BACKGROUND: A variety of angiogenic factors are involved in bone healing after osteonecrosis of the femoral head.
OBJECTIVE:To explore the role and mechanism of angiogenic factors in osteonecrosis of the femoral head.
METHODS: A computed-based online search of PubMed, Google and SpringerLink databases was performed using the key words of “angiogenic factors, osteonecrosis of the femoral head, vascular endothelial growth factor, angiopoietin-1, fibroblast growth factor-2, hypoxia inducible factor-1, calcitonin gene related peptide and hypoxia inducible factor-1α” for literatures published from December 1980 to May 2015.
RESULTS AND CONCLUSION:Finaly, 68 articles were included. Bone angiogenesis which is dependent on special signaling factors in the microenvironment is closely linked with bone repair. A variety of cytokines, such as vascular endothelial growth factor, angiopoietin-1, fibroblast growth factor-2, platelet-derived growth factor, calcitonin gene-related peptide, and hypoxia inducible factor-1α, have been identifiedto control angiogenesis in different ways and be involved in the repair of necrotic femoral head.

Objective:To analyze the value of pepsinⅠ( PGⅠ) , pepsinⅡ( PGⅡ) , gastrin-17 ( G-17 ) diagnostic and Helicobacter pylori( Hp IgG) antibody in screening chronic atrophic gastritis and gastric cancer.Methods:90 patients with an upset stomach in our hospital from May 2014 to May 2015 were selected for the study, according to the pathological diagnosis which were divided into normal control group( including chronic non-atrophic gastritis) ,chronic atrophic gastritis group and gastric cancer,30 cases in each group.The level of PGⅠ, PGⅡ, G-17 and Hp IgG antibody positive rate in the three groups of patients were compared.Results:The level of PGⅠ,PGⅡin gastric cancer patients were lower than the control group and chronic atrophic gastritis group.And the index of chronic atrophic gastritis patients were lower than control group.The level of G-17 in gastric cancer group was higher than chronic atrophic gastritis group and the control group, and chronic atrophic gastritis group and the control group had no significant difference.The Hp IgG antibody positive rate in gastric cancer group was significantly higher than other two grups.The level of PGⅠand PGⅡin Hp-infected patients were lower than uninfected Hp patients,and the level of G-17 was higher than uninfected Hp patients.The level of PGⅠ, PGⅡ were significantly negatively correlated with age, pathological stage and metastasis, and positive related with the degree of differentiation;but the level of G-17 and Hp IgG antibody rate were positive related with age,pathological stage and metastasis, and negatively correlated with the degree of differentiation.Conclusion: PGⅠ, PGⅡ and Hp IgG antibody screening have a good diagnostic value in chronic atrophic gastritis and gastric cancer,and better diagnostic value of gastric cancer,G-17 diagnostic value of gastric cancer is much better than the chronic atrophic gastritis;and the level of PGⅠ,PGⅡ,G-17 and IgG antibody positive rate are closely related to the clinicopathological features of gastric cancer patients.

Objective To examine the usefulness of shock index (Sl) and adjusted shock index (corrected to temperature) (ASI) in predicting prognosis of patients with return of spontaneous circulation after cardiac arrest.Methods A prospective study,which data such as vital signs of the cases were collected by the Utstein template,was conducted in 111 of cases with return of spontaneous circulation after cardiac arrest to assess the value of SI and ASI for predicting their prognoses.Results There was no evidence to show difference between the cases with survival to hospital discharge and the ones who died about systolic blood pressure and heart rate (P ＞0.05).SI and ASI [(1.109 ±0.428) and (1.082 ±0.410)] of the group of death were higher significantly than the ones [(0.899 ± 0.303) and (0.844 ± 0.265)] of the group with survival to hospital discharge,P ＜ 0.05.The risk of death was elevated in the group with ASI ＞ 1.1,which odds ratio (5.4) higher than the ones of systolic blood prcssure ＜90 mm Hg (1.6)and ventricular rat ＞ 100 beat/min (3.1) significantly.The odds ratio of death with AS ＞ 1 was 2.8.Conclusions Shock index and adjusted shock index are easy to derive and conducive to predict effectively diseases prognosis such as survival to hospital discharge or death of patients with ROSC.

AIM To establish a quantitative analysis of multi-components by single marker(QAMS) method for the content determination of six catechins in Xinnaojian Capsules (Tablets) (tea extract).METHODS The analysis of 50％ methanol extract of this drug was performed on a 35 ℃ thermostatic Shimadzu Wonda Cract ODS-2 column (4.6 mm ×250 mm,5 μm),with the mobile phase comprising of 0.5％ acetic acid (A)-acetonitrile (B) flowing at 1.0 mL/min in a gradient elution manner,and the detection wavelength was set at 280 nm.With epigallocatechin gallate as an internal standard,the relative correction factors of epigallocatechin,catechin,epicatechin,gallocatechin gallate and epicatechin gallate were calculated,from which the content determination was made.RESULTS Six constituents showed good linear relationships within their own ranges (r ≥ 0.999 8),whose average recoveries were 96.00％-98.47％ with the RSDs of 2.09％-2.91％.The results obtained by QAMS method approximated those obtained by external standard method.CONCLUSION This simple and reliable method can be used for the quality control of Xinnaojian Capsules (Tablets).

Objective To estimate the efficacy and safety of Voriconazole as antifungal prophylaxis of invasive fungal infection ( IFI) for malignant hematology patients. Methods The randomized controlled trials of Voriconazole treatment in invasive fungal infection for malignant hematology patients (ended in September 2014) were searched from Cochrane library, Medline, Embase, Pubmed, CBM, CNKI, Blood database. The meta analysis were performed by RevMan5.0. Results Ten literatures reported in 1 773 cases, in which there was significantly difference in effective rate between Voriconazole and other antifungal agents such as Amphotericin-B, Itraconazole, Micafungin and Fluconazole(P < 0.000 01); Four literatures indicated that there was significantly difference in adverse event rate between Voriconazole and amphotericin-B (P < 0.00 001); no significantly difference in adverse event rate between Voriconazole and amphotericin-B(P = 0.57); no significantly difference in adverse event rate between Voriconazole and Micafungin (P = 0.69); no significantly difference in adverse event rate between Voriconazole and Fluconazole (P = 0.70); Subgroup analysis indicated that adverse event rate between Voriconazole and Itraconazole is P=0.001, P = 0.17 respectively. Conclusion Voriconazole showed relative high efficient and low toxicity characteristics in treatment of malignant hematology accompanied by invasive fungal infection. But with its widely clinical application, the clinical value of Voriconazole needs to be further tested.

BACKGROUND:Intertrochanteric fracture is one of the most common fractures in older adults. The surgical treatment methods include artificial joint replacement (total hip and femoral head replacement) and internal fixation (proximal femoral nail anti-rotation and dynamic hip screw), but there is no clear evidence to evaluate the effect of them. OBJECTIVE: To compare the effect difference of arthroplasty and internal fixation in the treatment of intertrochanteric fracture in the elderly people. METHODS:We retrieved randomized controled studies on artificial joint replacement (total hip and femoral head replacement) and internal fixation (proximal femoral nail anti-rotation and dynamic hip screw) in the treatment of intertrochanteric fracture from 1990 to 2015. Meta-analysis was used to compare operation time, intraoperative bleeding volume, one-year postoperative Harris hip scores, and one-year postoperative complication between the arthroplasty and internal fixation. RESULTS AND CONCLUSION:(1) Twenty-one studies were included. (2) Intraoperative bleeding volume and one-year postoperative Harris hip scores were higher in the arthroplasty group than in the internal fixation group. (3) Operation time was similar between the arthroplasty and internal fixation groups. (4) Complication rate was lower in the arthroplasty group than in the internal fixation group. Incidence of complications was closed between the arthroplasty and internal fixation groups. (5) Results suggested that the effect of arthroplasty was better than internal fixation for treating intertrochanteric fracture in the elderly. However, prospective large-sample long-term randomized controled trials are needed for verification.

BACKGROUND:The pathogenesis of steroid-induced osteonecrosis of the femoral head remains unclear. Femoral head reconstruction after colapse is related to the bone remodeling due to disorder of the bone formation-absorption coupling. “Removing Blood Stasis” Method has been shown to have a positive effect on the disease in clinics. However, the mechanisms by which the “Removing Blood Stasis” Method confers bone repair after osteonecrosis remain poorly understood.
OBJECTIVE:To explore the effect of “Removing Blood Stasis” Method on bone repair in rabbits with steroid-induced femoral head osteonecrosis.
METHODS: Fifty New Zealand rabbits were randomly assigned into three groups: normal control (n=10),
model (n=20) andTaohong Siwu Decoction (n=20) groups, respectively. The steroid-induced osteonecrosis of the femoral head animal models were established by intramuscular injection of endotoxin combined with methylprednisolone (MPS). Rabbits inTaohong Siwu Decoction group were intragastricaly administered with 0.3 g/kg ofTaohong Siwu Decoction suspension after the last injection of methylprednisolone. The control and model groups were administrated by equal volume of ultrapure water for 8 consecutive weeks. High-resolution MRI and pathological determinations were used to assess the successful models. Protein expression levels of ABCB1, RUNX2, OPN, RANK, RANKL, PPAR, osteoprotegerin (OPG), vascular endothelial growth factor (VEGF) in rabbit femoral heads were detected by western blot assay.
RESULTS AND CONCLUSION:(1) Hematoxylin-eosin staining showed that trabecular bone fracture, karyopyknosis, empty lacunae, necrotic bone marrow cels were seen in the model group. Empty lacunae rate in the model group was significantly different from that in the normal control group (P < 0.05). Bone formation was active and kept better trabecular morphology in theTaohong Siwu Decoction group. It suggested that “Removing Blood Stasis” Method can improve repair of necrotic area. (2) In the model group, femoral head with a wide range of low-density areas in high-resolution MRI;Taohong Siwu Decoction group showed the relatively normal shape of the femoral head with smal areas of low density. It suggested that “Removing Blood Stasis” Method can improve image changes in the necrotic area. (3) Protein expression levels of RUNX2, RANK, RANKL were significantly up-regulated but protein expression levels of ABCB1, OPG, VEGF were significantly down-regulated in the model group compared with the normal control group; whereas, they were al significantly up-regulated in theTaohong Siwu Decoction group compared with the model group, except for RANK and RANKL (P < 0.05). These results suggest that the “Removing Blood Stasis” Method can promote bone repair in steroid-induced femoral head osteonecrosis rabbits by regulating protein expressions of ABCB1, RUNX2, RANK, RANKL, OPG, and VEGF.

BACKGROUND: Osteogenic ability of bone morphogenetic protein-2 has been wel documented in many experiments, but a series of factors are involved in osteogenesis induction that is a complex network adjustment process. OBJECTIVE: To quantitatively determine the level of insulin-like growth factor I during the lumbar spinal fusion of rabbits induced by recombinant human bone morphogenetic protein-2. METHODS: Sixty adult male New Zealand white rabbits were randomly divided into three groups: bone autograft, bone al ograft or composite bone (bone al ograft with 75 μg recombinant human bone morphogenetic protein-2) was implanted into the L5-6 intertransverse process of rabbits, respectively. At days 7, 14, 21, 28, 35 after implantation, formed cal us was taken to detect the expression of insulin-like growth factor I using real-time fluorescence quantitative PCR. RESULTS AND CONCLUSION: In the three groups, the expression of insulin-like growth factor I gradual y increased with implantation time, peaked at 28 days and then decreased. At 7 days after implantation, the expression of insulin-like growth factor I was higher in the autograft group than the composite and al ograft groups (P < 0.05); at 14 days, the expression of insulin-like growth factor I was higher in the autograft and composite groups than the al ograft group (P < 0.05); at 21, 28 and 35 days, the expression of insulin-like growth factor I was higher in the composite group than the autograft and al ograft groups (P < 0.05). These findings indicate that recombinant human bone morphogenetic protein-2 can improve the expression of insulin-like growth factor I effectively during the lumbar spinal fusion.

Objective To evaluate the feasibility and advantages of robot-assisted laparoscopic radical prostatectomy (RALRP) in treating high-risk prostate cancer.Methods From Mar.2010 to Dec.2014,69 men with high-risk prostate cancer (clinical stage ≥ T3a,serum PSA ≥ 20 μg/L or biopsy Gleason score ≥8) underwent surgical treatment at our center.RALRP was performed in 44 cases,with a mean age of (66.7 ± 8.6) yrs (range:50 ～ 82) and a mean baseline PSA of (23.1 ± 11.2) μg/L (range:3.6-48.8).Transperitoneal approach was adopted in all cases.Twenty-five patients were treated with ORP.The mean age was (64.3 ± 5.9) yrs (range:52-75) and baseline PSA was (21.7 ± 10.2) μg/L (range:5.7-41.3).Baseline clinical features,including age,initial PSA,biopsy Gleason score and clinical staging,were comparable between two cohorts.Surgical outcomes after RALRP were analyzed and compared between groups.Results All RALRP procedures were successfully performed with da Vinci robotic system and there was no open conversion.Mean operation duration were similarly (158 ± 47)min for RALRP group and (152± 42)min for ORP group,respectively.The mean estimated blood loss and postoperative length of hospital stay in RALRP group were (328 ± 254) ml and (8.4 ± 3.1) days,both of which were significant lower than those in ORP group,(674 ± 302) ml and (14.4 ± 3.7) days.Two cases of urine leak and two of lymphatic leak occurred after RALRP,and a statistically insignificantly higher complication rate was observed for the ORP group,in which four of urine leak and three of lymphatic leak happened.The positive surgical margin rates of two groups were 20.5％ and 24％,respectively.After the mean follow-up of 25 (RALRP) and 27 months (ORP),continence rate was significantly higher in the RARLP group (93.2％ vs.72.0％).PSA failure was observed in seven RALRP cases (15.9％) and four ORP cases (16.0％).Conclusion Compared with traditional ORP,RALRP shows significant advantages,including less blood loss,fewer complications,shorter length of stay,better postoperative continence and equivalent oncologic outcome when dealing with high-risk prostate cancer cases.Robot-assisted surgery is a safe and efficacious surgical modality in this setting.

BACKGROUND: Osteonecrosis of the femoral head (ONFH) following internal fixation of femoral neck fractures is difficult to be cured in clinic.OBJECTIVE: To analyze the literatures concerning ONFH in patients with femoral neck fractures treated with screw internal fixation in recent 15 years, and to summarize the research progress in views of epidemiology, etiology, diagnosis,treatment and rehabilitation.METHODS: Databases of CNKI, WanFang, CqVip, PubMed, Medline, Web of Science were searched with the keywords of femoral neck fracture, osteonecrosis of femoral head, osteonecrosis, internal fixation, internal fixation with screw in English and Chinese, respectively. Afterwards, the reviews and case reports were excluded. RESULTS AND CONCLUSION: (1) A total of 54 eligible articles addressing the ONFH following internal fixation for femoral neck fractures were included, and the incidence of ONFH varied from 8.1% to 37.2%, which was found at an average of 17 months after injury. (2) ONFH was found to be related to age, preoperative fracture displacement, preoperative traction,reduction condition, time from injury to operation, elderly patients companied with other diseases, older patients undergoing removal of the screws, closed or open internal fixation, restored time postoperatively, high body mass index, hyperlipidemia, season, and depression. (3) Early prevention and remedial surgery were used to treat ONFH. (4) The patients without weight-bearing activities at 3-6 months postoperatively could be beneficial for functional recovery. (5) These results suggest that choosing appropriate surgical programs and rehabilitation plan can reduce the incidence of ONFH and achieve good treatment outcomes, such as reasonable preoperative planning, standardized operation skills, correct diagnosis and treatment, proper postoperative rehabilitation and good doctor-patient cooperation.