The article put across Meta-analysis well by giving its definition and analyzing its development. It empha-sized its effect in the clinical medicine and dwelled on dealing with the problems encountered when meta-analysis wasapplied and the solutions to the problems. It also pointed out its significant role in raising the level of clinical medicine,teaching and scientific research.[

Objective To explore the clinical efficacy of proximal femoral locking compression plate (LCP)fixation in elderly intertrochanteric fractures patients. Methods 30 cases of intertrochanteric fracture fixed with LCP were collected,and the functional recovery of all hip joints was observed. Results The average follow-up and healing time of all cases was 10 months(6 to 14 months)and 3.5 months respectively. Hip joint function of 27 cases was excellent( Harris scoring≥90) ,that of the other 3 cases was good ( Harris scoring:80 ～ 89). Conclusion The proximal femoral LCP fixation had a good clinical value in treatment of elderly intertrochanteric fracture patients. It had many advantages, such as simplicity, rigid fixation, less trauma and bleeding, shorter operative time, less complications, high heal rate, etc.

Objective To establish virtual three-dimensional instrument and cerebral aneurysm models by using three-dimensional moulding software,and to explore the effect of the models in interventional preoperative simulation.Methods The virtual individual models including cerebral arteries and aneurysms were established by using the three-dimensional moulding software of 3D Studio MAX R3 based on standard virtual cerebral aneurysm models and individual DSA image.The virtual catheter,guide wire,stent and coil were also established.The study of interventional preoperative simulation was run in personal computer,and included 3 clinical cases.Results The simulation results of the working angle and the moulding angle of the head of catheter and guide wire in 3 cases were identical with that of operation results. The simulation results of the requirement of number and size of coil in 1 case of anterior communicating aneurysm and 1 case of posterior communicating aneurysm were identical with that of operation results.The simulation results of coil for aneurysmal shape in 1 case of giant internal carotid artery aneurysm were more than 2 three-dimensional coils with size of 3mm?3 cm from the operation results,and the position of the second coil in aneurysmal neck was adjusted according to the results of real-time simulation.The results of retrospective simulation of operation procedure indicated that the simulation methods for regular and small aneurysms could become a routine simulation means but more simulation experience was needed to build up for the giant aneurysms.Conclusions The virtual three-dimensional instrument and cerebral aneurysm models established by the general software provided a new study method for neuro-interventional preoperative simulation,and it played an important guidance role in developing neuro- interventional operation.

Objective To compare the clinical efficacy of extramedullary fixation system,intramedullary fixation system and hip arthroplasty in treatment of intertrochanteric fractures in the elderly.MethodsThe retrospective study involved 184 patients treated between January 2007 and January 2011,which were assigned to dynamic hip screw (DHS) group (n =99),locking plate group (n =19 ),intramedullary fixation group (n =25) and joint replacement group (n =41 ).There were 80 males and 104 females,at age range of 60-99 years,mean (72.4 ± 3.9) years.According to the modified Evan classification,the fractures included type Ⅰ A in 20 patients,type Ⅰ B in 21,type Ⅱ in 75 and type Ⅲ in 68.The preoperative conditions,postoperative weight-bearing time,fracture heating time,hip function and complications were comparatively studied among four groups.ResultsThe patients were followed up for 7-22 months (mean 12 months).The four groups showed no significant differences regarding the gender,age,fracture types and medical complications.The postoperative weight-bearing time of the joint replacement group was significantly shorter than that of the other three groups,with statistical significance.The fracture healing time was insignificantly different among the four groups.The postoperative complications were found in 24 patients (13％),including 11 patients in the DHS group,six in the locking plate group,five in the intramedullary fixation group and two in the joint replacement group.Harris score was the highest in the joint replacement group,with statistical significance in comparison with the other three groups. ConclusionsIntramedullary fixation should be the treatment of choice for the patients with unstable,or severe osteoporosis fractures and with intolerance of joint replacement.Artificial bipolar femoral head replacement is suitable for the elderly patients with unstable or severe osteoporosis fractures,capability of walk or tolerance of operation.

ObjectiveTo evaluate the anticancer activity of 5'-dexoxy-fluorouridine on colon cancer experimental models in BALB/C mice,compared with 5'-fluorouracil,an anticancer agent widely used in clinic,meanwhile,examined the conversion of 5'-Dexoxy-fluorouridine to 5' -fluorouracil in cancer tissues and serum of mouse models.MethodsThe xenografts of mouse colon cancer cell line CT 26 were transplantated to cecum in 60 male BALB/C mice.Three days lated,these mice were divided into 3 groups and intro- peritoneally injected:( 1 ) 5' - dexoxy- fluorouridine 0.1 mg/g,(2) 5' - Fluorouracil 0.02 mg/g,(3)0.9％ sodium chloride 0.4 mL (as a control),respectively.Two and three weeks later,6 mice were sacririced in every group respectively to measure the weight of tumors and bodies,to examine the Hb,RBC,WBC,PLT,AST,ALT,UREA,and CREA in blood.The rest 8 mice in each group were fed generally,and the survival time from operation to natural death was recorded.In addition,14 mice with xenografts of CT 26 about 2 weeks,were divided into 2 groups averagely,5' -dexoxy-fluorouridine 0.1 mg/g and 5' -fluorouracil 0.02 mg/g were intro-peritoneally injected respectively.Fifteen min later,the converted 5' -fluorouracil was detected from the blood and tumor tissues in sacrificed mice.ResultsThe lest tumor average weight was found in the mice injected 5 '-dexoxy-fluorouridine,being (0.07 ± 0.12) g and (0.24g ±0.29) g for the mice sacrificed at 2 and 3 weeks later,respectively.The average survival time for rest mice was ( 32.6 ± 8.9) d.The average tumor weight in 5' - fluorouracil group was (0.74 ± 0.43 ) g and ( 1.13 ±0.75) g at 2 and 3 weeks later,and the average survival time for the rest was (22.8 ±5.9)d,respectively.The average tumor weight in the control group was (0.70 ±0.47) g and ( 1.93 ±0.83) g at 2 and 3 weeks,and the average survival time for the rest was ( 17.5 ± 2.8 ) d.Either the average tumor weight or average survival time in the mice of 5 ' -dexoxy-fluorouridine group was significantly differen from either 5' -fluorouracil group or control (P ＜ 0.05 ).However,there was no significant difference for the numbers of WBC,PLC,Hb,and some function examination of liver and kidney among 3 group mice,besides the loss of weights in 5'-fluorouracil group mice after operation and medicine therapy which was significantly obvious than that in 5' -deoxy-fluorouridine and control groups ( P ＜ 0.05 ).In addition,( 54.71 ± 12.82) μg/g 5' -fluorouracil was detected in xenografts of mice injected 5' -dexoxy-fluorouridine 15 min later,which was the 6.20 folds of 5' -fluorouracil detected in serum from sthe ame group,P ＜0.05.However,( 133.35 ±20.69) μg/m 5'-fluorouracil were detected in serum of mice after 5' -fluorouracil were injected 15 min later,which was the 1.55 folds of 5' -fluorouracil detected in the xenografts from same group ( P ＜ 0.05 ).ConclusionsIn colon cancer tissues of mouse experimental models,5' - dexoxy- fluorouridine could be converted effectively to 5'-fluorouracil,an obvious high concentration being detected in serum of mice than in cancer tissues.The anticancer effect of 5'-dexoxy-fluorouridine on mouse colon cancer models was more effective than 5'-fluorouracil,resulting in a longer survival duration,less side effect and no significant injury on liver and kidney functions.However,the mechanism of 5' -dexoxy-fluorouridine converted to 5' -fluorouracil in cancer tissue is needed further investigation.

Inositol requiring enzyme 1 alpha (IRE1α), a widespread transmembrane protein in mammals, is an endoplasmic reticulum stress (ER stress) receptor. Among the three signaling pathways of the unfolded protein response (UPR), the IRE1α pathway is the most conservative. And there is a growing body of evidence that the occurrence and development of tumors is closely related to the over-expression of IRE1α. Therefore, the study of the IRE1α inhibitors is of great significance to the discovery of new anti-tumor drugs and has been attracting more and more attention. In the hope of providing ideas for the research of targeting IRE1α for cancer therapy, this paper reviewed the data of representative IRE1α inhibitors, including inhibitory activity, the mechanism of action, structural characteristics, and so on.

Background The pathogenesiof age-related maculadegeneration (AMD) iassociated with the senility of human retinal pigmenepithelium (RPE) cells.Seeking drug to arresRPE cell senility iof significance fothe prevention and treatmenof AMD.Research showed thathe lycium barbarum polysaccharide (LBP) can delay senility,buitinfluence on RPE cell aging iunclear.Objective Thistudy wato discusthe protective effecand mechanism of LBP on RPE cell aging.MethodPorcine retinal neural epithelial layewaisolated,and photoreceptooutesegmen(POS) waextracted by density gradiencentrifugation and marked by FITC.The POwathen co-cultured with RPE cellin the medium containing 0.01,0.10 and 1.00 g/L LBP fo24 hours.The areof fluorescence,representing the amounof POphagocytosed by RPE cells,wameasured undethe fluorescenmicroscope to evaluate the influence of LBP on the phagocytifunction of RPE cells.The POS-induced RPE lipofuscin-uptake cell model waestablished by co-culturing human RPE cellwith porcine POfo3 weeks.The RPE-POco-culture cell model waincubated in medium containing 0.01,0.10 o1.00 g/L LBP,and the autofluorescence caused by lipofuscin up-taken into RPE cellwadetected with flow cytometry.cell counting kiwaused to assescell proliferation and viability (value) 24,48 and 72 hourafteculturing.ResultPorcine POpresented athin rodundethe lighmicroscope and appeared abilayedisc-like structureundethe transmission electron microscope,and itFITC-labeled yellow-green autofluorescence waobserved undethe fluorescenmicroscope.No POwaup-taken into the RPE cellin the normal control group,buthe areof POphagocytosed by RPE cellwagradually enlarged with increasing doseof LBP,showing significandifference among the group(F =21.425,P =0.006).Compared with the POcontrol group,the phagocytosed areincreased avariouconcentrationof LBP+POgroup(P＜0.01).Flow cytometry showed thathe autofluorescence value in the POcontrol group wamore highethan thaof the normal control group.Athe LBP dose increased,the autofluorescence value in the RPE celldeclined gradually and iwaneathe normal value in the 1.00 g/L LBP+ POgroup.The rate of proliferation of the lipofuscin RPE cellvaried with the increase of doseof LBP with the maximal value in the normal RPE group and minimal value in the lipofuscin RPE group,and the rate of proliferation of the lipofuscin RPE cellascended with increasing doseof LBP until neathe normal value in the 1.00 g/L LBP + lipofuscin RPE cellgroup (P＞0.05).ConclusionLBP enhance the anti-aging effecof human RPE cellby strengthening the phagocytiability to POand the ability to remove lipofuscin and by heightening the proliferation of human RPE cells.

Objective To investigate the value of imaging-pathology fusion guided targeted cryoablation for localized prostate cancer.Methods Between June 2014 and February 2017,64 patients undergoing targeted cryoablation for localized prostate cancer were retrospectively collected and analyzed.The average age was 77.8 years old,ranging 45-87 years old.The preoperative valne of PSA ranged from 5.1 to 19.8ng/ml,with mean of 15.3 ng/ml,including 6 case of cT1c,35 cases of cT2a,and 23 cases of cT2b,and 35 cases of Gleason score 6,8 cases of 3 + 4 and 21 cases of 4 + 3.All patients had good continence and 11 cases had good erectile function before operation.All the patients received MRI or contrast-enhanced ultrasonography examinations before biopsies,and the sites and range of cryoablation were determined by MRI or contrast-enhanced ultrasonography and biopsy pathological results.Results All the patients underwent the surgery successfully.The average postoperative hospital stay was 1.6 days,ranging 1 to 3 days,including 22 cases discharged within 24 h after surgery.The operative duration ranged from 85 to 152 min,with mean of 99.6 min.The satisfaction rate of the patients was 100％.Seven patients had Clavien Ⅰ or Ⅱ postoperative complications,and recovered after symptomatic treatment.The follow-up duration ranged from 0.5 to 32.2 months,with median of 11.8 months.All patients were alive without new metastasis.Eight patients developed biochemical recurrence,5 of those underwent intermittent endocrine therapy,resulting in stable PSA levels.Conclusion Imaging-pathology fusion guided targeted cryoablation was safe and effective for localized prostate cancer with the advantages of few complications,high satisfaction rate and quick recovery.

Objective To investigate the diagnostic value of transbronchial lung biopsy (TBLB) under virtual bronchoscopic navigation (direct path), endobronchial ultrasonography with a guide sheath (GS) and rapid on-site evaluation (ROSE) for solitary pulmonary nodules (SPNs). Methods One hundred and seventy-eight patients who were underwent transbronchial lung biopsy in the Tianjin Medical University General Hospital between January 2015 to December 2016 were retrospectively evaluated. CT images of all patients showed solitary pulmonary nodules surrounded by lung tissue, and ROSE was undergone during the procedure. The patients were divided into conventional (C-TBLB) group, virtual bronchoscopic navigation (VBN) group, endobronchial ultrasonography with a guide sheath (GS) group, and virtual bronchoscopic navigation combined with endobronchial ultrasonography with a guide sheath group (combination) depending on the different devices. The diagnostic yield and the location or the effect of lesion on the diagnostic rate were compared between four groups. The coincidence rate of ROSE and the histopathological findings of TBLB were compared. The value of ROSE for the early diagnosis of disease was further evaluated. Results The diagnostic rates were 32.5％(13/40), 66.7％(24/36), 68.2％(30/44) and 75.8％(44/58) for C-TBLB group, VBN group, GS group and combination group, respectively. There were significant differences in diagnostic rates between C-TBLB group and other tree groups (χ2=8.853, 10.677 and 18.293, P<0.008). But there were no significant differences in diagnostic rates between VBN group, GS group and combination group (P>0.008). The diagnostic rates for peripheral pulmonary nodules were 12.5％ (2/16), 42.9％ (6/14), 40.0％ (4/10) and 75.9％(22/29) in C-TBLB group, VBN group, GS group and combination group. The diagnostic rate was significantly higher in combination group than that of other three groups (χ2=17.434, P<0.05). The result of ROSE was consistent with result of histopathology (Kappa = 0.775, P<0.001). The sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy of ROSE during transbronchial biopsy for solitary pulmonary nodules were 90.7％, 87.0％, 86.7％, 90.9％ and 88.8％, respectively. No pneumothorax, hemoptysis or other serious complications were found in patients. Conclusion Virtual bronchoscopic navigation, endobronchial ultrasonography with a guide sheath for solitary pulmonary nodules by transbronchial lung biopsy can improve the diagnostic rate of solitary pulmonary nodules.

ObjectiveTo explore the childhood trauma experience and its relation to the eye emotion recognition ability in patients with schizophrenia.MethodsSeventy-one schizophrenic patients and fifty-two healthy subjects were assessed with the Childhood Trauma Questionnaire (CTQ) and the Eye Basic Emotion Discrimination Task (EBEDT).ResultsThe CTQ total score in the patients group was significantly higher than those in the control group (47.86 ± 13.26 vs 34.27 ± 7.27,P ＜ 0.01 ).The subscores in emotional abuse,physical abuse,sexual abuse,emotional neglect and physical neglect of CTQ in the patients group were also significantly higher than those in the control group.(all P＜ 0.01 ).Compared with controls,the patients had significantly lower total accuracy( (86.74 ± 6.16vs73.42 ± 11.86) ％,P ＜ 0.01 ) and longer total reaction time ( (2776.75 ± 703.42 vs 4321.40 ± 1956.83 )ms,P ＜ 0.01 )of EBEDT.The significant difference were also found on the accuracy and reaction time of the EBEDT six basic emotion between the two groups ( all P ＜ 0.01 ).Correlation analysis indicated that CTQ total score were negatively correlated with the EBEDT total accuracy ( r=-0.390,P＜0.01 ),and its sub-accuracy of happiness,surprise,sadness,and anger ( respectively r =- 0.419,r =- 0.451,r =- 0.391,r =- 0.344,P ＜ 0.01 ) in the patients group.The correlation between CTQ total score and EBEDT total accuracy was also found in the control group.ConclusionChildhood trauma is related to eye basic emotion recognition in schizophrenia patients,suggesting that the trauma during childhood can affect the social recognition ability.