BACKGROUND: Internal fixation with cannulated screws is the most commonly used treatment for femoral neck fracture, but some patients may have the phenomenon of femoral neck shortening after surgery, and even cause the occurrence of postoperative dysfunction of the hip joint. OBJECTIVE: To investigate the incidence, clinical features, prognosis and influencing factors of femoral neck shortening after internal fixation of femoral neck fracture. METHODS: One hundred and eleven cases of femoral neck fracture treated by cannulated screw internal fixation at three orthopedic hospitals in Chengdu from January 2012 to March 2017 were retrospectively analyzed. All patients signed the informed consents and the study was approved by the ethics committee of the hospital. Femoral neck shortening was as the prognostic indicator. The incidence, occurrence time and main clinical characteristics of femoral neck shortening after surgery were recorded. Univariate chi-square test was used to analyze the correlation between sex, age, Garden type, Garden index, bone mineral density T value, Singh index, time from injury to operation, weight-bearing time and the femoral neck shortening after surgery. Statistically significant factors were included in the multivariate Logistic regression model. RESULTS AND CONCLUSION: (1) The incidence of femoral neck shortening was 48.6% (54/111), with 31.5% (35/111) of 10-19 mm shortening and 5.4% (6/111) of ≥ 20 mm shortening. (2) The occurrence time of femoral neck shortening was mainly within 6 months after surgery, accounting for 76%. (3) The clinical manifestations of the femoral neck shortening mainly included pain during weight-bearing, dysfunction of hip movement and claudication. The analysis results showed that the moderate pain (67%) was dominant in the shortening group, and no pain/mild pain (86%) was dominant in the non-shortening group; the incidence of hip motion limitation in the shortening group was higher than that in the non-shortening group (68% vs. 21%); and the incidence of claudication in the shortening group was higher than that in the non-shortening group (61% vs. 18%); the differences were significant (all P < 0.05). (4) Univariate and multivariate Logistic regression analysis showed that Garden classification of fracture was type III and IV, Garden index was grade III and IV, bone mineral density T value ≤ -2.5, weight-bearing time ≤ 2 months were independent risk factors for femoral neck shortening after reduction and internal fixation of femoral neck fracture. Therefore, there is a high risk of femoral neck shortening after internal fixation with cannulated nails for femoral neck fractures, which mainly occurs within 6 months after surgery.

Objective To explore preliminarily the role of the E2 subunit of pymvate dehydrogenase (PDC-E2) modified by xenobiotics (e.g.2-octynic acid,2-OA) in the pathogenesis of primary biliary cirrhosis (PBC).Methods Patients of PBC (102 cases),primary sclerosing cholangitis (PSC,34 cases) and healthy controls (HC,50 cases) were selected.The anti-PDC-E2,anti-2-OA and anti-lipoic acid (LA) antibody in the peripheral blood of the 3 groups were tested by enzyme linked immunosorbent assay (ELISA).By inhibitive ELISA (iELISA),30 of the 102 PBC patients with anti-PDC-E2 antibody but without anti-2-OA antibody were selected to detect whether there was any new epitope on the PEC-E2 conjugated with 2-OA.The chi-square test and Fisher exact test were taken to analyze the enumeration data.The two-tailed unpaired t test with Welch's correction was used to compare the measurement data.Spearman rank correlation analysis was also employed for proper test.Results The positive rate of anti-PDC-E2,anti-LA and anti-2-OA antibody in PBC patients was 94.1％(96/102),73.5％(73/102) and 53.9％(55/102) respectively,all of which were statistically significantly higher than those in healthy controls group but were of no significant difference between PSC and healthy controls group.There was no significant relevance between the levels of Anti-LA and anti-2-OA antibody in the PBC group (r=-0.065,P=0.520).The iELISA results showed that the antibody,which only identified the epitopes on 2-OA-PDC-E2 induced by the 2-OA conjugation with PDC-E2,existed in 40％(12/30) of the PBC patients,and more interestingly,this antibody was predominantly appeared in PBC patients at their early clinical stage.Conclusion There are anti-LA antibody and anti-2-OA antibody in PBC patients,which have shown no significant association with each other.It is very likely that new antigenic conformational epitopes on PDC-E2 modified by 2-OA would emerge,which might led to the immune response in the individuals who are susceptible to PBC,and thus contribute for the breaking of PDC-E2 immune tolerance,and PBC occurrence finally.

ObjectiveTo observe the effects of finger-acupuncture massage on the fine motor functions of children with cerebral palsy. Methods40 children with cerebral palsy following diplegia were randomly divided into two groups: observation group(n=20) and control group(n=20). The control group was treated with rehabilitation training, while the observation group received finger-acupuncture massage and the rehabilitation training. All patients were assessed by Peabody Developmental Motor Scale before and after the treatment.ResultsThere was no statistically significant difference in fine motor between the two groups before the treatment (P>0.05). There was a significantly difference in fine motor quotient(FMQ), grasp capacity index, and capacity index of visual-motor integration both in the observation group and the control group between before and after the treatment (P<0.001). There was also a difference in fine motor quotient (FMQ), grasp capacity index, capacity index of visual-motor integration between the observation group and the control group after the treatment(P<0.05).ConclusionFinger-acupuncture massage combined with rehabilitation training can improve fine motor functions of children with cerebral palsy following diplegia.

Objective The mechanism of inhibition of the proliferation and migration of osteosarcoma cells by miR-646 was investigated.Methods The effects of miR-646 on the proliferation of U2OS cells were detected by MTT assay.The effects of miR-646 on U2OS cell migration were analyzed by Tmnswell assay.MIRDB was used to predict the binding sites of miR-646 and epidermal growth factor receptor (EGFR),which were confirmed in a luciferase reporter assay.Western blotting was conducted to detect the effect of miR-646 on the EGFR pathway.Results The MTT test showed that transfection of miR-646 significantly inhibited U2OS cell proliferation;the 24 h inhibition rate was 21.76％± 1.05％.In contrast,the 24 h promotion was 18.89％± 0.81％.Transwell experiments showed that miR-646 inhibited the migration of osteosarcoma U2OS cells.MIRDB predicted that miR-646 bound in the 3'-untranslated region of EGFR,and luciferase reporter gene experiments showed that miR-646 directly acted on EGFR.Western blotting experiments demonstrated that miR-646 inhibited the proliferation and migration of U2OS cells to some extent by inhibiting the EGFR pathway.Conclusion miR-646 can inhibit the proliferation and migration of osteosarcoma cells by inhibiting the EGFR pathway.

Objective To investigate the relationship between pulmonary arterial ( PA) enlargement and pulmonary function in patients with chronic obstructive pulmonary disease (COPD).Methods From December 2012 to June 2016,78 patients with acute exacerbation of COPD in the Eighth People＇s Hospital of Qingdao were selected. According to pulmonary CT findings,they were divided into two groups : PA enlargement group (38 cases) was PA＞3.0cm,normal PA group(40 cases) was PA≤3.0cm.FEV1and FVC of stable phase were compared.Results The FEV1of men in the A enlargement group was (1.08 ±0.44)L,that in the normal PA group was (1.44 ±0.66)L,the difference was statistically significant (t＝2.27,P＝0.028).The FEV1of women in the PA enlargement group was (0.90 ±0.41)L,which in the normal PA group was (1.35 ±0.58)L,the difference was statistically significant (t＝2.28,P＝0.026).Correlation analysis showed that the diameter of PA was negatively related with FEV 1/FVC(r＝-0.509,P＝0.001),PA enlargement was related with lung function decline.Conclusion COPD patients with PA enlargement are more associated with accelerated loss of lung function and should be treated early.

Objective:To investigate the clinical characteristics and possible mechanisms of remote intracranial hematoma (RIH) in patients with intracranial aneurysm after interventional embolization.Methods:Six patients with RIH from a series of 58 consecutive patients with intracranial aneurysm, admitted to and performed interventional embolization in our hospital from January 2016 and December 2018, were chosen in our study. Their clinical data were analyzed retrospectively and compared with those without RIH at the same period.Results:In these 6 patients, 4 had history of hypertension, 5 had aneurysm located in the internal carotid artery, 5 were treated with stents combined with postoperative routine anticoagulation treatment. The remote intracranial hematoma occurred within 7 d of interventional embolization, and the hematoma was located in the cerebral hemisphere on the same side of the aneurysm; 4 patients underwent intracranial hematoma puncture catheter drainage; 1 patient was treated conservatively, and one was treated by craniotomy. After treatment, 1 patient recovered (modified Rankin scale [mRS] score of 1), 1 patient had poor prognosis (mRS scores of 5) and discharged automatically, and the rest 4 patients (mRS scores of 3-5) left some degrees of neurological dysfunction. As compared with 52 patients without RIH, 6 patients with RIH had significantly higher percentages of patients used stents and postoperatively used anticoagulation, and higher percentages of patients with poor clinical outcomes at discharge ( P<0.05). Conclusion:Stent-assisted coil embolization in patients with internal carotid artery aneurysm combined with hypertension should be highly vigilant about the possibility of RIH.

Objective To describe the cardiovascular risk profile of inpatients with schizophrenia and estimate the 10-year CVD risk in schizophrenia patients. Methods Four hundred sixty-six randomly selected cases of schizophrenia patients and 507 health controls were included in the study. Body mass index (BMI), Fasting blood glucose (FBG), triglyceride (TG),,total cholesterol (TC), smoking rate (smoking people/total people), Framing-ham Risk Score (FRS), high density lipoprotein-cholesterol (HDL-C) and age of the vessel (VA). The 10-year cardiovascular risk(FRS) and age of the vessel (VA) were assessed using the Framing-ham Risk Score. Results 10-year CVD risk was significantly higher in patients with schizophrenia than in control group [(6.71 ±6.95)％ vs. (4.76 ±3.07)％], (P<0.05). Comparing with the control group, smoking prevalence[(41％) vs. (19％)], MS[(25％) vs. (17％)], BMI[(23.67 ±3.61)kg/m2 vs. (21.73±4.11)kg/m2] and VA[(46.7±15.3) vs. (43.7±9.8)] were higher in patients group. SBP[(119.86±14.90)mmHg vs. (128.10±15.41)mmHg] and HDL-C [(1.08±0.27)mmol/L vs. (1.38±0.22)mmol/L] were lower in patients group than in the healthy controls. The FRS score of the patient group was positively correlated with BMI, FBG level and SBP, waist circumference and smoking index (P<0.05) and was negatively correlated with the levels of HDL-C. Multivariate Linear Regression analysis demonstrated that FRS was correlated with FBG (β=0.181,P<0.01)、SBP (β=0.149,P<0.01)、HDL-C (β=-0.107,P<0.01) and smoking index(β=0.554,P<0.01). Conclusion The risk of cardiovascular disease in patients with schizophrenia over the next 10 years is 6.7％, which is significantly higher compared with the control group. Fasting blood glucose, systolic blood pressure, high density lipoprotein, smoking may be associated with 10-year CVD risk of schizophrenia patients.

Objective:To investigate the expression of activator of basal transcription 1 (ABT1) protein in gastric cancer tissue and its relationships with the clinical parameters and prognosis of gastric cancer patients, and to clarify the role of ABT1in the occurrence and development of gastric cancer.Methods:A total of 100cases of cancer tissue of the gastric cancer patients and 80pairs of adjacent tissue were selected.The expressions of ABT1in cancer tissue and adjacent tissue were detected by immunohistochemistry and the proportion of stained cells and the degree of staining in the immunohistochemistry results were analyzed using semi-quantitative analysis.The relationships between the semi-quantitative analysis results and the clinical parameters of gastric cancer patients were statistically analyzed.Kaplan-Meier method was used to analyze the correlation between the ABT1 protein expression level and the survival of gastric cancer patients.Results:ABT1-positive staining was observed in the nucleus and cytoplasm of gastric cancer tissue and adjacent gastric tissue.The expression level of ABT1in gastric cancer tissue was lower than that in adjacent tissue (P=0.021) .The ABT1protein expression level in gastric cancer tissue was significantly negatively correlated with the pathological grade (r=-0.224, P=0.026) .The Kaplan-Meier analysis results of the survival curve showed that the high expression of ABT1was associated with good prognosis in the gastric cancer patients (HR=1.483, P＜0.01) .The survival rate of gastric cancer patients with high ABT1expression was significantly higher than that of the patients with low ABT1expression (HR=2.411, P=0.0272) .Conclusion:The expression of ABT1in gastric cancer tissue is lower, indicating that ABT1can be used one of the markers of good prognosis of gastric cancer.

The access evaluation of new medical technology is an important part of the preclinical application of medical technology and plays a vital role in ensuring the quality and safety of medical services.However,in the con-crete practice of access evaluation,there are still some problems such as imperfect access theoretical framework,imperfect evaluation index system.With the strategic support of health policies,laws,and regulations,the theory and method of HB-HTA are used for reference,core elements such as assessment subject,assessment object,and assessment content are comprehensively considered,the index system is designed from the dimensions of tech-nical characteristics,safety,effectiveness,economy and applicability,and the access evaluation framework of im-ported medical new technologies is constructed.To offer a theoretical framework and evidence-based basis for medi-cal facility medical technology access management.

Objective:To investigate the correlation between the expression of GLI1 and im-mune invasion and clinical prognosis in gastric cancer.To study the effect of GLI1 expression on drug resistance in gastric cancer.Methods:The expression difference of GLI1 in gastric cancer and normal tissues was analyzed by using TCGA database,and the effect of clinical features and GLI1 gene ex-pression level on prognosis of patients with gastric cancer was analyzed.The correlation between GLI1 gene expression and tumor immune cell infiltration in gastric cancer tissues was analyzed to explore its influence on drug resistance of chemotherapy drugs and targeted drugs.Clinical samples were collect-ed to analyze the difference of GLI1 expression in gastric cancer and paracancer tissues.Results:The expression of GLI1 in gastric cancer tissues was 1.7 times that in normal tissues,and the overall sur-vival and disease-free survival of patients with high expression are shorter than those with low ex-pression(P＜0.05).The interstitial score,immune score and abundance of immunoinfiltrating cells were higher in the high expression of GLI1 in gastric cancer tissues.High expression of GLI1 reduces drug sensitivity and is positively correlated with the expression of immune checkpoint markers PDCD1(P＜0.05).GLI1 expression was significantly increased in patients with subdifferentiated gastric cancer.Conclusions:GLI1 expression is associated with the prognosis and immune infiltration of patients with gastric cancer,and it may lead to poor prognosis of patients by regulating chemotherapy resis-tance,which may be a potential therapeutic target and molecular marker for gastric cancer.