Objective To explore the clinical effects of three nail and plate systems in treating femoral intertrochanteric fracture.Methods The clinical data of 75 patients with femoral interochanteric fiactures treated by internal fixation were analyzed.According to different treatment methods,75 patients were divided into three groups:DHS group(treated with dynamic hip screw) 26 cases,PFN group(treated with proximal femoral nail) 15 cases,LCP group (treated with anatomical proximal femoral locking plate) 34 cases.Fracture union time,complications and hip function scores according to Harris's scoring were recorded.Results All patients were followed up for 18 to 36 months.Four patients appeared coax vara in DHS group and one case appeared coax vara in PFN group,three case appeared coax vara in anatomical proximal femoral locking plate (LCP.) There was no significant difference in fracture union time and the excellent and good rate of hip function scores among the three groups (F =2.25,χ2 =0.032,all P ＞ 0.05).Conclusion The effects of three nail and plate systems in treating femoral intertrochanteric fracture is similar,but they have their own characteristics and indications.And the reasonable treatment should be selected according to different fracture types.

Objective To study the effective evaluation of short peptide enteral nutrition powder in advanced digestive tract cancer. Methods 50 cases of advanced digestive tract cancer were randomly divided into two groups: experimental group(short peptide enteral nutrition powder) and control group(routine treatment). Results Data regarding to nutritional status and immune function (WT/IBW, TSF, MANC, ALB, TRF, PA, lgG, lgM, IgA, C3, CD3, CD4, CD8, CD4/CD8) showed a significant difference between experimental group and control group after two weeks's treatment,as well as between before and after two weeks's treatment in experimental group(P <0.05). Conclusion Short peptide enteral nutrition powder maintenance is beneficial to improve the nutritional status and the immune function of patients with advanced cancer and to promote their life quality.

ObjectiveTo study the expressions of Ki-67 and p53 in the surface cells and polygonal cells in pulmonary sclerosing hemangioma(PSH)and investigate the relation of cell proliferation index and biological behaviour of the tumor.MethodsDouble-staining immunohistochemistry was used to detect the expressions of Ki-67 and CK8/18 protein. Double immunofluorescence staining was used to detect the expressions of p53 and AE1/AE3 protein. ResultsThe positive signal of AE1/AE3 and CK8/18 were localized in cytomembrane of surface cells. The positive signal of Ki-67 and p53 were localized in cell nucleus of the two kinds of cells.The positive rate of Ki-67 was under 1％ in surface cells and 1％-10 ％ in polygonal cells. p53 protein was mainly expressed in polygonal cells (6/9, 33.3 ％) and only exsited in seldom surface cells.ConclusionThere are differences on cellular morphous and immunophenotype between the surface cells and polygonal cells.The proliferation index and gene mutation are all predominant in polygonal cells than in surface cells. The biological behaviour of PSH maybe mainly be decided by the polygonal cells.

OBJECTIVE: This experiment aims to determine the diagnostic value of diffusion-weighted imaging (DWI) in the differentiation of axillary inflammatory lymph nodes from metastatic lymph nodes in rabbit models in comparison with conventional magnetic resonance imaging (MRI). MATERIALS AND METHODS: Conventional MRI and DWI were performed at 4 weeks after successful inoculation into the forty female New Zealand white rabbits' mammary glands. The size-based and signal-intensity-based criteria and the relative apparent diffusion coefficient (rADC) value were compared between the axillary inflammatory lymph nodes and metastatic lymph nodes, with histopathological findings as the reference standard. Receiver operating characteristic (ROC) curve analysis was performed to evaluate the diagnostic performance of the aforementioned criteria and rADC value in differentiating the axillary inflammatory lymph nodes from metastatic lymph nodes. RESULTS: Thirty-two axillary inflammatory lymph nodes and 46 metastatic ones were successfully isolated and taken into pathological analysis. The differences of the aforementioned criteria between the two groups were not statistically significant (p > 0.05). However, the rADC value of the inflammatory lymph nodes (0.9 +/- 0.14) was higher than that of metastatic ones (0.7 +/- 0.18), with significant difference (p = 0.016). When the rADC value was chosen as 0.80, the area under the ROC curve is greater than all other criteria, and the sensitivity, specificity, accuracy, positive predictive value, and negative predictive value for differentiating two groups were 86.2%, 79.3%, 81.2%, 84.2%, and 85.6%, respectively. CONCLUSION: Diffusion-weighted imaging is a promising new technique for differentiating axillary inflammatory lymph nodes from metastatic lymph nodes. Compared with routine magnetic resonance sequences, DWI could provide more useful physiological and functional information for diagnosis.
Animals ; Axilla ; Diagnosis, Differential ; Diffusion Magnetic Resonance Imaging ; Female ; Inflammation/pathology ; Lymphatic Metastasis/*pathology ; Magnetic Resonance Imaging/*methods ; Mammary Neoplasms, Experimental/*pathology ; ROC Curve ; Rabbits ; Sensitivity and Specificity

OBJECTIVETo explore if CHA2DS2 VASc score can predict substrate for persistent atrial fibrillation ( AF) and outcome post catheter ablation of AF.

METHODSFrom January 2011 to December 2012,116 patients underwent catheter ablation of persistent AF in our department and were enrolled in this study. CHA2DS2VASc score was calculated as follows: two points were assigned for a history of stroke or transient ischemic attack and age ≥ 75 and 1 point each was assigned for age ≥ 65, a history of hypertension, diabetes,recent cardiac failure, vessel disease, female. Left atrial geometry ( LA) was reconstructed with a 3.5 mm tip ablation catheter with fill-in threshold 10 in CARTO system. The mapping catheter was stabled at each endocardial location for at least 3 seconds for recording. The electrogram recordings at each endocardial location were analyzed with a custom software embedded in the CARTO mapping system. Interval confidence level (ICL) was used to characterize complex fractionated atrial electrograms (CFAEs) . As the default setting of the software, ICL more than or equal to 7 was considered sites with a highly repetitive CFAEs complex. CFAEs index was defined as the fraction of area of ICL more than or equal to 7 to the left atrial surface. The CFAEs index and outcome of catheter ablation among different CHA2DS2VASc groups were compared.

RESULTSOf the 116 patients, CHA2DS2VASc was 0 in 33 patients, 1 in 31 patients and ≥ 2 in 52 patients. Left atrial surface ((121.2 ± 18.9) cm2, (133.6 ± 23.8) cm2, (133.9 ± 16.1) cm2, P = 0.008), left atrial volume ((103.6 ± 24.8) ml, (118.3 ± 27.8) ml, (120.9 ± 20.9) ml, P = 0.005) and CFAEs index (44.6% ± 22.4%, 54.2% ± 22.2%, 58.7% ± 23.1%, P = 0.023) increased in proportion with increasing CHA2DS2VASc. ICLmax, ICLmin and CFAEs spatial distribution were similar among the three groups. During the mean follow-up of (13 ± 8) months, the recurrence rate were 36.4%, 35.5%, 55.8% among the three groups (P = 0.025).

CONCLUSIONA high CHA2DS2VASc score is associated with extensive AF substrate and higher recurrence rate post catheter ablation of persistent AF.

Aged ; Atrial Fibrillation ; Catheter Ablation ; Electrophysiologic Techniques, Cardiac ; Female ; Heart Atria ; Heart Failure ; Humans ; Hypertension ; Recurrence ; Stroke ; Treatment Outcome

Objective To explore the clinical characteristics and perioperative treatment of chronic obstructive pulmonary disease (COPD) in patients with non-small-cell lung cancer (NSCLC) in department of thoracic surgery,and to guide the clinical diagnosis and treatment. Methods From January 2013 to December 2016,patients with newly diagnosed NSCLC treated in the thoracic surgical department of Lanzhou University Second Hospital were reviewed retrospectively. The patients were divided into the COPD group and non-COPD group. The clinical data,including the incidence and clinical characteristics of COPD in non-small-cell lung cancer,pulmonary complications after surgery,COPD diagnosis and perioperative pulmonary rehabilitation were analyzed retrospectively. Results A total of 726 NSCLC patients were reviewed,six hundred and seventy-five cases who took the full lung function test were included in the study,of which 95 cases received bronchial diastolic test,86 cases were accorded with COPD diagnosis and were included in incorporated COPD group,and 589 cases were in the non- incorporated COPD group. The proportion of men (69 cases,80. 2%,χ2 = 24. 032), age ≥65 (51 cases,59. 3%,χ2 = 6. 784),smoking history (55cases,64. 0%,χ2 = 29. 474) and a large number of smokers (43 cases,50. 0%,χ2 = 5. 802) and lung squamous cell carcinoma(47 cases,54. 7%,χ2 = 6. 241) in the incorporated COPD group were higher than those in differences were statistically significant (P<0. 05); the incidence of pulmonary complications after radical resection of lung cancer in the incorporated COPD group was 23. 9% (16/ 67),which was significantly higher than that in the unincorporated COPD group(13. 7% (78/568)) (χ2 = 4. 894,P<0. 05). The incidence of pulmonary complications in the lung rehabilitation group was 13. 5% ( 5/37) , lower than that of the non-lung rehabilitation group ( 36. 7% ( 11/30 ) ) (χ2 = 4. 886, P<0. 05);Among the 86 cases (12. 7%) of incorporated COPD,only 6 cases (8. 9 ‰) were diagnosed with COPD at the time of admission, and 23 cases ( 3. 4%) at discharge. No COPD guidelines were given. Conclusion NSCLC often combined wtith COPD,especially in males,elders (≥65 years old) ,smokers, squamous cell carcinoma patients. At present,the diagnosis and treatment of co-morbidity of COPD is seriously inadequate,which needs to be paid much attention to by the thoracic surgeons,in order to improve the diagnosis and treatment of COPD,and improve the prognosis of the patients with NSCLC and COPD.

Objective: To investigate the expression of inhibitory receptor TIGIT gene in peripheral NK cells of patients with rheumatoid arthritis (RA) and its clinical significance. Methods: A case control study was conducted of 58 RA patients(30 patients with active RA disease, 28 patients with remission of RA) and 22 healthy controls (HC) in the department of rheumatology and immunology from Affiliated Hospital of Jiangxi University of Traditional Chinese Medicine during December 2018 to June 2019, the related clinical data were collected. Flow cytometry was used to compare the expression of TIGIT gene on peripheral NK cells. The IFN-γ secretion level of cytokines in peripheral blood was detected by ELISA, and analyzed the correlations between TIGIT gene and disease activity and IFN-γ level. T-test or non-parametric test was used for comparison between the two groups, and Pearson correlation analysis was used for correlation between the two variables. Results: Compared with HC group, the number of NK cells in RA disease group was reduced, which was (13.88±4.56) ×10⁷ cells/L in RA disease group and (25.69± 2.48) ×10⁷ cells/L in HC group (t=-2.036, P=0.041). The percentage of TIGIT gene expression in peripheral blood NK cells was not statistically different between RA disease group (39.73±9.37)% and HC group (45.64±9.91)% (t=-1.241, P=0.218). However, the average fluorescence intensity (MFI) of TIGIT gene expression was decreased, which was (7.21±2.03) in RA group and (9.01±3.29) in HC group (t=-2.947, P=0.004).MFI of TIGIT gene in NK cells of the disease active subgroup was (6.72±2.01), lower than that of the disease remission subgroup (8.75±2.64), (t=-3.316, P=0.002), and MFI of TIGIT gene in NK cells of the disease active subgroup was negatively correlated with DAS28 score (r²=0.649 6, P<0.000 1).The secretion level of IFN-γ cytokine in the RA disease group was (67.13±14.84) pg/ml, higher than that in the HC group (57.21±14.23) pg/ml (t=2.757, P=0.017), and the secretion level of IFN-γ cytokine in the disease active subgroup was negatively correlated with the MFI of TIGIT gene on NK cells (r²=0.662 2, P<0.000 1). Experimental results of peripheral blood mononuclear cell stimulation in the RA disease activity subgroup showed that the secretion level of cytokines IFN-γ was reduced after stimulation compared with that before stimulation (t=11.38, P<0.000 1). Conclusion The abnormal expression of TIGIT gene on peripheral NK cells are observed in patients with RA, which correlate with disease activity and IFN-γ secretion level.

OBJECTIVETo evaluate the efficacy of catheter ablation in Chinese hypertrophic cardiomyopathy (HCM) patients with atrial fibrillation (AF), and to determine the risk factors of AF recurrence.

METHODSThis study enrolled 40 HCM patients with AF who underwent primary AF ablation at Beijing Anzhen Hospital from June 2005 to June 2013. Ablation strategy included bilateral pulmonary vein isolation (PVI) for paroxysmal AF (n = 27) and PVI plus left atrial roof, mitral isthmus and tricuspid isthmus linear ablations for persistent AF (n = 13). AF recurrence was followed-up by means of electrocardiography or Holter monitoring. Risk factors associated with AF recurrence were determined by a Cox regression model and the predictive power was evaluated by receiver operating characteristic (ROC) curve.

RESULTSAfter (34 ± 18) months follow-up, 30% (12/40) cases remained in sinus rhythm off antiarrhythmic drug, most AF recurrence (18/28, 64.3%) occurred within 1 year post ablation. Multivariate Cox regression demonstrated that left atrial dimension (LAD, HR = 1.124, 95% CI 1.051-1.202, P = 0.001) and female gender (HR = 3.304, 95% CI 1.397-7.817, P = 0.007) were independent risk factors of AF recurrence. The cut-off value of LAD at 43.5 mm predicted AF recurrence with sensitivity of 93.5% and specificity of 60.0%. Every 1 mm enlargement in LAD was associated with an increased risk of arrhythmia recurrence (HR = 1.095, 95% CI 1.031-1.163, P = 0.003).

CONCLUSIONSAF ablation in Chinese HCM patients is safe and feasible. However, sinus rhythm maintenance rate is low at long-time follow-up. Most of the recurrent AF occurs within 1 year post AF ablation procedure. Left atrial diameter and female gender are independent risk factors of AF recurrence.

Anti-Arrhythmia Agents ; Atrial Fibrillation ; pathology ; therapy ; Beijing ; Cardiomyopathy, Hypertrophic ; Catheter Ablation ; Electrocardiography ; Electrocardiography, Ambulatory ; Female ; Heart Atria ; anatomy & histology ; Humans ; Male ; Pulmonary Veins ; ROC Curve ; Recurrence ; Risk Factors ; Sensitivity and Specificity ; Treatment Outcome

Human secreted phospholipase A2 GIIE (hGIIE) is involved in inflammation and lipid metabolism due to its ability of hydrolyzing phospholipids. To reveal the mechanism of substrate head-group selectivity, we analyzed the effect of mutation of hGIIE on its activity and selectivity. hGIIE structural analysis showed that E54 might be related to its substrate head-group selectivity. According to the sequence alignment, E54 was mutated to alanine, phenylalanine, and lysine. Mutated genes were cloned and expressed in Pichia pastoris X33, and the enzymes with mutations were purified with 90% purity by ion exchange and molecular size exclusion chromatography. The enzymatic activities were determined by isothermal microthermal titration method. The Km of mutant E54K towards 1,2-dihexyl phosphate glycerol decreased by 0.39-fold compared with that of wild type hGIIE (WT), and the Km of E54F towards 1,2-dihexanoyl-sn-glycero-3-phosphocholine increased by 1.93-fold than that of WT. The affinity of mutant proteins with phospholipid substrate was significantly changed, indicating that E54 plays an important role in the substrate head-group selectivity of hGIIE.
Humans ; Kinetics ; Mutation ; Phospholipases A2, Secretory ; Phospholipids ; Saccharomycetales ; Substrate Specificity