Objective To retrospectively analyze the results of treatment with Asian proximal femoral nail anti rotation intramedullary nail (PFNA Ⅱ) in senile patients with unstable intertrochanteric femoral fractures. Methods 1 06 cases of unstable intertrochanteric femoral fracture with internal fixation of PFNAⅡ were analyzed retrospectively,and the treatment effect was observed.Results 1 06 cases were followed -up(mean 1 3.5 months, ranged 1 0 -22 months).Bone union occurred in all cases,average fracture healing time was 3.8 months.The average operation time was 48 minutes,the average volume of blood loss was 1 06mL.The hip functions were analyzed using Harrison score.And found 80 excellent cases,1 4 good cases,1 2 fair cases,with 88.7% of excellent and good rate. Conclusion For the senile patients of unstable intertrochanteric femoral fractures,PFNAⅡ has the biomechanical advantages of intramedullary fixation,small trauma,short operation time,reliable internal fixation,early functional exercise,low incidence of complications,significant functional recovery,and is a preferred treatment option.

OBJECTIVE:To provide theoretical foundation for individualized treatment of aspirin in patients with cardiovascu-lar disease. METHODS:Domestic and foreign literatures in recent years were collected and summarized. RESULTS & CONCLU-SIONS:The gene polymorphism can significantly affect the platelet activity. GPIII a PLA2,PEAR1 and PTGS1 alleles are associat-ed with aspirin resistance,and cardiovascular events have significant difference in different genotype patients. Adjusting reasonably dosage regimen and conducting individualized treatment according to the genetic testing result and other factors can reduce aspirin resistance and the incidence of cardiovascular adverse events in the patients.

Objective To investigate the clilic effects of the compound danshen diwan in menopause women with ST changes and angina.Methods56 menopause women with ST changes and angina were randomly divided into two groups,a controlled group(n=28)with base medicine treatment and a observed group(n=28)with the compound danshen diwan.The change of vasodilation endothelium functon and symptom relief were oberved before and after treatment in all patients.ResultsVasodilation endothelium functon were improved markedly in the observed group while the controlled group had no significantly changes;Meanwhile,the clinic relief rates of the observed group was markedly superor to that of controlled group.ConclusionThe compound danshen diwan would have a positive effect in menopause women with ST changes and angina.

Objective Acute aortic dissection occurs when a tear in the inside of the aorta causes blood to flow between the layers of the wall of the aorta,forcing the layers apart.In most cases this is associated with a sudden onset of severe chest or back pain,often described as "tearing" in character.The main management includes medication,endovascular repair and surgery.Medical management plays an very important role in the management of acute aortic dissection.Aortic dissection generally presents as a hypertensive emergency.Individuals can benefit from blood pressure control and anti-impulse therapy in perioperative period.

Objective:To compare surgery-related indicators, patient recovery status, perioperative complications and risk factors affecting the occurrence of postoperative grade Ⅲ or higher complications in patients undergoing laparoscopic gastric mesenchymal tumor surgery with different visceral fat areas.Methods:Clinical data of 116 patients with gastric interstitial tumor in Shaanxi Provincial People′s Hospital from April 2014 to June 2020 were retrospectively analyzed, including 44 male patients and 72 female patients, with patient aged from 25 to 88 years old and the mean age was (61.8±10.7) years, including 54 patients in the high VFA group and 62 patients in the low VFA group. SPSS 23.0 was used for statistical analysis, and t-test and χ2 test were applied to compare and analyze the patients′ surgery-related indexes, postoperative recovery status, complications within 30 d after surgery and differences in Clavien-Dindo classification of complications, while univariate and multifactorial analyses were used to study the factors affecting the occurrence of postoperative grade Ⅲ or higher complications. Results:Patients in the high VFA group had a higher body mass index than in the low VFA group, and the difference was statistically significant ( t=4.48, P<0.001); patients in the high VFA group had longer operative time ( t=2.88, P=0.005), more intraoperative bleeding ( t=2.17, P=0.032), longer period of fasting ( t=2.73, P=0.008), longer time for defecation ( t=4.46, P<0.001) and bowel movement ( t=4.62, P<0.001), and longer postoperative hospital stay ( t=3.43) compared with those in the low VFA group ( t=2.73, P=0.001), prolonged defecation ( t=4.46), prolonged bowel movement ( t=4.62), and prolonged postoperative hospitalization ( t=3.43), with statistically significant differences ( P<0.05); the incidence of postoperative complications was significantly higher in the high VFA group (31.4%) compared with the low VFA group (14.5%) ( χ2=4.78, P=0.029); among them, the incidence of postoperative pulmonary infection was significantly higher in patients in the high VFA group (12.9%) compared with those in the low VFA group (1.6%), and the difference between them was statistically significant ( χ2=4.16, P<0.05); while the differences in postoperative incision-related complications, anastomotic fistula, lower limb venous thrombosis, and intestinal obstruction were not statistically significant ( P>0.05). The incidence of postoperative complications above grade Ⅲ of the Clavien-Dindo complication classification was significantly higher in patients in the high VFA group (16.7%) compared with those in the low VFA group (4.8%), and the difference between the two was statistically significant ( χ2=4.35, P<0.05); univariate analysis revealed that operative time ≥300 min and increased VFA were the risk factors for postoperative grade Ⅲ or higher complications, while VFA was not an independent risk factor. Conclusion:Larger visceral fat area increases the difficulty of laparoscopic gastric mesenchymal tumor surgery operation, and also affects patients′ postoperative recovery, leading to increased postoperative complications, but VFA is not an independent risk factor affecting the occurrence of postoperative grade Ⅲ or higher complications in patients with gastric mesenchymal tumor.

To investigate the therapeutic effect and mechanism of sodium formononetin-3′-sulphonate (SFS) on collagen-induced rheumatoid arthritis in mice, C57 mice were induced with chicken type II collagen to establish a model of rheumatoid arthritis (collagen-induced arthritis, CIA), and were injected intraperitoneally with different doses of SFS (50,100,200 mg/kg). Body weight, food intake and foot swelling of all groups were observed during the experiment.After the treatment, TNF-α, IL-6, and IL-10 in the serum were detected with the CBA kit; NF-κB p65, p-NF-κB p65 (p-p65), TIPE2, PCNP and IκB-α in spleen tissue were determined by Western blot; the organ index, pathological changes of ankle joint cartilage tissue and the positive expression of NF-κB p65 in ankle joint tissue were also observed.The results showed that, compared with the model group, the body weight and food intake of mice in the treatment group increased, while the degree of foot swelling decreased; the expression levels of inflammatory factors TNF-α and IL-6 in serum decreased, while the expression of anti-inflammatory factor IL-10 increased; the expression levels of NF-κB p65, p-p65 and PCNP in spleen tissue decreased, while the expression of TIPE2 and IκB-α protein increased; the index of spleen and thymus of the CIA mice in the treatment group, the infiltration of inflammatory cells in the ankle joint, the destruction of synovial tissue and cartilage, and the positive expression of NF-κB p65 decreased.Among them, the high-dose group of SFS showed a better therapeutic effect.It is suggested that SFS has a therapeutic effect on CIA mice, and the mechanism may be achieved by regulating the NF-κB p65 signaling pathway and inhibiting the expression of inflammatory factors.

Objective:To investigate the risk factors affecting the occurrence of perioperative complications in patients with locally progressive gastric cancer undergoing radical gastric cancer treatment.Methods:The clinical data of 129 patients with locally progressive gastric cancer from January 2017 to December 2019 in Shaanxi Provincial People′s Hospital were retrospectively analyzed, including 98 males and 31 females, with an age ranged from 27 to 79 years and a mean age of (60.61±10.00) years. The postoperative complications of 129 patients with gastric cancer were firstly counted, and then the relationship between clinical data such as patients′ general condition, intraoperative status and pathological indexes and the occurrence of perioperative complications was analyzed by using univariate analysis, and significant factors were included in the logistic regression model for multifactor analysis to study the independent risk factors for the occurrence of perioperative complications.Results:Of the 129 patients, 25 cases (19.38%) had postoperative complications, including 10 cases (7.75%) with Clavien-Dindo classification combined with grade Ⅲ or higher complications. The results of univariate analysis suggested ACCI score >4 (30.76% vs 68.00%, χ2=11.86, P=0.001), body mass index ≥25 kg/m 2 (24.03% vs 60.00%, χ2=12.18, P=0.001), and preoperative hypoproteinemia (17.30% vs 36.00%, χ2=4.25, P=0.039), vascular cancer embolism (14.42% vs 40.00%, χ2=7.70, P=0.006), operative time ≥ 400 min (26.92% vs 52.00%, χ2=5.84, P=0.016), intraoperative bleeding ≥ 400 mL (13.46% vs 44.00%, χ2=12.03, P=0.001) were risk factors for the development of perioperative complications in patients with locally progressive gastric cancer. Multifactorial analysis showed that ACCI score >4, body mass index ≥25 kg/m 2, preoperative hypoproteinemia, vascular cancer embolism, and intraoperative bleeding ≥400 mL were independent risk factors for the occurrence of perioperative complications in patients with locally progressive gastric cancer ( P<0.05). Conclusions:The occurrence of perioperative complications in locally progressive gastric cancer hands was closely associated with ACCI score, body mass index, preoperative hypoproteinemia, vascular cancer embolism and intraoperative bleeding. ACCI score is expected to be a predictor of the occurrence of perioperative complications in patients with locally progressive gastric cancer.

Objective To assess the factors associated with the restoration of spontaneous circulation (ROSC) and 2-year survival prognosis in patients with cardiac arrest (CA) after acute myocardial infarction (AMI),and after ROSC,the effects of various factors on midian survival time and on 2-year survival.Methods In a registry study from January 2005 to January 2015,all consecutive AMI-induced CA patients treated with cardiopulmonary resuscitation (CPR) admitted to our hospital were enrolled.The survivors were followed-up for 2 years.Univariate analysis was applied to evaluate factors associated with rate of ROSC and 2-year survival.Multivariable logistic regression analysis was applied to evaluate statistically significant factors in the univariate analysis.Medians with inter-quartile ranges were used to describe 2-year survival time affected by various factors after ROSC.Kaplan-Meier survival curve analysis was used to evaluate the effect of factors on 2-year survival.Results A total of 254 cases with CA after AMI were enrolled,including 129 cases of ROSC and 71 cases of 2-year survival.Univariate analysis showed age ≥ 70 years,CA occurred during 22:00-8:00,the duration time ofCPR ≥ 15 min and adrenaline dosage ＞ 5 mg were unfavorable predictors of ROSC;while,left ventricular ejection fraction (LVEF) ≥ 40％ before CA,shockable rhythm and percutaneous coronary intervention (PCI) therapy were favorable predictors.Besides,age ≥ 70 years,intubation during CPR,adrenaline dosage ＞ 5 mg and cardiogenic shock were unfavorable predictors of 2-year survival;While,male,normal daily activity before CA and PCI treatment were favorable predictors.Multivariable analysis showed age,the duration of CPR,adrenaline dosage,LVEF before CA,the rhythm during CPR and PCI therapy were independent predictors of ROSC.Age and PCI therapy were independent predictors of 2-year survival.Among patients,the survival time was affected by various factors after ROSC,and the factors with minimum 25％ and small median value were associated with cardiac rupture,cancer,adrenaline dosage ＞ 5 mg and cardiogenic shock.The factor with maximum 25％ value was PCI treatment (216 days).Kaplan-Meier survival analysis suggested that age ≥ 70 years was an unfavorable factor of 2-years survival (Log-rank test,P=0.007);while,PCI treatment was a favorable factor (Log-rank test,P＜0.01).PCI-related prognosis analysis showed that the effectiveness of PCI was related to the timing of PCI,the number of infarctrelated artery and the difference in culprit lesion.Conclusions The age ≥ 70 years was disadvantageous to both ROSC and 2-year survival.PCI treatment was favorable to both ROSC and 2-year survival.

The interleukin (IL) -23/IL-17 axis is the main pathway in the pathogenesis of plaque-type psoriasis vulgaris, and IL-17A plays a key role in the relevant immune pathways. IL-17A mediates overlapping inflammatory pathways in atherosclerosis and psoriasis, promotes inflammation, coagulation and thrombosis, and plays an important role in the occurrence and development of cardiovascular comorbidities in patients with psoriasis. Inhibiting the inflammatory effect of IL-17A can reduce the incidence and mortality of cardiovascular comorbidities in patients with severe psoriasis. This review summarizes recent research progress in IL-17A-mediated systemic inflammation and cardiovascular comorbidities in patients with psoriasis, and provides a reference for prevention and reduction of cardiovascular comorbidities in patients with psoriasis in clinical practice.

Objective:To analyze clinical characteristics of neurosyphilis patients with abnormal mental behaviors as the initial symptom, and to provide a reference for clinical classification of, as well as outcome prediction and efficacy monitoring in neurosyphilis.Methods:Clinical data were collected from 67 HIV-negative neurosyphilis patients with abnormal mental behaviors as the initial symptom in the Second Affiliated Hospital of Soochow University from November 2012 to November 2019, and retrospectively analyzed. Statistical analysis was carried out by using t test. Results:Among the 67 patients, 52 (77.6%) were males, and 15 (22.4%) were females; there were 63 (94.0%) middle-aged and elderly patients and 4 (6.0%) adolescent patients; 38 (56.7%) patients were diagnosed with progressive general paresis, 21 (31.3%) with meningovascular neurosyphilis, 1 (1.5%) with meningeal neurosyphilis, 3 (4.5%) with tabes dorsalis, and 4 (6.0%) with mixed-type neurosyphilis. As laboratory examination showed, 67 patients all presented with positive serum rapid plasma reagin (RPR) test, serum Treponema pallidum particle agglutination (TPPA) test, and cerebrospinal fluid TPPA test, 55 (82.1%) had positive cerebrospinal fluid RPR test, 47 (70.1%) had elevated cerebrospinal fluid protein levels of > 0.45 g/L, 50 (74.6%) had increased white blood cell counts of > 8 ×10 6/L in cerebrospinal fluids, and 28 (41.8%) had elevated IgG levels in cerebrospinal fluids. Magnetic resonance imaging of the brain revealed multiple ischemic foci in 21 (31.3%) cases, multiple leukodystrophy in 17 (25.4%) , cerebral atrophy in 15 (22.4%) , infarction in 8 (11.9%) , and encephalitis-like changes in 2 (3.0%) . Of the 67 patients, 48 were treated with penicillin in aqueous solutions, 15 with ceftriaxone, and 4 with doxycycline. Six months later, the follow-up showed that 46 (68.7%) patients responded to the treatment, and the early course of disease was significantly shorter in the highly responsive group than in the poorly responsive group ( P < 0.05) . Conclusion:The middle-aged and elderly males were predominant in the neurosyphilis patients with abnormal mental behaviors as the initial symptom, magnetic resonance imaging is helpful for clinical classification and prognosis prediction of neurosyphilis, and early and standardized antisyphilitic treatment can markedly improve the prognosis of patients.