Objective To explore the current status and influencing factors of fall among the elderly in Niujie area of Beijing so as to provide evidences for prevention. Methods Based on the basic survey of fall in 1703 elderly people, the people were divided into intervention group and control group according to different habitation areas using cluster sampling method. The elderly people in intervention group of 874 were accepted intervention management for one year, including cognitive behavioral intervention, fall-inducing diseases intervention and intervention of elderly static and dynamic behaviors that affected the balance function, so as to help the elderly to master the relevantfactors of fall and preventive measures. Results The annual occurrence rate of fall was 11.7% (200/1703) and the fall injury incidence was 9.0% (152/1703). The prevalence of fall was increased with aging, and it was high in people with balance dysfunction. After one year intervention, the incidence of fall was decreased to 5.2%, while it was 7.6% in control group. Conclusions Cognitive behavior intervention can effectively prevent fall in the elderly, which has an important significance for improving the life quality of the elderly.

Human CD38, a type II glycoprotein, is widely expressed in kinds of tissues and cells. It has been shown to have a wide range of effects.The multifunctional cyclase function of CD38 effects on the regulation of osteoclasts activation, which maybe important in the therapy of osteoporosis.

[Summary] Lumbar disc herniation is rare in juveniles , which makes it more difficult to diagnose and treat .The prevalence , causes and risk factors , pathological changes , clinical characteristics , main treatment methods , and curative effects of lumbar disc herniation in juveniles were summarized in this review , for benefiting clinical diagnosis and treatment .

Objective:To explore auxiliary therapeutic effect of exercise intervention on hypertension and/or diabetes mellitus (DM) .Methods :A total of 456 patients with hypertension and/or DM from community were selected and randomly equally divided into intervention group (n=228 ,wore exercise amount monitor ,and lifestyle disease inte‐grated control software was used to monitor exercise ,and unique person provided quantitative exercise guidance for them for three months and they were followed up for eight times ) and control group (n=228 ,did routine activity as usual) .Body weight ,BMI ,waist circumference (WC) ,blood pressure ,blood sugar ,blood lipid etc .and exercise a‐mount were measured and compared between two groups before and after intervention .Results:Compared with be‐fore intervention ,there were no significant changes in all above indexes in control group after intervention , P>0.05 all;there were significant reductions in body weight ,BMI ,WC ,blood pressure ,blood sugar ,blood lipid etc . in intervention group after intervention ( P< 0.01 all) .After intervention ,compared with control group , there were significant reductions in body weight [ (68.28 ± 8.43) kg vs . (65.93 ± 10.43) kg] ,blood pressure [ (124.32 ± 13.70 /77.81 ± 8.22) mmHg vs . (120.94 ± 8.35 /74.58 ± 5.76) mmHg] ,HbA1c [ (7.12 ± 1.53) mmol/L vs . (6.73 ± 1.04) mmol/L] ,LDL‐C [ (2.72 ± 0.40) mmol/L vs . (2.46 ± 0.67) mmol/L] ,and significant rose in total exercise amount [ (537.85 ± 338.63) kcal vs .(637.15 ± 447.65) kcal] ,effective exercise amount [ (229.46 ± 239.04) kcal vs . (323.56 ± 257.84) kcal] in intervention group ,P<0.01 all .Conclusion:Exercise can improve ex‐ercise capacity ,reduce blood pressure ,blood sugar ,blood lipid levels ,is help to disease control and quality of life improvement in patients with hypertension and/or diabetes mellitus .

BACKGROUND:Traditional open surgical transforaminal lumbar interbody fusion often needs a broader dissection of the paraspinal soft tissue and longer stretch time of soft tissue, induces greater surgical trauma and more blood loss. Minimal y invasive transforaminal lumbar interbody fusion (MIS-TLIF) may reduce or avoid these shortcomings. However, MIS-TLIF technique needs a process of learning curve. Correctly understanding the MIS-TLIF technique and dealing with their associated complications, have an important clinical significance. OBJECTIVE:To summarize the MIS-TLIF complications for treatment of lumbar disease, and explore the prevention and treatment strategies. METHODS:Between May 2008 and May 2012, 100 patients with lumbar disease were treated using MIS-TLIF. Al of patients had typical low back pain combined with leg pain, and were ineffective by conservative treatment for 6 months. There were lumbar spinal stenosis syndrome in 42 cases, lumbar spondylolisthesis in 31 cases, and lumbar disc herniation with lateral recess stenosis in 27 cases. The operative levels included L 3/4 in 2 patients, L 4/5 in 28 patients, L 5/S 1 in 50 patients, L 3-L 5 in 2 patients, and L 4-S 1 in 18 patients. The intraoperative and postoperative complications were recorded. RESULTS AND CONCLUSION:One patient appeared extradural hemorrhage 1 000 mL and was given blood transfusion, no complications were found. Pedicle screw malposition was found in 11 pedicle screws (11/435, 2.5%). Only one patient had new L 5 radicular pain due to impingement by the tip of a bicortical S 1 screw upon the lumbosacral trunk anterior to the sacrum. This screw was re-positioned at a subsequent procedure, with resolution of the radicular pain. Interbody cage malposition was found in 2 patients with 2 cages (2/120, 1.7%) after operations, they showed no clinical symptoms and were not treated. One patient with one cage (1/120, 0.8%) appeared cage displacement during fol ow-up, which required twice revision surgeries, one is cage re-position and the other is posterior interbody fusion. Within one month after operations, two patients had poor visualization in the right pulmonary arteriography, which was diagnosed as pulmonary embolism and was treated with thrombectomy and thrombolysis. No death and other consequence were found. Experimental findings indicate hat, MIS-TLIF is a safe, reliable and effective surgery for treating lumbar diseases, with few complications.

Objective　To evaluate the diagnositic value of exercise stress echocardiography (ESE) in patients with pacemaker-dependnet.Methods　Forty-six patients remained pacemaker dependent with a fixed heart rate throughout ESE and coronary angiographic studies.Results　Thirty-four of 46 patients completed the ESE. Coronary artery disease was confirmed in 28 of 34 who had coronary angiograms. ESE had a sensitivity of 75% and specificity of 83% in pacemaker-dependent patients.Conclusions　ESE has preserved diagnostic utility in pacemaker dependent patients with absolute chronotropic incompetence.

Objective To study the clinical use of intramedullary interlocking nail in treatment of femoral and tibial fractures. Methods104 cases of femoral or tibial fractures were treated with intramedullary interlocking nails.Results The close and open reduction fractures had healed 6 10 and 8 12 weeks after surgery, and the fixation nails were taken out after 48 weeks. No broken nail, no delayed or nonunion, no infection, no fat embolism, no stiff joint occurred, All cases were followed up and the average following was 20 months without fracture.Conclusion The intramedullary interlocking nail had obvious advantage of reliable fixation, rotation and separation prevention, no need of external fixation support, high rate of fracture healing and allowance of early walk without support.

[Objeetive] To develop the recombinant human bone morphogenetic protein-2(rhBMP-2)loaded amorphous calcium phosphate(ACP)delayed release nano-sized material,investigate its cytotoxicity of cell,and provide a reference for the experiment of composite material in vivo.[Method]The rhBMP-2/ACP delayed release nano-sized material were prepared by chemical wet method and cultured on rabbit bone marrow-derived mesenchymal stem cells(BMSCs)in vitro.Then the adhesion,proliferation,growth and functional expression of BMSCs were measured.[Result]Cytotoxicity test demonstrated that rhBMP-2/ACP delayed release nano-sized material had not affect the percentage of cell's proliferation with material-extracted liquid cultured with BMSCs and the cytotoxicity was graded zero.The adhesion,proliferation,configuration of the cells on the surface of this material were identical to the control group.[Conclusion]It was suggested that rhBMP-2/ACP delayed release nano-sized material might have good cellular biocompatibility,no cytotoxicity and not effected the normal functional expression of BMSCs in vitro.

[Objective]To study the biocompatibility and security of the recombinant human bone morphogenetic protein-2(rhBMP-2) loaded amorphous calcium phosphate(ACP) delayed release nano-sized material and investigate the feasibility of the clinical use as a kind of bone substitute in bone engineering.[Method]The in vitro hemolyzation,cytotoxicity,microkernel test in marrow smear,acute systemic toxicity,pyrogenicity,subcuticular stimulation reaction and short-term intramuscular implantation,as well as endosseous implantation were performed on the rhBMP-2/ACP delayed release nano-sized material.[Result]The material-extracted liquid induced no hemolyzation,no toxic effects of genetic,no pyrogenic reaction in rabbits,no cytotoxicity cultured in rabbit bone marrow-derived mesenchymal stem cells(BMSCs) in vitro and no acute toxicity in mice.The intramuscular implantation and endosseous implantation in rabbits induced no inflammatory reaction,tissue necrosis and the material was degraded gradually,fused organically with tissues.[Conclusion]The biocompatibility and security of the rhBMP-2/ACP delayed release nano-sized material could meet the requirements given in biological standards for implanted biomaterials ISO10993 and GB/T16886,suggesting that it could be a good bone substitution for the clinical trial.

Objective To investigate whether RNA interference in mediated Bcl-2 gene silence can decrease the gallbladder carcinoma xenograft formation rate and inhibit growth of xenograft in nude mice.Methods In the xenograft formation ability group,the Bcl-2-siRNAs were transfected into the gallbladder carcinoma cell.Transfected gallbladder carcinoma and gallbladder carcinoma were injected into nude mice hypodermically to form a gallbladder carcinoma tumor.The formation rate and volume of the tumors were measured and the tumor growth rates were calculated.In the therapy group,the animal models of human gallbladder carcinoma in nude mouse body were constructed.The nude mice were randomly divided into pSilencerTM-EGFP sh515 group,pSilencerTM-EGFP shCon group,and normal control group.After the formation of tumor knot,siRNA expressing plasmids pSilencerTM-EGFP sh515 and pSilencerTM-EGFP shCon were injected into the knots of pSilencerTM-EGFP sh515 group and pSilencerTM-EGFP shCon group.The tumor volume was measured and tumor growth rate was calculated.All mice were sacrificed after 6 weeks.The distribution of Bcl-2 in the tumors was detected by immunohistochemistry.Results The nude mouse model of human gallbladder cancer xenograft tumor was constructed successfully.Xenograft formation ability:The xenograft formation rate of gallbladder carcinoma and Bcl-2 siRNA transfected gallbladder carcinoma was 100% and 60%,respectively;the average tumor volume in gallbladder carcinoma group and transfected gallbladder carcinoma group was(1 914.6?125.0)mm3 and(629.7?78.9)mm3;the growth rate was 45.58% and 14.99%,and the average tumor weight was(2.24?0.33)g and(0.77?0.12)g,respectively.The tumor volume,weight and growth rate in the transfected gallbladder carcinoma group decreased significantly when compared with those in control group(P