Objective To explore the selection of prostheses for the elderly patients with severe displaced fracture of the femoral neck through retrospective comparison of the long term clinical results between bipolar hemiarthroplasty and total hip replacement. Methods From January 1986 to December 2002, 101 cases of Garden Ⅲand Ⅳtypes of the femoral neck fracture were treated with either bipolar hemiarthroplasty (Group A: 55 cases) or total hip replacement (Group B: 46 cases). The age of the patients at the time of operation ranged from 55 to 94 years old (mean: 70.4 years old) in Group A, and from 57 to 75 years old (mean 69.5 years old) in Group B. The average period of follow up was 4.9 years (1 to 10 years) in Group A and 3.5 years (1.5 to 5 years) in Group B. The clinical results were evaluated according to Harris and Merle d'Aubigue criteria. The perioperative complications were compared. Results The excellent and good clinical results were 78.12 %in Groups A and 95.65 %in Group B respectively. The rate of groin and thigh pains was higher in Group A (36.36 %) than in Group B (6.52 %). The flexion of the hip in Group A was more limited (mean 85 degrees) than in Group B (mean 110 degrees). There were more cases of sunken femoral stem in Group A. The perioperative complications were similar in both groups. Conclusions The total hip arthroplasty is the first choice for the elderly patients with severe displaced femoral neck fracture if the conditions of the patient and the skills of the surgeon permit. The bipolar hemiarthroplasty is suitable for patients of more than 75 years old, or for those with severe diseases.

Atherosclerosis ; diagnosis ; Humans ; Tomography, Optical Coherence ; methods

Objective To explore the relationship of peritoneal transport patterns and the nutritional status in continuous ambu-latory peritoneal dialysis(CAPD) patients .Methods 89 patients who took CAPD in 2010 January to December 2012 in the perito-neal dialysis center of our hospital were selected in this study .According to the ratio of creatinine in peritoneal dialysis solution and in blood(D/Pcr)of the peritoneal equilibrium test(PET) ,all CAPD patients were divided into HA group(high average transport) and LA group(low average transport) .Nutritional status including serum albumin(ALB) ,prealbumin(PA) ,transferrin(TF) ,hemo-globin(Hb) ,Lean body mass(LBM) ,subjective global assessment(SGA)and normalized Protein Equivalent of Nitrogen Appearance (nPNA) were compared in both groups .The relationship of D/Pcr and the nutritional status were analyzed .Results D/Pcr in HA group were significantly higher than in LA group(P<0 .01) .ALB ,PA ,TF ,Hb and SGA in HA group were significantly higher than in LA group(P<0 .01) ,but nPNA in two groups has no statistical differences (P>0 .05) .D/Pcr was negative related to ALB , TF ,Hb and SGA(P<0 .01) ,but not related to nPNA ,PA and LBM (P>0 .05) .Conclusion The nutritional status is related to peritoneal transport patterns in peritoneal HA patients ,it is necessary to strengthen nutritional guidance ,as the nutritional status is worse compared to LA ones .

To construct a lentiviral shRNA vector targeting human protein phosphatase 1D magnesium-dependent (PPM1D) gene and detect its effectiveness of gene silencing in human gliomas, specific siRNA targets with short hairpin frame were designed and synthesized. DNA oligo was cloned into the pFU-GW-iRNA lentiviral expression vector, and then PCR and sequencing analyses were conducted to verify the constructs. After the verified plasmids were transfected into 293T cells, the lentivirus was produced and the titer of virus was determined. Real-time quantitative PCR and Western blot were performed to detect the PPM1D expression level in the infected glioma cells. PCR and Western blot analyses revealed the optimal interfering target, and the virus with a titer of 6×10(8) TU/mL was successfully packaged. The PPM1D expression in human glioma cells was knocked down at both mRNA and protein levels by virus infection. The expression of PPM1D mRNA and protein was decreased by 76.3% and 87.0% respectively as compared with control group. The multiple functions of human glioma cells after PPM1D RNA interference were detected by flow cytometry and cell counting kit-8 (CCK-8). Efficient down-regulation of PPM1D resulted in significantly increased cell apoptosis and reduced cell proliferation and invasion potential in U87-MG cells. We have successfully constructed the lentiviral shRNA expression vector capable of stable PPM1D gene silencing at both mRNA and protein levels in glioma cells. And our data gave evidence that the reduced cell growth observed after PPM1D silencing in glioma cells was at least partly due to increased apoptotic cell death.

Objective To investigate the changes in the number of microglias and astrocytes in the spinal dorsal born in a rat model of phantom limb pain.Methods Eleven healthy adult SD rats of both sexes weighing 290-300 g were randomly divided into 2 groups:sham operation group (group S,n =5 ) and unilateral sciatic nerve transection group (group SNT,n =6).Phantom limb pain model was induced by resection of a 0.5 cm segment of unilateral sciatic nerve in group SNT.In group S unilateral sciatic nerve was exposed but not transected.The animals were observed for autotomy and scored (0 =no autotomy,13 =the worst autotomy) after operation and were sacrificed on the 28th day after operation.The L5 segment of the spinal cord was removed for determination of the number of microglials (by iba-1 immuno-histochemistry) and astrocytes (by GFAP immuno-histochemistry).Results In group S no animal developed autotomy.In group SNT autotomy started from the 2nd day after operation and the score reached 9-11.Compared with group S,the number of the microglias and astrocytes in the spinal dorsal horn was significantly decreased in the operated side in group SNT ( P ＜ 0.05 ).Conclusion The number of microglias and astrocytes in the spinal dorsal horn is decreased in animals with phantom limb pain.

Objective To investigate the changes in the number of synapses and neurons in the spinal dorsal horn in a rat model of phantom limb pain. Methods Eleven healthy adult SD rats of both sexes weighing 209-300 g were randomly divided into 2 groups: sham operation group (group S, n = 5) and phantom limb pain group (group P, n = 6). Phantom limb pain was induced by resection of a 0.5 cm segment of unilateral sciatic nerve in group P. In group S unilateral sciatic nerve was exposed but not transected. The animals were observed for autotomy and scored (0 = no autotomy, 13 = the worst autotomy) after operation and were sacrificed on the 28th day after operation. The L3-6 segment of the spinal cord was removed for determination of the number of neurons (by Nissl's staining) and synapses (by synaptophysin immuno-histochemistry).Results In group S no animal developed autotomy. In group P autotomy started from the 2nd day after operation and the score reached 9-11. The number of the neurons in the spinal dorsal horn in all 4 segments and the number of synapses in L3 and 16 segments were comparable between the two sides and the 2 groups. The number of synapses in the spinal dorsal horn of L4and L5 segment was significantly larger in the operated side than in the contralateral side in group P. Conclusion The number of synapses in the spinal dorsal horn significantly increases in animals with plantom limb pain which induces no increase in the number of neurons in the spinal dorsal horn.

BACKGROUND:Insufficient blood supply after major bone defects leads to osteocyte necrosis;therefore, the tissue-engineered bone cannot meet the clinical requirements. OBJECTIVE:To construct an artificial vessel using in vitro cultured rabbit bone marrow stromal stem cel s and human umbilical vein endothelial cel s combined with the rabbit aortic decel ularized vascular matrix. METHODS:Rabbit bone marrow stromal stem cel s were cultured by adherent method, human umbilical vein endothelial cel s were cultured in vitro and isolated, and rabbit aortic decel ularized vascular stent was prepared. The stent-cel composite was constructed, and its biocompatibility was observed under scanning electron microscope. There were three groups:blank control, control (bone marrow stromal stem cel-stent) and experimental (stent-cel composites) groups (n=10 per group), fol owed by implantation around the smal vessels. Three months later, the vascular samples were col ected for gross observation and hematoxylin-eosin staining. RESULTS AND CONCLUSION:Fibroblast-like cel clones were formed by adherent method, and were positive for CD44+and STRO-1+after climbing;calcified nodule formed in the ossification. Flow cytometry showed CD34+accounting for 43.83%, and visible VIII factor in the endothelial cel s. In the experimental group, endothelial cel s formed a single cel layer onto the scaffold under scanning electron microscope;the artificial vessel grew wel and tubular structure presented and eight angiod structures were found. Thin film-like vessels formed in the blank control group and there were only endothelial-like tissues in the control group. These results suggest that angiod structures can form after the stent-cel composite implantation, causing no immune reaction, but the artificial vessel is visible in absence of muscular layer.

Objective:To study the diagnostic value of MR diffusion weighted imaging (DWI) and CT and MR perfusion imaging in patients with different degrees of liver cirrhosis.Methods:A total of 60 patients with liver cirrhosis,who were treated in Ziyang Hospital of West China Hospital of Sichuan University from August 2015 to February 2017 were selected.According to the Child-Pugh classification,32 cases of grade A were mild cirrhosis (denoted as group A),16 cases of grade B and 12 cases of grade C were moderate to severe cirrhosis (denoted as group B),30 healthy volunteers were selected as group C in the same period.All the subjects in the three groups were examined by DWI,CT and MR perfusion imaging.The ADC value,hepatic portal perfusion ratio [SSr (CT) and SSr (MR)] were compared among the three groups,and Spearman correlation analysis was used to analyze the correlation between the indexes.Results:There was no significant difference in ADC values among the three groups (P＞0.05),and the ADC values of group A and B were lower than those of group C,but the difference was not statistically significant (P＞0.05).There was no significant difference in ADC values between group A and B (P＞0.05).The levels of SSr (CT) and SSr (MR) in the three groups were compared,the difference was statistically significant (P＜0.05);the levels of SSr (CT) and SSr (MR) in group B were significantly higher than those in group A and C,the difference was statistically significant (P＜0.05).There was no significant difference in the levels of SSr (CT) and SSr (MR) in group A and C (P＞0.05).Spearman correlation analysis showed that SSr (CT) was positively correlated with SSr (MR) in the patients with liver cirrhosis (r=0.687,P=0.000).Conclusion:CT and MR perfusion imaging can reflect the lesion degree of liver cirrhosis,and diagnostic effects of the two are better than DWI imaging,which is worthy of clinical promotion.

Adult ; Female ; Hemofiltration ; Hemolysis ; drug effects ; Humans ; Male ; Methylprednisolone ; administration & dosage ; therapeutic use ; Middle Aged ; Plasma Exchange ; Treatment Outcome ; Wasp Venoms ; poisoning ; Young Adult

Angioplasty, Balloon, Coronary ; adverse effects ; Coronary Restenosis ; prevention & control ; Drug Therapy, Combination ; Drugs, Chinese Herbal ; therapeutic use ; Endothelial Cells ; drug effects ; physiology ; Humans ; Phytotherapy ; Stents ; adverse effects