Objective To evaluate bone cement longer handle artificial femoral head replacement treatment the clinical effect of the treatment of femoral fractures between rotor-instability.Methods There were 98 patients with fracture of instability-between the femur rotor ,women 60 cases,38 cases,male,aged 75 to 94 years old,average 83.5 years.Fractured by Tronzo-Evans type III 56 cases,type IV 42 cases.All use of bone cement longer handle arti-ficial femoral head replacement therapy ,to observe clinical therapeutic effect .Results All cases of postoperative X-ray showed both fracture reduction and fixation well between the rotor and prosthesis position is good .96 cases of post-operative for 6 to 24 months followed-up,the average 15 months.Harris score was 85.4%.Conclusion Bone cement longer handle artificial femoral head replacement has quick postoperative functional recovery ,weight-bearing activities earlier,which can avoid the advantages of long-term complications in bed ,instability is treatment of older femoral frac-tures between rotor reasonable operation method .

Objective To investigate the relationship among the leptin receptor(lepr) gene exon 20,nucleotide 3057 G→A transition and lipid metabolism,insulin sensitivity index,high blood coagulation in type2 diabetes mellitus.Methods Polymerase chain reaction(PCR) and restriction fragment length polymorphism(RFLP) were used to detect the variation of leptin receptor gene nucleotide 3057 G→A transition;Simultaneusly,we detected some parameters,including blood lipids,height,weight,blood glucose,waistline to hipline ratio(WHR).The body mass index(BMI),fat percent,insulin sensitivity index(ISI) were calculated out in all subjects.Results The variation frequency at 3057 nucleotide G→A transiton was 80% in type 2 diabetic group,though it was 68% in control group(P

BACKGROUND:Total knee arthroplasty had been generaly accepted as the final treatment plan, relieving pain and reconstructing function of knee joint. However, whether drainage tube can be used after replacement is stil controversial.
OBJECTIVE:To compare the clinical effects of drainageversusnondrainage after primary unilateral total knee arthroplasty.
METHODS:Total 102 patients undergoing primary unilateral total knee arthroplasty were randomly divided into 2 groups. In the drainagegroiup, a drainage tube was used. In the nondrainage group,
drainage tube was not used. Total blood loss was calculated by recording the hemoglobin and hematocrit before operation and that after 1, 3, 7 days of operation. The pain visual analogue scale scores, arthrocele, ecchymosis, infection rate, and deep venous thrombosis of lower extremity were examined and analyzed postoperatively. Knee Society Scores were recorded at 1 year postoperatively. Above indexes were compared between the two groups.
RESULTS AND CONCLUSION:(1) Total blood loss and blood transfusion rate were significantly higher in the drainage group than in the nondrainage group (P< 0.05). (2) There was no statisticaly significant difference in the pain visual analogue scale scores, arthrocele, ecchymosis, infection rate, and deep venous thrombosis of lower extremity between the two groups after replacement (P> 0.05). (3) No significant difference in Knee Society Scores was detected between the two groups (P> 0.05). (4) Results indicated that the total blood loss and blood transfusion rate may decrease significantly in patients without wound drainage after total knee arthroplasty. Limb sweling and ecchymosis area were not increased. No significant difference in infection, deep venousthrombosis of lower extremity and knee function was detectable between the two groups. Thus, total knee arthroplasty without wound drainage is safe and does not have obvious adverse consequences.

Objective To investigate the effects of a variety of different methods of analgesia on postoperative pain and cognitive function in elderly esophageal cancer patients.Methods Sixty elderly pa-tients scheduled for the left into the thoracic esophageal cancer surgery were randomly divided into two groups (n =30).Group A:Before the closure of thoracic cavity to block intercostal nerve with 0.375% rop-ivacaine,followed by intravenous pumps for analgesia,formulation of sufentanil 3 μg/kg+flurbiprofen 100 mg,pump speed 2 ml/h,self-controlled analgesia 0.5 ml/pressing,locking time 15 min.Group B:Before the closure of thoracic cavity given sufentanil 10 μg+flurbiprofen 50 mg as loading dose followed by epidural analgesia pump,recipe with group A.Two groups were observed mini mental state examination (MMSE) score 1 d before surgery and 3,5,7 d after surgery,each time point visual analogue pain score (resting and exercise VAS)score postoperative within 48 h,BCS comfort score and effective pressing times of postopera-tive analgesia pump.Results Compared with group B,the rest and exercise VAS scores of group A at post-operative recovery,4,8,12,24,48 h were significantly lower (P <0.05);the BCS scores of group A at postoperative 4,8,12,24,48 h were significantly higher (P <0.05);the pressing times of group A at postoperative 4,8,12,24,48 h were significantly reduced (P <0.05);the MMSE scores of group A at postoperative 3,5,7 d were significantly higher (P <0.05);the incidence of POCD of group A on postop-erative 3,5,7 d were significantly lower.Conclusion Thoracic surgery perioperative multimodal analgesia (intercostal nerve block and intravenous analgesia)can relieve postoperative pain,reduce the incidence of POCD,improve the postoperative patient comfort and help postoperative patients with rapid recovery.

Objective To investigate the neuroprotective effects of phycocyanin injection by internal carotid artery in acute cerebral ischemic reperfusion in rats.Methods The model of middle cerebral artery occlusion reperfusion(MCAO/R) was established using the intraluminal filament occlusion with 84 healthy adult male Wistar rats,and treated by phycocyanin injection through internal carotid artery.The nervous function scores,brain water content,cerebral infarction volume and cell apoptosis in brain tissues and the phycocyanin effects on above indexes were measured respectively.Results The rats showed some extent of neurobehavioral function disorders after ischemic reperfusion.In phycocyanin group rats,the nervous function scores,brain water content,cerebral infarction volume and the number of apoptotic cells in cortex,striatum and hippocampus reduced significantly compared to the model group.Conclusion phycocyanin injection through internal carotid artery showed obvious neuroproctective effects in acute cerebral infarction in rats.

Objective To study the T cells lineage polymorphism of TCR BV CDR3 in the peripheral blood of ankylosing spondylitis (AS) patients,in order to provide experimental basis for the immunological patho-genesis study of AS.Methods Twenty-six subfamilies of CDR3 T cells of TCR BV in the PBMC of AS patients were amplified by RT-PCR method,then TCR BV CDR3 lineages polymorphism were analyzed by immunization scanning spectrum.Results TCR BV CDR3 scanning spectrum of 20 active AS patients showed abnormal distribution peak,including monoclonal,oligoclonal/oligoclonal trend,skewing peak and irregular abnormal peak.Among them,some subfamilies of 18 patients showed oligoclonal/oligoclonal trend expansion,BV16 and BV18 two subfamilies of one case showed monoclonal expansion.Most spectral type of PBMC TCR BV CDR3 in five normal controls showed Gauss distribution.Conclusion TCR BV CDR3 lineage have significant characteristic polymorphism and spectrum drift characteristics in the peripheral blood of AS patients,which further indicate that T cells has plaied an important role in the immunological pathogenesis of AS.Monoclonal/oligoclonal expansion of T cells may be autoreactive T cells in nature and they may be involved in the pathogenesis of AS.

The rats were assigned to blank control group, classical induction group, and drynaria total flavonoid group. Whole bone marrow culture method was applied to isolate and purify rats bone mesenchymal stem cells (BMSCs). Akaline phosphatase activity, calcium nodes, TGF-β1 and BMP-2 secretion in the process of bone mesenchymal stem cells osteogenic differentiation were detected. The results showed that compared to the blank group and classical group, drynaria total flavonoid promoted osteogenic differentiation accompanied with increased TGF-β1 and BMP-2 secretion (all P＜0. 05). Drynaria total flavonoid may promote osteogenic differentiation of BMSCs via upregulating TGF-β1 and BMP-2 expressions, and play an active role in the treatment of osteoporosis.

Objective To evaluate the prognosis influencing factors of early non-small cell luny cancer (NSCLC) after radiotherapy.Methods 81 early NSCLC patients received definitive radiotherapy and were eligible.Among these patients,60 were diagnosed as squamous cell carcinoma,16 were adenocarcinoma and 5 were diagnosed through imaging instead of pathology.45 patients received conventional radiotherapy,36 patients received three dimensional conformal radiotherapy (3D-CRT),All of them received a total dose of 50-96 Gy with a median dose of 67.8 Gy. Kaplan-Meier survival curves and Cox regression model analysis were applied to evaluate the survival and prognostic factors. Results The median survival time was 34 months.The 1-,3- and 5-year survival rates (OS) were 88.7 ％,41.9 ％,21.8 ％,respectively.Karnofsky performance status≥80,Clinical stage, diameter≤4 cm and the therapeutic effect were associated with improving overall survival.Cox hazards model showed that Karnofsky performance status≥ 80 and diameter≤4 cm were likely to be independent positive prognostic factors. Conclusion Karnofsky performance status and tumor diamater can be used to evaluate the prognosis of early NSCLC after radiotherapy.

AIM: To observe effect of Diyu Shengbai Tablet on preventive treatment for interferon-induced leu-kopenia. METHODS: One hundred and twelve patients with chronic hepatitis B treated by IFN were randomly as-signed into two groups, and they were respectively treated with Diyu Shengbai Tablet and Leucogen for 7 days before treatment by IFN. The leukocyte count of each group was done in 3 days,7 days, 10 days, 14 days,28 days after treatment by IFN. Comparison was made on the value of leukocytes between two preventive treatment groups. RE-SULTS: In the third day after treatment by IFN the value of ANC were(1.91±0.56)×10~9/L, (1.48±0.55)× 10~9/L respectively. The value of leukocytes were (3.91±0.33)×10~9/L, (3.16±0.49)×10~9/L respectively. They had the statistical difference (P<0.05). CONCLUSION: Diyu Shengbai Tablet has an effect on preventing lekopenia induced by IFN, and it is a safe, cheap and convenient drug to treat leucopenia by IFN.

Objective To investigate the relationship between human leptin receptor(LEPR)gene G3057A polymorphism and type 2 diabetes complicated with non-alcoholic fatty liver disease(NAFLD).Methods 216 cases of newly diagnosed type 2 diabetes(104 cases complicated with NAFLD)and 108 cases of normal glucose tolerances(NGT)were recruited.Hemi-nested PCR-RFLP and PCR direct sequence analysis were conducted to detect the polymorphisms of LEPR G3057A polymorphism.The plasma leptin and insulin levels were measured by ELISA kit.Plasma lipid and glucose metabolic parameters were measured routinely.Liver ultrasound scanning Was carried out among all subjects.Results Type 2 diabetic patients complicated with NAFLD had higher plasma alanine aminotransferase(ALT),triglycerides(TG),low density lipaprotein cholesterol(LDL-C),leptin levels and lower plasma insulin levels than those cages without NAFLD and NGT.The variant frequency at nucleotide 3057 G to A transversion Was 76.0% in type 2 diabetic patients complicated with NAFLD,which Was also significant higher than those cases without NAFLD(62.1%)or NGT cases(53.2%)(x2=14.63,P＜0.01).Conclusions The polymorphism of LEPR gene 3057 probably contributes to the onset of NAFLD in type 2 diabetes by regulating lipid metabolism and affecting insulin sensitivity.