Objective To asses the effects of Gamma nail and DHS/Richard (dynamic hip screw) in the treatment of proximal femoral fractures. Methods A meta analysis of all the relevant randomized controlled trials (RCTs) was performed. We included randomized and quasi randomized controlled trials in patients with proximal femoral fracture to compare Gamma nail and DHS/Richard. Results First we identified 88 papers on comparison of Gamma nail and DHS/Richard in the treatment of proximal femoral fractures published from 1969 to 2003. 7 trials involving 1256 patients were identified as meeting all the eligibility criteria. 3 investigators independently graded study quality and abstracted relevant data, including information on mortality rates, wound infection, function, revision in patients with a proximal femoral fracture. 4 trials, which included a total of 621 patients, provided detailed information on mortality rates over the first 6 postoperative months. We found there was no significant difference in the relative risk of death in the first 6 months postoperative between treatments of Gamma nail and those of compression hip screw (relative risk 1.17;P=0.51). 6 trials that included a total of 1083 patients provided data on operative complications. The risk of operative complications from Gamma nail fixation appeared to be higher than that from compression screw and side plate fixation but not higher than that from compression hip screw (relative risk 1.41; P=0.02). We also found an obvious increase in the relative risk of fracture of femoral shaft between Gamma nail and compression hip screw (relative risk 6.99; P=0.00). Patients treated with Gamma nail had a higher rate of revision compared with those with compression hip screw, but there was no significant difference between the two groups (relative risk 1.85; P=0.20). In addition, wound infection, operative blood loss and functional recovery were similar between the tow groups(relative risk 0.98 for wound infection and 1.02 for function). Operating time for Gamma nail patients was significantly less than that for DHS/Richard ones (P

Background Research showed that the morbidity rate of primary angle closure glaucoma (PACG) in Mongolian population is 3.02 times more than Han nationality population.To understand the cause and mechanism of PACG in Mongolia is of an important significance.Objective This study was to investigate the pathogenesis of Mongolian PACG.Methods Thirty-two eyes of 32 PACG patients in Mongolia and 40 eyes of 40 PACG patients of Han peoples were included in Inner Mongolia Autonomous Region People's Hospital according to the diagnosis criteria of glaucoma group of Chinese Medical Ophthalmology Association (version 1987),and 13 eyes of 13 normal Mongolia and 17 eyes of 17 normal Han peoples who suffered with ocular truma were recruited as controls.Intraocular pressure(IOP) was measured before surgery.The trabecular meshwork tissue was obtained from all the eyes during the operation.Annexinv-FITC/PI double staining was performed and the apoptosis rate of trabecula cells was tested with flow cytometry.Written informed consent was obtained initial of the study.Results The IOP value in Mongolia PACG group,Han PACG group,Mengolia normal group and Han normal group was (35.97±7.11)mmHg,(38.70± 6.82) mmHg,(14.69 ± 2.91) mmHg and (13.59 ± 2.91) mmHg,respectively,showing a significant difference among the 4 groups(F=106.144,P=0.000),and the IOP was significantly higher in the Mengolia PACG group and Han PACG group than the normal groups(P＜0.05).The apoptosis rate of the cells was (7.14±0.67)％,(5.40±0.69) ％,(5.86±0.91) ％ and(2.29±0.65) ％ in the Mongolia PACG group,Han PACG group,Mongolia normal group and Han normal group,respectively,with a significant difference among them (F =174.888,P =0.000),and apoptosis rate of the Mongolia PACG group was significantly higher than that of the Han PACG group and the Mongolia normal group (P＜0.05).No significant difference was found between the Mongolia PACG group and the Han PACG group or between the Mongolia normal group and Han normal group (P＞0.05).The cell apoptosis rate was increased with the elevation of IOP (b =0.990,F=10.209,P =0.009) with the regression equition Y =2.788 +0.092X.Conclusions The apoptosis rate of trabecula cells in Mongolian is higher than Han people.If these results are associated with the high incidence of Mengolia PACG is worth of study.

Abstract： Objective　To understand the new HIV-1 infection in MSM (men who have sex with men) sentinel population in Haikou and explore the influencing factors of HIV/AIDS epidemic, so as to provide a basis for AIDS prevention and control. Methods　A continuous cross-sectional study was used to detect HIV-1 infection in the MSM sentinel surveillance population in Haikou City from 2019 to 2023, excluding those with known past positive results and those who had been on antiretroviral therapy for more than six months. The positive cases suitable for new infection testing were examined by HIV-1 restriction antigen affinity enzyme immunization method, and binary non-conditional logistic regression model conducted multivariate analysis of new infections. Results　A total of 2 001 MSM were recruited, with a median age M（P25, P75）of 28 (23, 33) years, 89.8% were recruited from the Internet, 90.8% were single; 79.7% resided in the local area for >2 years, 72.6% were educated to college level or above, and the proportion of household registration in the province was 78.0%. From 2019 to 2023, the HIV-1 positive rate among MSM in Haikou from 2019 to 2023 was 6.85% (137/2 001), with a new infection rate of 2.95% (59/2 001). The estimated new infection rate was 8.61% (95%CI: 6.41-10.81), with no significant trend changes in HIV-1 positivity and new infection rates over the years (P>0.05). Multivariate analysis revealed that, compared to those who lived locally for ≤2 years, those residing locally for >2 years had a lower probability of recent HIV-1 infection (OR=0.473，95%CI: 0.273-0.821). Compared to those who had never received intervention services, those who had received such services had a lower risk of recent HIV-1 infection (OR=0.347, 95%CI:0.197-0.613). Conclusions　In recent years, the Haikou MSM population has shown characteristics of higher education and younger age, and the rate of new HIV-1 infections has not changed significantly. Receiving intervention services is the protection factor to prevent HIV-1 new infections, whereas the mobile MSM population has a higher risk of HIV-1 new infection. Health management of the mobile MSM population should be strengthened to expand the coverage of AIDS intervention services.

Objective: To investigate the value of the trigeminocervical response (TCR) for revealing bulbar involvement in patients with spinal and bulbar muscular atrophy (SBMA). Methods: Thirty patients with SBMA and 30 healthy male controls were included in this study. In all of the normal controls, stimulation of the infraorbital nerve on one side produced bilateral short latency waves consisting of a positive/negative wave, p19/n31, the mean latency of which was measured. The mean square root of the ratio between the amplitude of p19/n31 and the mean rectifi ed surface electromyography (EMG) activity preceding the stimulus, the A value, was estimated. The parameters of the TCR were compared between the two groups. Results: Among the patients with SBMA, 21 (70.0%) had delayed latencies of p19/n31 (P < 0.01) and all (100%) had reduced A values (P < 0.01) relative to the normal controls. Conclusions: All parameters of the TCR were signifi cantly different between the patients with SBMA and the normal controls. T

OBJECTIVE: To investigate the effect of asymmetric dimethylarginine (ADMA), an endogenous inhibitor of nitric oxide synthase, on the activation of hepatic stellate cells (HSCs) and its mechanism. METHODS: Primary HSCs isolated from SD rats were cultured and treated with different concentrations (1, 3 or 10micromol/L) of ADMA for various periods (12 approximately 48h). Expression of alpha-smooth muscle actin (alpha-SMA) and synthesis of type-I collagens in HSC were determined. Messenger RNA levels of the transforming growth factor-beta1 (TGF-beta(1)) in the HSCs were determined using RT-PCR. Intracellular reactive oxidant species (ROS) production was measured using oxidant-sensitive fluorescent indicator. Activation of nuclear factor-kappaB (NF-kappaB) was detected by electrophoretic mobility shift assay (EMSA). RESULTS: ADMA could increase alpha-SMA-positive cells ratio and Type I collagens production of HSCs in a concentration- and time-dependent manner, concomitant with the increase of the TGF-beta(1) mRNA level. Treatment with ADMA (10micromol/L) significantly increased the intracellular ROS production and activated NF-kappaB. Such effects of ADMA on the level of TGF-beta(1) mRNA could be markedly attenuated by pretreatment with antioxidant pyrrolidine dithiocarbamate (25micromol/L). CONCLUSION ADMA can induce the HSC activation by increasing TGF-beta(1) expression through ROS-NF-kappaB-dependent pathway. Therefore, ADMA should be a novel and endogenous activator of HSC, which may be involved in the development of liver fibrosis.
Actins ; biosynthesis ; Animals ; Arginine ; analogs & derivatives ; pharmacology ; Cells, Cultured ; Collagen Type I ; metabolism ; Dose-Response Relationship, Drug ; Gene Expression ; drug effects ; Hepatocytes ; cytology ; drug effects ; metabolism ; Male ; NF-kappa B ; metabolism ; Nitric Oxide ; metabolism ; Nitric Oxide Synthase ; metabolism ; RNA, Messenger ; genetics ; metabolism ; Rats ; Rats, Sprague-Dawley ; Reactive Oxygen Species ; metabolism ; Reverse Transcriptase Polymerase Chain Reaction ; Transforming Growth Factor beta ; genetics

Animals ; Antihypertensive Agents ; isolation & purification ; pharmacology ; Antioxidants ; isolation & purification ; pharmacology ; Antiviral Agents ; isolation & purification ; pharmacology ; Benzofurans ; chemistry ; isolation & purification ; pharmacology ; Chromones ; chemistry ; isolation & purification ; pharmacology ; Flavonoids ; chemistry ; isolation & purification ; pharmacology ; Magnetic Resonance Spectroscopy ; Mass Spectrometry ; Molecular Structure ; Morus ; chemistry ; Plants, Medicinal ; chemistry ; Resorcinols ; chemistry ; isolation & purification ; pharmacology ; Spectrum Analysis ; methods

OBJECTIVE: To evaluate the protective effect of recombinant human granulocyte colony stimulating factor (rhG-CSF) on acute hepatic failure induced by galactosamine (D-GalN) and lipopolysaccharide (LPS) in mice, and to explore its mechanism. METHODS: The mice were intraperitoneally administered D-GalN (800 mg/kg) and LPS (10 microg/kg), and then were intraperitoneally injected either saline (the control group )or rhG-CSF at 300 microg/kg body weight (the therapy group) at 4 h, 2 h and 0 h before the D-GalN/LPS injection. The survival rate of the mice was estimated at 24 h after the D-GalN/LPS injection. The degree of hepatic injury was evaluated at 6 h after the D-GalN/LPS injection, and the levels of TNF-alpha, IFN-gamma, IL-6 and IL-10 mRNA were simultaneously measured by semiquantitative RT-PCR. RESULTS: The survival rate of the therapy group was significantly higher than that of the control group (68.4% vs 20%, P<0.01). As compared with the control group, the degree of liver injury in the therapy group significantly decreased (P<0.05), and the levels of TNF-alpha and IFN-gamma mRNA in the hepatic tissue also reduced remarkably (P<0.01, respectively), while the levels of IL-6 and IL-10 mRNA increased (P<0.01, respectively) at 6 h after the D-GalN/LPS injection. CONCLUSION G-CSF can protect the mice from acute hepatic failure induced by D-GalN/LPS.
Animals ; Galactosamine ; Granulocyte Colony-Stimulating Factor ; therapeutic use ; Lipopolysaccharides ; Liver Failure, Acute ; chemically induced ; drug therapy ; Male ; Mice ; Protective Agents ; therapeutic use ; Random Allocation ; Recombinant Proteins

OBJECTIVETo report a case of pure erythroid leukemia.

METHODSThe clinical features, treatment and prognosis of a rare case of pure erythroid leukemia were reported, and the related literature was reviewed.

RESULTSThe pure erythroid leukemia patient was diagnosed by 90.4% pronormoblasts in bone marrow, 99.5% for erythroid antigen CD71, 67.4% for glycophorin A were detected, while no differentiation antigen of myeloid, lymphoid and megakaryocyte lineages were observed. HAG (homoharringtonine + Cytarabine and G-CSF) regimen were administered with no effect. The patient developed multiple organ failure and died soon.

CONCLUSIONPure erythroid leukemia has a fulminant clinical course with poor response to chemotherapy and worse prognosis.

Humans ; Leukemia, Erythroblastic, Acute ; therapy ; Male ; Middle Aged ; Prognosis

BACKGROUNDNon-small cell lung cancer (NSCLC) is the leading cause of cancer mortality worldwide. Platelet activation may play an important role in pathologic progress in lung cancer. In this study, we aimed to clarify the influence of activated platelets on lung cancer generation and growth, and the relationship among these functional and ultrastructural changes of platelets and the severity of pathogenetic condition in these patients with NSCLC.

METHODSOne hundred and thirty-six cases of patients with pathologically confirmed NSCLC were included in this study. Fifty-four healthy people were enrolled as controls. The change of ultra microstructure and activity of blood platelets were observed under the transmission and scanning electron microscope. Simultaneous determination of plasma granule membrane protein 140 (GMP-140) was made.

RESULTSTransmission electron microscopy showed remarkable changes of ultra microstructure of platelets in patients with NSCLC, including swelling, increase of a-granules, vesicles, and glycogenosome. Scanning electron microscopy showed many more surface processes and wrinkles on platelets in patients with NSCLC. The reference plasma levels of GMP-140 of healthy controls were (18.2 +/- 2.7) microg/L. The plasma levels of GMP-140 in patients with NSCLC were (47.8 +/- 12.3) microg/L, which were much higher than those of the controls. There was a medium positive correlation between plasma levels of GMP-140 and amount of a-granules (r = 0.514, P < 0.01) and a high positive correlation between plasma levels of GMP-140 and area of platelet (r = 0.84, P < 0.01) in patients with NSCLC. The Kaplan-Meier survival curve analysis showed significant shift to the left in patients with NSCLC whose a-granules per platelet were 19 or more compared to those 18 or less (Log rank statistic, chi(2) = 17.38, P < 0.01).

CONCLUSIONSThere are significant activated changes of ultra microstructure and increased activity of blood platelets in patients with NSCLC. These activated platelets may play an important role in the generation and growth of lung cancer. These changes can be used as a diagnostic index of severity, progression, and prognosis of NSCLC.

Adult ; Aged ; Blood Platelets ; ultrastructure ; Carcinoma, Non-Small-Cell Lung ; blood ; drug therapy ; mortality ; ultrastructure ; Female ; Humans ; Male ; Microscopy, Electron, Transmission ; Middle Aged ; P-Selectin ; blood ; Survival Analysis

OBJECTIVETo sum up causes and the prevention of complications after using the radio frequency ablation (RFA) to treat of primary and secondary liver cancers.

METHODSThe clinical courses of 735 patients, undergoing percutaneous RFA treatment for a total of 1780 times were reviewed. The causes of the complications occurring after the RFA treatment, and their prevention and treatment were evaluated.

RESULTSEleven complications after RFA treatment were found. Postoperative fever, sweating, and local pain were common. Serious complications, such as gut perforation, intraabdominal hemorrhage, and cardiovascular accident were found in 4 patients, and the mortality was 75%.

CONCLUSIONSThe RFA treatment is an effective method for the treatment of primary and secondary liver tumor. Careful selection of patients, appropriate preoperative preparations, proper operative procedures, and suitable postoperative care are the key points in preventing the complications.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Carcinoma, Hepatocellular ; secondary ; surgery ; Catheter Ablation ; adverse effects ; Female ; Humans ; Liver Neoplasms ; secondary ; surgery ; Male ; Middle Aged