BACKGROUND: The treatment strategy for femoral neck fractures has not been confirmed, and choosing internal fixation or arthroplasty remains controversial. After internal fixation, the occurrence of bone nonunion and osteonecrosis of femoral head makes its long-term treatment outcomes far from satisfactory. Can we improve the functional recovery through high-quality reduction, accurate fixation and active postoperative exercise? If so, it may be favorable for the elderly with femoral neck fractures, especially for those combined with other serious diseases.OBJECTIVE: To compare the quality of life in the elderly with femoral neck fractures after internal fixation and hemiarthroplasty.METHODS: 148 patients with femoral neck fractures aged more than 60 years old in the First Affiliated Hospital of Dalian Medical University from January 2010 to December 2013 were analyzed retrospectively. The operation time,intraoperative blood loss, hospitalization time, mortality rate, reoperation rate and postoperative quality of life were compared between internal fixation and hemiarthroplasty in the patients with undisplaced femoral neck fractures (Garden type I or II) displaced femoral neck fractures (Garden type III or IV), respectively.RESULTS AND CONCLUSION: (1) Among 148 patients, 137 cases completed follow-up, and the follow-up rate was 92.6%. (2) The operation time, intraoperative blood loss and hospitalization time in the internal fixation group were significantly superior to those in the hemiarthroplasty group in patients with displaced or undisplaced femoral neck fractures (P < 0.05). (3) There was no significant difference in the mortality rate between two groups, and the reoperation rate in the internal fixation groups was slightly higher than that in the hemiarthroplasty group. (4) The Harris and SF-36 scores in both groups were increased with time, and the difference between two groups was decreased with time, which became equal at 2.5 years postoperatively (P > 0.05). Besides, the time of the patients with undisplaced femoral neck fractures in the internal fixation group achieving the same quality of life with the hemiarthroplasty group was earlier than that of displaced ones. (5) These results suggest that internal fixation holds short operation time, simple operation skills and less trauma in the treatment of femoral neck fractures, and with the development of technology, it can achieve the early functional recovery. Thereafter, it is an effective method for senile femoral neck fractures.

ObjectiveTo identify the association of HLA-DQA1*0302 and DQB1*0303 alleles with vitiligo in Uygur nationality in Xinjiang Uygur Autonomous Region. MethodsPolymerase chain reaction with sequence-specific primers(PCR-SSP) was performed to analyze the distribution of HLA-DQA1*0302 and HLA-DQB1*0303 alleles among 300 patients with vitiligo and 300 normal human controls of Uygur nationality in Xinjiang region. ResultsA significant increase was observed in the frequency of HLA-DQA1*0302 and -DQB1*0303 alleles in patients with vitiligo compared with the controls(20.5％ vs. 13.83％, 30.17％ vs. 13.33％, both P ＜ 0.01 ). Increased frequency of HLA-DQA1*0302 and -DQB1*0303 alleles was also seen in patients with adult vitiligo (onset age ＞ 12 years) and those with childhood vitiligo (onset age ≤≤ 12 years) ascompared with the normal controls(both P ＜ 0.01). The frequency of DQB1*0303 allele was higher in both patients with and without family history of vitiligo than in the normal controls(both P ＜ 0.01), while that of DQA 1*0302 was higher in only patients without family history (P ＜ 0.01 ). No significant difference was observed in the frequency of HLA-DQA 1*0302 or HLA-DQB1*0303 between patients with adult vitiligo and those with childhood vitiligo or between patients with and without family history(all P ＞ 0.05). Conclusions HLADQA 1*0302 and DQB 1*0303 alleles may be associated with vitiligo in Uygur nationality in Xinjiang region,and there seems to be genetic heterogeneity between patients with adult and childhood vitiligo and between vitiligo patients with and without family history.

Adult ; Altitude ; Asian Continental Ancestry Group ; genetics ; Female ; Humans ; Janus Kinase 2 ; genetics ; Male ; Middle Aged ; Mutation ; Polycythemia ; diagnosis ; ethnology ; genetics

Objective To evaluate anesthesia efficacy of sevoflurane combined midazolam and remifentanil and propofol in patients undergoing short surgery. Methods Fifty ASA Ⅰ or Ⅱ patients who scheduled for elective surgery under general anesthesia were enrolled in study. The anesthesia was induced with intravenous injection of midazolam 0.03 mg/kg and sevoflurane inhalation. Induction of anesthesia was started with 6% sevoflurane and fresh gas flow rate of 6 L/min. The inspired concentration of sevoflurane was reduced to 2% as soon as eyelash reflexes of these patients were abolished. At the same time, remifentanil 2 μg/kg was injected slowly over 1 min,and 30 s later,patients were mechanically ventilated after tracheal intubation. 2% sevoflurane was kept inhaling, and remifentanil and propofol were kept pumping for anesthesia maintenance. The mean arterial pressure (MAP), heart rate, pulse oxygen saturation (SpO_2) and bispectral index (BIS)were recorded before administration,at the time of the disappearance of eyelash reflex, immediately before tracheal intubation,and immediately after tracheal intubation. The time period from sevoflurane inhalation to the disappearance of eyelash reflex was also recorded. And conscious recovery, spontaneous breathing recovery,the endotracheal extubafion time and OAAS score were recorded. Results All patients were successfully intubated at the first attempt. The satisfactory intubation conditions were found in 82% (41/50) of cases. The time period from sevoflurane inhalation to the disappearance of eyelash reflex was (73 ± 12) s. MAP,heart rate and SpO_2 remained stable and BIS was maintained at 45-55 before and after tracheal intubation, and all patients were quick recovery. Conclusion The anesthesia efficacy of sevoflurane combined midazolam and remifentanil and propofol without muscle relaxant in patients undergoing short surgery is smooth, safe and reliable.

Objective To investigate the expression of vascular endothelial growth factor/vcascular endothelial growth factor receptor(VEGF/VEGFR) in bone marrow of children with acute leukemia(AL),and explore their relationship of the clinical features,and observe changes before and after chemotheropy.Methods The bone marrows of 53 children with AL were assayed to study the expression of VEGF/VEGFR(KDR,Flt-1)before and after chemtheropy with S-P immhistochemical staining.Their relations to the clinical features were evaluated.Results The expressions of VEGF,Flt-1,KDR were significantly higher in newly diagnosed children with AL than those of control group.They were significantly higher in children with acute myeloid leukemia(AML) than in children with ALL.The expressions of VEGF,Flt-1,KDR in remission chidren after chemotheropy were significantly lower than before chemotheropy.There was a positive correlation of the percentage of bone marrow blasts with VEGF expression in children with AL.There was also a positive correlation of the percentage of leukemic cell in blood rountine with VEGF expression.For the untreated group of children,no correlation was found between expressions of VEGF,Flt-1,KDR and age,sex,extramedullary infiltration.Conclusions Expression levels of VEGF,Flt-1,KDR in bone marrow of children with AL increases.VEGF/VEGFR may play an important role in process of chidhood AL.

To study the B cell linear epitopes of rabies virus CVS-11 nucleoprotein, peptides were synthesized according to the amino acid sequences of B cell linear epitopes. Linear epitopes predicted by bioinformatics analysis were evaluated with immunological techniques. Indirect enzyme-linked immunosorbent assay showed that titers of antibodies to peptides (355-369 and 385-400 residues of rabies virus CVS-11 nucleoprotein) were above 1:12 800 in mouse sera. The antibodies recognized denatured rabies virus CVS-11 nucleoprotein in Western blot analysis. Purified anti-peptide antibodies recognized natural rabies virus CVS-11 nucleoprotein in BHK-21 cells in indirect fluorescent antibody test. The 355-369 and 385-400 residues of rabies virus CVS-11 nucleoprotein were validated as B cell linear epitopes.
Amino Acid Sequence ; Animals ; Antibodies, Viral ; immunology ; Epitope Mapping ; Epitopes, B-Lymphocyte ; chemistry ; genetics ; immunology ; Female ; Humans ; Male ; Mice ; Mice, Inbred BALB C ; Molecular Sequence Data ; Nucleoproteins ; chemistry ; genetics ; immunology ; Rabies ; immunology ; virology ; Rabies virus ; chemistry ; genetics ; immunology

Objective To discuss the method of interventional intravascular treatment in traumatic carotid cavernous fistula(TCCF)and the significance of clinical application in emergency.Methods In 297 cases of TCCF,36 cases were treated by interventional intravaseular embolization by detachable balloon, embolization orificium or occlusion in one side of carotid artery.In the 36 cases,serious epistaxis occurred in 22 cases,cortical vein inflow in 9 cases,intracranial hemorrhage in 3 cases,aggravation of eyesight in 3 cases,and limb dysfunction in 2 cases.Results Fistula was successfully embolized and internal carotid artery remained patent in 19 cases.Complete embolization of orificium or internal carotid artery was achieved in 17 cases.The serious epistaxias in 22 cases and intracranial hemorrhage in 3 cases stopped.Eyesight recovered in 2 cases and improved in 1 case.Limb dysfunction improved evidently in 2 cases. Conclusion Intravascular embolization treatment is the first therapeutic choice for TCCF,especially in emergency.It is necessary,safe and effective.

Objective To determine the methods and results of treating traumatic pseudoaneurysms in siphon segment of internal carotid artery(ICA)by interventional therapy.Methods Twelve cases of traumatic pseudoaneurysms in siphon segment of internal carotid artery were treated.The collateral circulation of Willis circle was observed after DSA.Different methods of treatment were applied according to the collateral circulation of Willis circle.Ten cases were treated by occlusion of ICA completely,1 case was embolized by guglielmi detachable coil(GDC)only.Results Nine of 12 treated by occlusion of ICA were cured.In the 3 cases who had poor collateral of Willis circle,one was cured by GDC embolization alone;one died 48 hours later after ICA occlusion though his consciousness and the activity of extremities were normal during the temporary balloon test occlusion(BTO)of ICA.One died during the training to improve the collateral of the Willis circle.Conclusion ICA embolization is feasible for treatment of traumatic pseudoaneurysms in siphon segment of internal carotid artery after evaluating the collateral circulation of Willis circle.

Objective To establish a rapid fluorescent inhibition test (RFFIT) for testing rabies virus neutralizing antibody and the titer of rabies virus neutralizing antibody.CVS-11 was used as the standard challenge virus,and three generations prepared for the establishment of the virus library.Methods International standard for rabies immunoglobulin was used as the reference serum.RFFIT test was established under consulting the protocol of Institute of Pasteur,and its specificity,stability and reproducibility were validated.Results We established the RFFIT which showed both good specificity ( 100% ) and reproducibility (P＞0.5).Conclusion The establishment of RFFIT test perfected the rabies laboratory techniques and would enhance the overall ability in detecting rabies in China.

Objective To detect the relationship between apical rotation and apical myocardial structure.Methods To observe the change of apical rotation,14 mongrel dogs were heated at apexes,and half and three quarter of apical wall thicknesses were destroyed according to their corresponding heating time.Ultrasonic tissue Doppler imaging was used to record the velocities of apical rotation.Computer programming was applied to calculate apical rotation according to the formulas of apical rotation calculation.Apical rotations were compared between before apical heating,half and three quarter of apical wall thicknesses destruction,respectively.Results Compared with the apical rotation before heating,apical rotation after half of apical wall destroyed decreased [(5.2±3.1)°vs (12.4±2.9)°,P＜0.001];but after three quarter of apical wall destroyed,the apical rotation increased [(7.3±3.6)°vs (5.2±3.1)°P＜0.01].Conclusions Outer part of apical myocardium was outer layer myocardium of which the damage leads to the decrease of apical rotation;inner part of apical myocardium was inner layer myocardium of which the damage leads to the increase of apical rotation to some extent.