Objective To investigate the clinical efficacy of Asian proximal femur intramedullary nail antirotation (PFNA-Ⅱ) in the treatment of intertrochanteric fractures in elderly people.Methods From July 2009 to December 2011,127 elderly patients with intertrochanteric fracture were treated by PFNA-Ⅱ.They were 49 cases of male and 78 cases of female,with a mean age of (74.3±15) years.127 elderly patients were classified by modified Evans:type Ⅰ (n=37),typeⅡ (n=42),type Ⅲ (n=26),type Ⅳ (n=15),type V (n=7).We made the statistics on the intraoperative bleeding volume,operation time,incision length,X-light exposure times,and made evaluation of the efficacy of postoperative follow-up and complications by the Harris hip score.Results The average operation time was 42.5 min (35-90) min,the average intraoperative bleeding volume was 107.5 ml (65-410)ml,X-light exposure times were (2.5±1.4) times (2-4) times and the average total incision length was (6.5± 1.8) cm (5.5-11.0) cm.No serious complications or original complications were found during perioperative period.All patients received a 6 to 24 month follow-up (mean 12.5 months in average).The X ray examination showed that the average neck shaft angle was (134±13)° (120°-150°).The average fracture healing time was (14.0±2.5) weeks (11 to 19 weeks).The average hip Harris score was (86.5± 19.5) points (65-100 points).Among them,29 cases (22.83％) were excellent,76 cases (59.8％) were good,20 cases (15.7％) were moderate,2 cases (1.6％) were poor.Totally,excellent and good rate was 82.7％.No complications including hip varus deformity,screw cut-out and femoral shaft fractures were found.There were 14 patients (11.0％) with thigh pain and 5 patients (3.9％) with inner thigh pain.The heavier pain in 4 patients were improved by physical therapy.Conclusions Asian PFNA-Ⅱ has advantages including simple operation,fewer complications,and better clinical efficacy for the treatment of intertrochanteric fractures,but its longterm efficacy and complications still need a large sample and multi-center observation.

Objective:To create hospital data fusion centers to solve the problems involving data incompatibility between business system and administration system and incomplete data-sharing service.Methods:The needs for hospital data fusion center were analyzed, and the protocol design for creating hospital data fusion center was put forward according to the needs.Results:The protocol design for creating hospital data fusion center facilitates the specific methods of promoting hospital data fusion.Conclusion: The protocol design for creating hospital data fusion center may promote in-and out-hospital data-sharing service and comprehensive data utilization, so as to improve hospital information utilization.

Objective To find out easily-processed and longly-preservated nerve allograft transplantation which has not only no-obvious antigenicity,but the integral structure of intermal nerve membrane.Mehtods Acquire the nerve allografts under sterile condition,submerge them into 50 ,70 and 85 percent of glycerol for 3 hours respectively at 37 Centigrade degree,then put them into the containers which contain 85 percent of glycerol. After sealed and preservated at 5 Centigrade degree for 6 weeks,the processed nerves can be used for transplantation.Results 14 nerve allografts processed with glycerol were transplanted in 10 patients with nerve defects varying from 2.5 to 18 cm. After follow-up for 5 to 42 months,the effects were proved to be satisfactory.Conclusion It is obviously effective to transplant nerve allograft processed with glycerol and preservated for 6 weeks for bridging the defects of peripherall nerve through a series of clinical observations.

Objective To investigate the clinical features,safety and clinical efficacy of the posterior decompression and interbody fusion with internal fixation for complete thoracolumbar fracture and dislocation.Methods The clinical data of 23 patients with complete thoracolumbar fracture and dislocation treated by posterior decompression and interbody fusion with pedicle screw fixation from August 2011 to October 2014 were retrospectively analyzed.There were 18 males and 15 females,aging from 20 to 50 years old with an average age of 38.2±0.3 years.There were 8 cases of T10,11 vertebral dislocation,8 of T11,12 vertebral dislocation,3 of T12L1 vertebral dislocation,and 4 of L1.2 vertebral dislocation.All the patients had different degrees of multiple rib fractures and pneumothorax complications.Preoperative spinal cord nerve function was evaluated according to the American Spinal Injury Association of spinal cord function (ASIA).There were 10 cases of ASIA grade A and 13 cases of grade B.Operation time,intraoperative blood loss,clinical outcome,imaging X-ray and CT examination,segmental kyphosis angle and bone graft fusion were recorded.Results All the patients were followed up for 13 to 26 months,average 20.2±4.3 months.The operation time ranged from 150 to 260 min with the average time of 180.3± 14.8 min;intraoperative blood loss was 800-1 500 ml with the average of 950.2±98.1 ml.Preoperative sagittal Cobb angle was-13.5° ±6.3° (range,-20.1° to 2.3°);postoperative sagittal Cobb angle was 1.43°±6.4° (range,-7.6° to 3.5°);at the latest follow-up,sagittal Cobb angle was 1.6°±6.3° (range,-8.1° to 10.3°);the dislocation reduced from preoperative 100％ to postoperative 0-15％ (10％±6％).After operation,the ASIA grade of 2 cases improved from A to B,and 5 cases improved from B to C.All of the patients had bone fusion after operation,no false joint or nonunion occurred,no loosening or breakage of internal fixation occurred.Conclusion There are high risks and difficulty of surgery for those who with thoracolumbar fracture dislocation and severe injuries of spine and spinal cord combined with multiple injuries.Proper treatment of preoperative complications is the premise of good curative effect;reliable fusion and long segment internal fixation is the key of operation.Single posterior decompression and reduction with interbody fusion and internal fixation is less invasive and could achieve satisfactory clinical efficacy.

Objective To explore the effects of upper limb robot-assisted therapy on motor function and activities of daily living in con-valescent stroke patients. Methods From June to September, 2016, 12 chronic stroke patients at their first-ever stroke were enrolled and ran-domized into experimental group (n=6) and control group (n=6). Both groups received routine rehabilitation. Additional robot-assisted thera-py was provided to the experimental group, and additional repetitive movement training was provided to the control group, 20 minutes a day, five days a week for four weeks. Fugl-Meyer Assessment-Upper Extremities (FMA-UE), modified Ashworth Scale (MAS) and Func-tional Independent Measure (FIM) were used to assess the motor function of the upper limbs and hands, the muscular tension of shoulder and elbow, and activities of daily living (ADL) before and after treatment. Results After treatment, the scores of FMA-UE and FIM were bet-ter in both groups (Z>2.032, P<0.05), and no significant difference was found between two groups (t<0.723, P>0.05), however, the scores were a little bit higher in the experimental group than in the control group. After treatment, for the experimental group, the MAS scores of shoulder abduction/adduction and elbow flexion/extension improved (Z>2.121, P<0.05);for the control group, the MAS scores of shoulder abduction/adduction improved (Z>2.000, P<0.05), but the MAS scores of elbow flexion/extension were not significantly different (Z<1.890,P>0.05). There was no significant difference in the MAS scores of shoulder abduction/adduction and elbow flexion/extension between two group (Z<1.734, P>0.05). The moving trail recorded by the computer, gradually became a regular pattern from the mass, saying the motor control ability became better. Conclusion Upper limb robot-assisted therapy can promote the recovery of the motor function of upper limbs and ADL in convalescent stroke patient, similar to the repetitive movement training.

Objective To investigate the protective mechanism of hyaluronic acid (HA) antagonistic to nitmprusside sodium (SNP) on the tissue engineering cartilage. Methods Alginate culture for two weeks was used to recover phenotype of dedifferentiated chondrocytes. Differentiation state of chondrecytes was analyzed by immunostaining. The growth of alginate-recovered chondrocytes on the chitosan-based scaffold was observed by scanning electron microscope. After cultured for 3 weeks, this tissue engineering cartilage was treated with SNP in the absence or presence of HA combined with specific β1 integrin blocking antibody collagen type Ⅱ and aggreean were detected by RT-PCR and Western blot. Results Collagen type Ⅱ expression in dedifferentiated chondrocytes was significantly enhanced by alginate bead culture. The chitosan-based scaffold supported cell adhesion, proliferation and migration. A dose-dependent inhibitory effect on the expression of collagen type Ⅱ and aggrecan was observed when tissue engineering cartilage was treated with SNP alone. HA significantly promoted collagen type Ⅱ, and aggrecan expression antagonistic to low concentrations of SNP (p<0.05). However, the specific β1,integrin blocking antibody abrogated the effects of HA. Conclusion Alginate culture recovers the phenotype of dedifferentiated chondrocytes. HA abrogats the inhibitory effect of SNP via β1 integrin signal pathway to protect tissue engineering cartilage.

Objective To investigate the effect of different bone cement volume injected after vertebroplasty on stress distribution of the upper and lower endplates of the injured vertebra in the flexion and extension positions by finite element analysis.Methods Two patients with osteoporotic compression fractures of L2 vertebral body were chosen.Bone cement volumes of 25％ and 50％ were respectively injected into the fractured vertebral body bilaterally.Pre-and post-operative finite element models of fractured and adjacent vertebral bodies were developed after extracting the CT data.Stress changes at L2 superior-and inferior-vertebral endplates were observed in the vertical,flexion,and extension loading.Results Stress at the upper and lower endplates of the fractured vertebra increased after bone cement injection and more increase was observed in 50％ bone cement group than in 25％ bone cement group.In the neutral position,the stress mainly concentrated at posterior vertebral body,with stress of the upper endplate improving from 0.91 × 106 N · mm to 0.93 × 106 N · mm and stress of the lower endplate from 0.98 × 106 N ·mm to 1.03 × 106 N · mm.In the anterior flexion,the stress mainly concentrated at anterior vertebral body,with stress of the upper endplate improving from 4.44 × 106 N · mm to 5.55 × 106 N · mm.In the posterior extension,the stress mainly concentrated at medial vertebral body,with stress of the upper endplate improving from 21.95 × 106 N · mm to 22.10 × 106 N · mm and stress of the lower endplate from 30.60 ×106 N · mm to 30.88 × 106 N · mm.The finite element model revealed stress at the upper and lower endplates was higher in the anterior flexion and posterior extension than in the neutral position,while in the anterior flexion the stress was comparatively higher.Conclusions A small amount of implanted bone cement act no evident effect on stress distribution of the upper and lower vertebral endplates.However,the stress changes are significant as cement volume reached up to 50％,especially in the flexion position,as may suggest an enhanced risk of adjacent intervertebral disc degeneration and adjacent vertebral body fractures.

Taxus is the source plant of anti-cancer drug paclitaxel and its biosynthetic precursor, analogs and derivatives, which has been studying for decades. There are many endemic Taxus species in China, which have been studied in the field of multiple disciplines. Based on the recent studies of the researchers, this review comments on the study of Taxus biology and chemistry. The bibliometric method is used to quantify the global scientific production of Taxus-related research, and identify patterns and tendencies of Taxus-related articles. Gaps are present in knowledge about the genomics, epigenomics, transcriptomics, proteomics, metabolomics and bioinformatics of Taxus and their endophytic fungi. Systems biology and various omics technologies will play an increasingly important role in the coming decades.

BACKGROUND:Compared with traditional autogenous bone graft, composite, as the carrier of seed cells, possesses advantages of fewer traumas and no limitation of donor site in repairing bone defect.OBJECTIVE: To observe the ability of the composite of β-tricalcium phosphate artificial bone-hyaluronic acid-type I collagen (β-TCP/HA/COL-I), as induced bone marrow stromal cell (MSC) carrier, to repair rabbit radial defect, and the feasibility with the composite as bone substitute material.DESIGN: A randomized and controlled trial.SETTING: Department of Orthopaedics, Renmin HospitaL, Wuhan University.MATERIALS; The study was conducted in the Department of Orthopaedics Renmin Hospital, Wuhan University between September 2003 and July 2004. Thirty-one New Zealand big white rabbits, aged 6 months, with body mass of 1.5 to 2.0 kg were enrolled in this study. The rabbits were randomized into control group (n =4) and experimental group (n =27).METHODS : ①In vitro induction and culture of MSCs was performed on 31 white rabbits, and the alkaline phosphatase (ALP) positive ratio of induced MSCs was observed. The structure of β-TCP/HA/COL-I was observed under scanning electron microscope. ② A 2 cm radial defect was created through operation. Eight weeks later, composites of β-TCP/HA/COL-I/MSCs were implanted into one side of rabbits in the experimental group, and autogenous bone was implanted into the other side. Rabbits in the control group were untouched. ③All the animals in the experimental group were randomly sacrificed at postoperative 4,8 and 12 weeks, 6 rabbits at 4 and 8 weeks, 15 at 12 weeks; Animals in the control group were sacrificed at 12 weeks. Gross observation, X-ray photographing, haematoxylin-eosin (HE) dyeing, and assessment of inorganic ingredient were performed. Osteogenic area and biomechanical tests were performed at 12weeks. Repairing effects on bone defect in each group were compared.MAIN OUTCOME MEASURES: The ALP positive ratio of induced MSCs; The structure of composite ofβ-TCP/HA/COL-I;Gross observation; X-ray photographing; HE dyeing and assessment of inorganic ingredient; Osteogenic area and biomechanical tests.RESULTS: All the 31 rabbits entered the stage of result analysis. ① The ALP positive ratio of cells reached 75% after induction and culture. ② Scanning electron microscope observation showed that 3 kinds of materials with abundant cellular structure distributed evenly. ③ The osteogenic area at 12 weeks was (72.5±3.6)% and (76.7±6.2)% in the experimental group and autogenous group, respectively (P ＞ 0.05). ④The maximum bending moment was (521.0±61.1) and (554.3±53.3)N·mm in the experimental group and control group, respectively; The maximum displacement at point of application of force was (0.816±0.071)and (0.870±0.103)respectively, without significant difference (P ＞ 0.05). ⑤Inorganic ingredient in the composite was 75%, 57% and 42% at 4,8 and 12 weeks respectively, suggesting that the inorganic component in the material was gradually decomposed with the elongation of time. ⑥Results of gross observation,X-ray photographing, histopathological examination, biomechanical test showed that with the elongation of time, composite of β-TCP/HA/COL-I/MSCs could repair bone defect in the experimental group, while bone defect in the control group had not been repaired.CONCLUSTON: Composite of β-TCP/HA/COL-I /MSCs possesses the same effect on repairing bone defect as autogenous bone, so it may be used as autogenous bone graft substitute.