BACKGROUND:There are many reports about clinical effect of femoral fractures with intramedul ary nail and distal femoral fractures with locking plate. However, there is less report about clinical effect of femoral and distal femoral fractures.
OBJECTIVE:To investigate the clinical effect of femoral and distal femoral fractures using intramedul ary nail combined with locking plate.
METHODEighteen patients with femoral and distal femoral fractures were treated by internal fixation with intramedul ary nail combined with locking plate. Among them, six cases had femoral and supracondylar fractures, seven cases had femoral and condylar fractures, and five cases had femoral and intercondylar fractures.
According to the AO classification, three cases were type 33A2, three cases were type 33A3, two cases were type 33B1, five cases were type 33B2, one case was type 33C1, three cases were type 33C2, and one case was type 33C3. The fractures union and complications were fol owed up and observed, and knee joint function was judged by HSS score.
RESULTS AND CONCLUSION:Al the 18 patients were fol owed up for 12-24 months. The time for fracture union ranged from 3 to 5 months, average 3.4 months. No infection and disunion, no fracture malunion, no internal fixation loosening and breaking, no refracture happened. The HSS score ranged from 68 to 96 points, average 86.8 points. There were 12 excellent cases, 5 good cases, and 1 common case. The excellent and good rate was 94.4%. The internal fixation using intramedul ary nail combined with locking plate is a good method for treatment of femoral and distal femoral fractures, due to less surgical trauma, simple and reliable fixation, high rate of fracture healing, low rate of complications, and excellent function.

AIM: The purpose of this study was to determine whether the signal transduction systems were activated at the molecular atrial tissue level in patients with atrial fibrillation (AF) and whether atrial expression of extracellular-signal regulated kinase (ERK) and protein phosphatases is altered. METHODS: Atrial tissue sample of 30 patients undergoing cardiac surgery were examined. 20 patients had AF, 10 patients had no history of AF. The mRNA expression of calcineurin B and MKP-1 were detected by semi-quantitative RT-PCR. ERK1 and phospho-ERK1 were analyzed at the protein level by Western blot. RESULTS: Western blot analysis showed that atrial fibrillation did not induce significant change in ERK1 expression level in the left atrium. In contrast , phospho-ERK1 content was increased in the patients with AF in comparison with those who had sinus rhythm (SR). The mRNA expression of calcineurin B and MKP-1 in the patients with AF were significantly higher than that in patients with SR. CONCLUSION: The activation of extracellular-signal regulated kinase and protein phosphatases may have correlation with the initiation or maintenance of atrial fibrillation.

The main acupoints ofZhongwan (CV 12), Tianshu (ST 25), Zusanli (ST 36), Shangjuxu (ST 37), Dachangshu (BL 25) and Shenque (CV 8), in combination with the corresponding acupoints based on the syndrome differentiation, were selected to treat 28 cases of chronic nonspecific ulcerative colitis, the result showed clinical cure in 18 cases, clinical effect in 15 cases, failure in 5 cases. The most treatment times were 46, and the least 25.

[Objective]To compare the clinical outcomes of fresh embryo transfer of the in vitro fertilization/intracytoplasmic sperm injection and embryo transfer(IVF/ICSI-ET)in different age groups as well as in different responders using gonadotropin-re-leasing hormone agonist(GnRH-a)long protocol or GnRH antagonist(GnRH-ant)protocol.[Methods]A retrospective analysis was performed on 737 IVF/ICSI cycles,including 386 cycles of GnRH-a long protocol(group A)and 351 cycles of GnRH-ant protocol (group B),from August 28,2015 to December 31,2016. Then all the cycles were divided into sub-groups by ages and retrieved oo-cyte numbers:group a1(<38 years),group a2(≥38 years);group b1(n≤5),group b2(6≤n≤15),group b3(n>15). The basic information of patients and clinical outcomes were compared.[Results](1)Comparable results were obtained from group A and group B in these following variables such as fertilization rate,normal fertilization rate,biochemical pregnancy rate and miscarriage rage. But the stimulation period,the total gonadotropin(Gn)dosage,estradiol(E2)level and endometrial thickness on the day of human chorionic gonadotropin(hCG)administration,number of oocytes retrieved and mature oocytes,ovarian hyperstimulation syn-drome(OHSS)rate,implantation rate and clinical pregnancy rate were significantly higher in group A than group B(P<0.05),and significantly higher cancellation rate of fresh embryo transfer was observed in group B(P<0.001).(2)When divided by ages,no mat-ter in sub-group a1 or sub-group a2,the implantation rate was slightly lower in GnRH-ant protocol than in GnRH-a long protocol, although they failed to reach significant difference(sub-group a1:32.6%vs 39.8%,P=0.067;sub-group a2:9.7%vs 17.9%,P=0.066). The clinical pregnancy rate was comparable using these two protocols in sub-group a1(54.8%vs 50.4%,P=0.429),but it was significantly lower by using GnRH-ant protocol than GnRH-a long protocol in sub-group a2(19.6%vs 39.1%,P=0.021).(3) When divided by numbers of oocytes retrieved,the implantation rate was significantly lower when using GnRH-ant protocol in sub-group b1(13.1%vs 26.0%,P=0.026),but we failed to observe significant differences in other two sub-groups. The clinical preg-nancy rates were comparable in all sub-groups ,whereas differed considerably in sub-group b1 (36.6% vs 19.3%,P = 0.056).[Conclusion]Overall,the implantation rate and clinical pregnancy rate were higher in GnRH-a long protocol than those in GnRH-ant protocol. Nevertheless,GnRH-ant protocol could reduce the dosage of Gn,shorten the treatment duration,and effectively reduce the occurrence of OHSS. There were similar pregnancy outcomes in two protocols for normal responders and high responders ,while for advanced patients or other poor responders,the implantation rate and clinical pregnancy rate were higher in GnRH-a protocol.

Objective Analyzing risk factors for gastrointestinal bleeding(GIB) after coronary artery bypass grafting(CABG). Methods 582 cases undergoing CABG from August 2001 to May 2005 were divided into two groups (GIB group ,n=6 ;control group,n=576) . Preoperative , operative and postoperative clinic data were com-pared. Results The ratio of over-aging(age greater than 70), hypertension, cerebrovascular disease, myocardial in-fraction,heart function (NYHA) over Ⅲ and postoperative low output syndrome (LOS) in GIB group were signifi-cantly higher than that in control group;age, blood transfusion and hospitalized time were significantly higher and left ventricular ejective fraction was significantly lower in GIB group than that in control group. Age over 70,history of myocardial infraction and heart function (NYHA) over Ⅲ were selected as risk factors of GIB after CABG by step-wise logistic regression analysis. Conclusions It is very useful for precaution, early diagnosis and early therapy of GIB after CABG to evaluate if patients have the risk factors of GIB after CABG before operations.

Background Antagonists against vascular endothelial growth factor (VECF) play key roles in treating and preventing neovascular ophthalmopathy. As a novel anti-angiogenic factor, insulin-like growth factor binding protein-related protein 1 (IGFBP-rP1) might be an antagonist against VEGF in eye. Objective This study was to explore the inhibitory effect of IGFBP-rP1, a novel anti-angiogenic factor, on VEGF-induced retinal angiogenesis in vitro. Methods The retina-choroid endothelial cell line ( RF/6A ) was cultured in DMEM containing 10% fetal bovine serum. Culture cells were divided into control group(free-serum culture group) ,10mg/L VEGF culture group and different concentrations of IGFBP-rP1 (50,100,200 mg/L) +10 mg/L VEGF group. The expression of IGFBP-rP1 in the cells was detected by immunofluorescence assay. The proliferation and migration of RF/6A cells were evaluated using MTS colorimetric assay and the chemotactic motility assay, respectively. Flow cytometry was used to detect the apoptosis of RF/6A cells. Results The immunofluorescence assay RF/6A cells showed the green fluorescence in cytoplasm and red fluorescence in nuclei after cells were exposed to any concentration of IGFBP-rP1 ,but only red fluorescence was seen in nuclei in control cells. After stimulation of 10 mg/L VEGF,the proliferation value (A490) was elevated and the numbers of cell migration were increased in comparison with control group (t = -15. 191, P = 0. 000; t = -21. 274, P = 0. 000 ) , but the cellular apoptosis rate was lower than the control group (t - 10. 228, P = 0. 000 ) . After treated with various concentrations of IGFBP-rP +10% VEGF, the proliferation and migration of RF/6A cells were significantly decreased in comparison with only 10% VEGF group (F = 534. 158,P = 0. 000;F = 2742. 323,P = 0.000,respectively) ,and the inhibitory effects were gradually enhanced with the increase of IGFBP-rP1 levels (P<0. 05). The apoptosis rate of RF/6A cells in 50,100 and 200 mg/L + 10 mg/L VEGF groups increased by ( 1. 26±0. 04)% ,( 1. 50±0. 07)% and ( 1. 93±0. 27)% respectively,showing significant differences among different groups ( F = 274. 273, P = 0. 000). Conclusion IGFBP-rP1 inhibits the proliferation and activity of retina and choroid endothelial cells induced by VEGF at a concentration-independent manner. It appears to be as a novel endogenous inhibitory factor in retinal angiogenesis.

OBJECTIVETo study the predicting effect of proly 4-hydroxylase beta polypeptide (P4HB) in treating non-small cell lung cancer (NSCLC) patients by Yiqi Chutan Recipe (YCR).

METHODSTotally 46 stage III and IV NSCLC patients were treated by YCR for 4 therapeutic courses. Effect was assessed by RECIST of solid tumor. P4HB expression was detected in the lung cancer tissue by immunohistochemical assay. Factors affecting disease control rates (DCR) of YCR were analyzed by Logistic regression analysis. The correlation between P4HB expression and the effect of YCR was analyzed.

RESULTSThe DCR of advanced NSCLC treated by YCR was 36.96% (17/46 cases). P4HB was high expressed in advanced lung cancer tissue (6/15 cases). Gender, initial treatment, and retreatment are independent factors for affecting DCR of treating lung cancer by YCR.

CONCLUSIONP4HB might be taken as a factor for predicting the effect of YCR in treating NSCLC.

Carcinoma, Non-Small-Cell Lung ; drug therapy ; metabolism ; Drugs, Chinese Herbal ; therapeutic use ; Humans ; Lung ; Lung Neoplasms ; drug therapy ; metabolism ; Male ; Procollagen-Proline Dioxygenase ; metabolism ; Protein Disulfide-Isomerases ; metabolism

OBJECTIVETo compare the efficacy difference in the treatment of functional dyspepsia between acupuncture at the acupoints selected by pattern/syndrome differentiation and domperidone.

METHODSSeventy cases were randomized into an acupuncture group (35 cases) and a western medication group (35 cases). In the acupuncture group, Zusanli (ST 36) and Neiguan (PC 6) were selected. Taichong (LR 3) and Neiting (ST 44) were added for excess syndrome while Gongsun (SP 4) and Yinlingquan (SP 9) were added for deficiency syndrome. A pair of electrodes was attached to one acupoint and an assistant point (2 mm next to the acupoint centripetally) and stimulated with disperse-dense wave at 2 Hz/100 Hz, once a day. In the western medication group, domperidone was prescribed for oral administration, 10 mg each time, three times a day. In the two groups, the treatment of 5 days made one session and 4 sessions were required totally. Nepean dyspepsia index (NDI) was compared after treatment, 1, 2, 3, 4 and 5 months after treatment between the two groups respectively.

RESULTSThe score of symptom and score of life quality in NDI after treatment and at each follow-up time point were improved obviously in the acupuncture group as compared with those before treatment (all P < 0.01). In the western mediation group, the score of symptom and the score of life quality in NDI after treatment and in follow-up of 1, 2 and 3 months were improved obviously as compared with those before treatment (all P < 0.01), but the differences were not significant in follow-up of 4 and 5 months (both P > 0.05). Compared with the western medication group, the symptom score of NDI was reduced obviously after treatment and in each time point of follow-up in the acupuncture group (P < 0.05, P < 0.01), and the score of life quality was increased obviously (P < 0.05, P < 0.01).

CONCLUSIONAcupuncture at the acupoints selected by pattern/syndrome differentiation and domperidone are effective in the treatment of functional dyspepsia. Domperidone is unsatisfactory in the long-term effect, but acupuncture achieves the positive short-term and long-term effects on functional dyspepsia.

Acupuncture Points ; Acupuncture Therapy ; Adult ; Aged ; Dyspepsia ; diagnosis ; psychology ; therapy ; Female ; Humans ; Male ; Middle Aged ; Quality of Life ; Time ; Treatment Outcome ; Young Adult

Objective To study the dosimetric impact of different angle fields in intensitymodulated radiotherapy (IMRT) and the feasibility of beam angle optimization (BAO) for multiple intracranial metastases.Methods In total,11 patients with multiple intracranial metastases were included in these analyses.Two treatment techniques were designed for each patient:the 7 equal spaced fields (BAF group) IMRT,and 7 fields by beam angle optimization (BAO group) IMRT.The dose distribution in the target,the dose to the organs at risk and normal brain tissues,and total MU in two groups were compared to explore the dosimetric differences.Results In comparison to the BAF group,the BAO group reduced the maximum dose to left and right lenses by an average of 45％,37％ (t =-5.707,-4.438,P ＜ 0.05);the mean dose to the left and right eyes were reduced by an average of 42.6％,44.5％ (t =-4.380,-5.638,P ＜0.05);the maximum dose to the right eyes were reduced by an average of 32.5％ (t =-2.518,P ＜ 0.05).The maximum dose of the right optic nerve and the mean dose of normal brain tissue were reduced by an average of 23％ and 3％ (t =-3.105,-3.437,P ＜0.05),respectively.For the target dose,conformity and homogeneity in PTV,no statistical differences were observed between the two groups (P ＞ 0.05).The BAO group reduced the maximum dose of the brainstem and the optic chiasm,as well as the number of MU,however,the differences were not statistically significant (P ＞ 0.05).Conclusions In comparison to the BAF group,the BAO group shows a similar target dose and reduces the dose for the organs at risk.For multiple intracranial metastases,IMRT protocols with BAO are feasible and beneficial.

This study was aimed to observe the effect ofJian-Zhong-Li-Lao(JZLL) decoction-mediated serum on the TGF-β1-induced proliferation of HBZY-1 cells, the expression of matrix metalloproteinases and its inhibitory enzyme, in order to investigate the mechanisms of JZLL decoction in treatment of the renal fibrosis of chronic renal failure. HBZY-1 cells were culturedin vitro. JZLL decoction-mediated serum was prepared. The experiment contained the blank control group, TGF-β1-induced group, control serum group, low-dose JZLL decoction group, high-dose JZLL decoction group, and theNiao-Du-Qinggroup. The cytotoxic effects of JZLL decoction-mediated serum on HBZY-1 cells were assessed by LDH assay. The morphology and proliferation of HBZY-1 cells were examined by CCK8 assay. The expression of matrix metalloproteinases (MMP-2, MMP-9) and its inhibitory enzymes (TIMP-1, TIMP-2) were examined by ELISA assay. The results showed that there was no cytotoxic effect of JZLL decoction-mediated serum on HBZY-1 cells (P > 0.05). Compared with the model group, JZLL decoction can obviously inhibit TGF-β1-induced proliferation of HBZY-1 cells (P < 0.05). JZLL decoction can obviously increase the expressions of MMP-2 and MMP-9 (P < 0.05), and inhibit the expressions of TIMP-1 and TIMP-2 (P < 0.05). It was concluded that JZLL decoction-mediated serum significantly inhibited TGF-β1-induced proliferation of HBZY-1 cells, relieved the renal fibrosis of chronic renal failure through affecting the expression of matrix metalloproteinases and its inhibitory enzymes.