BACKGROUND:Doubld-action hemiarthroplasty and total hip arthroplasty are reliable methods to treat intertrochanteric fracture of femur in the elderly, but which is better remains controversial in the clinic. OBJECTIVE:To observe the practical effect of prosthetic replacement with different methods in treatment of intertrochanteric fracture of femur in the elderly, and to assess the clinical value. METHODS:A total of 54 elderly patients with intertrochanteric fracture of femur at the age of over 65 years old were randomly assigned to two groups. In the observation group (n=27), patients underwent graded cement double-action arthroplasty. In the control group (n=27), patients received cementless total hip arthroplasty. They were folowed up for 2 years. Harris scores were recorded in the two groups so as to assess the therapeutic effects. Folow-up recurrence rate, adverse events and host response to materials were analyzed. RESULTS AND CONCLUSION: The therapeutic effects were similar between the observation and control groups (89%, 81%;P > 0.05), but recurrence rate of 2-year folow-up was significantly lower in the observation group than in the control group (4%, 30%;P < 0.05). Moreover, dislocation, acetabular wear and loosening were not found. Results indicate that the midterm effects were similar between graded cement double-action arthroplasty and total hip arthroplasty in treatment of intertrochanteric fracture in the elderly, but graded cement double-action arthroplasty significantly decreases the recurrence rate.

BACKGROUND:General anesthesia or continuous epidural anesthesia can be commonly selected for lower limb joint surgery in the elderly. The effect of epidural anesthesia is precise, and can be easily controled. The effect of muscle relaxation is good. However, the time of anesthesia induction is relatively long, and it is not ideal in the control of pain in the visceral peritoneum reflection region. Moreover, circulatory system interference can be greatly affected by lumbar anesthesia. OBJECTIVE:To evaluate the effects of combined spinal-epidural anesthesia with ropicavaine in elderly patients undergoing lower limb arthroplasty. METHODS: Ninety patients undergoing lower limb arthroplasty admitted to Heze Municipal Hospital from September 2013 to November 2014 were chosen and were equaly and randomly assigned to two groups, including 52 cases of knee replacement and 38 cases of hip replacement. Patients in the control group received continuous epidural anesthesia. Patients in the observation group received combined spinal-epidural anesthesia with ropicavaine. Vital signs, onset time of anesthesia, drug consumption, analgesic effect and postoperative side effects were observed and compared in both groups. RESULTS AND CONCLUSION:Heart rate, pulse, and arterial oxygen saturation were significantly lower in the control group than in the observation group. Vital signs in the observation group were more stable, and the significant difference was detected between the two groups (P < 0.05). Onset time of anesthesia and drug consumption were significantly better in the observation group than in the control group, showing very significant differences between the two groups (P < 0.01). The excelent and good rate of analgesic effects was lower in the control group (67%) than in the observation group (89%), which showed significant differences between the two groups (P < 0.05). In the control group, vomiting appeared in 10 cases and dyspnea appeared in 4 cases, with an incidence of side effect of 31%. In the observation group, vomiting appeared in 3 cases and dyspnea in 2 cases, with the incidence of side effects of 11%. The incidence of side effect was significantly higher in the control group than in the observation group (P< 0.05). These data indicate that combined spinal-epidural anesthesia with ropicavaine showed good analgesic effect in elderly patients receiving lower limb arthroplasty. The onset time of anesthesia was short. Drug consumption was low. The incidence of side effects was low.

Objective To investigate the clinical features of uterine empyema complicated with perforation of the uterus,the causes of misdiagnosis and measures of reducing misdiagnosis.Methods Twenty clinical cases from 2008 to 2013 in the First People's Hospiptal of Shangqiu were treated postmenopausal,uterine empyema and uterine perforation,and 16 cases of whose first diagnosed leak or misdiagnosed patients were retrospectively analyzed.Summarize the clinical characteristics,misdiagnosis and experiences in order to reduce the misdiagnosis of the disease.Results Among 20 cases of uterine perforation and Uterine empyema,16 cases first diagnosed misdiagnosed,and the incidence was 80％ (16/20).One case was diagnosed tumor torsion,1 case of diagnosis of pelvic abscess,14 cases first diagnosed of surgery (8 cases of acute peritonitis,gastrointestinal perforation in 4 cases and 2 cases of perforated appendicitis).It all occurred in postmenopausal women,and the main clinical features were that:high fever,lower abdominal pain,feel bloated in the rectal,mass pelvic cavity,weakened movement of intestine and cervical disturbance pain.results of emoyemic bacteria culture were mainly colon bacillus (E.coli).The main causes of misdiagnosis were atypical clinical manifestations,clinicians lack of comprehensive analysis and dynamic observation of the disease,over-reliance on laboratory examinations;their performance was often the first diagnosis of acute abdomen surgery,the surgeon only undergraduate examination,as well as undergraduate diagnosis of inertia thinking,neglect gynecological examination.All patients had a one-time cure after surgery.Conclusion Uterine empyema complicated with uterine perforation occurs mainly in postmenopausal women,which had a higher rate of misdiagnosis.Correctly diagnosis and timely treatments make benefits to the prognosis.

Curcumin,a polyphenol compound,is a bioactive constituent extracted from the roots of the perennial herb Curcuma longa L.It has antioxidant,anti-inflammatory,anti-infective,heart protective and anti-tumor properties.Recent research has shown that curcumin can exert neuroprotective role in cerebral ischemia via the mechanisms of antioxidative stress,antiapoptosis,anti-cerebral edema,and anti-inflammation.This article reviews the neuroprotective mechanisms of curcumin in cerebral ischemia.

Natural killer (NK) cells,a major cell type of the innate immunity,have a central role in infections,immunizations and tumors.The relationship between NK cells and hematological malignancies is increasingly pursued by domestic and foreign researchers.Exploring the relationship between function and activity of NK cells and malignant hematological disease is of great importance.

Mantal cell lymphoma (MCL) is a rare and special type of non-Hodgkin lymphoma.MCL is classified as an aggressive variety of lymphoma and yet it sometimes behaves as an indolent lymphoma.Although the first-line therapy of MCL is highly effective,but it is incurable through conventional chemotherapy.Patients with MCL have a poor prognosis.This review focus on a new therapeutic approach,mammalian target of rapamycin (mTOR) inhibitor.Temsirolimus,a derivation of rapamycin,in MCL cell lines inhibited mTOR.Temsirolimus could inhibits tumor cell proliferation through cell cycle arrest and able to down-regulation of cyclin D1 and Ki-67 in lymphomacell.Clinical trials showed that temsirolimus induced patients with MCL response rate and a prolong progression-free survival.In addition,preclinical studies demonstrated the use of a combination of temsirolimus with monoclonal antibodies or conventional chemotherapy to improve the efficacy of single agent use.Altogether,temsirolimus shows promising results in the therapy of patients with heavily MCL,and especially responses in chemotherapy refractory patients,providing a novel approaches to treatment of MCL.

Acupuncture and moxibustion is classified as category of alternative medicine and has been incorporated into the public medical institution in Oman. There are two public hospitals which have set up acupuncture and moxibustion service at present, but only in outpatient department regions. Private clinics of traditional Chinese medicine are not uncommon, and the local government is constantly improving the management policy on it now. The musculoskeletal system diseases are predominant diseases treated by acupuncture and moxibustion, and obesity female is mostly common. Compared with other Arabian countries, Oman is more inclusive to foreign culture and the local government attaches great importance to acupuncture and moxibustion, so there is much better development space for acupuncture and moxibustion in Oman.