[Objective]To investigate the effect of using Minimully invasive percutuneous plate osteosunthosis to insert DHS for fixation of intertrochanteric hip fractures in elderly patients,in order to reduce operative trauma.[Method]To study retrospectivly 75 cases of the intertrochanteric fracture of elderly patients treated with DHS,these patients were treated from july 2004.7 to october 2005.10.MIPPO was used in 29 out of 75 cases,classic technique for fixation was used in other ones.[Result]All patients successfully discharged except two died because of fungal septicemia and lung embolism.Totally 73 cases were followed up from 7 to 21 months(averagd 12.3 months),one died of morbus internus in follow-up period.All the fractures had successful union,union time in average was 3.5 months,the diference between MIPPO group and classic incision group was not distinguished.Blood loss and transfusion in MIPPO group was less than classic incision group.Recovery of ESR and detumescence of the femoral was quickly in minimal incision group,time in bed was short.[Conclusion]Technique of minimal invasive fixation using DHS has little trauma and quick functional recovery for patients,therefore,this technique should be better for treatment of intertrochanteric fracture in elderly patients.

BACKGROUND: Bone marrow mesenchymal stem cells (BMSCs) can be induced to differentiate into neuron-like cells in new environment after transplantation, and then to replace damaged cells for reconstructing neural circuit. OBJECTIVE: To establish the co-culture system between rat BMSCs and neural cells in vitro, and to study the influence of neural cells on the differentiation of BMSCs into neuron-like cells in the co-culture system. METHODS: The neural cells obtained from Wistar rat fetal brain tissue and BMSCs gained from rat thighbone were co-cultured in Transwell culture plate. The morphological changes of BMSCs were observed and the special markers of neural cells in BMSCs were examined by immunofluorescence on the fifth day of the co-culture. The results were compared with control group which where BMSCs were alone cultured. RESULTS AND CONCLUSION: BMSCs in the neural cells co-culture system extended, were radial, connected each other. Neuron specific enolase immunoreactions showed positive results, showing neuron-like cells. The positive ratio of neuron specific enolase-positive cells was (33.0±10.5)%. However, BMSCs in the control group did not express neuron morphological character. Immunofluorescence exhibited that cells were negative for neuron specific enolase. These indicate that microenvironment provided by neurons improves the differentiation of BMSCs into neuron-like cells.

Adult ; Dimethylformamide ; poisoning ; Female ; Humans ; Occupational Exposure ; Young Adult

Objective To investigate the effects of insulin on vascular diameter of the peri -infarct region and infarct volume after cerebral infarction in mice. Methods Forty male C57/BL6j mice w ere randomly divided into a control group ( n = 5), a cerebral infarction group ( n = 15), a cerebral insulin resistance group (n = 5), and a cerebral insulin resistance infarction group ( n = 15). A model of cerebral infarction w as induced by the photochemical method. A model of cerebral insulin resistance w as induced by intracerebroventricular injection of streptozocin. Tw o -photon confocal microscope w as used to in vivo evaluate the changes of vascular diameter in the peri-infarct region at 20 min after insulin injection into the cerebelomedulary cistern. After modeling of cerebral infarction, artificial cerebrospinal fluid or insulin (10 ng/ml) w as immediately injected into the cerebelomedulary cistern, and the effect of insulin on cerebral infarct volume w as evaluated at 24 h after infarction. Results Insulin did not have significant effect on various types of cerebral vascular diameters in the normal control group, but it significantly contracted cerebral arteries ( -23.16% ±6.86% and -23.32% ±6.40%, respectively; al P <0.001) and penetrating arteries ( -15.20% ±5.51% and -16.40% ±4.27%, respectively; al P < 0.001) in the cerebral insulin resistance group and the cerebral insulin resistance infarction group, but it did not have any effect on the diameters of the cerebral veins. There w ere no significant differences in the vasoactive effects of insulin betw een the cerebral infarction group and the normal control group, as w el as betw een the cerebral insulin resistance group and the cerebral insulin resistance infarction group. Insulin significantly reduced the volume of cerebral infarction in the cerebral infarction group (9.0 ±1.0 mm3 vs.6.0 ±1.2 mm3; t = 4.294,P =0.002), and it did not have significant effect on the volume of cerebral infarction in the cerebral insulin resistance infarction group ( 12.6 ±2.3 mm3 vs.11.6 ±1.7 mm3; t = 0.782, P = 0.456). Conclusions Insulin can reduce ischemic brain injury in normal mice and can not affect the cerebrovascular diameter of the peri-infarct region. The neuroprotective effect of insulin is not significant in cerebral insulin resistance in mice, and it may be associated w ith the vasoconstrictor effects of insulin in the peri -infarct region.

Objective To evaluate the effect of methylprednisolone on hepatic ischemia-reperfusion (I/R) injury in the patients undergoing hepatolobectomy.Methods Sixty ASA physical status Ⅱ or Ⅲ patients,aged 30-64 yr,weighing 45-75 kg,scheduled for elective hepatolobectomy,were randomized to control group or methylprednisolone group (n =30 each).After induction of anesthesia,methylprednisolone 500 mg (in 100 ml of normal saline) was infused intravenously at 5 ml/min before skin incision in group M.Anesthesia was induced with propofol,fentanyl and cisatracurium.The patients were endotracheally intubated and mechanically ventilated.PETCO2 was maintained at 35-45 mmHg.Anesthesia was maintained with 1％-3％ sevoflurane inhalation,remifentanil infusion,and intermittent iv boluses of fentanyl and cisatracurium.MAP was maintained at 70-100 mmHg and HR at 50-90 bpm.At 10 min before induction of anesthesia,and on postoperative day 1,3 and 5,venous blood samples were collected for determination of the plasma levels of alanine aminotransferase (ALT),aspartate amminotransferase (AST),total bilirubin (TBIL),tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6).Results Compared with group C,the plasma levels of ALT,AST and TBIL were significantly decreased on postoperative day l and 3,and the plasma concentrations of TNF-α and IL-6 were decreased on postoperative day 1,3 and 5 in group M.Conclusion Methylprednisolone can reduce hepatic I/R injury in the patients undergoing hepatolobectomy and inhibition of systemic inflammatory responses is involved in the mechanism.

Objective To investigate the epidemiological characteristic of influenza in children in Guangzhou ,and provide the sci-entific basis for prevention .Methods A total of 20 throat swabs were collected from children with influenza-like illness(ILI) each week from 2014 to 2015 .A total of 2080 samples were obtained .The virus was isolated with MDCK cell line and virus type identi-fication were detected by real-time PCR .The relevant data was collected and analyzed epidemiologically .Results A total of 244 were detected positive in 2080 ILI cases in Guangzhou from 2014 to 2015 .The positive rate was 11 .7% .The positive rate of influ-enza virus reached peak in February and June in 2014 ,and the major type of influenza virus was new type H1N1 in February and H3N2 in June .The positive rate of influenza virus reached peak in March and June in 2015 ,and the major type of influenza virus were B type in March and H3N2 in June .Only one case of new H1N1 was detected in 2015 .The positive rate of influenza virus was 25 .6% in 3 to 6 years old ILI children which took larger part than other groups .Conclusion In Guangzhou ,the influenza virus epi-demic is more active in 2015 .The major type of influenza virus in the epidemic is seasonal type H 3N2 and B .Type A and type B appeared in the epidemic alternatively .The 3-6 year-old children are the high-risk group of influenza infection ,and should be monitored .

Objective To evaluate the clinical efficacy of different treatments on non-small cell lung cancer (NSCLC) patients with brain metastases and to explore the influential factors of the prognosis.Methods The NSCLC patients with brain metastases treated from Jan.2010 to Dec.2011 were follow-up.The survival time and influences resulted from the treatments were analyzed.Results The average survive time of these patients was (11.93±5.53) months,and the median survive time was 11 months.The 6-month,1-year and 2-year overall survival rates were 90.7 ％,41.1％ and 6.4 ％,respectively.Multivariate analysis showed that control of extracranial lesions,Kamofsky score,target therapy and age were independent predictive factors of survival,and the OR value were 0.358 (95 ％ CI0.217-0.593),0.302 (95 ％ CI 0.182-0.502),0.170 (95 ％ CI 0.098-0.296) and 1.635 (95 ％ CI 1.010-2.647),respectively (all P ＜ 0.01).Conclusions Radiation therapy is an effective treatment on non-small cell lung cancer with brain metastases.Biological target therapy can effectively improve survival.The survival time also is correlated with age,Karnofsky score and control of extracranial lesions.

Objective To afford an new effective imaging technique for the morphological observation of the normal male pelvic floor by observing the normal male puborectalis with transrectal ultrasound and magnetic resonance imaging (MRI). Methods Thirty-six normal males were examined by transrectal ultrasound and MRI,data of puborectalis were recorded and compared including starting point, end point,appearance, structure, thickness and the relationship with peripheral organs. Results The results including the appearance,direction and internal echo of puborectalis and the relationship with peripheral organs can be clearly displayed by transrectal ultrasound compared with MRI. The thickness of right and left puborectalis at rest measured in ultrasound and in MRI were (6.22±0.57)mm, (6.19±0.59) mm, (6.20±0.61) mm and (6.17±0.53) mm, respectively. The thickness by two methods and two sides had no significant differences (P>0.05). The thickness of puborectalis measured by two methods did not correlate with age,height,body weight,the volume of prostate and interspinal diameter respectively. Conclusions Transrectal ultrasound is a new imaging method to observe male puborectalis. Identification for nomal puborectalis sonography is the foundation of diagnosis pelvic floor disease.

AlM:To observe the efficacy of the multiple wave length laser in treating diabetic retinopathy combined with central retinal vein occlusion.
METHODS:Totally 95 cases ( 100 eyes ) with diabetic retinopathy combined with central retinal vein occlusion were treated by multiple wave length laser. Krypton yellow laser was used for macular edema in focal photocoagulation and diffuse photocoagulation. For peripheral retina, krypton green or krypton red laser were used. Visual acuity, slit - lamp biomicroscopy, ophthalmoscopy and fundus fluorescein angiography were performed preoperatively and postoperatively. The patients were followed up for 12 to 48wk. ln this study, change in visual acuity and macular edema were observed in both groups, and statistical analysis was performed. RESULTS: The effective rate was 61. 2% in diffuse macular edema group and 86. 3% in focal macular edema group. The general effective rate of later was higher than the former, while the treatment effect had significant statistical difference (P<0. 05).
CONCLUSlON:Multiple wave length laser is an effective and safe way to treat diabetic macular edema of diabetic retinopathy combined with central retinal vein occlusion, which is worth widely applying in clinical practice.

Objective To determine the activities of 131I for treating differentiated thyroid carcinoma with diffuse pulmonary metastases ( DTC-DPM ) from the perspective of internal radiation dosimetry.Methods According to Medical Internal Radiation Dosimetry (MIRD) schema, the activity constraint,from which the whole bdy retention at 48 h should not exceed 2.96 GBq (2.96 GBq rule), was converted to dose-rate constraint(DRC) to lungs at 48 h ( DRCLU ·48 h ) in 131I therapy for DTC-DPM. Based on the assumption of DRCLU·48 h at 48 h in lung, the fractions of whole body activities ( F48 ), the effective half times of 131I in lungs ( TLL ) and the remainder of body ( TRB ) were 0.6-0.9, 20- 120 h, and 10- 20 h, respectively. The maximum safe activities of 131I for different human phantoms from the Organ Level Internal Dose Assessment (OLINDA) software were calculated. Results According to MIRD schema and 2.96 GBq rule, DRCLU ·48 h should not exceed 46.4 mGy/h in 131I therapy for DTC-DPM. Depending on varying F48 h,TLL and TRB, the maximum safe activities of 131I were 6.77-81.36, 5.29-56.20, 5.08-55.19 and 3.87-40. 52 GBq for the male adult, female adult, 15-year-old, and 10-year-old patients with DTC-DPM, respec tively. Conclusion Dosimetry-guided 131I therapy for DTC-DPM considers adequately the differences of 131I kinetics in individual patients and can adjust administered activities of 131I on the precondition of avoiding radiological pneumonitis and pulmonary fibrosis.