Objective To explore the curative effect of dynamic hip screw(DHS) and proximal femoral nail (PFN)in treatment of intertrochanteric fractures. Methods Dynamic hip screw(DHS) group is A group:30 patients, proximal femoral nail( PFN) group is B group:30 patients. In the respect of the average length of the incision, operation time,blood loss,X-ray exposure times,postoperative drainage volume,blood transfusion volume,antibiotics usage time,hospitalization time,postoperative ambulation time,healing time of fracture,criteria of Harris hip function score after half a year,complication rate,this paper made the comparative analysis of clinical efficacy and statistical analysis between the two groups. Results 60 patients were followed up for 9 months to 4 years, with the average of 2 years and 3 months and no death. The average length of the incision, operation time, blood loss, X-ray exposure times, postoperative drainage volume,blood transfusion volume, DHS group were( 13. 4 ± 1. 9) cm, (92. 8 ± 13. 0) min, (321.0±39.4)ml,(5. 8 ± 1.2)times, (84.1 ± 10. 1)ml, (316.6 ±79. 1 )ml;PFN group were(7.6 ± 1.1 )cm,(59. 0±6. 9)min, (204. 6 ±32. 7) ml, (5.0 ±0.9) times, (53. 9 ± 8. 7) ml, ( 196. 6 ± 18. 2) ml; the differences between two groups were statistically significant ( all P ＜ 0. 05 ) . Hospitalization time, postoperative ambulation time, healing time of fracture,DHS group were(6.2±3.7)d,(17.8±1.8)d,(69. 8 ± 12. 3)d, (13. 0 ± 1. 6) weeks,PFN group were(4.7 ±2. 6)d,( 16.0 ±2. 2)d, (46.9 ±4. 9)d, (11. 3 ±0.7) weeks, the difference was statistically significant (all P＜0. 05). Antibiotic use of time,hip function(Harris score standard)excellent and good rate after half a year, there's no significant difference between the two groups( all P ＞ 0. 05). Complication rate, DHS group:40% ; PFN group: 10%. The difference was statistically significant (P ＜ 0. 05). Conclusion Intertrochanteric fracture fixation PFN group had an advantage of smaller surgical trauma,less bleeding,shorter healing time,more rapid postoperative recovery,lower complication rate and other characteristics comparing with the DHS group. So it was worth being recommended for a wider use.

In recent years, various network assistant teaching platforms which have flooded into universities have been well received by the majority of teachers and students and educators. Network teach-ing platforms in oral medicine education now, especially the assistant teaching and information management have gradually risen to play a decisive role position. Combined with the characteristics of oral medical un-dergraduate course and the present situation of teaching, a preliminary practical use has been made on the new digital teaching management platform of College of Stomatology, Chongqing Medical University, and the analysis based on its advantages and disadvantages has also been made, in order to make an improvement of oral medicine teaching quality and management efficiency.

OBJECTIVE:To systematically review the efficacy and safety of misoprostol combined with 10% Calcium gluco-nate injection in the treatment of postpartum hemorrhage,and provide evidence-based reference for the clinical treatment. METH-ODS:Retrieved from PubMed,EMBase,Ovid,CBM,CJFD and VIP,randomized controlled trials (RCT) about misoprostol combined with 10% Calcium gluconate injection (test group) versus conventional oxytocin in the treatment of postpartum hemor-rhage were collected. Meta-analysis was performed by using Rev Man 5.2 software after data extract and quality evaluation by Co-chrane systematic review manual 5.1.0. RESULTS:Totally 7 RCTs were enrolled,involving 1254 pregnant women. Results of Me-ta-analysis showed,compared with conventional oxytocin,misoprostol combined with 10% Calcium gluconate injection can signifi-cantly reduce 2 h postpartum hemorrhage [MD=-76.76,95%CI(-105.73,-47.79),P<0.001],24 h postpartum hemorrhage [MD=-118.28,95%CI(-167.78,-68.78),P<0.001] and the incidence of postpartum hemorrhage [OR=0.19,95%CI(0.08, 0.46),P<0.001],and shorten the 3rd delivery process [MD=-3.52,95%CI(-4.20,-2.84),P<0.001],the differences were sta-tistically significant;there was no significant difference in the intraoperative hemorrhage [MD=-61.31,95%CI(-121.98,-0.64), P=0.05] and neonatal 1 min Apgar score [MD=0.10,95%CI(-0.38,0.59),P=0.67] in 2 groups. The incidences of chest dis-tress,breathlessness and stomach discomfort in test group were significantly higher than control group [OR=18,95%CI(2.42, 133.98),P=0.005],but it was mild,and there was no significant difference in the incidence of fver,chills and nausea,vomiting, diarrhea and other adverse reactions. CONCLUSIONS:Both the efficacy and safety of misoprostol combined with 10% Calcium gluconate injection in the treatment of postpartum hemorrhage are good. Due to low quality and small-scale of included studies, more large-scale and long-term follow-up studies with strict designed are required for further validation of the conclusions.

Objective Observing the process of cell aggregation and differentiating into myocardium after the P19 cells treated with different methods and dimethyl sulfoxide(DMSO) inducer.Methods P19 cells were cultivated with DMSO in suspension for 7 days in Petri dishes or dishes containing a thin layer of soft agar to form cell aggregation.Then the aggregates were plated on gelatin-coated culture dishes,and cultured without DMSO to 19 days.The beating of cells was observed.?-sarcomeric actin and cardiac Troponin T(cTnT) immunocytochemical stains were used to identify cell differentiation.Results Cell aggregations were cohering-cultured with growth culture medium after DMSO induced for 7days,spontaneous and rhythmically beating cells were present within the aggregation outgrowths at day 15,which were ?-sarcomeric actin-positive and cTnT-positive.By day 19,positive rates were about 26% and 15% respectively.Conclusion By using DMSO exposure combination prior aggregation can induce P19 cells differentiate into cardiac myocytes which can spontaneously and rhythmically beat.

OBJECTIVE: To develop software for individualized dosage regimen of valproic acid and carbamazepine according to population pharmacokinetics and Bayesian estimation method. METHODS: Based on the prior population pharmacokinetic (PPK) information, Microsoft Excel 2010 was employed as the input-output interface to run the PPK program, Nonlinear Mixed Effect Modeling (NONMEM), to estimate the PK parameters and design the regimen. RESULTS: The software fulfills the functions of patient information management, initial dosage design, dosage calculation by maximum a posterior Bayesian estimation (MAPB) and compliance assessment. CONCLUSION: The established software provides a powerful tool in the clinical settings to facilitate the individualized therapy for the epilepsy patients.

Objective To elucidate the characteristics of the apoptosis of ovarian cell in DahlS hypertensive rats .Methods Sixty DahlS hytertensive femal rats(5 weeks old) were devided into 3 experimental groups and 3 control groups randomly,then the rats fed with 8% salt and normal forage respectively.Materials were gathered at 11,13,15 weeks old sacrifice.The apoptosis characteristics of granulosa cell and corpus luteum cell were studied by light,electron microscopy in situ end labelling techriqe,flowcytometry,etc.Results As hypertensive coures prolongation resut in the following conditions:⑴By light microscope,granulosa cell(GC) of developing follicles arranged inorderly and loosing ,the number of follicle atresia increased and corpus luteum decreased.⑵In TUNEL staining,apoptosis was mainly observed in granulosa cell of developing follicles,and it could not observed in corpus luteum cells. ⑶By electron microscope,the apoptosis of granulosa cell and corpus luteum cell assume typical characteristics as cytoplasm,a little nucleous,abnormal cytoblast,chromatin condensed and edged,appeared concetraction band,etc.It could also be observed that mitochondrion ridge had dearranged,the nmuber of smooth endoplasmic reticular(SER) decreased,and the change of lipid's lamellae was serious.⑷Flow cytometry assay showed the apoptosis rate of ovarian cell increased gradually,experimental groups of 13,15 weeks old(6 42?1 06)%,(6 67?2 11)% increased significantly as compared with controls(1 26?0 57)%,(1 46?0 73)%(t=3 027,3 085,P

Objective To explore the effects of estrogen and angiotensin Ⅱ receptor 1 inhibitor（saralasin）on cell proliferation,cell cycle and apoptosis in endometrial carcinoma cell line HEC-1A.Methods Immunocytochemical assay was applied to detect the expression of AT1-R,PI3K,p-Akt and ERK protein in HEC-1A cell.The effects of estrogen and saralasin on cell proliferation,cell cycle distribution and apoptosis of HEC-1A cell were detected by MTT assay and fluorescence activated cell sorting technique.The expression of ERK and p-Akt protein in HEC-1A cell treated with estrogen and saralasin were analyzed by Western blot.Results The expression of AT1-R,PI3K,pAkt,and ERK protein was found in HEC-1A cell.Estrogen stimulated the proliferation of HEC-1A cell,decreased G0~G1 phase proportion and increased S phase proportion significantly,minimized the number of apoptotic cells,and up-regulated the expression of ERK protein.Saralasin obviously inhibited the proliferation and induced apoptosis of estrogen induced HEC-1A cell,increased G0~G1 phase proportion and decreased S phase proportion,and down-regulated the expression of ERK protein.Conclusion Estrogen could promote the proliferation of HEC-1A cell through AT1-R.AT1-R inhibitor saralasin could inhibit the proliferation and induce the apoptosis of estrogen induced HEC-1A cell.The down-regulation of ERK protein expression by interrupting the mitogen-activated protein kinase（MAPK）signaling pathway might be involved in the possible mechanism.Thus saralasin could be a valid approach to treat ER-negative endometrial carcinoma.

The autonomic nervous system contributes to prostate cancer proliferation and metastasis. However, the exact molecular mechanism remains unclear. In this study, muscarinic acetylcholine receptor M1 (CHRM1) expression was measured via immunohistochemical analysis in human prostate cancer tissue array slides. PC-3, LNCaP, and A549 cells were treated with pirenzepine or carbachol, and the cell migration and invasion abilities were evaluated. Western blotting and quantitative real-time PCR were performed to measure GLI family zinc finger 1 (GLI1), patched 1 (PTCH1), and sonic hedgehog (SHH) expression levels. High expression of CHRM1 was found in early-stage human prostate cancer tissues. In addition, the selective CHRM1 antagonist pirenzepine inhibited PC-3, LNCaP, and A549 cell migration and invasion, but the agonist carbachol promoted the migration and invasion of these three cell lines. Muscarinic signaling can be relayed by hedgehog signaling. These data show that CHRM1 is involved in the regulation of prostate cancer migration and invasion through the hedgehog signaling pathway.

OBJECTIVETo explore optimal choice of surgical treatment for subtrochanteric fractures in older children.

METHODSA retrospective study of 36 older children with subtrochanteric fractures was performed between January 2010 and January 2012. Among them, 18 patients (11 males and 7 females) aged from 7 to 13 years old with an average of 9.4 were treated with titanic elastic nail (TEN) fixation, 4 cases were Type II A, 3 cases were II B, 2 cases were II C, 4 cases were III A, 3 cases were III B according to Seinsheimer classification. Eighteen patients (10 males and 8 females) aged was from 8 to 13 years with an average of 9.6 were treated with locking compression pine (LCP) fixation, and 3 cases were Type II A, 4 cases were II B, 3 cases were II C, 4 cases were IIIA, 2 cases were III B. Fracture healing time, postoperative complications (including wound infection, failure and breakage of internal fixtion, deformities of angular on the sagittal view, deformities of coxa vara) and recovery of hip joint function were observed and recorded.

RESULTSAll children were followed up from 15 to 36 months with an average of 21. Fracture were all healed, the time ranged from 7 to 16 weeks (mean 9.5). Three cases in TEN group occurred mild deformities of angular on the sagittal view, 3 cases occurred deformities of coxa vara and 2 cases occurred limb shortening; while 1 case occurred mild deformities of angular on the sagittal view, and no deformities of coxa vara and limb shortening occurred in LCP group. No early close of epiphyseal injury, avascular necrosis of femoral head occurred. Clinical efficacy were evaluated by Sanders standard, 14 cases got excellent results, 3 cases were moderate in LCP group, while 9 cases in excellent, 4 in moderate in TEN group. There were no significant differences between two group in recovery of hip joint function and complications.

CONCLUSIONFor the treatment of subtrochanteric fractures in older children,the efficacy of LCP fixation is better than that of TFN fixation, which has advantages of reliable fixation, and less complications.

Adolescent ; Bone Nails ; Child ; Female ; Fracture Fixation, Intramedullary ; instrumentation ; methods ; Hip Fractures ; surgery ; Humans ; Male ; Retrospective Studies ; Treatment Outcome

Objective To explore the characteristics and its influential factors of bone mineral density (BMD) changes in partial androgen deficiency in aging male patients.Methods 186 aging male patients with partial androgen deficiency and 125 healthy persons were selected, and their BMD in the first to fourth lumber spine and the proximal left femur was measured with the dual-energy X BMD measuring instrument.The biochemical and bone metabolic markers and sexual hormones were collected, and the relationship between changes of BMD in the patients with partial androgen deficiency, age, BMI, sexual hormones and bone metabolic markers were observed by multivariate stepwise regression analysis.Results There was no significant difference in BMD at the lumbar spine between two groups( P ＞ 0.05 ), but BMD in PADAM group was lower than control groups at the hip[Neck: (0.831 ±0.136) g/cm2 vs (0.954 ±0.143) g/cm2,War's: (0.712 ± 0.127 ) g/cm2 vs ( 0.811 ± 0.149 ) g/cm2,Troch: ( 0.697 ± 0.124 ) g/cm2 vs ( 0.764 ±0.131 )g/cm2, P ＜ 0.05 )].The incidence of PADAM and control group with osteopenia were 48.9% and 36%, and the osteoporosis was 33.3% and 20.8%, respectively.The bone mineral density was positively correlated to BMI at the first to fourth lumber spine and the proximal left femur in the patients with PADAM and negatively correlated to age and serum level of androgen.Conclusion BMD in PADAM group was significantly decreased, and age and low BMI and androgen deficiency wwere the risk factors of low BMD in PADAM patients.