[Objective]To explore the technique and results of reverse less invasive stabilization system(LISS) plating for subtrochanteric femur fractures.[Method]From October 2007 to May 2009,31 cases of fresh subtrochanteric femur fractures were treated with reverse LISS. There were 23 males and 8 females,with an average age of 48.6 years (range 27 to 83 years). Twelve injuries were the result of a traffic accident,six,a fall from a greater height,four,a crush injury and nine,a fall from a standing height. According to Seinsheimer classification,four fractures were type ⅡC,twelve ⅢA,six ⅢB,six Ⅳ and three Ⅴ. After anesthesia was effectively administered,subtrochanteric fracture was reduced indirectly with patient on a fracture table. Then,the reverse LISS plate was inserted through a lateral incision of the greater trochanter between the lateral vastus muscle and the periosteum. Guided by the aiming arm,4 to 5 screws were inserted through stab incisions into the proximal and distal fragments,respectively. [Result]Operative time averaged 50 minutes (range,35-80 minutes) and estimated blood loss averaged 90 ml(range,60-150 ml). Thirty-one patients were available for evaluation with an average follow-up of 15.6 months. All fractures healed at a mean of 18.2 weeks (range 13 to 32 weeks). There was no failed fixation,or deep infection. Average range of motion of the hip joint was recorded as follows:flexion 115?,external rotation 35?,internal rotation 15?,adduction 15?,and abduction 36?. According to the modified Harris hip score,scores ranged from 82 to 100 (average,92.6),and there were 24 excellent and 7 good results.[Conclusion]Reverse LISS plating yields good results in subtrochanteric femur fractures,with stable fixation and minimal invasive procedure.

Cyclooxygenase is the key enzymes mediating prostaglandings release. In recent years, two isoforms of cyclooxygenase, a constitutive cyclooxygenase(COX-1)and an inducible cyclooxygenase (COX-2),have been identified, from which people have known more about gastrointestinal pathophysiology. This article is a review of COX-1 and COX-2 on the distribution, inducement and regulation in gastrointestinal tract and its relation to programmed cell death, tumor, ulcer and Crohn's disease.

[Objective]To explore the operative techniques of open reduction and internal fixation of displaced radial head fractures in adults. [Methods]Twenty-six cases of radial head fractures had been treated with open reduction and internal fixation. According to Mason classification, 16 fractures were type II, 6 were type III and 4 were type IV. Operative exposures of radial head were performed through the Kocher approach in 22 cases, and through a midline posterior skin incision in 4 cases in order to repair concomitant fracture of proximal ulna. After being reduced, fractures of radial head were fixed with mini-fragment plate and screw which were placed in "safe zone" not to impinge on the proximal radioulnar joint with forearm rotation.[Results]At a mean follow-up of 32 months, all fractures had united. There was no patient who suffered from wound infection or injury to posterior interosseous nerve. According to the Broberg and Morrey functional elbow index, the outcome were excellent in 17 patients, good in 9.[Conclusion]Open reduction and internal fixation of displaced radial head fractures may get satisfying outcomes, with successful performing of the requirements below: (1) sustaining lateral ulnar collateral ligament; (2) avoiding injury to posterior inerosseous nerve; (3) getting anatomic reduction; (4) stably fixing fractures without impinging on joint.

Objective To explore the effect of enteral nutrition applied to bowel preparation of diabetes patients before electronic colonoscopy. Methods A total of 172 diabetes patients were randomly allocated to the experimental group and the control group with 86 patients in each group. The experimental groups executed no dietary restriction within 3 days before the examination, and received Ensure 1h before colonoscopy. However,the control group was given low residue diet within 3 days before the examination, and received no Ensure before colonoscopy. The enteral cleanness and incidence of hypoglycemic reaction, abdominal pain and horror was compared between the two groups. Results 72 cases(83.72%) of the experimental group and 70 cases (81.40%) of the control group had better enteral cleanness, and there was no statistical difference in intestinal cleanness between the two groups. In the experimental group the incidence of hypoglycemic reaction, abdominal pain, horror was significantly lower than those in the control group. Conclusions Bowel preparation with unrestricted diet and ingested ensure before colonoscopy can not only ensure intestinal cleanness but also enhance endurance of colonoscopy.

Objective To introduce a modified replantation for thumb rotating avulsion amputation,and to evaluate its short term clinical outcome.Methods From January 2007 to July 2009,7 patients with thumb rotating avulsion amputation underwent replantation,including 6 males and 1 female,aged from 21 to 47 years (average,28.3 years).The amputation level of each thumb was metacarpophalangeal joint.During operation,fusion of metacarpophalangeal joint was performed according to injury degree of soft tissue; interphalangeal joint of the thumb was fixed in 15 degrees of flexion by sewing flexor pollicis longus muscle tendon and extensor pollicis longus muscle tendon to tendon sheath or soft tissue; the superficial vein harvested from ipsilateral forearm was used to bridge the dorsal carpal branch of radial artery and the ulnar palmacollateral artery of the thumb; direct anastomoses of dorsal veins were performed in 6 cases and venous transplantation in 1 case; and bilateral nerves were transferred to the back of the first metacarpal and anastomosed to the superficial branch of the radial nerve.Results All 7 replanted thumbs survived completely.Arterial crisis occurred in 1 case after operation,which was cured after operative and medication treatment.The follow-up period ranged from 3 to 24 months.The appearance and opposition function of replanted thumbs were satisfactory and the sensation of fingertip recovered to S4 in 4 cases and to S3 in 3 cases.The two point discrimination ranged from 8 to 12 mm.Conclusion Because bridging the dorsal carpal branch of radial artery and the ulnar palmar collateral artery of the thumb with a superficial vein harvested from ipsilateral forearm to reconstruct blood supply of the thumb is available and easy to be performed,this modified replantation is an ideal way to repair thumb rotating avulsion amputation.

Objective To observe the distribution proportion of insulin resistance(IR) and non -insulin resistant(NIR) in aged subjects with impaired glucose tolerance (IGT)and to evaluate their states of metabolic syndrome and atherosclerosis. Methods Some indexes were detected in elderly subjects with IGT such as body mass index(BMI),waist-to-hip ratio(WHR), cholesterol(TC),triglyceride(TG), low density lipoprotein cholesterol(LDL-C) and high density lipoprotein cholesterol(HDL-C), systolic blood pressure (SBP), diastolic pressure (DBP), insulin,insulin area under curve(InsAUC) , inflammation markers(hsCRP,Fg), proinsulin and proinsulin area under curve(PIAUC),IMT and carotid artery atheromatous plaque were also examined in some people. Subjects were divided into insulin resistance group(IR group) and non-IR group(NIR group) according to HOMA-IR. Results (1)156 subjects with IGT, the rates of IR and NIR were 75.6% and 24.4% respectively.(2)BMI, TG,TC,LDL-C,hsCRP, Fg, SBP, DBP,HOMA-IR, InsAUC, PIAUC in IR group\[(26.8?2.1) kg/m2,0.96?0.23,(2.9?1.3)mmol/L,(5.4?1.8)mmol/L,(3.9?1.5)mmol/L,(154?12)mm Hg,(96?7) mm Hg,(239?71)mU/L,(170?42)pmol/L,(7.5?1.2)mg/L,(4.5?1.4) g/L \] were higher than those in NIR group\[(22.8?2.5) kg/m2, 0.80?0.2,(1.7?1.2) mmol/L,(4.5?1.5)mmol/L, 3.0?0.8 mmol/L,(133?10)mm Hg,(83?1)mm Hg,(180?66)mU/L,(109?25) pmol/L,(4.3?0.8)mg/L,(3.8?1.5 )g/L\], but HDL-C in IR group was lower than that in NIR group(1.0?0.4)mmol/L (P

Objective To investigate the effect of chemotherapy combined with amino acid on quality of life(QOL)in elderly patients with non-small cell lung cancer(NSCLC). Methods Seventy-four elderly patients with NSCLC were divided randomly into experimental group and control group.The same NP(cisplatin+vinorelbine)chemotherapy was carried out in all the 2 groups for 3 cycles.Except of chemotherapy,experimental group were treated with amino acid 500 ml/d in the same time,while control group recieved chemotherapy only.After 3 monthes,the QOL was analyzed using Chinese Version of European Organization for Researeh and Treatment of Cancer(EORTC)core questionnaire(QLQ-C30)and specific lung cancer module QLQ-LC13,and therapeutic effectiveness was evaluated according to WHO standard as well. Results After chemotherapy,the body function,mood function,social function were better in experimental group than in control group(all P＜0.05),the effective rate was 87.8%,83.8%and 77.0%in experimental group;77.0%,45.9%and 45.9%in control group.Insomnia(8.1%),suppressed appetite(5.4%),weary(47.3%)were less serious in experimental group than in control group(17.6%,17.6%and 59.5%)(all P＜0.05).The primary symptoms were cough,emptysis,thoracalgia and dyspnoea in both 2 groups before chemotherapy.All the symptoms were alleviated after chemotherapy.Some patients have side effects such as tongue pain,alopecie,hand and foot tingle.But the number of patients with tongue pain was less in experimental group(8.3%)than in control group(18.4%).The chemotherapy effect had no difference by the WHO standard. Conclusions The QOL of elderly patients with NSCLC can be improved by chemotherapy combined with amino acid treatment,and the treatment with amino acid 500 ml/d is safety.

Objective To investigate the effects of aging and the decreased glomerular filtration rate on the prevalence of anemia in elder receiving body check from urban area of Hefei, China.Methods A total of 4547 >60 years subjects received healthy examination in Healthy Center of Anhui Provincial Hospital from January 2005 to December 2007 were enrolled in this study.Anemia was defined as hemoglobin < 120 g/L in men or < 110 g/L in women.Results The prevalence of anemia in the subjects was 4.40% (95% CI: 3.83% -5.05% ) and significantly increased with the aging process and the decline of estimated glomerular filtration rate ( eGFR) .With logistic analyses, increasing age, female, decreased eGFR were major risk factors for anemia Conclusions The morbidity of anemia is 4.40% in old population receiving body check from urban area of Hefei, China.Aging and the decline of eGFR are the independent risk factors of anemia.

Objective To study the changes of circulating triglyceride (TG) in the obese elderly, and to investigate the effect of hypertriglyceridemia on the development of insulin resistance. Methods A total of 82 subjects were divided into simple obesity group, obesity with IGT group, obesity with T2DM group and normal control group. The body height, body weight, blood pressure, fasting plasma glucose (FPG) and insulin(FPI), circulating TG and total cholesterol (TC) were measured. The homeostasis model assessment-insulin resistance (HOMA-IR) was calculated. Results The levels of serum TG were significantly higher in the simple obesity group ( 1.3 ± 0. 6) mmol/L, obesity with IGT group (1.9 ± 0.9)mmol/L and obesity with T2DM group (2.1±0.7) mmol/L than in the normal controls [(1.0±0.2)mmol/L, all P<0. 05], Furthermore, the levels of TG, FPG, FPI, HOMA-IR and systolic pressure were significantly higher(all P<0. 05) in obesity with IGT group and obesity with T2DM group than in simple obesity group. There were significantly positive correlations between TG and body mass index (BMI), FPG, HOMA-IR, TC, systolic pressure respectively (all P < 0.05). Multiple linear regression analysis indicated that FPG and HOMA-IR were the independent factors affecting TG (both P < 0. 05 ). Conclusions Hypertriglyceridemia may play an important role in the development of insulin resistance.

ObjectiveTo investigate the prevalence and associated risk factors of chronic kidney disease (CKD) in adult population receiving body check from urban area of Hefei, Anhni. MethodsA total of 33 451 subjects who were older than 20 years and received healthy examination in Health Center of Anhui Provincial Hospital from January 2005 to December 2007 were enrolled in this study. CKD was defined as proteinuria, and/or hematuria, and/or using the simplified MDRD equation. ResultsThe prevalence of proteinuria was 2.74% (95%CI: 2.57%-2.92%), hematuria 7.67% (95% CI:7.39%-7.96%), and reduced eGFR 0.80%(95% CI:0.71%-0.90%). 9.92% (95% CI:9.60%-10.25%) subjects had at least one indicator of kidney damage. Age, female, diabetes mellitus, hypertension, and hyperuricemia were independently associated with CKD. ConclusionsThe prevalence of chronic kidney disease is 9.92% in adult population receiving body check from urban area of Hefei, Anhui. Independent risk factors associated with CKD are age, female, diabetes mellitus, hypertension, and hyperoricemia.