OBJECTIVETo compare clinical effects between percutaneous compressing plating (PCCP) and proximal femoral nail antirotation (PFNA) for the treatment of patients with intertrochanteric fracture with risk external wall.

METHODSFrom September 2007 to June 2010, 43 patients with intertrochanteric fracture with risk external wall were treated by PCCP or PFNA according to different kinds of internal fixations. There were 22 cases in PCCP, including 9 males and 13 females with an average age of 68.4 (ranged, 60 to 86) years old, and 13 cases with type A2.2 and 9 cases with type A2.3; while 21 cases in PFNA, including 7 males and 14 females with an average age of 67.7 (ranged, 57 to 93) years old, and 10 cases with type A2.2 and 11 cases with type A2.3. Blood loss, operation time, hospital stay, fracture healing time, complications and Harris score after 1 years' following-up were observed and compared.

RESULTSAll patients were followed up for 12 to 22 (means 18.4) months, and all patients were obtained fracture healing, and recovered walking ability as before injury. There were no significant differences in blood loss, operation time, hospital stay, fracture healing time, complications and Harris score after 1 years' following-up (P>0.05). One case occurred displacement on the top of greater trochanter, and 1 case injuried weakness of hip abduction. One case occurred screw breakage in PCCP, while 1 case occurred hip joint pain in PFNA.

CONCLUSIONBoth of PCCP and PFNA in treating patients with intertrochanteric fracture with risk external wall can receive good clinical effects, while the effects and therapy strategy for displacement of bone on the top of lateral wall should further study.

Aged ; Aged, 80 and over ; Bone Nails ; Bone Plates ; Case-Control Studies ; Female ; Fracture Fixation, Intramedullary ; Fracture Healing ; Hip Fractures ; physiopathology ; surgery ; Humans ; Male ; Middle Aged

Objective To explore the relationship between DNA repair gene XRCC1 and XPD polymorphisms and individual susceptibility to prostate cancer. Methods PCR-restriction fragment length polymorphism assay was used to analyze the XRCC1 (C26304T and G28152A) and XPD A35931C polymorphisms in 358 prostate cancer patients and 312 healthy controls. Unconditional logistic regression analysis was performed to calculate odd ratio (OR) and 95% confidence interval (CD for estimating the correlation between different genotypes and prostate cancer risks. Results Forty-seven(13.1%) cases present XRCC1 28152AA genotype in prostate cancer group, while 24 cases in the control group (7. 1%), individuals with this genotype had a significantly increased risk for prostate cancer (OR 1. 924, 95%CI=1.126 - 3. 288, P=0. 017). There was no significant difference between two groups at XRCC1 C26304T and XPD A35931C sites. Combined analysis of the three sites polymorphisms showed that individuals with XRCC1 28152 AA and XPD 35931AC+CC genotype had a higher risk of prostate cancer than those with three wild genotypes (OR = 3. 087,95%CI 1. 081 - 8.813;OR = 3. 376,95%CI 1.067-10.683;OR 3. 216,95%CI=1. 439-7.188,P = 0. 004). Analysis stratified by age of onset, PSA, Gleason score and T stage revealed that XRCC1 28152AA and XPD 35931 AC+CC high-risk genotype was especially associated with early age at onset of prostate cancer (P<0. 05). Conclusions The XRCC1 and XPD genotypes may be contributed to the risk of developing prostate cancer, particularly for younger patients.

BACKGROUND: Osteoblasts derived from bone marrow stromal stem cells are the main force of the cells In bone marrow cavity.In the artificial joint replacement cases, their life situation is closely related to conductive pressure of prosthesis.OBJECTIVE: To observe the continuous pressure on the proliferation of rabbit's bone marrow stromal stem cells, and to reveal the biomechanism of continuous pressure causing loosening and sinking of prosthesis and its activity after replacement.DESIGN, TIME AND SE'I-I'ING: A randomized study based on cytology was performed at the Institute of Othorpaedics, the Fourth Military Medical University of Chinese PLA from February 2004 to October 2007.MATERIALS: One New Zealand rabbit aging 1 month and weighing 0.5 kg was used to extract the bone marrow stromal calls.METHODS: The third-passaged bone marrow stromal stem cells were inoculated in seven 24-well culture plates at the density of 1 × 104 cells/well. After 14 hours, cells were adherent completely and cultured in DMEM culture media containing 10% fetal bovine serum. Thereafter, the four culture plates were randomly divided into 4 experimental groups, including control group without any pressure, and continuous pressure (20, 60, and 100 kPa) groups. The continuous pressure was performed for 3 hours every day.MAIN OUTCOME MEASURES: Absorbance was detected at day 1, 3, 5, and 7 after culture using MTT assay.RESULTS: Absorbance of the three pressure groups after 3, 5 and 7 days was significantly lower than the control group (P < 0.01). There was no significant difference in absorbance between 20 kPa continuous pressure group and 60 kPa continuous pressure group on the third day (P >0.05); but the absorbance was significantly higher than 100 kPa continuous pressure group (P < 0.05). On the fifth day, there was significant difference in absorbance between paired continuous pressure groups (P < 0.05),i.e., the higher the continuous pressure was, the lower the absorbance was. On the seventh day, the absorbance of the 100 kPa continuous pressure group was significantly lower than 20 kPa continuous pressure group (P < 0.05).CONCLUSION: Patients with eady post-joint replacement had better not stand on the ground; otherwise, a continuous stress will be caused so as to induce the restrain of bone marrow stromal stem calls in the bone marrow cavity, which is not helpful for bone healing and easily causes subsidence and loosening of prosthesis.

Objective To investigate the value of MSCT in evaluating pulmonary functional changes in silicosis.Methods 56 cases of silicosis and 10 healthy people(as control group) underwent inspiratory and expiratory MSCT scans and pulmonary functional test one week later.The CT findings including silicotic nodules,large opacity,emphysema,reticular opacities,bronchiectasis and air trapping were recorded and graded subjectively on CT images.Air retention and emphysema were quantified using the software of Pulmo.CT scores were correlated with spirometric findings by using spearman rank correlative analysis in comparison with pulmonary functional index.Results The scores of CT features except for reticular shadows were of significant difference between silicotic group and control group,but not between simple silicotic group and complex silicotic group.The scores of air retention and emphysema on CT were significantly negative correlation.The reticular shadows were of positive correlation with FEF 75%,FEF 50% and FEV1,but on correlation with FEV1/FVC.There were no correlation between the scores of silicotic nodules,bronchiectasis,large shadows and pulmonary functional test.There was obvious correlation between air retention,the scores of emphysema on CT and the index of pulmonary function in obstruction of small airway.Conclusion MSCT is of important value in evaluating the damage of pulmonary function in silicosis.

OBJECTIVETo investigate and clarify the key surgical techniques and evaluate clinical effectiveness of modular cementless femoral stems(LINK MP modular stem) in complex revision hip arthroplasty.

METHODSFrom January 2002 to December 2013, 470 patients in Chinese PLA General Hospital received revision hip arthroplasties using MP stems. Among them, 246 patients were followed for an average of 5.7 years (ranged, 0.5 to 11 years). There were 148 males and 98 females, with an average age of 62.5 years old (ranged from 26 to 83 years old). The most common reason for revision was aseptic loosening of femoral stems (107 cases, 43.5%), followed by prosthetic joint infection (104 cases, 42.3%). Other reasons included unexplained hip or thigh pain, periprosthetic femoral fracture, prosthesis wear and dislocation. According to Paprosky classification of femoral deficiency, there were 171 cases of type IIIA (69.5%), 14 cases of type I, 39 cases of type II, and 22 cases of type IIIB. The average preoperative Harris hip score (HHS) was 37.4 ± 7.5. In addition, radiographic presentation, degree of patients' subjective satisfaction, and clinical effectiveness were assessed as well.

RESULTSThe average Harris score was im- proved to 87.8 ± 4.2 after operation,with significant statistical difference when compared to preoperative score (t = 92.13,P = 0.00). Analysis of patients' subjective satisfaction for leg length discrepancy, stability and overall degree of satisfaction showed that the number of patients with great satisfaction were 27, 60, 61 respectively. The most common complication was the periprosthetic fracture (intraoperatively 21 cases and postoperatively 8 cases). Other complications included infection (7 cases), dislocation (5 cases), numbness possibly caused by incomplete sciatic nerve injury (6 cases) and thigh swelling (3 cases). The X-ray taken at the final follow-up revealed that prosthesis subsidence occurred in 4 cases, 2 of which needed a second revision.

CONCLUSIONThe application of modular cementless femoral stems (LINK MP modular stem) in complex revision hip arthroplasty (especially in cases with the serious defect of proximal femoral bone) shows good results at both the short-term and long-term follow-up, especially in the revision for prosthetic infection with the high success rate. In order to avoid complications and improve clinical outcomes,the surgeons should carefully select proper surgery candidates,perform the procedure with care, and master the key surgical techniques.

Adult ; Aged ; Aged, 80 and over ; Arthroplasty, Replacement, Hip ; adverse effects ; methods ; Female ; Hip Prosthesis ; Humans ; Male ; Middle Aged ; Patient Satisfaction ; Postoperative Complications ; therapy

Animals ; Dose-Response Relationship, Drug ; Male ; Mice ; Mice, Inbred Strains ; Nickel ; toxicity ; Oxidative Stress ; physiology ; Testis ; drug effects ; metabolism

Objective Neuropsychiatric systemic lupus erythematosus ( SLE) is a common complication of SLE, whose path-ogenesis is not yet clear but associated with the alteration of cerebral blood flow ( CBF) in some studies.This study was to investigate the CBF alteration in SLE patients without overt neuropsychiatric symptoms by arterial spin labeling ( ASL) MRI. Methods Twenty-eight SLE patients without overt neuropsychiatric symptoms and 30 age-and sex-matched healthy controls underwent conventional MRI and ASL examinations, and all received such neuropsychologic tests as number connecting test-A ( NCT-A ) , digit symbol test ( DST ) , self-rating anxiety scale ( SAS ) , and self-rating depression scale ( SDS) .Independent sample-t test was used to detect the mean CBF in the whole brain, gray matter, and white matter of the SLE patients and healthy controls.The voxel-wise CBF maps of the two groups of subjects were further analyzed with the SPM8 software to compare the regional CBF between the two groups, followed by evaluation of the correlation between the regional CBF values and clinical markers. Results In comparison with the healthy controls, the SLE pa-tients showed significantly reduced CBF in the gray matter (40.5 ±3.7 vs 37.3 ±6.5, P=0.028) and the whole brain (38.0 ±3.5 vs 35.1 ±6.1, P=0.032), especially in the supplementary motor area and the adjacent middle cingulate, anterior cingulate, left medial frontal gyrus, left inferior frontal gyrus, and left insula (P<0.05, FWE corrected).The NCT-A score was negatively correlated with the CBF values of the left medial frontal gyrus (r=-0.402, P=0.032) and left inferior frontal gyrus (r=-0.382, P=0.045) of the SLE patients. Conclusion ASL and MRI showed significantly reduced cerebral blood flow in the SLE patient without overt neu-ropsychiatric manifestations, which was correlated with the change of the patient's cognitive function.

0.05).Conclusion: Enteral nutrition may improve the nutrition status.The naso-jejunum tube feeding has no advantage to nasogastric tube feeding in our patients.The route of enteral nutrition should be selected according to the individual condition and local nosocomial experience.

To enhance the quality and efficiency of ozagrel by investigating the differences between the ozagrel polymorphs in bioavailability. Solid ozagrel in different polymorph forms were orally administered to SD rats. An HPLC method was established to determinate plasma level of ozagrel. The bioavailabilities of two polymorph forms were calculated and compared. The pharmacokinetic parameters of ozagrel, were as follows: Cmax was 32.72 ± 17.04 and 34.01 ± 19.13 mg · L(-1), respectively; AUC0-t was 61.14 ± 14.76 and 85.56 ± 18.08 mg · L(-1) · h, respectively; t½ was 1.53 ± 0.51 and 4.73 ± 3.00 h, respectively. There was no significant difference in pharmacokinetic parameters between form I and II polymorphs of ozagrel while the t½ of form II is longer, which indicates that the use of form II polymorph as pharmaceutical product may prolong the effective action time in clinics. This would help the polymorph quality control in drug production.
Animals ; Biological Availability ; Chromatography, High Pressure Liquid ; Methacrylates ; chemistry ; pharmacokinetics ; Rats ; Rats, Sprague-Dawley

AIMTo establish a new and simple flow injection method for the rapid determination of acetylspiramycin (ASPM).

METHODSASPM was determined by chemiluminescence (CL) method combined with flow injection (FI) technology, which was based on the inhibitive effect of ASPM on the chemiluminescence reaction of the luminol-K3Fe (CN)6 system.

RESULTSThe decrease of chemiluminescence intensity was proportional to the logarithm of ASPM concentration (0.1-100) microgram.L-1, the detection limit was 40 ng.L-1 (3 sigma). The whole process, including sampling and washing, could be completed in 0.5 min with a RSD less than 3.0% (n = 5).

CONCLUSIONThe FI-CL method is of both high sensitivity and good selectivity giving a throughput of 120 h-1. The proposed method was applied successfully to the determination of ASPM in pharmaceutical preparations and human urine without any pre-treatment. It was found that the ASPM concentration reached its maximum after being orally administrated for two hours.

Anti-Bacterial Agents ; analysis ; blood ; urine ; Flow Injection Analysis ; Humans ; Luminescent Measurements ; Luminol ; chemistry ; Male ; Microchemistry ; Spiramycin ; analogs & derivatives ; analysis ; blood ; urine