Objective To investigate different surgical treatments for femoral intertrochateric fractures. To evaluate the results of treatment of intertrochateric fractures with PFNA. Methods 37 patients with femoral intertrochateric fracture were retrospectively reviewed,of which 12 patients were treated operatively with PFNA,25 patients were treated operatively with DHS. Therapeutic efficacy were compared and analyzed. Results All the patients were followed up for 5-18 months(an average of 11 months). All fractures healed in a mean of 3 months. According to Harris'standard of hip-joint fuction,the outcome was classified into excellent,good and poor. In 25 patients with DHS,the good clinical results was 21 cases. In 12 patients with PFNA, excellent and good clinical result was 11 cases. Conclusion PFNAintemal fixation was an effective method for treating the femoral intertrochateric fractures and better than that by DHS.

[ ABSTRACT] AIM:To study the effects of anti-aging Klotho protein on neonatal rat myocardial cells with hypo-xia/reoxygenation ( H/R) injury.METHODS:The cardiomyocytes of neonatal SD rats were cultured to establish hypoxia/reoxygenation model.The myocardial cells were divided into normal control group, H/R model group, different concentra-tions of Klotho protein (0.1μmol/L, 1μmol/L and 10μmol/L) pretreatment groups.The myocardial cells pulse frequen-cy was observed before and after H/R.The cell viability was measured by MTT assay.The leakages of LDH, CK and AST, the content of MDA and the activity of SOD were detected.The apoptotic rate of the myocardial cells was analyzed by flow cytometry.The mRNA expression of endoplasmic reticulum stress markers and apoptosis-related molecules GRP78, CRT, CHOP and caspase-12 was measured by real-time PCR.The protein levels of CHOP, caspase-12 and phosphorylated Akt in the myocardial cells were determined by Western blot.RESULTS: Compared with normal control group, the pulse fre-quency, cell viability rate and SOD activity of myocardial cells were significantly decreased, the cell apoptotic rate as well as the contents of LDH, CK, AST and MDA were increased in H/R model group.The mRNA expressions of GRP78, CRT, CHOP and caspase-12 as well as the protein levels of CHOP and caspase-12 were increased, whereas p-Akt level was decreased obviously.Compared with H/R model group, the pulse frequency, cell viability rate and SOD activity were in-creased significantly, the cell apoptotic rate as well as the contents of LDH, CK, AST and MDA were decreased in Klotho pretreated group.The mRNA expression of GRP78, CRT, CHOP and caspase-12 as well as the protein levels of CHOP and
caspase-12 were decreased, while p-Akt level increased significantly.CONCLUSION:Anti-aging Klotho protein improves the myocardial cell survival and inhibits the apoptosis by increasing the resistance of the cells to oxidative stress and exces-sive endoplasmic reticulum stress response, which is related with the activation of Akt phosphorylation in H/R-injured my-cardial cells.

AIM:To study the protective effect of anti-aging Klotho protein on human umbilical vein endothe-lial cells (HUVECs) treated with high glucose (HG).METHODS:HUVECs were cultured in vitro, and divided into PBS control group, 5.5 mmol/L glucose group, 33.3 mmol/L glucose group, 0.1 μmol/L Klotho +33.3 mmol/L glucose group, 1 μmol/L Klotho+33.3 mmol/L glucose group , and 10μmol/L Klotho+33.3 mmol/L glucose group .The viabili-ty of the HUVECs was measured by MTT assay .The content of malondialdehyde ( MDA) , and the activities of lactate de-hydrogenase (LDH), superoxide dismutase (SOD) and glutathione (GSH) in cell culture supernatants were observed . The production of reactive oxygen species ( ROS) in HUVECs was analyzed by flow cytometry .The levels of nitric oxide ( NO) , endothelin ( ET-1 ) , intercellular adhesion molecule-1 ( ICAM-1 ) in HUVEC culture medium were detected by ELISA.The protein expression of nuclear factor-kappa B (NF-κB) in the HUVECs was determined by Western blot .RE-SULTS:Compared with PBS control group , 33.3 mmol/L glucose significantly decreased the HUVEC viability , increased ROS, LDH and MDA levels , reduced the activities of SOD and GSH , decreased the NO secretion , and induced the ET-1 and ICAM-1 secretion and the protein expression of NF-κB in HUVECs.When HUVECs were treated with Klotho protein at different concentrations combined with 33.3 mmol/L glucose, the cell viability was increased significantly , the ROS, LDH and MDA levels were decreased significantly , the antioxidant SOD and GSH activities were significantly increased , the se-cretion of NO was increased , but ET-1 and ICAM-1 releases and protein expression of NF-κB were significantly reduced . CONCLUSION:Anti-aging Klotho protein promotes the viability of HUVECs treated with HG , reduces the oxidative dam-age and ROS production , and restores the normal secretory function of HUVECs , thus playing a protective role in vascular endothelial cells through reducing the protein expression of NF-κB.

Objective To investigate the incidence, clinical symptoms, correlative risk factors and prognosis of dysautonomia in patients with severe traumatic brain injury. Methods A total of 142patients with severe traumatic brain injury treated from January 2008 to March 2010 were retrospectively surveyed to compare the clinical features of dysautonomia group and control group. Logistic regression was used to analyze the risk factors for dysautonomia. At 6 months post-trauma, the Glasgow Outcome Score (GOS) was used to measure the outcome. Results Of all the patients, 94 patients survived and were followed up. There were 16 patients ( 17% ) diagnosed as dysautonomia depended on clinical symptoms,with statistical difference in aspects of GCS, coma duration, ICU time and average length of stay (ALOS)(P < 0.05). The patients with dysautonomia tended to have poorer outcome ( P < 0.05 ) and showed a positive association with diffuse axonal injury (DAI) ( OR = 11. 25, CI 7.65-16.54 ). Conclusion Dysautonomia has high incidence and is usually severe in patients with severe traumatic brain injury,when DAI may contribute to its occurrence and result in poor prognosis.

Objective To discuss the feasibility and clinical outcomes of mini-open reduction through lateral deltoid muscle and locking plate fixation in treatment of proximal humeral fractures.Methods A retrospective study was carried out on 39 patients with proximal humeral fractures treated with mini-open reduction through lateral deltoid muscle and locking plate fixation from September 2012 to September 2015.There were 7 males and 32 females,with a mean age of 66.8 years (range,33-86 years).According to the Neer's classification system,there were 26 patients with two-part fracture and 13 with three-part fracture.visual analogue scale (VAS),Constant-Murley shoulder score,time of bone healing and complications were evaluated for all patients.Results All patients were followed up for 12-48 months (mean,21.3 months).All fractures were proved to be bone healing with duration of (12.0 ± 2.7) weeks.The VAS was improved from preoperative (5.7 ± 1.0) points to (0.9 ± 0.6) points at the final follow-up (P ＜ 0.05).The Constant-Murley shoulder score was increased from preoperative (42.3 ±5.1) points to (89.2± 2.5)points at the final follow-up (P ＜ 0.05).Ranges of shoulder motion were improved with satisfactions.There were no complications like axillary nerve injury,loss of reduction,nonunion or humeral head necrosis.Conclusion For proximal humeral fractures,the miniopen reduction through lateral deltoid muscle and locking plate fixation has advantages of minimal invasion,excellent shoulder function,high rate of bone healing and low incidence of complications.

Objective To explore the therapeutic efficacy of percutaneous compression plate internal fixation in the treatment for elder-ly patients with interchanteric fractures. Methods All 17 patients with interchanteric fractures from March 2012 to January 2013 were trea-ted with percutaneous compression plate internal fixation(Fracture classification:type A1. 2 with 3cases,A1. 3 with 4cases,A2. 1 with 6 ca-ses,A2. 2 with 3 cases,A2. 3 with 1 case). After operation,the patients did functional exercises at the early stage. Then the efficacy were e-valuated and analyzed. Results Operation time was 30~80 min,with average time 50 min, blood loss was (40~100) mL,with average volume 60 mL,time of X-ray exposure was 12~22 s,with average time 20 s. All 17 patients were followed up for 3~18 months. Postoperative function were evaluated according to Harris Hip Score,15 cases were excellent,and 2 cases were good,the excellent and good rate was 100%. Conclusion Percutaneous compression plate internal fixation is suitable for the elderly patients of interchanteric fractures,with shorter oper-ation time,less blood loss,reliable fixation and less complications.

Mongolia is a parliamentary republic country in the north of our country. Healthcare system is mainly composed of three parts: state-owned medical institutions, private clinics and mixed-ownership medical institutions, characteris by the wide coverage but uneven resources. Due to the folk customs and climate, diseases of the digestive system are more common, and the main diseases that cause deaths of Mongolian residents are ischemic heart disease, stroke, and liver cancer. Mongolia is located by and culturally related to China, so the development and dissemination of Traditional Chinese Medicine (TCM) is likely acceptable to the public. Mongolia’s traditional medicine and TCM have long-term exchanges and influences, promoting each other’s development, which also are protected by Mongolian laws. The concerns such as the inheritance, study and protection of Mongolian traditional medicine, the promotion of non-medicinal therapies restrict the development Mongolian and Chinese traditional medicine. It is recommended that Mongolian and TCM jointly promote the development and dissemination of traditional medicine in the world by cultivating high-level medical talents, increasing research and protection of herbal medicines, and expanding the application of non-drug therapies.

Objective: To construct a risk prediction model for poly victimization (PV) among rural left behind middle and high school students in Chaoshan, and to evaluate the prediction effect of the model, so as to provide scientific basis for early identification and prevention of PV among students. Methods: A questionnaire survey was conducted among 1 005 left behind students, selected from 7 middle and high schools in rural areas of Shantou City and Jieyang City by a stratified random cluster sampling method from January 2020 to September 2021, for the personal, family, external environmental factors, psychological factors (mental resilience, coping approaches, self esteem and social support) and PV situations. R software and Logistic regression were used to screen predictor variables to build a risk prediction model, and the area under the ROC curve (area under the curve, AUC), accuracy, precision, recall, F1 value and calibration curve were used to evaluate the model s effect. Results: The incidence rate of PV among left behind middle and high school students was 23.38%. The results of Logistic regression analysis showed that physical illness or disability ( β =1.02), grade retention during the past year ( β =1.31), having no close partner ( β =1.00), self harm intention (seldom: β = 0.58 , occasionally: β =0.79), negative peer behavior ( β =0.90), family member smoking ( β =0.59), criminal offenses of parents ( β =1.04), witnessing school bullying ( β =0.78), house moving ( β =0.58), using venting ( β =0.34) and the coping style of patience ( β =0.28) were positively correlated with PV among left behind children in Chaoshan area, and family support in psychological flexibility ( β =-0.31) was negatively correlated with PV ( P <0.05). A nomogram prediction model was constructed for the meaningful variables included in the multivariate analysis, and the prediction model AUC was 0.88, the accuracy was 82.00 %, the precision was 77.78%, and the F1 value was 43.75%. The calibration plot fitted well, and the model had good discrimination and calibration. Conclusion The risk prediction model for left behind middle and high school students with PV has good predictive performance and is helpful for schools and communities to early identify high risk middle and high school students with PV.

Objective To investigate genotyps of Treponema pallidum (Tp) in several cities in Guangxi province. Methods A total of 300 patients with suspected early syphilis were enrolled from STD clinics in Guangxi between January 2012 and July 2016, and tissue fluid samples were collected from skin lesions. Silver staining was performed to detect Tp, and PCR to amplify the Tp polA gene for the diagnosis of early syphilis. Positive samples were subjected to PCR amplification of a 60-bp tandem repeat region within the arp gene, restriction fragment length polymorphism(RFLP)analysis of the tpr Ⅱgene after digestion with Mse Ⅰ enzyme and tp0548 genotyping. Results Finally, 215 patients were diagnosed with early syphilis, including 210(97.7%)patients positive for PCR and 105(48.8%)patients positive for silver staining, and the positive rate significantly differed between the two methods (χ2 = 103.01, P < 0.05). Among the PCR-positive samples, 190 could be genotyped by analysis of three target genes, and 17 genotypes were identified. The genotype 14d/f was predominant (45.3%, 86/190), followed by 15d/f (13.7%, 26/190), 16d/f(11.6%, 22/190), 17d/f(7.4%, 14/190), 13d/f(6.8%, 13/190), 10d/f(4.2%, 8/190), 18d/f(1.6%, 3/190), 16a/f(1.6%, 3/190), 5d/f(1.1%, 2/190), 7d/f(1.1%, 2/190), 12d/f(1.1%, 2/190), 16d/e(1.1%, 2/190), 14a/f(1.1%, 2/190), 9h/c(1.1%, 2/190), 15l/f(0.5%, 1/190), 25a/e(0.5%, 1/190), 15i/f(0.5%, 1/190). Conclusion Tp genotypes are diversified in patients with early syphilis in Guangxi, and the genotype 14 d/f is predominant.

Objective To investigate the clinical efficacy of esmolol combined with atorvastatin on se-vere sepsis complicated with cardiac insufficiency.Methods This study was a prospective,double-blind,ran-domized controlled clinical trial.A total of 153 patients with severe sepsis complicated with cardiac insufficien-cy admitted to this hospital from January 2021 to December 2022 were selected and divided into groups A,B,and C by random number table method,with 51 cases in each.Patients in group A were given routine symp-tomatic supportive treatment after admission.On this basis,patients in group B and group C were given esmo-lol,esmolol+atorvastatin,respectively.The hemodynamic indexes,serological indexes and clinical prognosis of the three groups before and after intervention were compared.Results There was no significant difference in baseline data,and hemodynamic and serological indexes of three groups before intervention(P＞0.05).Compared with before intervention,after five days of intervention,heart rate,systemic vascular resistance in-dex(SVRI),blood levels of creatine kinase-MB(CK-MB),cardiac troponin Ⅰ(cTn Ⅰ),tumor necrosis factor-α(TNF-α),interleukin-6(IL-6)and high sensitive C-reactive protein(hs-CRP)in three groups were de-creased,while the values of cardiac index(CI)were increased,and the differences were statistically significant(P＜0.05).After five days of intervention,the heart rate,SVRI,blood levels of CK-MB,cTn Ⅰ,TNF-α,IL-6,and hs-CRP in group C were lower than those in group A and group B,and the levels in group B were lower than those in group A;the value of CI in group C was higher than that in group A and group B,and group B was higher than that in group A,the differences were statistically significant(P＜0.05).After intervention,the length of stay in intensive care unit(ICU)in group C was the shortest,and that in group B was shorter than that in group A,the difference was statistically significant(P＜0.05).There was no significant difference in 28 d mortality among the three groups(P＞0.05).Conclusion Esmolol combined with atorvastatin can signif-icantly inhibit the inflammatory response in patients with severe sepsis complicated with cardiac insufficiency,relieve myocardial injury and promote rehabilitation,and the therapeutic effect is better than esmolol alone.