Objective To investigate the effectiveness of femoral troehanter reconstruction and artificial femoral head replacement in treatment of unstable intertrochanterie fractures in the elderly pa- tients. Methods Femoral trochanter reconstruction and artificial femoral head replacement was done on 106 patients with unstable intertrochanterie fractures. There were 45 males and 61 females, at age range of 80-105 years (average 88 years). Most of patients slipt in the room and got fractured. According to the Evans classification, there were 31 patients with type ⅢA fractures, 45 with type ⅢB and 30 with type IV. We used 4 kinds of methods to reconstruct the fracturad imertrochanters : (1) shape of" ∞ " ten- sion band fixation after intertrochanterie fracture reduction;(2) wire loop fixation of the lesser troehanter around proximal femur;(3)defect within the femoral ealear was filled with bone cement and remodeled; (4) for patients with relative intact base of femoral neck, the intertrochanterie fracture was transformed in- to femoral neck fracture and the femoral ealear was fixed with femoral prosthesis stem. Results All the operations continued successfully, with duration of the operation for 45-70 minutes (average 55 minutes). No artificial femoral head dislocation occurred during hospitalization. Of all, 79 patients were followed up for 6-48 months (average 16 months). No Late loosening, dislocation or infections occurred, with total excellence rate of 87.3%. Conclusions For elderly patient with unstable intertrochanterie fractures, reconstruction of femoral intertrochant and artificial femoral head replacement can restore the proximal femoral anatomy, maintain stability of the hip joint and help early functional exeereise, as can reduce ease fatality rate and improve the quality of life.

Objective To investigate the cause of fracture nonunion and discuss the experience of locking plates fixation combined with autoallergic cancellous bone in the management of non-infective long bone nonunion.Methods A retrospective analysis was made in 38 patients(29 males and 9 females)with fracture nonunion treated with locking plates fixation combined with autoallergic cancellous bone from August 2006 to August 2010.Of all,22 patients were treated with plates and 16 with interlocking intramedullary nails.Results All the patients were followed up for a mean of 12 months(range,6-24 months).The bone union time for all the fractures averaged 5.3 months(range,3-7 months),with no complications like implant loosening or fracture.Conclusions Iatrogenic factor is the main cause for fracture nonunion after open reduction and internal fixation of long bone fractures and the locking plates combined with autoallergic cancellous bone are a safe and effective treatment procedure.

This study was designed to investigate the correlation between autophagy and polarization of macrophages in atherosclerosis (AS) plaque in arteriosclerosis obliterans amputees. Femoral artery specimens from arteriosclerosis obliterans amputees were performed hematoxylin and eosin (HE) staining, oil red O and immunofluorescence staining to observe the morphology of atherosclerotic plaque, phenotype of macrophages and autophagy in plaque; using real-time quantitative RT-PCR technology to detect the mRNA level of M1 and M2 type markers in arterial tissue; to analyze polarized signal pathway and autophagy protein levels in macrophages by Western blotting. Arterial specimens staining showed obvious lipid deposition and obvious infiltration of amount of foam cells and inflammatory cells. Macrophages were mainly expression M1 type in percentage in fibrous plaque. Although both M1 and M2 macrophages were upregulated in atheromatous plaque, the increase was dominant in M2 type in percentage. The level of autophagy was significantly higher in the atheromatous plaque than that of fibrous plaque. The expression of tumor necrosis factor- α (TNF-α), monocyte chemotactic protein-1 (MCP-1), inducible nitric oxide synthase (iNOS), interleukin-6 (IL-6) and interleukin-12 (IL-12) mRNA was significantly higher in fibrous plaque than that of atheromatous plaque (P < 0.01 or 0.05), and arginase-1 (Arg-1), transforming growth factor-β (TGF-β), CD163 and interleukin-10 (IL-10) mRNA was significantly lower than that in atheromatous plaque (P < 0.01). The levels of p-STAT1 and NF-κB were significantly increased in fibrous plaque (P < 0.01), while p-STAT6 expression was significantly increased in atheromatous plaque (P < 0.01). The level of LC3-II was significantly higher in atheromatous plaque than that in fibrous plaque (P < 0.01). Macrophages in early atherosclerotic plaque were induced to M1 type through p-STAT1/NF-κB pathway and expressed moderate levels of autophagy; while macrophages in advanced plaques were induced to polarization of M2 type through p-STAT6 pathway. M2 macrophages expressed a higher level of autophagy than M1 macrophages.
Amputees ; Arginase ; metabolism ; Arteriosclerosis Obliterans ; pathology ; Atherosclerosis ; pathology ; Autophagy ; Cell Polarity ; Chemokine CCL2 ; metabolism ; Foam Cells ; cytology ; Humans ; Interleukin-10 ; metabolism ; Interleukin-12 ; metabolism ; Interleukin-6 ; metabolism ; Macrophages ; cytology ; NF-kappa B ; metabolism ; Nitric Oxide Synthase Type II ; metabolism ; Phenotype ; STAT6 Transcription Factor ; metabolism ; Tumor Necrosis Factor-alpha ; metabolism ; Up-Regulation

Objective To discuss the causes of failure of transpedicular screw fixation in treatment of thoracolumbar fractures. Methods A retrospective analysis was done to analyze the failure causes of 24 patients (15 males and 9 females) who received pedicle screw fixation for their thoracolumbar fractures from June 2002 to June 2008 in our department. There were two patients with delayed infection, eight with pedicle screw breakage, one with connecting rod breakage, 10 with internal fixation loosening (including nut loosening) and three with poor screw position. Results All patients received reo-perations including removal of internal fixation plus debridement and lavage in two patients, simple removal of internal fixation in nine patients, removal of inter fixation and posterior fusion in two, replacement of the lengthened fixation plus posterior fusion in nine, and adjustment of the position and orientation of screw in two. All patients were followed up for 6-18 months (average 11 months) , which showed no any complications. Conclusion Improper surgical indication or approach, ineffective fusion, incorrect postoperative rehabilitation exercise, too late removal of the screws and improper surgical operation are main causes for failure of internal fixation.

Objective To explore the mechanism of percutaneous laser disc decompression (PLDD) for treating prolapse of intervertebral disc. Methods 15 rabbits were divided into 3 groups randomly: sham group, model group with PLDD treatment, model group without PLDD treatment. The nerve conduction velocity (NCV) of L6 nerve root and the activity of phospholipase A2 (PLA2) in the intervertebral disc of L5-6 were determined 2 weeks after the initial surgery. Results NCV in the group with PLDD was significantly faster than that in the group without PLDD (P<0.001); NCV in the group without PLDD was significantly lower than that in the sham group (P<0.001). The activity of PLA2 in the group with PLDD was significantly lower than that in the group without PLDD (P<0.001); The activity of PLA2 in the group without PLDD was significantly higher than that in the sham group (P<0.001). Conclusion The activity of PLA2 in the herniated discs is higher than that in normal discs, which result in NCV falls remarkably. The PLDD can reduces chemical factors such as PLA2.

Objective To observe the preventive value of recombinant human granulocyte colony stimulating factor(rhG-CSF)in cancer patients after chemotherapy.Methods In the open study,enrolled 52 patients with previously untreated cancer and with normal bone marrow function were randomly divided into 2 matched groups,A and B group.Each patient received one cycle of chemotherapy.In the study cycle,the pa- tients received a single subcutaneous injection of rhG-CSF 150 ?g before 24 hours of chemotherapy and in control cycle the patients only received chemotherapy.Efficacy and safety parameters were monitored.Results The incidence rates of leukopenia in the 26 valuable study cycles and 26 valuable control cycles were 19.23 % and 53.85 %,There were significant lower than those of group B(P

ObjectiveTo discuss the clinical application of the temporary balloon occlusion of the common iliac artery in the control of hemorrhage in the operations of the old pelvic fractures.Methods From January 2006 to June 2009,twelve patients (10 males,2 females; mean age 33.9 years) with old pelvic fractures of Tile C type were treated operatively.Three cases were treated with external fixator.Operative treatments were delayed for the treatment of the life-threatening visceral injuries in six nonunions and three malunions.A balloon catheter was placed through intravascular intervention in the common iliac artery of the affected side.The balloon catheter was infolded when the osteotomy was performed and the operations were undertaken under temporary and total occlusion of the common iliac artery.Osteotomies and internal fixations were performed in 12 cases.Decompressions of lumbosacral trunk were undertaken in 4 cases complicated with injuries of sciatic nerve.ResultsThe mean time of operations was 290 min(range,210-367min).The mean time of occlusions was 65 min (range,45-90 min).The loss of blood ranged from 700 ml to 2800 ml,with an average of 1833 ml.All cases were followed up for 12-48 months,with an average of 35 months.The mean time of bone healing was 20.6 weeks (range,16-24 weeks).No thrombosis of the common iliac artery and deep venous thrombosis of the lower extremity or ischemic necrosis happened.In the four cases complicated with injuries of sciatic nerve,three recovered partly and could walk with a crutch and one recovered completely and could walk normally.Two cases limped and other six cases could walk normally.ConclusionThe effect of temporary balloon catheter occlusion of common iliac artery is reliable.It drastically reduces hemorrhage during the operation and avoid the complications of selective arterial embolism and ligation and makes the operations of the old pelvic fractures more safer.

OBJECTIVETo evaluate the efficacy and safety of using Jiangzhi Tongluo Soft Capsule (JTSC) combined with Atorvastatin Calcium Tablet (ACT) or ACT alone in treatment of combined hyperlipidemia.

METHODSA randomized, double blinded, parallel control, and multi-center clinical research design was adopted. Totally 138 combined hyperlipidemia patients were randomly assigned to the combined treatment group (A) and the atorvastatin treatment group (B) by random digit table, 69 in each group. All patients took ACT 20 mg per day. Patients in the A group took JTSC 100 mg each time, 3 times per day. Those in the B group took JTSC simulated agent, 100 mg each time, 3 times per day. The treatment period for all was 8 weeks. Serum levels of triglyceride (TG), total cholesterol (TC), low density lipoprotein cholesterol (LDL-C), and high density lipoprotein cholesterol (HDL-C) were observed before treatment, at week 4 and 8 after treatment; and safety was assessed as well.

RESULTSAt week 4 and 8 after treatment serum TG decreased by 26.69% and 33.29% respectively in the A group (both P < 0.01), while it was decreased by 25.7% and 22.98% respectively in the B group (both P < 0.01). At week 8 decreased serum TG was obviously higher in the A group than in the B group (P < 0.05). Compared with before treatment, serum levels of LDL-C and TC levels decreased significantly in the two groups (all P < 0.01). There was no statistical difference in the drop-out value and the drop-out rate of serum LDL-C and TC levels (P > 0.05). At week 8 the serum HDL-C level showed an increasing tendency in the two groups. No obvious increase in peptase or creatase occurred in the two groups after treatment.

CONCLUSIONJTSC combined with ACT could lower the serum TG level of combined hyperlipidemia patients with safety.

Adult ; Atorvastatin Calcium ; Double-Blind Method ; Drug Therapy, Combination ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Heptanoic Acids ; therapeutic use ; Humans ; Hyperlipidemias ; drug therapy ; Male ; Middle Aged ; Pyrroles ; therapeutic use ; Treatment Outcome ; Triglycerides ; blood

OBJECTIVETo investigate the effect of the mammalian target of rapamycin (mTOR) inhibitor CCI-779 on the chemosensitivity of androgen-independent prostate cancer cell line PC-3.

METHODSProstate cancer cells PC-3 were cultured and treated with CCI-779, Paclitaxel and combination of the two. Then the inhibitory effects of the three medications on the growth of the PC-3 cells were determined by MTT, and the their cell cycle and apoptosis were detected by flow cytometry.

RESULTSCompared with the control group, the three medications all significantly inhibited the proliferation of the PC-3 cells, and the combined method even enhanced the effect. Flow cytometry showed that CCI-779 and Paclitaxel blocked the cell cycle mainly in the G1/G2 stage, while the combined medication mainly in the G0/G1 stage. Significantly increased apoptosis of the PC-3 cells was observed in the three medication groups as compared with the control group (P < 0.01).

CONCLUSIONCCI-779 can inhibit the proliferation of PC-3 cells and enhance the chemosensitivity of prostate cancer.

Antineoplastic Agents ; pharmacology ; Cell Cycle ; drug effects ; Cell Line, Tumor ; Drug Therapy, Combination ; Humans ; Male ; Paclitaxel ; pharmacology ; Prostatic Neoplasms ; drug therapy ; Protein Kinase Inhibitors ; pharmacology ; Sirolimus ; analogs & derivatives ; antagonists & inhibitors ; pharmacology

Objective To investigate the characteristics of infecting pathogens,their changes and antimicrobial susceptibilities on CAPD related peritonitis in our peritoneal dialysis(PD) center in the past 15 years.Methods Two hundred and six CAPD related peritonitis episodes in 145 patients from 2000 to 2005 were analyzed and compared with 109 episodes from 1991 to 2000.The causative pathogens,their antimicrobial susceptibilities and outcomes on CAPD related peritonitis from the two periods were retrospectively reviewed and compared.Results Culture negative rate decreased from 60.6% in 1990 s to 47.6% in the last five years (P=0.031 ).Among culture positive peritonitis episodes,the incidence of gram positive bacteria (GPB) peritonitis increased from 25.6% to 39.8% (P=0.059).This was mainly due to a significant increase in coagulase-neagative staphylococcus peritonitis,which significantly increased from 4.7% to 26.9% (P=0.01).Gram negative bacteria (GNB) peritonitis decreased slightly (44.2% vs 34.3%,P=0.322).The incidence of Klebsiella pneumoniae peritonitis significantly decreased (14.0% vs 3.7%,P=0.023),while Pseudomonas aeruginosa and Escherichis coli peritonitis rates slightly increased (4.7% vs 9.3%,P = 0.338;7% vs 18.7%,P=0.072).The decrease of fungal peritonitis rate was not significant (30.2% vs 17.6%,P= 0.123).The comparison of clinical outcomes showed an improvement of total recovery rate from 68.8% in 1990 s to 73.9% for 2000-2005 (P=0.09).The catheter removal rate decreased from 19.2% to 14.3% (P=0.238),and the mortality from 10.1% to 5.4% (P=0.118).In both periods,fungal peritonitis had the poorest results,which all the patients either withdrew from PD or died.Conclusions Compared with that in 1990 s,the culture positive rate for CAPD related peritonitis in 2000-2005 has been greatly improved.Coagulase-negative staphylococcus is the most common causative pathogen.The mortality and catheter removal rate have been markedly reduced in the last five years.Fungal peritonitis is the most important reason for patients' dropout.