OBJECTIVETo observe therapeutic effects of locking titanium plate for the treatment of comminuted proximal humeral fracture in elderly.

METHODSFrom June 2011 to May 2013, 72 elderly patients with comminuted proximal humeral- fractures were divided into locking titanium plate group and anatomical plate group, 36 cases in each group. In locking titanium plate group, there were 16 males and 20 females aged from 60 to 79 years old with an average of (69.55±5.62) years old; 10 cases were type Neer II, 18 were type Neer III and 8 cases were type Neer IV in accordance with Neer classification; treated with locking titanium plate. In anatomical plate group, there were 15 males and 21 females aged from 60 to 81 years old with an average of (69.76±5.70) years old; 9 cases were type Neer II, 20 were type Neer III and 7 cases were type Neer IV; and treated with anatomical plate. Clinical effects, preoperative and postoperative Neer scoring, operative time, bone healing time and incidence of complications between two groups were compared.

RESULTSAll patients were followed up from 1 to 3 years with an average of 15 months. The excellent and good rate of locking titanium plate group (91.7%) was significantly higher than anatomical plate group (75.0%). Postoperative Neer score of two groups were improved obviously, but locking titanium plate group (92.51±7.85) was higher than anatomical plate group (83.64±8.56); there was no significant differences between two groups in operative time (P>0.05); bone healing time in locking titanium plate was (18.6±3.4) weeks, and shorter than anatomical plate group (24.3±3.9) weeks; incidence of complications in locking titanium plate was (5.6%) shorter than anatomical plate group (22.2%), and had obviously differences between two groups.

CONCLUSIONLocking titanium plate for the treatment of comminuted proximal humeral fracture in elderly plays an important role in good rate, bone healing time and Neer score. It has advantages of early rehabilitation exercise, less shoulder pain, rapid recovery of shoulder joint, less complications, safe and effective, and be worthy of clinical application, especially for senile osteoporosis patients.

Aged ; Aged, 80 and over ; Bone Plates ; Case-Control Studies ; Female ; Fractures, Comminuted ; surgery ; Humans ; Male ; Middle Aged ; Shoulder Fractures ; surgery ; Titanium

The reports on chemical constituents of Hyoscyamus niger were summarized. The compounds include alkaloids, saponins, lignans, coumarinolignans, flavonoids, and some other nonalkaloidal compounds. TLC, HPLC, and GC were used for the qualitative and quantitative analyses of some chemical constituents in H. niger. Modern pharmacological experiments showed that H. niger had the analgesic, anti-inflammatory, antipyretic, anticonvulsant, spasmolytic, antidiarrhoeal, antisecretory, bronchodilatory, urinary bladder relaxant, hypotensive, cardiosuppressant, vasodilator, antitumor, and feeding deterrent properties. In addition, the toxicities of this medicinal plant were also described.

Objective To identify the important risk factors for type 2 Diabetes Mellitus (T2DM) and develop effective strategies to address the problem of T2DM.Our study aimed to evaluate the association between apolipoprotein E (ApoE) genetic polymorphism and type 2 diabetes,and to provide clues for the etiology of T2DM.Methods Based on the criteria of inclusion and exclusion,we extracted,pooled,analyzed and assessed the case-control studies of ApoE polymorphism and T2DM published in PubMed,Web of Science,Medline,WanFang,VIP,and CNKI databases by R soft-ware (version 3.4.3).We used Random-effect models when heterogeneity was present in between-study,and fixed-effect models otherwise.Results We had 59 studies covering 6,872 cases with T2DM and 8,250 controls,and compared the alleles and genotypes of ApoE between cases and controls.When we conducted a comparison between ApoE ε4 and ε3 alleles,we produced a pooled OR of 1.18 (95％ CI:1.09-1.28;P ＜ 0.001).ApoE ε2/ε2 genotype displayed a possible association with T2DM (OR =1.46;95％ CI:1.11-1.93;P =0.007),ε3/ε4 genotype showed a 1.11-fold risk (OR =1.11;95％ CI:1.01-1.22;P =0.039) and ε4/ε4 genotype had a 1.71-fold risk of developing T2DM (OR =1.71;95％ CI:1.33-2.19;P ＜ 0.001) when they were compared with ε3/ε3 genotype.Conclusions There is an association between ApoE polymorphism and T2DM:allele ε4 and genotypes (ε2/ε2,ε3/ε4,and ε4/ε4) are associated with the increased risk for the development of T2DM,and they may be risk factors for T2DM.

OBJECTIVES: This study aimed to compare psychomotor performance related with automobile driving in patients with schizophrenia under the treatment of a typical antipsychotic agent, haloperidol, or an atypical antipsychotic agent, aripiprazole. METHODS: We evaluated driving ability of schizophrenia patients by using the cognitive perceptual assessment for driving (CPAD). Twelve patients receiving haloperidol monotherapy and 18 taking aripiprazole monotherapy participated in this study and the results of CPAD were compared with each other. RESULTS: Of 30 participants, 15 (50%) of the patients passed the CPAD to be regarded as competent to drive, 3 (10%) of the patients failed the CPAD considered to be severely impaired. Controlling for sex, age, education, duration of illness, there were no significant differences in the CPAD results between two treatment groups. We observed a trend that patients who received aripiprazole showed a higher total score of the CPAD than haloperidol-treated patients (55.2+/-4.9 vs. 45.7+/-8.4, p=0.080). CONCLUSION: There were no significant differences in the psychomotor performance relevant to driving ability between haloperidol and aripiprazole groups. But our results suggest that aripiprazole might have the neurocognitive advantage over haloperidol. Future study with a large sample size and diverse antipsychotics is warranted.
Antipsychotic Agents ; Automobile Driving ; Haloperidol ; Humans ; Imidazoles ; Nitro Compounds ; Piperazines ; Psychomotor Performance ; Quinolones ; Sample Size ; Schizophrenia ; Aripiprazole

OBJECTIVETo determine the effects of Chinese herbal monomers such as baicalin, berberine, and matrine on the androgen receptor (AR) mRNA expression in SZ95 sebocytes in vitro and to explore the possible mechanism of using traditional Chinese medicines to treat acne.

METHODSSZ95 sebocytes were cultured and then treated with berberine, baicalin, matrine, and 13-cis-retinoic acid for 24 hours. Reverse transcription polymerase chain reaction was applied to detect the changes of AR.

RESULTAR mRNA was downregulated by 13-cis-retinoic acid of 1 x 10(-5) mol/L and 1 x 10(-6) mol/L, and by baicalin of 1 x 10(-4) mol/L (P < 0.05).

CONCLUSION13-cis-retinoic acid and baicalin may exert antiandrogenitic action by inhibiting AR mRNA expression in human sebocytes.

Androgen Antagonists ; pharmacology ; Cell Line ; Down-Regulation ; Drugs, Chinese Herbal ; pharmacology ; Flavonoids ; pharmacology ; Humans ; RNA, Messenger ; biosynthesis ; Receptors, Androgen ; biosynthesis ; genetics ; Skin ; cytology

Adult ; Aged ; Biomechanical Phenomena ; Bone Screws ; Female ; Humans ; Joint Instability ; physiopathology ; surgery ; Lumbar Vertebrae ; physiopathology ; surgery ; Male ; Middle Aged ; Spinal Diseases ; physiopathology ; surgery ; Spinal Fusion ; instrumentation

OBJECTIVETo analyze the inpatient cost of AIDS related opportunistic infection in a high HIV epidemic area of China.

METHODSInformation was collected and analyzed from 158 inpatients with AIDS related opportunistic infection, including demographic characteristics of patients, types of opportunistic infection and treatment cost (median) from 2008 to 2010 in a high HIV epidemic area.

RESULTSThe inpatient cost per visit for AIDS related opportunistic infection was 2935.7 yuan. The fee per visit for examination, laboratory test, medicine, diagnosis and treatment, nursing, bed was 132.5, 269.0, 1485.5, 367.3, 302.5 and 264.0 yuan, respectively. The inpatient cost per visit for AIDS related opportunistic infection was 4383.1 yuan for male and 3418.6 yuan for female inpatient (U = -1.279, P = 0.201). The cost per visit for AIDS related opportunistic infection was 4703.1 yuan for Han nationality and 3475.9 yuan for minority patient (U = -1.025, P = 0.305). The inpatient cost per visit for AIDS related opportunistic infection was respectively 3429.3, 5022.2, 6705.5 and 2396.7 yuan for farmers, individual businessmen, employees of enterprise and public institution and jobless (H = 28.633, P = 0.000). The cost per visit was lowest for illiteracy patients (2590.2 yuan), 3626.5 yuan for primary school, 4214.3 yuan for junior high school and 6865.8 yuan for high school and higher education (H = 10.828, P = 0.013). The cost per visit for AIDS related opportunistic infection was respectively 2873.6, 4534.3, 3077.8 and 3208.1 yuan for under the age of 29, 30-39 years old, 40-49 years old and beyond the age of 50 (H = 1.515, P = 0.679). The AIDS related opportunistic infection cost per visit for inpatients infected through sex (4621.3 yuan) was higher than that of intravenous drug users (3208.6 yuan, U = -2.588, P = 0.010). Among various types of opportunistic infections, the cost was highest for neurological diseases (5819.7 yuan), 4300.8, 2806.8, and 2083.9 yuan for respiratory diseases, digestive system diseases and skin and mucous membrane diseases, respectively (H = 15.142, P = 0.004).

CONCLUSIONThe study shows difference of inpatient cost per visit between subgroups, the cost of public institution was higher than that of other professions, the cost of illiteracy patients was lower than other education level, the cost of inpatients infected through sex was higher than that of intravenous drug users, the cost of neurological diseases was higher than that of other types of opportunistic infections.

AIDS-Related Opportunistic Infections ; economics ; Acquired Immunodeficiency Syndrome ; economics ; Adult ; Female ; Health Care Costs ; Hospitalization ; economics ; Humans ; Male ; Middle Aged

Objective To assess the laparoscopic technique combined with open surgical technique in pyeloplasty.Methods Overall,45 patients with ureteropelvic junction obstruction underwent laparo- scopic dissection of the renal pelvis and upper ureter transperitoneally,and pyeloplasty was performed through a expanded trocar-incision(extension of 1-2 cm)as open surgery was performed.Results The opera- tion was successful in all 45 patients.The mean operative time was 58 min(range,40-85 min),and the mean blood loss was 22 ml(range,15-30 ml).No complication was observed during and after operation. Follow-up for 3-36 months was available in 34 patients.Intravenous urography(IVU)showed no obstruc- tion of the anastomotic stoma,and B-ultrasound indicated relief of hydronephrosis.Conclusions Laparo- scopic approach combined with open surgery in pyeloplasty is an effective way to treat ureteropelvic junction obstruction.This technique can simplify the operative manipulation and shorten the operative time without more trauma to the patients.It is worth general application in clinical practice.

Toxoplasma gondii is a ubiquitous protozoan parasite responsible for causing toxoplasmosis. Preventive measures for toxoplasmosis are currently lacking and as such, development of novel vaccines are of urgent need. In this study, we generated 2 virus-like particles (VLPs) vaccines expressing T. gondii rhoptry protein 4 (ROP4) or rhoptry protein 18 (ROP18) using influenza matrix protein (M1) as a core protein. Mice were intranasally immunized with VLPs vaccines and after the last immunization, mice were challenged with ME49 cysts. Protective efficacy was assessed and compared by determining serum antibody responses, body weight changes and the reduction of cyst counts in the brain. ROP18 VLPs-immunized mice induced greater levels of IgG and IgA antibody responses than those immunized with ROP4 VLPs. ROP18 VLPs immunization significantly reduced body weight loss and the number of brain cysts in mice compared to ROP4 VLPs post-challenge. These results indicate that T. gondii ROP18 VLPs elicited better protective efficacy than ROP4 VLPs, providing important insight into vaccine design strategy.
Animals ; Antibody Formation ; Body Weight ; Body Weight Changes ; Brain ; Immunization ; Immunoglobulin A ; Immunoglobulin G ; Influenza, Human ; Mice ; Parasites ; Toxoplasma ; Toxoplasmosis ; Vaccines

Objective To investigate the efficacy and pregnancy outcomes of women receiving double-catheter epidural block in labor analgesia, and compare the results with single-catheter epidural block.Methods A double-blind clinical trial was conducted on 206 full-term singleton primiparas, aged 25-35 and at the 37 -42 weeks of gestation who delivered at the Department of Obstetrics, Qingdao Municipal Hospital from August 2006 to December 2008, which were randomly divided into two groups:double-catheter epidural block ( group D, n = 103) and single-catheter epidural-block ( group S, n = 103 ).Women in group D were given mixture of 0.1% repivacaine hydrochloride and 0.5 mg/L sufentinil 4 -6 ml as initial dose.Patient control epidural analgesia pump (PCEA) was connected with the upper catheter after 45 minutes.A bolus dose of 4 -6 ml analgesia mixture was infused according to the condition through the lower catheter.Women in group S received analgesia mixture 10 - 15 ml as initial dose and PCEA pump was connected after 45 minutes.Oxytocin was infused in both groups according to uterine contraction after 30 minutes.The following indexes was observed: ( 1 ) visual analogue scales (VAS); (2) modified Bromage Scores;(3) the total dose of analgesia mixture, the percentage of oxytocin infusion, duration of labor and duration of the second stage of labor; (4) fetal birth weight and Apgar scores( 1,5 minutes); (5) mode of delivery; (6) the concentration of plasma cortisol and angiotension Ⅱ at the beginning of regular uterine contraction and at the time when cervical dilated to 4 cm and 10 cm and fetal disengagement; (7)anesthesia-related complications.Results ( 1 )The neonatal birth weight and Apgar scores ( 1,5 minutes)of group D were (3456 ±468)g, 9.8 ±0.6 and 9.9 ±0.7, respectively, while(3399 ±569) g, 9.8 ±0.5 and 9.9 ±0.7 in group S( P ＞0.05).No motor function block was reported in any group and the modified Bromage score was zero.(2) The total dose of analgesia mixture in group D was similar to that in group S [(57 ±9) ml vs.(58 ±11) ml, P＞0.05].However, the percentage of women received oxytocin in group D was smaller [59.2% (61/103) vs.81.6% (84/103), P ＜ 0.01], and the total time of labor and the duration of second stage of labor in group D were shorter[(532 ± 140) minutes vs.(608 ± 150) minutes;(46 ± 31 ) minutes vs.(60 ± 34) minutes, P ＜ 0.05].(3) There were no significant differences in VAS at 30 minutes after initial dose and in the first stage of labor between group D and S ( 1.2 ± 1.1 vs 1.2 ± 1.1,1.1 ± 1.1 vs.1.2 ± 1.0, P＞0.05).VAS at the second stage of labor stage was lower in group D than in group S ( 1.2 ± 1.1 vs.4.5 ± 2.2, P ＜ 0.01 ).(4) The rate of cesarean section, instrumental delivery and episiotomy in group D were lower than in group S (7.8% vs.17.5%, 7.8% vs.15.5%, 10.7% vs.18.4%, P ＜ 0.05).The incidence of fetal distress and meconium-stained amniotic fluid as the indication of cesarean section were similar between the two groups (P ＞ 0.05 ).Lower incidence of fetal malpresentation and arrested second stage of labor were shown in group D than in group S (2.9% vs.9.7%, 1.0% vs.5.8%, P ＜ 0.05 ).(5) The concentration of plasma cortisol and angiotension Ⅱ were lower in group D than in group S [(86 ±25) ng/L vs.( 100 ±20) ng/L, (278 ±53) nmol/L vs.(311 ±53)nmol/L, P＜0.05] only at the end of second stage of labor, but not at any other times(P ＞0.05).(6) No serious anesthesia-related complications were reported in any groups.Some light backache around the puncture point were complained by 29.1% (30/103) of the women in group D and 31.1% (32/103) in group S(P ＞0.05).Conclusion Double-catheter epidural block can provide better analgesia effect during labor than single-catheter epidural block, without any adverse influence on delivery outcomes.