BACKGROUND:Osteoporosis-induced unstable intertrochanteric fracture has a high failure rate and incidence of complications, and treatment is stil controversial. OBJECTIVE:To compare the clinical effects of proximal femoral nail anti-rotation and modified proximal femoral nail anti-rotation II for treating intertrochanteric fractures in the elderly. METHODS: Data of 26 patients with intertrochanteric fracture who were treated with surgery in the Department of Orthopedic Surgery, Pingguo County People’s Hospital were retrospectively analyzed. Of them, 13 cases received proximal femoral nail anti-rotation, and 13 cases received modified proximal femoral nail anti-rotation II. RESULTS AND CONCLUSION:The patients in both groups were folowed-up for 12 months, no drop out. Hip function restored perfectly after implantation in both groups. No significant difference in Harris score and fracture healing time was detected between the two groups. The incidence of pain in the lower limbs was lower in the proximal femoral nail anti-rotation II group than in the proximal femoral nail anti-rotation group (P < 0.05). Results verified that the therapeutic effect of modified proximal femoral nail anti-rotation II was better than proximal femoral nail anti-rotation, and it is safe and reliable.

Objectives To investigate the relationship between the insertion and deletion (I/D) polymorphism of human angiotensin converting enzyme (ACE) gene and the vascular complications in type 2 diabetes. Methods The I/D polymorphism of ACE gene was detected by polymerase chain reaction in 120 type 2 diabetic patients and 100 healthy controls. Results The frequency of DD genotype was significantly higher, while frequency of II genotype was lower in diabetic nephropathy patients (DN) than those in control group. The frequency of ID genotype was significantly higher, while frequency of II genotype was lower in type 2 diabetic patients with coronary heart disease (CHD), when compared to those without CHD. The frequencies of ACE genotypes in patients with diabetic retinopathy (DR) or hypertension (HP) were not different from those in control group and non-DR or non- HP patients. Conclusions ① There were relationships between the I/D polymorphism of ACE gene and DN and CHD in type 2 diabetes. ② The DD genotype and D allele of ACE gene might be as markers in predisposing DN, while II genotype and I allele as protective factors for DN in diabetes. The ID genotype might be as a marker in predisposing CHD, while II genotype as a protective factor for CHD in diabetes.③ There was no relationship between I/D polymorphism of ACE gene and HP or DR in diabetes in Guangxi region.

AIM: To observe the efficacy, feasibility and safety of endovascular stent-grafts in treating aortic dissection.METHODS: Six patients with aortic dissecting aneurysm (3 males and 3 females, aged 32-67 years, average of 50 years old) were selected from Department of Cardiology, First Affiliated Hospital of Gannan Medical College between March 2005 and March 2006. They were diagnosed by transthoracic magnetic resonance imaging (MRI) and aortic angiography, and as type Ⅲ aortic dissecting aneurysm according to Debakey typing. The tumor diameter was ranged from 3.2 to 4.3 cm. The informed consent was obtained from all patients. Two weeks after the onset, the blood pressure was control between 90-110 and 60-70 mm Hg and heart rate at 60-65 times/min, then the straight circular and bifurcated stents, the product of Yuhengjia Company, composed of single naked membrane, straight circular and bifurcated stents made of nickel-titanium memory alloy, and cover of domestic artificial blood vessel were implanted with the patients generally anesthetized. The aortic dissection and general condition of patients after operation were observed with angiography, and the patient recovery condition was examined by spiral CT at postoperative months 3 and 12.RESULTS: All 6 cases were involved in the result analysis.①The diameters of stents for the patients were appropriate. The angiography showed that the thoracic aortic dissection in 4 cases disappeared, and thrombogenesis was found in false lumen; the thoracic aortic dissections in 2 cases disappeared, however, a little contrast agent was found in false lumen, but the blood flow was very slow. The general condition of all patients was good with stable vital signs, all patients discharged after 7-10 days.②CT results at 3 month after operation suggested that the original false lumen significantly contracted, and the true lumen restored to normal level. In case 3, there was mural thrombus in the distal stent that connected with stent vessel wall, and the thrombus hyperplasia was not obvious during follow up. At 12 months after operation, there was no distinct alteration in the stent location and appearance, and the life quality of patients was significantly improved.CONCLUSION: Endovascular stent-grafts are effective and safe in treating aortic dissection.

The effect of 17?-estradiol ( 17?-E2 ) on expression of estrogen receptor ?( ER?) was observed in cultured MC63 cells and human osteoblast-like (HOB) cells. The results show that the expression of ER* is in a dose-dependent manner with 17p-E2 (0-1?10-6 mol/L) in MC63 cells and has an optimal 17?-E2 concentration (1?10-8 mol/L) in HOB cells resulting in maximum expression of ERp protein.

Daxx is found in the nucleus where it localizes to PML oncogenic domains (PODs). Its multiple domains can interact proteins involved in transcriptional regulation and apoptotic signal transduction. In addition, Daxx is associated with viral infection、tumorigenesis and embryonic development.

Objective To investigate the application effect of pelvic rocking with balloon bionic midwifery in head dystocia. Methods Prospective research method was selected, and 400 pregnant women with head dystocia were divided into 2 groups by random digits table method with 200 cases each. The observation group was given pelvic rocking with balloon bionic midwifery delivery, and the control group was given gauge and comfortable posture with manual rotation fetal head delivery. The labor stage and delivery outcome were observed in two groups. Results The rate of successfully correct the fetal position was 91.00%(182/200) in observation group and 65.00%(130/200) in control group,and there was significant difference between 2 groups, χ2=39.394,P<0.01. The cesarean section rate was 7.00%(14/200) in observation group and 27.00%(54/200) in control group,and there was significant difference between 2 groups, χ2=113.119,P<0.01. The first, second and total labor stage were (8.86 ±2.20), (0.72 ±0.52), (9.78 ±2.82) h in observation group and (12.60±2.10), (1.02±0.82), (13.83±3.01) h in control group, and there were significant differences between 2 groups, t=15.684,4.058,12.609, P<0.01. The incidence of episiotomy, perineal laceration of Ⅱ degree, fetal distress, neonatal asphyxia and postpartum hemorrhage were 17.20%(32/186), 6.45%(12/186), 1.00%(2/200), 0, (150.80 ±43.54) ml in observation group, and 42.47%(62/146), 41.48%(61/146), 9.00%(18/200), 3.00%(6/200), (254.60±83.50) ml, and there were significant differences between 2 groups, P <0.01 or 0.05. Conclusions Pelvic rocking with balloon bionic midwifery can effectively correct the fetal position, reduce head dystocia and cesarean section rate, shorten the first labor stage, the second labor stage, reduce the occurrence of complication of mother and infant.

Aim To study the effects of probucol on THP-1 macrophage apoptosis and CD36、Caveolin-1 expression induced by ox-LDL.Methods Apoptosis of THP-1 macrophages was determined by flow cytometry analysis.RT-PCR and immunofluorescence were used to detect CD36,Caveolin-1 mRNA level and protein expression respectively.Results Probucol had no effect on mRNA level of CD36,Caveolin-1 in THP-1 macrophages,but it attenuated Caveolin-1 protein expression.Conclusions Probucol can inhibit apoptosis induced by ox-LDL in THP-1 macrophages by down-regulating Caveolin-1 protein expression.

Objective To investigate the distribution of water fluoride and the present status of water-improving defuoridation projects in the endmie fluorosis areas in Gansu Province in 2006. Methods The content of fluoride in drinking water in 18 endemic disease counties was screened, and the defluoridation projects built after the 1980s were supervised and inspected. The content of fluoride in drinking water was assessed by F-ion selective electrode. Results Fluoride content was determined in water of 6260 sources in 1252 fluorosis villages in 18 counties, with 63.50% (3975/6260)≤1.0 mg/L and 36.50%(2285/6260)>1.0 mg/L. Nine hundred and ninty-seven water-improving and clefluoridation projects had been investigated in 16 counties, among which 95.49% (952/997) were function well, and projects intermittently running or abandoned respectively accounted for 3.11% (31/997) and 1.40%(14/997). Nine hundred and eighty-three sources of water treated by the water-improving and defluoridation projects had been determined for fluoride content, it turned out that 91.76% (902/983) were within the standard, only 8.24% (81/983) were not; as for outlet and leftover water of 934 water-improving and defluoridatian projects determined for water fluoride content, qualified projects accounted for 92.08% (860/934) and 91.97%(859/934), leaving 7.92%(74/934) and 8.03%(75/934) disqualified, respectively. Water-improving and defluoridation projects mostly relied on drilling a well in gaining under-ground water or collecting surface-ground water, so under-ground water and surface-ground water are the majority. Conclusions Water fluoride content exceeds the standard in some of the villages. A few projects do not function well. Fluorosis damage still exists in Gansu Province, therefore countermeasures for endemic fluorosis must be carried out as promptly as possible and surveillance on water-improving and defluoridation projects must be strengthened and managed.

To establish the quality standard for Pingyou granules. Methods: Paeoniae radix, Carthamus tinctorius, Coicis semen and Nutgrass galingale rhizome were qualitatively identified by TLC. The content of peoniflorin was determined by HPLC. The separation was performed on a Lichrospher-C18 (250 mm × 4. 6 mm, 5 μm) column with the mobile phase of methanol-acetic acid (24∶76). The detection wavelength was 232nm. Results:Paeoniae radix, Carthamus tinctorius, Coicis semen and Nutgrass galingale rhizome could be identified by TLC without any interference from the negative control. The linear range of peoniflorin was 6. 560-104. 920 μg·ml-1(r=0. 999 9) with the average recovery of 98. 77%(RSD=2. 73%,n=9). Conclusion:The qualitative identifi-cation is specific and reproducible, and the quantitative method is simple, accurate and reliable, which can be used in the quality con-trol of Pingyou granules.

Objective To observe the impact of the diverse caloric energy intake on the outcomes and occurrence rate of complications in septic patients.Methods A prospective single-blind randomized controlled trial was conducted.158 cases of septic patients in intensive care unit (ICU) were enrolled and randomly assigned to three groups according to their different target value of nutrition:group A [measurements of resting energy expenditure (MREE)＜90％],B (MREE 90％-110％) and C (MREE ＞ 110％).The caloric intake,mechanical ventilation duration (MVD),nosocomial infection rate,28-day and 60-day mortality were analyzed.Results Daily energy intake in 7 days after ICU admission was as follows:the difference in target value of nutrition(kJ/d:7 075.0 ± 1 046.5,5 667.8 ± 1 908.8,4 428.8 ± 1 377.8),calory intake (kJ/d:4 671.6 ± 1 205.6,5 655.3 ± 1 373.0,6 053.0 ± 1 557.2),enteral nutrition value (kJ/d:2 051.1 ± 1 046.5,3 980.9 ± 1 586.5,5 337.1 ±2 921.8) and average intake rate [(66.0 ± 15.8)％,(100.0 ± 5.7)％,(134.0 ± 19.7)％],and they were statistically significant difference among A,B,C groups (all P＜0.05).The parenteral nutrition in group C were much higher than that in group A and group B (kJ/d:2 055.3 ± 273.4vs.427.0 ± 273.4,473.0 ± 332.0,both P＜0.05).The calories provided by glucose and diprivan were similar among three groups.The MVD and ICU stay were shorter in group B than that in groups A and C [MVD (days):8.4 ± 6.3 vs.11.0 ± 8.2,17.8 ± 13.0,P＞ 0.05 and P＜ 0.05 ; ICU stay (days):11.0 ± 6.4 vs.14.9 ± 9.6,17.8 ± 13.0,respectively,P＞0.05 and P＜0.05].The total hospital stay (days:32.0 ± 22.5,26.8 ± 7.0,30.4 ± 21.4) and nosocomial infection rate [91.1％ (51/56),84.0％ (42/50),90.4％ (47/52)] were similar among A,B,C groups (all P＞0.05).There was no difference in survival rate at 28 days among three groups as shown by the Kaplan-Meier survival curve (F=3.145,P=0.076).The survival rate at 60 days showed a tendency of lowering in groups A and C,especially in group C (F=9.284,P=0.010).Conclusion Both higher and lower caloric energy intake may be associated with an adverse impact,but appropriate caloric intake would improve the outcome and reduce the complication rate in septic patients.