Objective To analyze the causes for the thigh pain after treatment of femoral trochanteric fractures by proximal femoral nail antirotation Ⅱ( PFNA Ⅱ) . Methods Included in this ret-rospective study were 236 patients who had been treated by us for femoral trochanteric fracture from October 2011 to December 2015. They were 103 men and 133 women, aged from 42 to 86 years (average, 50. 3 years) . According to AO classification, 13 cases belonged to type 31-A1. 2, 32 to type 31-A1. 3, 35 to type 31-A2. 1, 27 to type 31-A2. 2, 33 to type 31-A2. 3, 38 to type 31-A3. 1, 39 to type 31-A3. 2 and 19 to type 31-A3. 3. All the fractures were single, fresh and closed and treated with PFNAⅡinternal fixation. Results This cohort was followed up for 8 to 26 months (average, 13. 2 months). Nonunion occurred in one case who had to accept artificial hip replacement. The remaining 235 cases obtained bony union after 22 to 39 weeks (average, 29. 3 weeks). By the Harris evaluation at final follow-ups, the affected hips scored from 81 to 93 points (average, 85. 1 points) . Post-operative thigh pain was reported in 19 cases (8. 05％) . The causes included varied anatomic morphology of the proximal femur in 6 cases, distal defects of the intramadullary nails in 4, insufficient stability of internal fixation or uneven biomecanical distribution in 3, unskillful operation in 2, and severe oesteoporosis in 4. Avascular necrosis of femoral head was not observed during follow-ups. Conclusions Postoperative thigh pain is worthy of serious atention from orthopaedists following PFNA Ⅱtreatment of femoral trochanteric fractures. PFNA Ⅱshould be modified according to the specific Chinese features of the proximal femur, especially in the respects of anterior arch and distal structure of the main nail and lateral declination as well.

Objective To observe the anti-tumor effect and mechanism of curcumin on triple-negative breast cancer mouse model.Methods Human breast cancer cells MDA-MB-231 were inoculated to the chest subcutaneous fat pad of mice(about 1 million cells in 0.1 mL cell suspension).At day 2 after tumor inoculation,nodules were seen at inoculation site (tumor formation rate being 100％).Forty successfully-modeled mice were randomly divided into low-,middle-,and high-dose curcumin groups (10,20,40 mg/kg) and model control group,10 mice in each group.The medication lasted for 30 continuous days.After medication,the blood was taken out from the orbital venous plexus,and the serum was separated for the detection of tumor necrosis factor alpha (TNF-α) and interleukin-6 (IL-6) contents.Spleen was separated for the calculation of organ coefficient,tumor mass was weighed,and the expression levels of Bcl-2 and caspase-3 were detected by Western blotting method.Results Compared with the model control group,caspase-3 expression level was significantly increased in the three curcumin groups(P ＜ 0.05 or P ＜ 0.01),but the contents of TNF-α and IL-6,tumor weight,spleen index and Bcl-2 expression were significantly decreased(P ＜ 0.05 or P ＜ 0.01).Conclusion Curcumin has inhibitory effect on triple-negative breast cancer mouse model through promoting the apoptosis of breast cancer cells.

Objective The aim of this study was to analyze the characteristics of upper gastrointestinal bleeding (UGIB) admitted on Ramadan or no-Ramadan.Methods We analyzed HuiNation patients' admissions of UGIB in Ningxia Medical University General Hospital from 2000 to 2013 (a total of 1192 admissions).Differences in etiological,transfusion undergo early esophagogastroduodenoscopy (EGD) and hospital stays between Hui-Nation patients on Ramadan.Results Ramadan admissions were associated with significantly higher hemorrhage rates than no-Ramadan admissions among Hui-Nation patients.Peptic ulcer (56％),esophageal varices (17％) and gastric erosive (12％) were the main reason of UGIB in Ramadan.Ramadan admissions were associated with significantly blood transfusion,less likely to undergo early EGD,mortality and long length of stay (p ＜ 0.05).Conclusions Ramadan admission of UGIH was higher than no-Ramadan.Doctor should pay more attention to this phenomenon.

AIM: To explore the role of PI3K /PKB pathway in the growth inhibition effect of rabbit lens epithelial cells (LECs) induced by (-)-epigallocatechin-3-gallate (EGCG). METHODS: Rabbit LECs were obtained by tissue culture; MTT colormetric assay was used to study growth of LECs; Western blotting was used to study the kinsae phosphorylation- and nonphosphorylation- level of PKB. RESULTS: (1) When LECs were preincubated with 25, 50 ?mol/L LY294002 for 1 h, 50 ?mol/L EGCG had little influence on the proliferation of LECs. It showed significant inhibition when EGCG increased to 100, 200 ?mol/L ( P

Inquiry is the main method of history taking. The training should not be limited to the medical inpatients inquiry. Different training scenes should be taken. The outpatient history inquiry needs a similar clinic room and set time limit, and focuses on key point history inquiry as well as document writing. Some principles in emergency inquiry are introduced, such as SAMPLE principle. The key points of inquiry of different patients including elderly patients, child patients, traumatic patients and drug addiction patients are also introduced. Through the combination of theory and practice mode, the group discussion and role-play, different scenes design and standardized patients application, reasonable design of teaching hours and content distribution, as well as feedback in time, optimal teaching effect can be finally achieved.

AIM: To investigate the effect of silymarin on homocysteine-induced cell viability and apoptosis in human umbilical vein endothelial cells (HUVECs). METHODS: Cell viability was analyzed by using MTT and LDH assay. Apoptotic cells were detected by using DNA fragmentation and flow cytometric analysis. The level of intracellular reactive oxygen species (ROS) and the potential of mitochondrial membrane were determined by flow cytometric assay. The activity of caspase-3, -6 and -9 were measured with microplate spectrofluorometer. Protein levels were examined by Western blotting. RESULTS: Treatment of cultured HUVECs with HCY for 48 h induced a significant decrease in cell viability, and the percentage of apoptosis increased to 76.8%. The level of intracellular ROS and activity of caspase-3, -6 and -9 enhanced, and the red/green ratios of mitochondrial membrane decreased. However, simultaneous treatment with silymarin exhibited cytoprotective effects, reduced formation of the DNA ladder, prevented the levels of Bax and Bcl-2 proteins and the accumulation of ROS as well as caspase-3, -6 and -9 activation, reconverted the potential of mitochondrial membrane, and the percentage of apoptosis/necrosis was significantly decreased to 12.7% in a dose-dependent manner. CONCLUSION: These results demonstrate that silymarin has the protective capacity to antagonize HCY-induced apoptosis in HUVECs. The antiapoptotic action of silymarin may be partially dependent on an anti-oxidative stress effects, inhibition of caspases activity, and maintenance of mitochondria function.

Open wedge high tibial osteotomy (OWHTO) is one of the effective treatments of medial knee arthritis and an important step in the treatment of knee arthritis. However, with the popularization of OWHTO, more and more of its related complications have been reported, including under- and over-correction of the alignment, tilted joint line, fracture of the cortical hinge, and changes in the posterior tilt of the tibial plateau. This paper reviewed the domestic and foreign research literature on the OWHTO treatment of knee arthritis to analyze the incidence of intraoperative and postoperative complications, treatment strategies and prevention methods concerning the complications in the treatment of OWHTO. A comprehensive understanding of the prevention and treatment methods of the complications can help avoid and reduce some of the complications so that OWHTO can be popularized more widely.

Objective To find out factors related to avascular necrosis (AVN) of femoral head through a retrospective study of patients with femoral neck fractures treated with cannulated screws.Methods Two hundred and thirty cases of femoral neck fracture whn had been treated with cannulated screws in our department from August 1994 to October 2003 were analyzed statistically.Six factors of patient,age,gender,fracture type (Garden clas- sification),reduction method (close or open),the quality of reduction (Garden Index) and time interval from injury to surgery were analyzed statistically with rank sum test and logistic multiple regression.Results Factors that might have an impact on avascular necrosis of femoral head were ranked in the following likelihood sequence: fracture type,quality of reduction,reduction method,time interval from injury to surgery and age.Gender was found to have little impact on the prognosis of femoral neck fracture (P＞0.05).Conclusions Fracture displacement is the most critical factor that influences the prognosis.Anatomical reduction (close or open) must be achieved to re- duce the risk of AVN.Timing of surgery shows its importance.High age will not lead to an increased incidence of AVN.

Objective To summarize the preliminary experience of early anticoagulant therapy after endovascular stent graft exclusion for Stanford B type aortic dissection.Methods From June 2006 to June 2011,75 patients[ 65 males,10 fe males,mean age (59.1±13.5) years,range 22 -81 years ] under went endovascular stent-graft exclusion for Stafford B type aortic dissection in Shanghai Xinhua Hospital.Computed tomography angiography (CTA) was used to evaluate the lesions of aortic dissection before endovascular stent-graft exchusion.The descending thoracic aortic diameters were 22 mm to 42 mm [ mean (30.3±4.0) mm ].The distance from the breakage of dissection to the left vertebral artery(LSA)was longer than 1.5 mm in 29 cases,and shorter than 1.5cmin 46 cases.During the operation,left subclavian artery revascularization was per formed to patient,whose left vertebral artery was advantage and needs to be fully or partially covered From the second day after operation,asprin was given to patint,whose left subclavian artery was fully or partially coverd by endovascular stent-graft(no endoleak and residual distal tear).Early anticoagulant therapy lasted 3 months.The symptoms or signs about nervous system were observed in the early stage of postoperation,and the CTA was examined at postoperative 3 months.Results The operation succeeded in 75 patients.The diameters of aortic stent were 26mm to 46rmm[ mean(34.3±4.0) mm ].Left subclavian ar tery revascularization was carried out for 2 cases of all patients.The left subclavian artery was fully or partially coverd in 58 patients(fully covered in 19 cases,2/3 covered in 15 cases,1/2 covered in 24 cases),and 56 patints(no endoleak and residualdistal tear) were given anticoagulant therapy to prevent vertebral artery thrombosis.2 patients(2.7％)died in the early stage after operation.1 patient died of renal failure,1 patient died of dissection rupture,The duration of hospitalization was 4 to 19 days [ mean (7.9±3.5)days ].No neurological complications occurred in hospital.The follow-up period was 6 to 66 months.1 patient died during the follow-up,1 patient had recurrence of Stanford A type aortic dissection and was cured by ascending aorta and aortic arch replacement,1 patient had recurrence of Stanford B type aortic dissection and was cured by second endovascular stent-graft exclusion.All patients had no neurological complications,such as cerebral infarction and paraplegia.Concluslon Early anticoagulant therapy could safely and effectively prevent the neurological complications (such as cerebral infarction and paraplegia) related to vertebral artery thrombosis for Stanford B type aortic dissection patients whose left subclavian artery was fully or partially coverd by endovascular stent-graft.

Objective To investigate the distribution and drug resistance of pathogens in elderly patients with gastric cancer complicated with diabetes mellitus.Methods 367 elderly patients with gastric cancer and diabetes mellitus were selected from the hospital from March 2010 to March 2017.The samples were isolated and cultured.The Gram positive bacteria were tested by GN201,the Gram negative bacteria susceptibility test was carried out by GP,and the drug susceptibility test was carried out by disk diffusion method.Results There were 68 cases of postoperative infection in gastric cancer patients with diabetes mellitus,and 79 strains were isolated and cultured.Among the gram negative bacteria,Escherichia coli,Klebsiella pneumoniae and Pseudomonas aeruginosa were the main pathogens.Among the Gram positive bacteria,Staphylococcus aureus and Staphylococcus epidermidis were the main pathogens.The main Gram negative bacteria,Escherichia coli to ceftazidime with levofloxacin resistance rates were 93.33% and 80.00%;Klebsiella pneumoniae had a higher drug resistance rate for cefoperazone and ciprofloxacin,76.92% and 69.23% respectively;a relatively high rate of Pseudomonas aeruginosa resistant to levofloxacin was 80.00%.Among the gram positive bacteria,the re-sistance rates of Staphylococcus aureus to penicillin and erythromycin were relatively high,respectively 91. 67% and 83.33%.Staphylococcus epidermidis had relatively high resistance rates to penicillin and erythromy-cin,100.00% and 77.78% respectively.Conclusion Gastric cancer complicated by diabetes mellitus elderly patients with postoperative infection of pathogenic bacteria distribution is given priority to with Gram-negative bacteria was the most common in,Pseudomonas aeruginosa,the main pathogenic bacteria of Escherichia coli to ceftazidime with levofloxacin resistant rate of Klebsiella pneumoniae was higher on cefoperazone and ciproflox-acin resistant Pseudomonas aeruginosa,the resistance rate of Pseudomonas aeruginosa to levofloxacin is high, and it is important to apply antibiotics rationally according to drug sensitivity test.