Objective To investigate the clinical efficacy of lengthened proximal femoral nail antirotation (PFNA) and Gamma nail treatment of proximal femoral fractures (including the intertrochanteric and inferior intertrochanteric area) combined with ipsilateral femoral shaft fractures.Methods A retrospective case control study was made on 68 cases of proximal femoral fractures combined with ipsilateral femoral shaft fractures received from January 2013 to October 2014.According to the operation mode,the patients were assigned to PFNA group (30 cases) and Gamma nail group (38 cases).Between-group differences were compared in aspects of surgical condition,treatment effect,Visual Analogue Scale (VAS),postoperative hip function (Harris score) and living ability (Barthel index).Postoperative complications were recorded as well.Results Duration of follow-up was 12-24 months [(20.8 ± 1.9) months].Incision length in PFNA group was (5.4 ± 1.2) cm versus (7.3 ±1.7) cm in Gamma nail group (P ＜ 0.01).Operative time in PFNA group was (96.8 ± 24.7) min versus (153.5 ±30.4)min in Gamma nail group (P ＜0.01).Blood loss in PFNA group was (151.5 ±16.8) ml versus (184.7 ± 22.7) ml in Gamma nail group (P ＜ 0.01).Healing time of proximal femur fractures and femoral shaft fractures in PFNA group [(16.1 ± 2.5) weeks,(19.5 ± 3.4) weeks] were significantly less than that in Gamma nail group [(18.9 ± 2.6) weeks,(22.6 ± 2.6) weeks] (P ＜0.01).VAS was (3.4 ±0.5) points in PFNA group versus (6.2± 1.3) points in Gamma nail group (P ＜ 0.01).At postoperative 2 weeks,6 months and 12 months,Harris score in PFNA group [(62.4 ±4.9),(73.7 ± 6.3),(86.4 ± 3.7) points] were significantly higher than that in Gamma nail group [(50.1 ± 4.7),(65.5 ± 6.1),(81.0 ± 3.5) points] (P ＜ 0.01).At postoperative 6 months and 12 months,Barthel index in PFNA group (76.4 ± 6.3,88.1 ± 7.0) were significantly higher than that in Gamma group (70.4 ±5.4,81.3 ±6.9) (P ＜0.01).No implant failure,screw cut-out,coxa vara or fracture displacement occurred.One patient (3％) in Gamma nail group had surgical wound infection compared to PFNA group (P ＞ 0.05).Conclusion In treatment of proximal femoral fractures combined with ipsilateral femoral shaft fractures,the lengthened PFNA fixation has advantages over Gamma nail in terms of minor trauma,rapid postoperative recovery and significant effect.

Objective To establish a HPLC method for the determination of quercetin from different parts of L. cuncata(Dum. Cours.)G.Don.,including roots,old branches,young shoots,leaves and seeds,and to build the fingerprints. Methods The HPLC method determination of quercetin and fingerpints were establised. Results The restults showed that there were great differences be?tween the quercetin contents from different parts,with the highest contents found in seeds,followed by young shoots,leaves,old branches,and roots. The similarities of HPLC fingerprints of the medicinal material were quite different from the parts of L. cuncata (Dum.Cours.)G.Don.. The similarities were all above 0.95 for L. cuncata(Dum.Cours.)G.Don. samples,roots,old branches and young shoots below 0.85,leaves and seeds similarities below 0.60. Conclusion It was concluded that different parts(such as roots, old branches,young shoots,leaves,seeds)of L. cuncata(Dum.Cours.)G.Don. should be divided in clinical and productive practice so as to supply the scientific basis for enhancing the curative effect and reasonable utilization of the resource of L. cuncata(Dum.Cours.)G. Don.

Aim To investigate the effects of endogenous and exogenous hydrogen sulfide(H_2S)on the proliferation and apoptosis of human fetal lung fibroblasts.Methods Human fetal lung fibroblasts were cultured under 2% O2～93% N_2～5% CO_2 for 24 h to produce hypoxia.Cells were divided into 6 groups:(1)Hypoxia group(N_2);(2)N_2+600 μmol·L~(-1) NaHS group;(3)N_2+1 200 μmol·L~(-1) NaHS group;(4)N_2+6 400 μmol·L~(-1) NaHS group;(5)N_2+400 μmol·L~(-1) cysteine(Cys)group;(6)N_2+200 μmol·L~(-1) S-adenosyl-L-methionine(SAM)group.After they were cultured for 24 h, MTT assay was used to evaluate the cell proliferation, and flow cytometry was used to detect cell apoptosis.Results Compared with N_2 group, 600 and 1 200 μmol·L ~(-1) NaHS(H_2S donor)significantly reduced proliferation induced by hypoxia of human fetal lung fibroblasts(P <0.01)without effects on apoptotic rates of cells(P >0.05)and 6 400 μmol·L~(-1) NaHS increased apoptosis of human fetal lung fibroblasts during hypoxia significantly(P <0.05), although no effects were found on proliferation of cells(P >0.05).In addition, Cys, substrate of cystathionine β-synthetase(H2S synthase, CBS) or SAM(activator of CBS)did not affect proliferation of human fetal lung fibroblasts induced by hypoxia(P >0.05), whereas apoptotic rates were increased significantly compared with that of N_2 group(P <0.05).Conclusions Endogenous and exogenous hydrogen sulfide can inhibit proliferation induced by hypoxia and promote apoptosis of human fetal lung fibroblasts, suggesting endogenous hydrogen sulfide may play a protective role through lung fibroblasts by inhibiting the pulmonary vascular structural remodeling caused by hypoxia.

Objective To compare and explore the morphological characteristics of mast cells in different tissues of 6 types of common laboratory animals.Methods Ten healthy adult SPF Kunming mice, 10 SD rats, 10 Hartley guinea pigs, 10 New Zealand rabbits, 6 beagle dogs and 6 Macaca mulata ( male:female=1:1, for all) were used in this study. The animals were sacrificed by euthanasia, samples of the skin, lung, spleen and sigmoid colon were taken from mouse, rat, guinea pig, rabbit, dog and monkey, and fixed in formalin and Bouin’ s solution.Paraffin sections were stained with toluidine blue and Alcian blue-safranin O, respectively.The mouse skin and dog spleen were immunohistochemically stained for substance P.A color pathological image analysis system was used to conduct the analysis of morphometric pa-rameters of mast cells.Samples of the skin of these animals were also fixed in glutaraldehyde for the electron microscopic observation and comparison of the mast cells.Results Mast cells in different types of animals were distinctive in distribu-tion, morphology, size, metachromasia and staining properties.Density and morphometric parameters of the mast cells had significant differences among the 6 types of animals ( P＜0.05 ) .Characteristic granules were contained in the skin mast cells of guinea pig, dog and monkey.Mast cells in the mouse skin, dog spleen and nerves in the mouse skin showed immu-noreactive substance P.Conclusions Mast cells in the 6 types of laboratory animals showed histochemical and morphologi-cal heterogeneity, which have important reference values in animal experimental research on mast cell function.

Objective To explore the clinical value of the duplex ultrasonography (duplex US) for evaluating the re-stenosis after peripheral arterial bypass grafting. Methods Eighty prosthetic grafts of sixty-three patients with femoral-pop-liteal arterial bypass grafting were follow-up regularly by duplex US. They were divided into non significant stenosis group (n=56), the significant stenosis group (n=15) and occlusion group (n=9) according to the tube diameter and arterial blood flow-ing parameters, which changed postoperatively. The diagnostic results were compared and analyzed between duplex US and digital subtraction angiography (DSA). The peak flow velocity of middle grafts (MG) to 40 cm/s was defined to evaluate risk of graft occlusion. Results The diagnostic coincidence rate of duplex US and DSA for grafts stenosis classification was 90%. The diagnostic sensitivity of duplex US to grafts stenosis was 91.7%, and the specificity was 92.9%. The positive pre-dictive value was 84.6%for grafts stenosis, and the negative predictive value was 96.3%, the false positive rate was 16.7%, and the false negative rate was 8.3%. The grafts occlusion rate was higher in MG<40 cm/s group than that of MG≥40 cm/s group. Conclusion There was a good consistency with Duplex US and DSA for the diagnosis of peripheral artery bypass graft restenosis. Duplex US showed characteristics of non-invasive, simple and easily accepted by patients.

0.05).Conclusions SNP of 2350G→A in ACE gene is associated with MI,AA genotype is probably a genetic marker of MI in Han nationality.

10.3969/j.issn.1007-3969.2013.04.005

Objective To evaluate the clinical efficacy of tacrolimus and cyclophosphamide (CTX) on lupus nephritis.Methods The clinical trials on treatment of lupus nephritis with tacrolimus and CTX published before October 2012 were searched at Cochrane library,PubMed,OVID,Wanfang database,Chinese Journal full-text Database,Chongqing Weipu Database by using the methods of Cochrane systematic review.At the same time the information from related journals,professional data and network were hand-searched.The homogeneous evaluation was performed by Meta-analysis.Statistical analysis of clinical data was performed by using Stata11 software.Results A total of 4783 reports were found,while only 9 papers (8 randomized controlled trials and 1 cohort study) met the inclusion criteria.Tacrolimus group got better complete remission ratio (Z =4.05,P ＜ 0.01),similar partial remission ratio (Z =0.44,P =0.661),and better overall remission ratio (Z =4.29,P ＜ 0.01) as compared with CTX group.There were no significant differences between tacrolimus group and CTX group in the incidence of infection (Z=1.75,P=0.081),renal damage (Z=0.88,P=0.38) and abnormal glucose metabolism (Z =1.91,P =0.070).Side effects such as liver function impairment (Z =2.65,P＜0.01),gastrointestinal discomfort (Z=2.31,P＜0.05),menstrual disorders (Z=3.88,P＜0.01),bone marrow suppression (Z =3.29,P ＜ 0.01) in tacrolimus group were lower than those in CTX group.Conclusions Compared with CTX,tacrolimus has better complete remission ratio and overall remission ratio,with less side-effects in the treatment of lupus nephritis.However,large scale,multicenter,well-designed clinical trials should be adopted to further confirm the conclusions.

Objective To observe the changes of the heart rate turbulence(HRT)in patients with isolated systolic hypertension(ISH).Methods 85 patients with ISH,80 patients with common hypertension and 58 control subjects were investigated.Turbulence onset(TO)and turbulence slope(TS)were recorded of 24 hours dynamic electrocardiogram.Results The difference of HRT in the three groups was significant(P＜0.01).The values of TO and TS was significantly higher in common hypertension group and ISH group than in control group(P＜0.05);TS was significantly lower in ISH group than in common hypertension group(P＜0.05),but the difference of TO between ISH group with common hypertension group was not obvious.Conclusion The HRT in patients with primary hypertension is significantly lower,which is more significant in patients with ISH than in patients with common hypertension.It suggests that the cardiac autonomic nerves dysfunction perhaps has an important influence on development of hypertension and its prognosis.

Objective To study the spatial variation of T2 relaxation time of cartilage of knee in healthy adults.Methods T2 values of cartilage of knee in 21 asymptomatic young male adults ( age ranged 24 to 39 years ; mean age , 30 years) were calculated by using a multiecho,spin-echo MR imaging sequence at 1.5T MR scanner on sagittal T2 maps,including the patellar,distal femoral weight and non-weight-bearing as well as proximal tibial weight-bearing cartilages,the differences in the spatial variation between them were analysed using F test.Results All 21 asymptomatic volunteers demonstrated a consistent pattern of spatial variation of T2 values cartilage of knee with longer T2 values near the subchondral bone,decreased in deep zoon and increased in articular surface , there was difference between them (F=70.892 , P＜0.05 ) . The greates spatial variation occurred in the patella.T2 value(26.56 ms±4.4 ms) in the deeper zoon of cartilage of the patella was obviously lower than that of the weight-and non-weight-bearing articular cartilage (P = 0.001 ) . Lateral femoral weight-bearing articular cartilage showed lower T2 value ( 35.2 ms ± 6.31 ms) in the outer transitional superficial zone than thatof the patella and non-weight-bearing cartilage,P=0.002,P=0.000 respectively.Lateral tibial weight-bearing articular cartilage showed showed lower T2 value(37.11 ms±6.6 ms)in the outer transitional superficial zone than that of non-weight-bearing cartilage(P=0.000). Conclusion The spatial variation of T2 relaxation time of cartilage of knee in the vivo in the asymptomatic young adults is like slightly concave curve at 1.5T MR system,that is of reference value in study of degenerative osteoarthritis.