHD were associated with the serum ACE2 levels.Among them, sex and CHD were the independent factors to affect serum ACE2 levels.CONCLUSION:The serum ACE2 level of males was higher than that of females.Compared with the non-CHD samples, the serum ACE2 level of CHD patients was higher than that of the non-CHD samples.During the development of coronary heart disease, the serum ACE2 level increased constantly.

Objective To evaluate the analysis capability of urine protein qualitative test between AX-4030 and Cobas U411 u-rine dry chemistry analyzer,and study on evaluating the performance of qualitative test.Methods According to Clinical and Laboratory Standards Institute(CLSI)EP12-A2 document,analyzed the bias and imprecision of urineprotein qualitative test between the Aution MAX AX-4030 and Roche CobasU411 system.Their C50 ,C5 ~C95 intervals and imprecision curves were compared.The protein of 310 specimens were simultaneously determined by both Cobas U411 and AX-4030,in order to eval-uate their concordance.Results C50 for AX-4030 system was less than that for Cobas U411;C5 ~C95 interval of AX-4030 system was narrower than CobasU411.The imprecision curve of AX-4030 system was steeper than Cobas U411.The com-parison of the two analysis systems showed that the concordance was 96.8%,the positive concordance was 82.7%,and the negative concordance was 99.6%.The 95% credibility interval (CI)was 94.2%~98.16% and the Kappa value was 0.88. Conclusion For the sensitivity and imprecision of urine protein test in the C50 critical value,the AX-4030 system was better than Cobas U411.The concordance of them in determining clinical specimens was pole-strength.The evaluation recommen-ded by the EP12-A2 document is practical and effective.

w biomarker to predict the presence of vulnerable plaque.

AIM: To explore the expressive role of lipoprotein-associated phospholipase A_2, high sensitive C-reactive protein and matrix metalloproteinase-9 in vulnerable atherosclerotic plaques in a rabbit model. METHODS: Forty eight New Zealand white male rabbits were randomly divided into 4 groups (12 rabbits each): control group, stable plaque group, p53 group, and p53+drug group. Rabbits in control group were fed with a regular diet and underwent sham operation. Rabbits in stable plaque group, p53 group and p53+drug group underwent balloon induced arterial wall injury and then were fed on a diet with 1% cholesterol. The animals were all fed for 3 months, then the rabbits in p53 group and p53+drug group underwent Ad5-CMV p53 transfection at 10th week. Before killed, the animals in p53+drug group underwent pharmacological triggering with Russell's viper venom (RVV) and histamine to induce the rupture of the atherosclerotic plaques. At the 1st day and before sacrifice, the serum was collected for measuring Lp-PLA_2, hs-CRP, MMP-9, HDL, LDL and VLDL. The expressions of Lp-PLA_2, hs-CRP and MMP-9 in tissues were determined by the methods of hybridization and immunohistochemistry. RESULTS: At the end of 12th week, the serum and tissue levels of Lp-PLA_2 and MMP-9 in stable plaque group, p53 group and p53+drug group were significant different from those in control group and in each group at the first day (P<0.05). The serum levels of Lp-PLA_2 and hs-CRP in p53 group and p53+drug group were significantly higher than those in control group and stable group (P<0.05). The serum levels of Lp-PLA_2, hs-CRP and MMP-9 were all significantly different between p53 group and p53+drug group (P<0.05). At the end of 12th week, pathological results showed that 4 groups were normal artery, stable plaque, vulnerable plaque and rupture plaque, respectively. The fabric cap was thicker in plaque groups than that in normal group (P<0.05). The rupture and formation of thrombus were more significant in p53+drug group than those in p53 group. The serum level of Lp-PLA_2 had negative interrelated relationship with fabric cap in plaque groups (r=-0.710, P<0.01), and hs-CRP, MMP-9 had no interrelated relationships with fabric cap in plaque groups. CONCLUSION: Base on the successful establishment of the atherosclerotic plaque animal model, serum Lp-PLA_2 shows better interrelated relationships to plaques stability. Combination with hs-CRP and MMP-9, we can exactly evaluate the nature of plaques.

Objective:To investigate the predictive value of different body obesity measures for non-alcoholic fatty liver disease (NAFLD).Methods:It was a cross-sectional study. The present study was a case-control study involving 553 subjects who underwent physical examination from January to April 2022. The subjects were divided into NAFLD group ( n=321 cases) and control group ( n=232 cases) according to abdominal ultrasound imaging parameters. All subjects completed a general information questionnaire, liver ultrasound examination, serum biochemical indices and physical measurements. Logistic regression model was used to analyze the correlation between human obesity measures (neck circumference, triceps skinfold thickness (TSF),body mass index (BMI), waist-to-hip ratio, lipid accumulation index (LAP), visceral fat index (VAI), body roundness index (BRI) and a body shape index (ABSI)) and NAFLD. Receiver operating characteristic (ROC) curve and area under the curve (AUC) were used to evaluate the predictive value of single and combined measures of obesity for NAFLD. Results:The subjects were stratified by gender, and the quartile levels of BMI, neck circumference, TSF, waist-to-hip ratio, LAP, VAI and BRI were all correlated with NAFLD in both male and female (all P<0.05). After further adjustment for confounding factors, compared with those in group Q 1, group Q 4 of the above-mentioned indexes still had higher odds ratios ( P<0.05). The AUC value of LAP in predicting NAFLD was the largest in both men and women, which was 0.836(0.788-0.876) and 0.885(0.839-0.921), and the cut-off value was 41.93 and 33.27, respectively. There was no significant difference in AUC of ROC predicting NAFLD among LAP, BRI and BMI ( P>0.05). The AUC of ABSI in predicting NAFLD was less than 0.7(namely 0.584(0.525-0.641) and 0.679(0.618-0.735) in men and women, respectively), which indicated poor predictive performance for NAFLD. In the pairwise combination index, the AUC of ROC predicting NAFLD with TSF+LAP in male was the largest, which was 0.864(0.819-0.901), and there was statistical significance when compared with BRI (AUC=0.818(0.769-0.860)) and BMI (AUC=0.816(0.767-0.858)) ( P<0.05), but there was no statistical significance when compared with LAP (AUC=0.836(0.788-0.876)) ( P>0.05). The AUC of ROC predicting NAFLD with VAI+LAP in women was the largest, it was 0.894(0.849-0.928), there was statistical significance when compared with BMI (AUC=0.849(0.799-0.890)) ( P<0.05), but there was no statistical significance when compared with LAP (AUC=0.885(0.839-0.921)) and BRI (AUC=0.870(0.822-0.908)) ( P>0.05). Conclusion:BMI, neck circumference, TSF, waist-to-hip ratio, LAP, VAI and BRI all have good predictive value for NAFLD.