OBJECTIVE: The most commonly used intramedullary fixation systems for the treatment of elderly intertrochanteric fractures include the proximal femoral anti-rotation intramedullary nail (PFNA), the proximal femoral anti-rotation intramedullary nail of Asian (PFNA-II) and interlocking intramedullary nail for proximal femur (Inter-TAN), but the clinical effect of the three in the treatment of A2 and A3 type intertrochanteric fractures is still controversial. Meta-analysis was used to compare the clinical efficacy of Inter-TAN, PFNA, and PFNA-II in the treatment of unstable intertrochanteric fractures in the elderly. METHODS: A computer was used to search databases such as Cochrane, Embase, PubMed, Sinomed, CNKI, Wanfang, and VIP to collect and compare the literatures of Inter-TAN, PFNA, and PFNA-II in the treatment of elderly unstable intertrochanteric fractures. The search period was from the establishment of the database to December 2019. Two reviewers independently read the screening literature, extracted data and evaluated the quality. Meta-analysis was performed using RevMan5.3 software. RESULTS: (1) A total of eight studies were included, with 1 349 patients, including two randomized controlled studies and six cohort studies. The evidence level was ≥ III. (2) Meta-analysis showed that the operation time and intraoperative fluoroscopy time were longer, and intraoperative blood loss was more in the Inter-TAN group than those of the PFNA-II group [MD=-16.60, 95%CI (-23.22,-9.99), P <0.05; MD=-1.85, 95%CI (-2.53,-1.16), P <0.05; MD=-9.83, 95%CI (-12.66,-6.99), P <0.000 01], with no significant difference compared with PFNA group (P >0.05). There was no significant difference in tip-apex distance, length of hospital stay, and Harris score of Inter-TAN group compared with PFNA group and PFNA-II group (P > 0.05). The incidence of postoperative screw cut-out in the Inter-TAN group was less than in the PFNA group and the PFNA-II group [OR=6.47, 95%CI(2.79, 15.00), P < 0.05; OR=5.88, 95%CI(1.29, 26.69), P <0.05]. The incidence of hip or thigh pain in the Inter-TAN group was less than that in the PFNA group and the PFNA-II group [OR=2.57, 95%CI(1.19, 5.52), P < 0.05; OR=3.20, 95%CI(-1.56, 6.55), P <0.05]. Postoperative femoral shaft fractures in the Inter-TAN group were less than those in the PFNA group and PFNA-II group [OR=3.87, 95%CI(1.75, 8.57), P <0.05; OR=7.06, 95%CI(1.24, 40.07), P <0.05]. The incidence of postoperative secondary surgery in the Inter-TAN group was less than in the PFNA group [OR=4.10, 95%CI(2.45, 6.86), P <0.05], and there was no significant difference compared with PFNA-II group (P >0.05). CONCLUSION: For patients with osteoporosis and poor stability, Inter-TAN can provide better stability and reduce postoperative complications. For patients with poor general conditions and greater surgical risk, PFNA-II internal fixation can be selected.

OBJECTIVE: To compare the changes of gene expression profiles of multiple myeloma cell line RPMI 8226 before and after 24-hour intervention of arsenic trioxide. METHODS: The responses of the RPMI 8226 cells to arsenic trioxide were determined with cDNA microarray which included 4,096 different human genes. RESULTS: Of these 4,096 genes, the expressions of 273 genes were altered significantly at mRNA level. The expressions of 121 genes were up-regulated while the expressions of 152 genes were down-regulated. CONCLUSION: The effect of arsenic trioxide on RPMI 8226 cells is related to changing the expression levels of a number of genes. ZFYVE16, ALK1 and TXNIP genes may play important roles in apoptosis and differentiation of RPMI 8226 cells.

AIM: To study if the effect of arsenic sulfide combined with IFN-α can be increased on K562 cells. METHODS: Telomerase activity was determined by PCRELISA. Flow cytometry was used to analyze the cell apoptosis. The final concentration of IFN-α and arsenic sulfide was 10 000 U/mL and 0.6 mg/L. RESULTS: The rates of apoptosis was 37.8% and 37% in K562 cells treated with IFN-α or arsenic sulfide alone for 8 days; The rates of apoptosis and inhibition of telomerase activity was 59.9% and 81.2% in K562 cells treated with IFN-α and arsenic sulfide simultaneously for 8 days, or 60.37% and 78.8% in K562 cells was treated with arsenic sulfide for 5 days after affected by IFN-α for 3 days. 71.3% telomerase activity was inhibited in K562 cells by arsenic sulfide alone for 8 days. CONCLUSION: Combination of arsenic sulfide and IFN-α can increase the apoptosis and inhibit the telomerase activity of K562 cells obviously comparing with the two drugs used alone. IFN-α maybe promote arsenic sulfide inducing apoptosis of K562 cells.

Hemophilia F/F inhibitor is a kind of specific neutralizing antibody, making treatment invalid, and increasing bleeding and the incidence of death and disability. It is a serious complication of hemophilia and also a new challenge. Risk factors associated with the production of inhibitors are related to genetic factors and the environment, providing a direction for prevention. The existing effective treatments of hemophilia inhibitor include bypass drugs for homeostasis and immune tolerance induction therapy to clear inhibitor and new homeostatic prophylaxis. However, these treatment still cannot meet the needs. Recently, a variety of new hemostatic drugs have been developed, which have a long half-life and can be injected subcutaneously once every four weeks for prevention and treatment. The annual bleeding rate is 0 and no inhibitor is produced, which has made a breakthrough.

Objective: To explore the best parameter in the preparation technology of paste with different adjuvants. Methods: The appearance, the paste rate, and herb detection were selected as composite indicators. The multi-index comprehensive score method was used to evaluate the paste formability. Central composite design was used to optimize the preparation technology of paste by taking the adjuvant amount (A), the relative density of extract (B) and refined paste (C) as factors. Results: The best condition in the paste preparation process with different adjuvants was as follows: brown sugar (A1 18%-23%, B1 1.210-1.260, and C1 1.310-1.360), Cervi Cornus Colla (CCC, A2 14%-16%, B2 1.200-1.250, and C2 1.230-1.270), Testudinis Carapacis et Plastri Colla (TCPC, A3 12%-15%, B3 1.190-1.230, and C3 1.210-1.240), Asini Corii Colla (ACC, A4 5.0%-8.0%, B4 1.190-1.220, and C4 1.190-1.220). Conclusion: The parameters in the preparation technology of the paste with different adjuvants are accurate and feasible and the quality meets the requirement.

BACKGROUND: Due to airway remodeling and emphysematous destruction in the lung, the two classical clinical phenotypes of chronic obstructive pulmonary disease (COPD) are emphysema and bronchiolitis. The present study was designed to investigate the levels of small airway immunoglobulin A (IgA) in COPD with "emphysema phenotype." The study also evaluated the associations between the small airway IgA levels and the severity of disease by the extent of emphysema versus airflow limitation. METHODS: Thirty patients (20 with COPD and ten healthy smokers) undergoing lung resection surgery for a solitary peripheral nodule were included. The study was conducted from January 2015 to December 2018 in the Shanxi Dayi Hospital. The presence of small airway IgA expression was determined in the lung by immunohistochemistry. In vivo, Wistar rats were exposed to silica by intratracheal instillation. Rats were sacrificed at 15 and 30 days after exposure of silica (n = 10 for each group). We also evaluated airway IgA from rats. RESULTS: Small airway secretory IgA (sIgA), dimeric IgA (dIgA), and dIgA/sIgA of Global Initiative for Chronic Obstructive Lung Disease grade 1-2 COPD patients showed no difference compared with smoking control subjects (5.15 ± 1.53 vs. 6.03 ± 0.85; 1.94 ± 0.66 vs. 1.67 ± 0.04; 41.69 ± 21.02 vs. 28.44 ± 9.45, all P > 0.05). dIgA/sIgA level in the lung of COPD patients with emphysema showed higher levels than that of COPD patients without emphysema (51.89 ± 24.81 vs. 31.49 ± 9.28, P = 0.03). The percentage of low-attenuation area below 950 Hounsfield units was positively correlated with dIgA/sIgA levels (r = 0.45, P = 0.047), but not associated with the severity of disease by spirometric measurements (forced expiratory volume in the first second %pred, P > 0.05). Likewise, in the rat study, significant differences in sIgA, dIgA, dIgA/sIgA, mean linear intercept, mean alveoli number, and mean airway thickness of bronchioles (VV airway, all P < 0.01) were only observed between control rats and those exposed for 30 days. However, in the group exposed for 15 days, although the VV airway was higher than that in normal rats (27.61 ± 2.26 vs. 20.39 ± 1.99, P < 0.01), there were no significant differences in IgA and emphysema parameters between the two groups (all P > 0.05). CONCLUSION Airway IgA concentrations in mild and moderate COPD patients are directly associated with the severity of COPD with "emphysema phenotype" preceding severe airway limitation. This finding suggests that small airway IgA might play an important role in the pathophysiology of COPD, especially emphysema phenotype.

OBJECTIVE: To investigate the toxic effects of four different kinds of aluminum compounds in rat adrenal-derived pheochromocytoma cell PC12. METHODS: PC12 cells at logarithmic growth phase were treated with four different kinds of aluminum compounds: aluminum maltolate( concentration was 0. 0,0. 1,0. 2,0. 4,0. 8 mmol / L),aluminum chloride( concentration was 0. 0,1. 0,2. 0,4. 0,8. 0 mmol/L),aluminum citrate( concentration was 0. 0,1. 0,2. 0,4. 0,8. 0mmol / L) and aluminum lactate( concentration was 0. 0,2. 0,4. 0,8. 0,16. 0 mmol / L) for 24 hours,respectively. The cell viability was determined with CCK-8 assay,and the apoptotic rate was detected by flow cytometry. RESULTS: All of the aluminum compounds suppressed the cell viability and increased apoptosis( P < 0. 01). Most of the effects were in a dose dependent manner. Comparing with the control,the minimum effective concentration of aluminum maltolate,aluminium chloride,aluminum citrate and aluminum lactate were 0. 2,2. 0,2. 0 and 4. 0 mmol / L,respectively,in cell viability( P < 0. 05); and 0. 1,2. 0,1. 0 and 2. 0 mmol/L in cell apoptosis( P < 0. 05). The 24 hours 50% inhibitory concentration of the above four aluminum compounds were( 0. 45 ± 0. 01),( 4. 02 ± 0. 39),( 5. 37 ± 0. 88) and( 6. 31 ±0. 58) mmol / L,respectively. CONCLUSION: Treatment of all four aluminum compounds had reduced cell viability and increased the percentage of cell apoptosis in a dose-dependent manner in PC12 cells. The best dose-response relation was observed in aluminum maltolate treatment group,and a relatively low dose of it was required in in-vitro toxicology study.Therefore,aluminum maltolate posed to be better reagent than the other three for in-vitro aluminum toxicity study.

OBJECTIVE: To investigate the clinical effects of dual mobility total hip prosthesis in treating femoral neck fracture patients with hemiplegia. METHODS: A retrospective analysis was performed on 18 patients with femoral neck fracture combined with hemiplegia who underwent dual mobility total hip prosthesis replacement from March 2014 to December 2016. The follow up data of these patients was complete. There were 5 males and 13 females, aged 65 to 70 years old with an average of (66.50±1.38) years. The left side was involved in 12 cases, while the right side in 6 cases. There were 4 cases with Garden Ⅲ type and 14 cases with type Ⅳ. Limb muscle strength of hemiplegia were in grade Ⅳ. The posterior-lateral approach of hip joint was used in surgery for all patients. The implant position, dislocation and loosening of the prosthesis were evaluated by X-ray examination. Harris hip score and the Merle D'aubigne score were used to assess the hip function in the follow up. RESULTS: The operation duration was for 70-90 (81.56±7.48) min and the blood loss during the operation was for 160-200 (170.32± 12.56) ml. No blood was transfused during the operation. Postoperative incisions were healed at the first stage. The follow-up time was for 28-60(36.0±3.5) months. Harris hip score increased from 16.94±0.73 preoperatively to 96.19±1.27 at the final follow-up(<0.05). Merle D 'Aubigne score increased from 3.96±0.06 preoperatively to 16.81±0.63 at the final follow-up(< 0.05). No fracture or nerve or vascular injury were found during the operation. The postoperative X-ray showed that the prosthesis was in good position. No complications such as joint dislocation, dislocation of prosthesis, loosening of prosthesis, fracture around the prosthesis, pain in the front of thethigh, fracture of the self tapping screw in the ilium, and delayed infection occurred in the patients after operation. CONCLUSION Dual mobility total hip prosthesis has the advantages of both good initial stability and low dislocation rate of the prosthesis, and the clinical application of total hip replacement in hemiplegic femoral neck fracture is satisfactory.
Aged ; Arthroplasty, Replacement, Hip ; Female ; Femoral Neck Fractures ; surgery ; Follow-Up Studies ; Hemiplegia ; Hip Prosthesis ; Humans ; Male ; Retrospective Studies ; Treatment Outcome

OBJECTIVE: To compare and analyze the mechanical differences between single-row suture anchor fixation for repairing rotator cuff injuries and double-row suture bridges for repairing rotator cuff injuries from a biomechanical perspective. METHODS: The CT scan data of healthy adult shoulder joint were imported into Mimics, Geomagics and Hypermesh to carry out reverse reconstruction of two repair models, material assignment and mesh division, and the tearing of supraspinatus muscle was designed. After treatments, the load and boundary conditions were applied to the shoulder joint in ABAQUS software. The shoulder joint was fixed with four working conditions including flexion 15 °, flexion 30 °, internal rotation 15 ° and internal rotation 30 ° after anchor fixationand repair. The stress changes of the upper rotator cuff muscle and the anchor with thread were compared under these four conditions. RESULTS: Under the two flexion conditions, the stress of the supraspinatus in the double row suture bridge fixation model was 8.3% and 12% less than that in the single-row suture anchor fixation, respectively. Under the two internal rotation conditions, the stress of supraspinatus in the double row suture bridge fixation model was 47% and 48% less than that in the single row fixation repair model, respectively. CONCLUSION The "load sharing" effect between the two rows of four anchors makes the stress distribution more dispersed, increases the contact area between the supraspinatus muscle and the humerus, reduces the stress of the anchor, avoids the serious stress concentration phenomenon, and explains the advantages of the fixation method of the double row suture bridge from the biomechanical angle.
Adult ; Biomechanical Phenomena ; Cadaver ; Humans ; Rotator Cuff Injuries/surgery* ; Suture Anchors ; Suture Techniques ; Sutures

Antibodies, Antiphospholipid ; Antiphospholipid Syndrome ; Female ; Humans ; Killer Cells, Natural ; Pregnancy ; Pregnancy Complications