Objective To explore the efficacy of closed reduction with cannlated compression screws for the treatment of elderly paitents with intertrochanteric fracture.Methods From April 2002 to July 2006,guided by a C-arm X-ray system,58 elderly patients with intertrochanteric fracture were treated by closed reduction with cannlated compression screws.Results The mean operation time was 55 minutes(40 to 70 minutes),and the mean blood loss was 35 ml(30 to 40).The patients were discharged from hospital in 3 to 10 days after the operation(mean,6.5 days).All of the 58 patients were cured.According to criteria for evaluating the outcomes of intertrochantenic fracture,28 cases were excellent,25 were good,3 were fair,and 2 were poor.The Rate of excellent and good outcomes was 91.4%(53/58).Conclusion Closed reduction with cannlated compression screws is effective for elderly paitents with intertrochanteric fracture.

We revisited the "Xiao Chaihu Decoction event (XCHDE)" occurred in late 1980s in Japan and the Bupleuri Radix related adverse drug reaction (ADR) reports in China After careful review, comparison, analysis and evaluation, we think the interstitial pneumonitis, drug induced Liver injury (DILI) and other severe adverse drug envents (ADEs) including death happened in Japan is probably results from multiple factors, including combinatory use of XCHDE with interferon, Kampo usage under modern medicine theory guidance, and use of XCHD on the basis of disease diagnosis instead of traditional Chinese syndrome complex differentiation. There are less ADE case reports related to XCHD preparation in China compared to Japan, mostly manifest with hypersensitivity responses of skin and perfuse perspiration. The symptoms of Radix Bupleuri injection related ADEs mainly manifest hypersensitivity-like response, 2 cases of intravenous infusion instead of intramuscular injection developed hypokalemia and renal failure. One case died from severe hypersensitivity shock. In Chinese literatures, there is no report of the interstitial pneumonitis and DILI associated with XCHDG in Japan. So far, there is no voluntary monitoring data and large sample clinical research data available. The author elaborated the classification of "reevaluation" and clarified "re-evaluation upon events" included the reaction to the suspected safety and efficacy events. Based on the current status of the clinical research on the Radix Bupleuri preparations, the author points out that post-marketing "re-evaluation upon suspected event" is not only a necessity of continuous evaluation of the safety, efficacy of drugs, it is also a necessity for providing objective clinical research data to share with the international and domestic drug administrations in the risk-benefit evaluation. It is also the unavoidable pathway to culture and push the excellent species and famous brands of TCM to the international market, in that it enhances the pharmaceutical manufactures the ability to control enterprise risk and eliminate the negative impact on traditional Chinese medicine. With the widely used and ADR report concentrated Radix Bupleuri injection as an example, the author provide a new approach to post-marketing clinical research.
Bupleurum ; chemistry ; Drug Compounding ; Drug-Related Side Effects and Adverse Reactions ; etiology ; Drugs, Chinese Herbal ; adverse effects ; Humans ; Product Surveillance, Postmarketing ; methods ; Safety

OBJECTIVETo determine the infinite optical thickness of dentine porcelain of IPS E.max A color series.

METHODSCylindrical dentine porcelain specimens of the IPS E.max A color series were prepared with a diameter of 13 mm and thickness of 1.0, 1.5, 2.0, 2.5, 3.0, 3.5, 4.0, 4.5, and 5.0 mm. The chromatic value of all the specimens was determined with CM-5 spectrometer against standard black and white background. The chromatic aberration (deltaE) was calculated by regression equation.

RESULTSThe infinite optical thickness of dentine porcelain of the IPS E.max A color series ranged from 2.341 to 3.333 mm for a deltaE of 1.0, and from 2.064 to 2.904 mm for a deltaE of 1.5. As the chromaticity or thickness increased, the influence by the background color decreased, and the color of specimens became gradually close to the intrinsic color.

CONCLUSIONThe thickness of the background dentine porcelain specimens must exceed its infinite optical thickness to represent the intrinsic color and avoid the influence by the extrinsic color.

Coated Materials, Biocompatible ; chemistry ; Crowns ; Dental Porcelain ; chemistry ; Dental Prosthesis Design ; Humans ; Prosthesis Coloring ; Tooth Preparation, Prosthodontic ; methods

Objective: To analyze the expression of tight junction protein 3(claudin-3) in colorectal cancer and its relationship with the development, metastasis and prognosis of colorectal cancer. Methods: From February 2013 to February 2015, 78 patients with colorectal cancer operated in the People's Hospital of Sanmen County were selected in this study.The tissues of colorectal cancer and adjacent tissues were collected and claudin-3 expression was detected.The relationship between claudin-3 and clinicopathological features of colorectal cancer was analyzed. Results: The positive rate of claudin-3 in cancer tissues(83.33%) was higher than that in paracancerous tissues(48.72%), and the difference was statistically significant(χ²=20.832, P<0.01). The positive rate of claudin-3 in the poorly differentiated group(100.00%) was significantly higher than that in the well-differentiated group(85.71%) and the well-differentiated group(52.63%)(χ²=19.209, P<0.01). The claudin-3 positive rate with lymphatic metastasis(97.30%) was higher than that without lymphatic metastasis(70.73%), and the difference was statistically significant(χ²=9.882, P<0.01). The claudin-3 positive rate in patients with less than 3 years of survival (91.11%) was higher than that in patients with more than 3 years of survival(72.73%)(χ²=4.633, P<0.05). Conclusion The expression of claudin-3 is related to the occurrence, development and lymphatic metastasis of colorectal cancer, and can predict the prognosis of the patients.

Objective To evaluate the relationship between the hepatic toxicity induced by chemotherapy in patients with malignant tumor who test positive for HBV markers. Methods From January 2008 to January 2014, 887 cancer patients were treated by chemotherapy. Among 274 cases of patients were HBV positive (positive group), 613 patients were HBV negative (negative group), the liver function after chemotherapy were compared. Results Positive group patients receiving chemotherapy had higher rate of hepatic toxicity than those in negative group (24.1% vs. 11.3%,P<0.01),the incidence rate of 3-4 grade hepatic toxicity in positive group patients was 11.2%(13/116),more than that in negative group 0.65%(4/613). In the different treatment, there were statistically significant in two groups by TP regimen(paclitaxel+cisplatin), CAF(cyclophosphamide+adriamycin+5-Fluorouracil), CHOP(cyclophosphamide+doxorubicin+oncovin+prednisone)liver function after chemotherapy (P<0.05). In the TP scheme leaded to the incidence of abnor-mal liver function was the highest, the incidence rate in positive group was 36%(18/50),the incidence rate in negative group was 15.8%(19/120). Conclusion HBV infection is associated with higher risk of hepatic toxicity in patients with malignant tumor during chemotherapy(led by TP scheme).

BACKGROUNDThe aim of this research was to evaluate long-term pulmonary sequelae on paired inspiration-expiration thin-section computed tomography (CT) scans 3 years after influenza A (H1N1) virus-associated pneumonia, and to analyze the affecting factors on pulmonary fibrosis.

METHODSTwenty-four patients hospitalized with H1N1 virus-associated pneumonia at our hospital between September 2009 and January 2010 were included. The patients underwent thin-section CT 3 years after recovery. Abnormal pulmonary lesion patterns (ground-glass opacity, consolidation, parenchymal bands, air trapping, and reticulation) and evidence of fibrosis (architectural distortion, traction bronchiectasis, or honeycombing) were evaluated on follow-up thin-section CT. Patients were assigned to Group 1 (with CT evidence of fibrosis) and Group 2 (without CT evidence of fibrosis). Demographics, rate of mechanical ventilation therapy, rate of intensive care unit admission, cumulative prednisolone-equivalent dose, laboratory tests results (maximum levels of alanine aminotransferase, aspartate transaminase [AST], lactate dehydrogenase [LDH], and creatine kinase [CK]), and peak radiographic opacification of 24 patients during the course of their illness in the hospital were compared between two groups.

RESULTSParenchymal abnormality was present in 17 of 24 (70.8%) patients and fibrosis occurred in 10 of 24 (41.7%) patients. Patients in Group 1 (10/24; 41.7%) had a higher rate of mechanical ventilation therapy (Z = -2.340, P = 0.019), higher number of doses of cumulative prednisolone-equivalent (Z = -2.579, P = 0.010), higher maximum level of laboratory tests results (AST [Z = -2.140, P = 0.032], LDH [Z = -3.227, P = 0.001], and CK [Z = -3.345, P = 0.019]), and higher peak opacification on chest radiographs (Z = -2.743, P = 0.006) than patients in group 2 (14/24; 58.3%).

CONCLUSIONSH1N1 virus-associated pneumonia frequently is followed by long-term pulmonary sequelae, including fibrotic changes, in lung parenchyma. Patients who need more steroid therapy, need more mechanical ventilation therapy, had higher laboratory tests results (maximum levels of AST, LDH, and CK), and had higher peak opacification on chest radiographs during treatment are more likely to develop lung fibrosis.

Adult ; Female ; Humans ; Influenza A Virus, H1N1 Subtype ; pathogenicity ; Influenza, Human ; complications ; virology ; Lung ; diagnostic imaging ; pathology ; virology ; Male ; Middle Aged ; Pneumonia ; complications ; diagnostic imaging ; microbiology ; Tomography, X-Ray Computed ; methods

OBJECTIVETo investigate COX-2 expression in patients with gastric cancer and its relationship with angiogenesis and clinicopathologic features of gastric cancer.

METHODSCOX-2 expression and CD34-stained microvessel density (MVD) were detected by immunohistochemical methods in specimens from 96 patients with gastric cancer. The correlations among COX-2 expression, MVD and clinicopathologic features were analyzed.

RESULTSThe COX-2 positive rate and MVD in gastric cancer were significantly higher than those in the normal gastric mucosa (80.2% vs. 13.3%; 32.5+/- 8.3 vs. 13.1+/- 2.4, all P< 0.01). The COX-2 positive rate and MVD in the patients with stage III and IV were significantly higher (91.4% and 34.9+/- 8.7 respectively, P< 0.01), than that in the patients with stage I and II. The COX-2 positive rate and MVD in the cases with lymph node metastasis were 87.9% and (35.0+/- 8.5) respectively, higher than those in the cases without lymph node metastasis (P< 0.05). The Spearman rank correlation test showed a significant correlation between COX-2 expression and tumor MVD (r=0.311, P< 0.01).

CONCLUSIONSCOX-2 plays an important role in gastric cancer angiogenesis. COX-2 and angiogenesis induced by COX-2 contribute to tumor invasion and lymph node metastasis.

Adult ; Aged ; Cyclooxygenase 2 ; metabolism ; Female ; Humans ; Immunohistochemistry ; Male ; Middle Aged ; Neoplasm Staging ; Neovascularization, Pathologic ; metabolism ; pathology ; Stomach Neoplasms ; metabolism ; pathology

OBJECTIVETo compare the surgical results of two kinds of posterior approach for osteoporotic thoracolumbar Kvmmell's disease.

METHODSClinical and radiographic results of 1-segmental pedicle screw fixation combined with vertebroplasty (Group A, n equal to 12) or posterior shortening osteotomy (Group B, n equal to 16) for osteoporotic thoracolumbar Kvmmell's disease were analyzed retrospectively. Japanese orthopedic association (JOA) and visual analogue scale (VAS) scores were used for clinical evaluation. Neurological status was judged by Frankel grades. X-ray was used to evaluate the radiographic results. Complications related to operation and devices were also considered.

RESULTSThe follow-up period was 12-54 months (average 29 months). Pre-and post-operative VAS were 9.3 and 3.2 in Group A, 8.9 and 2.5 in Group B, respectively. The mean JOA score at the final follow-up was significantly higher than that of pre-operation (t equal to 5.306, P less than 0.001). There was no significant difference between Groups A and B (t equal to 0.618, P larger than 0.05). The kyphosis were corrected from preoperative 33.9 degree A)/37.3 degree B) to postoperative 10.3 degree A)/6.5 degree B), and 15.3 degree (A)/13.7 degree B) at the final follow-up. There was a significant difference between the two groups at the final follow-up. Frankel grade was improved from grade C preoperatively to postoperatively grade D or E in 7 cases of Group A and 5 cases of Group B, from grade D to E in 5 cases of Group A and 11 cases of Group B. The mean improvement was 1.6 and 1.7 grades for Groups A and B, respectively. There were no serious complications related to internal fixation.

CONCLUSIONSThe similar clinical results can be obtained by the two kinds of posterior surgical methods for osteoporotic Kvmmell's disease. Posterior spinal shortening is a better choice for patients with serious kyphosis combined with neurological deficit than the other.

Aged ; Bone Screws ; Female ; Follow-Up Studies ; Humans ; Kyphosis ; surgery ; Lumbar Vertebrae ; injuries ; surgery ; Male ; Middle Aged ; Osteoporosis ; complications ; Osteotomy ; Retrospective Studies ; Spinal Fractures ; surgery ; Thoracic Vertebrae ; injuries ; surgery ; Vertebroplasty

OBJECTIVETo investigate the effect of muscular rehabilitation on recovery after sagittal split ramus osteotomy.

METHODSTwenty-seven patients undergoing sagittal split ramus osteotomy received passive motion training and muscle endurance training after surgery using the new-developed mouth-opening trainer. The passive motion training began 2-3 days after the removal of inter-maxillary elastraction. The instrument was inserted into the inter-maxillary space for 5 min per time, 3-4 times per day. When the mouth opening reached a range of 20-25 mm, the muscle endurance training initiated. The results of the training were compared with another 20 cases who received the same surgery.

RESULTSThe mouth opening of the patients who received muscular rehabilitation achieved the pre-surgical level 4 weeks after surgery [(34.72 ± 3.75) mm], the bite force reached the pre-surgical level 8 weeks after surgery [(231.08 ± 62.52) N], but in the 20 cases without training the mouth opening [(28.42 ± 4.11) mm] in 4 weeks and the bite force in 8 weeks [(210.90 ± 73.40) N] were lower after surgery than before surgery.

CONCLUSIONSThe systematic and standard muscle function training, accompanied with the use of the new-developed mouth-opening trainer could improve the functional recovery of the patients who receive sagittal split ramus osteotomies.

Bite Force ; Humans ; Mandible ; physiopathology ; Maxilla ; Osteotomy, Sagittal Split Ramus ; rehabilitation ; Range of Motion, Articular

OBJECTIVETo investigate the effects of miR-181b on the migration and invasion of osteosarcoma cells.

METHODSThree cultured osteosarcoma cell lines and MG-63 cells transfected with miR-181b inhibitor were examined for miR-181b expression using qRT-PCR analysis. The cell migration and invasion of the transfected cells were assessed with Transwell assay. The targets of miR-181b were predicted using a miRNA target prediction software and the results were verified with luciferase reporter assay. The target protein expression in osteosarcoma cells lines was determined by Western blotting, and the cell migration and invasion changes following inhibition of miR-181b or its target protein were assessed using Transwell assay.

RESULTSAll the 3 osteosarcoma cells lines showed significantly up-regulated miR-181b expression. Inhibition of miR-181b expression obviously suppressed the migration and invasion of MG-63 cells. Based on luciferase reporter assay, N-myc downstream regulated gene 2 (NDRG2) was identified as the direct target gene of miR-181b, and inhibition of NDRG2 expression significantly reversed the effect of miR-181b on cell migration and invasion in MG-63 cells.

CONCLUSIONmiR-181b is over-expressed in osteosarcoma cells, and inhibition of miR-181b, which directly targets NDRG2, can suppress the migration and invasion of osteosarcoma cells.

Bone Neoplasms ; genetics ; pathology ; Cell Line, Tumor ; Cell Movement ; Cell Proliferation ; Gene Expression Regulation, Neoplastic ; Humans ; MicroRNAs ; genetics ; metabolism ; Neoplasm Invasiveness ; Osteosarcoma ; genetics ; pathology ; Tumor Suppressor Proteins ; genetics ; metabolism