[Objective]To evaluate the results of displaced neck fractures with internal fixation(AO compress cannulated screws) and total hip replacement.[Method]Form 1998.5～2003.10,forty-four patients(mean age 75.2 years) who had an acute displaced femoral neck fracture were treated with internal fixation(21 hips) and total hip replacement(23 hips).The hip function,including the pain,movement and walking,was evaluated by Charnley Score(Charnley improved Merle d' Aubign? score).The health-related quality of patients' life was rated with use of the EQ-5D index.[Result]Forty patients were followed up at least twentyfour months.The ratio of complications in fixation group,defined as nonunion,osteonecrosis and peri-implant fracture,was 36.8%.The ratio of complications in total hip replacement group,defined as dislocation,periprosthetic fracture,or radiographic signs of loosening of the femoral or acetaular component,was 4.7%.There was significance different between two group(P

BACKGROUND:Many present studies have reported the early clinical therapeutic effects of short-segment non-fusion fixation for the repair of thoracolumbar burst fracture. The results are satisfactory. However, the mid-and long-term fol ow-up results of this scheme for treating thoracolumbar burst fracture are seldom reported. ＜br> OBJECTIVE:To evaluate the mid-term results of short segment pedicle screw fixation without bone fusion for unstable thoracolumbar burst fracture. ＜br> METHODS:Data of 12 patients with unstable thoracolumbar burst fractures undergoing short segment pedicle screw fixation without bone fusion were retrospectively analyzed. Al patients experienced severe intraspinal occupying and neurological dysfunction, and al of them affected single segment thoracolumbar injuries. The surgical procedure included postural reduction for 2 days and screw fixations at one level above, one level below and at the fractured level itself. The patients underwent removal of implants at 12 months after the initial operation. Imaging and clinical findings, including canal encroachment, percentage of vertebral body height loss, Cobb angle, American Spinal Injury Association motor score, Frankel grade and adjacent segment degenemtion, were evaluated. ＜br> RESULTS AND CONCLUSION:Al patients were fol owed up for at least 5 years. Significant differences in canal encroachment, percentage of vertebral body height loss and Cobb angle were detectable between post-fixation and pre-fixation (P＜0.05). Evaluation results were significantly better after fixation than that before fixation, but no significant difference in evaluation results after fixation was detected (P>0.05). After implantation and removal of fixator, none cases affected aggravated symptoms of neurological impairment. American Spinal Injury Association motor score was 34.2±6.3 before fixation, and 47.7±9.5 during the final fol ow-up, showing significant differences (t=-4.103, P=0.000). During the final fol ow-up, adjacent segments in damage levels did not suffer from degeneration in al patients. Neurological function showed the recovery of Frankel grades 1 or 2. These data indicated that a good mid-term result of short segment pedicle screw fixation without bone fusion for unstable thoracolumbar burst fracture with neurological deficit can be achieved. The improved saggital alignment was effectively constructed and maintained. Adjacent segment degeneration was not found at the injury level.

Objective To explore the effects of traditional Chinese medicinal herbs (TCMHs) on the expression of tyrosinase gene, melanogenesis and proliferation of melanocytes and elucidate the mechanism of TCMHs in promoting melanogenesis. Methods Seven TCMHs including Herba Ecliptae, Spica Prunellae, Caulis Spatholob, etc, which were known to be effective in activating tyrosinase in vivo, were selected. Brownish guinea pigs were selected as the experimental model. The mRNA in situ hybridization (ISH), Schmorl-staining and dopa-oxygenase staining were performed to observe the effects of TCMHs on gene expression of tyrosinase, melanogenesis and melanocyte proliferation. Results The mRNA ISH showed that these seven drugs, especially Herba Ecliptae,Spica Prunellae and Tribulus terrestris could significantly increase the number of positive cells and the intensity of hybridization signal in the treated group as compared with that in the control group (P 0.1). Conclusions These results suggested that these 7 TCMHs including Herba Ecliptae can upregulate the gene expression of tyrosinase, enhance the melanogenesis and promote the proliferation of melanocytes.

Objective To Explored the relative factors which caused the extubation failure in neurological intensive care unit (NICU).Methods It was a retrospective study.40 cases of patients who met the criteria,were brought into statistical analysis.They were admitted in NICU in Nan Fang Hospital from December 2008 to February 2011.The name,sex,age,diagnosis,respiratory parameters,24 hours discrepancy quantity,sputum,and Glasgow Coma Scale,Full Outline of UnResponsiveness Scale were recorded.SPSS 13.0 was used as statistic software.P ＜ 0.05 was considered statistically significant.Results Both in extubation successful and failure groups,GCS and Four were significantly different (all P ＜ 0.05).Howerer,there were no statistically significant in the other factors.There were significantly differences between GCS and Four in predicting extubation results (P =0.012).Logistic multiple regression showed that Four and GCS grade were predictive factor of extubation failure (P =0.041).Conclusions The result suggests that it is statistically significant to use GCS and Four as factors to predict extubation results.It can be widely used to help medical personnels monitoring the changes of patients'clinical conditions,judging prognosis,and making treatment plan in NICU.Wether other factors would effect the extubation results,more prospective,randomized controlled studies were needed.

Objective To explore the causal relationship between social stress and tinnitus onset using a two-sample Mendelian randomization approach.Methods Genetic data pertaining to social stress and tinnitus were extracted from genome-wide association studies(GWAS)databases.Single nu-cleotide polymorphisms(SNP)that were independent and strongly correlated with social stress were se-lected as instrumental variables,with tinnitus serving as the outcome variable.Mendelian randomization analyses were performed using inverse-variance weighted(IVW)method,weighted median method,and Mendelian randomization-Egger regression.The intercept term from Mendelian randomization-Egger re-gression was utilized to assess horizontal pleiotropy,Cochran's Q statistic was employed to evaluate het-erogeneity,and leave-one-out analysis was conducted for sensitivity assessment.Results The social stress dataset encompassed 459,742 samples,while the tinnitus dataset comprised 117,882 samples.A total of 10 SNPs tightly associated with social stress were identified as instrumental variables.The a-nalysis results of random-effects inverse variance weighting(IVW),weighted median method,and Mendelian randomization-Egger regression were similar(OR=1.251,1.274,1.438),indicating that social stress was a risk factor for tinnitus,and there was a positive causal effect between them,with no heterogeneity or pleiotropy in the results.Conclusion There is a causal relationship between social stress and tinnitus onset,which may offer novel perspectives for the clinical prevention and treatment of tinnitus in the future.

Objective To explore the causal relationship between social stress and tinnitus onset using a two-sample Mendelian randomization approach.Methods Genetic data pertaining to social stress and tinnitus were extracted from genome-wide association studies(GWAS)databases.Single nu-cleotide polymorphisms(SNP)that were independent and strongly correlated with social stress were se-lected as instrumental variables,with tinnitus serving as the outcome variable.Mendelian randomization analyses were performed using inverse-variance weighted(IVW)method,weighted median method,and Mendelian randomization-Egger regression.The intercept term from Mendelian randomization-Egger re-gression was utilized to assess horizontal pleiotropy,Cochran's Q statistic was employed to evaluate het-erogeneity,and leave-one-out analysis was conducted for sensitivity assessment.Results The social stress dataset encompassed 459,742 samples,while the tinnitus dataset comprised 117,882 samples.A total of 10 SNPs tightly associated with social stress were identified as instrumental variables.The a-nalysis results of random-effects inverse variance weighting(IVW),weighted median method,and Mendelian randomization-Egger regression were similar(OR=1.251,1.274,1.438),indicating that social stress was a risk factor for tinnitus,and there was a positive causal effect between them,with no heterogeneity or pleiotropy in the results.Conclusion There is a causal relationship between social stress and tinnitus onset,which may offer novel perspectives for the clinical prevention and treatment of tinnitus in the future.