Objective To explore the value of different surgical methods in the treatment of the displaced femoral neck fracture of the elderly. Methods An follow up study was done on 89 cases older than 65 years who were treated with internal fixation, femoral head arthroplasty and total hip joint replacement between 1998 and 2003 to compare the difference upon operation time, blood loss, duration of hospitalization, joint function evaluation one and two years after operation, complications and reversion rate. Results The internal fixation group had the shortest operation time and hospitalization and the least blood loss but the longest immobilization time, highest complication rate and reversion rate as well as the worst joint function. While the total hip joint replacement group had the least immobilization time, the lowest complication rate and reversion rate, best joint function but required better health condition. The femoral head arthroplasty group had the least operation injury but had relative higher reversion rate and worse joint function compared to the total hip joint replacement group. Conclusion Total hip joint replacement is suitable for the displaced femoral neck fractures of the elderly, especially those who are active have relative longer life expectancy and good general condition.

Objective To explore the expression levels of RAS-interacting protein 1 (RASIP1) mRNA and protein in hepatocellular carcinoma (HCC) tissues and its cell lines,and to analyze the relationship between RASIP1 and tumorigenesis and progression of hepatocellular carcinoma.Methods The expression levels of RASIP1 mRNA and protein in 29 hepatocellular carcinoma tissues and the corresponding adjacent non-cancer liver tissues (ANLTs),as well as those in the HCC cell lines such as LO2,HEPG2,MHCC97-H and HCCLM3 were detected using real-time PCR and western blot.Results The RASIP1 expression levels decreased significantly in HCC tissues when compared with the corresponding ANLTs; The expression levels of RASIP1 mRNA and protein in LO2 were significantly higher than those in other HCC cell lines (P ＜ 0.05) ; The expression levels of RASIP1 mRNA and protein in MHCC97-H and HCCLM3 were significantly lower than those in HepG2 (P ＜ 0.05).Conclusions HCC tissues had lower expression than those in ANLTs.On analyzing the RASIP1 levels of HCC tissues and its cell lines,we speculated that RASIP1 might suppress recurrence and metastasis of HCC.

To investigate the effects of different fluid resuscitation on renal function and glycocalyx in septic shock rats. The septic shock SD rats (induced by lipopolysaccharide) were randomly divided into control group, normal saline resuscitation group, Lactate Ringer′s solution resuscitation group and succinyl gelatin resuscitation group ( n=6 each). The mean arterial pressure, heart rate, serum creatinine (Scr), urea nitrogen (BUN), renal blood flow, renal tissue pathology, serum interleukin-6, tumor necrosis factor α and glycocalyx were measured at baseline, the development of septic shock, 0 hour and 8 hours after resuscitation. When shock was established, the renal blood flow significantly decreased ( P<0.05) and recovered to normal at 0 hour and 8 hours after resuscitation. Compared with normal saline group and succinyl gelatin group, the levels of Scr, BUN and glycocalyx components (heparan sulfate, syndecan-1) were significant lower in Lactate Ringer′s solution group ( P<0.05). The pathology of kidney tissue suggested that the microscopic ischemic damage with Lactate Ringer′s solution were minor than the other two groups. Compared with normal saline and succinyl gelatin, Lactate Ringer′s solution can reduce the damage of renal function and glycocalyx in septic shock rats.

Objective To analyze the efficacy and safety of catheter-directed thrombolysis (CDT) for acute lower extremity deep venous thrombosis (DVT) in patients aged 70 years and over.Methods Clinical data of 109 cases who had acute lower extremity DVT and had been treated with CDT from March 2011 to September 2014 were retrospectively analyzed.Results Inferior vena cava filters (IVCF) were implanted in 109 patients.A thrombolytic catheter was inserted from the contralateral femoral vein (21 cases),ipsilateral popliteal vein (44 cases),posterior tibial vein (28 cases) or small saphenous vein (16 cases).The duration of thrombolysis was (5.47±2.13) d.The dosage of urokinase was (3.80 ± 0.56) million units.Forty-two cases underwent balloon dilatation alone,and 67 cases combined balloon dilatation with stent implantation.Gingival bleeding occurred in 7 patients and gross hematuria occurred in 4 patients during thrombolysis,which disappeared after medication adjustment.No symptomatic pulmonary embolism (PE) or other serious complications were found in any patients.There were significant differences in the venous patency score and lower limb circumferences at 10 cm above and below the knee one week after treatment (t=3.874,P=0.031).Ninety-seven cases were followed up for a mean period of (20.76.5) months,and the vein patencyrate was (77.9± 10.5) ％ and (73.1±9.4) ％ at 6 and 18 months after treatment,respectively.Recurrence of deep vein thrombosis was found in 6 cases,of which 2 cases had recurrent stent thrombosis,and treatment with CDT again was successful.No severe deep venous thrombosis syndrome (PTS) was found during the follow-up.Conclusions CDT is a minimally invasive procedure and can rapidly resolve limb venous drainage disorders.CDT is safe,has few complications and usually generates satisfactory outcomes.For very-old elderly patients who have no anticoagulation and thrombolytic contraindications,CDT is a useful option for the treatment of acute lower limb DVT.

Objective To explore the influence of continued case nursing on medicine compliance and disease relapse of patients with schizophrenia.Methods Eighty patients with schizophrenia were divided into experiment group and control group according to admission sequence and random digit table,with 40 in each group. Both groups received case management. The control group received routine outpatient visit.The experiment group received continued nursing of primary nurse’s case management based on traditional method for a year.The two groups were compared in terms of the medicine compliance and disease relapse.Result The medicine compliance of the experiment group was higher than that of control group and the disease relapse of the experiment group was lower than that of control group(P<0.05).Conclusion The continued case nursing to patients with schizophrenia can increase medical compliance and reduce incidence of disease relapse,which is an effective hospital-community management mode.

Objective To evaluate the difference between nodal and extra-nodal diffuse large B-cell lymphoma (DLBCL) in clinical-pathological feature and prognosis.Methods The clinical data of 134 cases of DLBCL patients were reviewed and analyzed.Results The DLBCL patients accounted for 52.14 ％ (134/257) of non-Hodgkin lymphoma of the same period and the extra-nodal DLBCL patients accounted for 69.4 ％.The proportion of stage Ⅲ/Ⅳ disease in extra-nodal DLBCL and nodal DLBCL were 55.9 ％ (52/93) and 75.6 ％(31/41),respectively.Elevated LDH was reported in 33.3 ％ (31/93) of extra-nodal DLBCL and 58.5 ％ (24/41)of nodal DLBCL Other clinical characteristics such as B symptoms,bulky disease,elevated ESR,ECOG scores and IPI scores were not significantly different between these two groups (all P ＞ 0.05).No difference in the frequency of GCB and non-GCB subtypes was observed between extra-nodal and nodal DLBCL (P =0.623).The 3-year overall survival rates and 3-year progression free survival rates for extra-nodal and nodal DLBCL were 73.2 ％,55.2 ％ (P =0.065) and 46.3 ％,44.1％ (P =0.748).Conclusions The morbidity of extranodal DLBCL is high.Primary extra-nodal DLBCL patients present early-stage disease and normal LDH more frequently than the nodal DLBCL,while no significant difference in the frequency of pathological subtypes and 3-year OS and PFS is observed between these two groups.

OBJECTIVE:To observe the clinical efficacy and safety of azithromycin combined with Reduning injection in the treatment of children with mycoplasma pneumoniae infection. METHODS:80 children with mycoplasma pneumoniae infection were randomly divided into control group and research group. All the children were given routine treatment,including oxygen inha-lation,defervescence,nutritional support,reducing sputum and relieving asthma,etc. Based on it,children in control group were orally treated by Azithromycin enteric coated tablets 10 mg/kg,once a day. Children in research group were treated by Reduning in-jection 10 ml and 5% glucose injection 100 ml by intravenous infusion,once a day,based on the treatment in control group. The course of both was 14 d. The clinical data was observed,including the clinical efficacy,interleukin-6 (IL-6),interleukin-8 (IL-8),tumor necrosis factor-α(TNF-α)and the incidence of adverse reactions(ADR)before and after treatment. RESULTS:The total effective rate in research group was significantly higher than control group,with significant difference(P<0.05). After treat-ment,the IL-6,IL-8 and TNF-α in 2 groups were significantly lower than before,and research group was lower than control group,with significant difference(P<0.05). There were no significant differences in the incidence of ADR in 2 groups(P>0.05). CONCLUSIONS:Based on the routine treatment,azithromycin combined with Reduning injection has more obvious efficacy than only azithromycin in the treatment of children with mycoplasma pneumoniae infection with similar safety.

To determine the etiologic agent of an outbreak of influenza viruses from Changsha Foothill Mountain International School in 2009, and to analyze the HA Gene Characteristic of the H1N1 influenza viruses. Twenty-five nasopharyngeal swab specimens from the outbreak of influenza viruses were tested by conventional RT-PCR and influenza viruses isolated simultaneously. Virus isolated (A/Yuelu/314/2009) from the outbreak was sequenced by CEQTM 8000 Genetic Analysis System and the sequencing results submitted to GenBank (Accession No: FJ912843), then the sequencing data was analyzed by ClustalX and Mega4.1softwares. Results showed the influenza viruses A(H1N1) of positive were 18 cases by influenza viruses isolated tests and 21 cases by conventional RT-PCR, respectively. The nucleotide and amino acid sequence homology of the HA gene of A/Yuelu/314/2009 are 99% compare with the vaccine strain (A/Brisbane/59/2007) in 2008~2009 years. The HA sequence data also showed that had 6 amino acid mutations (V148A, S158N, G202A, I203D, A206T, W435R), and the S158N located at antigenic site B of HA protein. Nine potential glycosylation sites (27, 28, 40, 71, 151, 176, 303, 497, 536) in the HA sequence of A/Yuelu/314/2009 is the same with A/Brisbane/59/2007, and the sequences of potential glycosylation sites were conserved. In this study, laboratory evidence diagnosed seasonal influenza A virus (H1N1) as the etiologic agent of the outbreak. The virus isolated (A/Yuelu/314/2009) strain of H1N1 subtype is not a new variant in Changsha in 2009 compare with the vaccine strain (A/Brisbane/59/2007), the outbreak of influenza A virus (H1N1) from Changsha Foothill Mountain International School maybe are caused by the change in genetic characteristics between vaccine strains and the decreased of immunity to influenza A virus (H1N1) in the crowd.

Objective To explore the effects of exemestane combined with chemotherapy on the expressions of matrix metalloprotein-9 (MMP-9) and E-cadherin in breast cancer mice.Methods The SPF BALB/c female mice were selected,25 mice with breast cancer model were successfully established and randomly divided them into 3 groups:endocrine group with 8 mice and was given 25 mg of exemestane tablets by gavage once a day;chemotherapy group with 8 mice and was given a range of TP chemotherapy (paclitaxel,135 mg · m-2 and cisplatinum 20 mg · m-2);combined group with 9 mice and was given 25 mg of exemestane tablets by gavage once a day and a range of TP chemotherapy.The normal group contained 6 normal healthy mice and was given the same feeding without drugs.After feeding for 3 weeks,all mice were killed.The expression levels of MMP-9 and E-cadherin in mice right axillary subcutaneous tissue of the four groups were investigated by fluorescence quantitative PCR,immunohistochemistry and Western blot.Results The expression levels of MMP-9 protein in mice:Compared with normal group 0.01 ± 0.00,endocrine group,chemotherapy group,combined group were 0.75 ± 0.37,0.71 ± 0.25,0.33± 0.01 with increased significantly (all P ＜ 0.05);compared with combined group,endocrine group and chemotherapy group increased significantly (all P ＜ 0.01).The expression levels of E-cadherin protein in mice:Compared with normal group 0.64 ±0.28,endocrine group,chemotherapy group,combined group were 0.17 ± 0.08,0.20 ± 0.17,0.44 ± 0.28 with decreased significantly(all P ＜ 0.05);compared with combined group,endocrine group decreased significantly(all P ＜ 0.01).The expression levels of MMP-9 mRNA (MMP-9/β-actin) in mice:Compared with normal group 0.48 ± 0.04,endocrine group,chemotherapy group,combined group were 10.80 ± 0.04,10.54 ± 0.13,3.48 ± 0.04 with increased significantly (all P ＜0.05);compared with combined group,endocrine group decreased significantly(all P ＜ 0.01).The expression levels of E-cadherin mRNA (E-cadherin/β-actin) in mice:Compared with normal group 13.36 ± 0.06,endocrine group,chemotherapy group,combined group were 5.13 ±0.04,5.25 ±0.02,11.36-±0.06 with decreased significantly (all P ＜0.05);compared with combined group,endocrine group decreased significantly (P ＜ 0.01).Conclusion There are close relationships between the expression levels of MMP-9 and E-cadherin and breast cancer,and the combination of exemestane and chemotherapy could significantly improve the expression levels of MMP-9 and E-cadherin.

To investigate the clinical features of laryngeal papilloma in children.Method:In a group of 62 patients with laryngeal papilloma in children,the tumors of 28 patients were cut under the direct laryngoscope,34 patients were treated with laryngeal micro-laser operation.Result:The post-operation followup ranged from 2 to 5 years,the cure rate of 2 years was 51.61%.Conclusion:The clinical features of this disease include rapid development,a large lesion,and it is often found in the infraglottic cavity.Furthermore,we believe that in order to eliminate the tumors more accurately and decrease recurrence,microlaser surgery and the use of interferon is very necessary.