Objective To compare the clinical outcome of internal fixation(IF)and total hip arthroplasty (THA)for the elderly patients with displaced femoral neck fracture. Methods A total of 128 patients with dis-placed femoral neck fracture admitted from January 2010 to December 2012 were selected and divided into IF group(61 cases)and THA group(67 cases). The operation and hospitalization index were compared between the 2 groups. All patients underwent follow-ups after operation. The functional recovery scale for hip fracture (FRS) and EQ-5D index were applied to evaluate the clinical outcomes periodically. Results Compared to THA group, the intraoperative trauma ,operation time and bed days were less in IF group(P<0.05),however the incidence of complication in IF group was higher than that in THA group. All the patients were followed up more than 3 years and mortality rate between the 2 groups showed no significant difference(P>0.05). Follow-ups at all time points revealed hip function in THE group is better than that in IF group(P<0.05),while no significant difference was found in terms of life quality(P > 0.05). Within 3 years,the costs related to fracture were 41772 yuan for IF group and 61174 yuan for THA group respectively. Conclusion Both internal fixation and total hip arthroplasty can provide satisfactory outcome for elderly patients with displaced femoral neck fracture. Compared with IF ,THA causes bigger trauma and costs more ,but ends up with lower complication incidences ,and improve hip function in a shorter period.

Objective To investigate the impact of body mass index (BMI) on short-term and long-term prognosis in the patients with ST-segment elevation myocardial infarction (STEMI).Methods The clinical data of inpatients with STEMI in our hospital during 2014 were retrospectively collected.The patients conforming to the inclusion and exclusion criteria were divided into 4 groups according to BMI,low BMI group (n=31),normal BMI group (n=139),overweight group (n=71) and obesity group(n=26).The clinical baseline data were analyzed and compared among 4 groups,and the all-cause mortality on 7 d and within 1 year after myocardial infarction(MI) was followed up.Results The higher the BMI increased,the younger the patient's onset age (P＜0.01),the smaller the female proportion(P=0.001),among them,the albumin and hemoglobin levels in the obesity group were relatively higher(P=0.004;P =0.006);the all-cause mortality at 1 year after MI was significantly decreased with BMI increasing (P =0.003),while which on 7 d after MI had no statistical difference (P=0.287).Conclusion BMI is correlated with the long-term prognosis in the patients with STEMI,and "obesity contradiction" phenomenon exists in the patients with STEMI.However,the influence of BMI on the prognosis in the patients with STEMI should be comprehensively evaluated by combining with the multiple factors such as the patient's age,sex,complications and medication therapy.

AIM:To observe how total flavonoids of Pterocarya hupehensis Skan(PHSTF)affects the migra-tion and invasion of human rheumatoid fibroblast-like synoviocyte line MH7A.METHODS:The MH7A cells were divided into control group(without any treatment),low-,medium-and high-dose(6.25,12.5 and 25 mg/L,respectively)PHSTF groups,phosphatidylinositol 3-kinase(PI3K)inhibitor 740Y-P(10 μmol/L)group,and 740Y-P(10 μmol/L)+high-dose(25 mg/L)PHSTF group.The viability of the MH7A cells was determined by CCK-8 assay,while the migration and inva-sion were assessed by scratch and Transwell assays.The protein levels of matrix metalloproteinase-2(MMP-2),MMP-9,PI3K,p-PI3K,AKT and p-AKT were detected by Western blot.RESULTS:Compared with control group,the cell via-bility in PHSTF treatment groups was reduced(P<0.05),the cell wound healing area was significantly decreased(P<0.01),migratory and invasive cells in the lower chamber were significantly reduced(P<0.01),and the protein expres-sion of MMP-2 and MMP-9 and the ratios of p-PI3K/PI3K and pAKT/AKT were decreased(P<0.01).Compared with high-dose PHSTF group,the addition of PI3K/AKT pathway agonist 740Y-P significantly increased the migration and invasion ability of MH7A cells(P<0.01)and elevated the protein expression of MMP-2 and MMP-9 and the ratios of p-PI3K/PI3K and pAKT/AKT(P<0.01)under the treatment with PHSTF.CONCLUSION:Total flavonoids of Pterocarya hupehensis Skan could inhibit the migration and invasion of MH7A cells by regulating the PI3K/AKT signaling pathway.