Objective To asses the effects of Gamma nail and DHS/Richard (dynamic hip screw) in the treatment of proximal femoral fractures. Methods A meta analysis of all the relevant randomized controlled trials (RCTs) was performed. We included randomized and quasi randomized controlled trials in patients with proximal femoral fracture to compare Gamma nail and DHS/Richard. Results First we identified 88 papers on comparison of Gamma nail and DHS/Richard in the treatment of proximal femoral fractures published from 1969 to 2003. 7 trials involving 1256 patients were identified as meeting all the eligibility criteria. 3 investigators independently graded study quality and abstracted relevant data, including information on mortality rates, wound infection, function, revision in patients with a proximal femoral fracture. 4 trials, which included a total of 621 patients, provided detailed information on mortality rates over the first 6 postoperative months. We found there was no significant difference in the relative risk of death in the first 6 months postoperative between treatments of Gamma nail and those of compression hip screw (relative risk 1.17;P=0.51). 6 trials that included a total of 1083 patients provided data on operative complications. The risk of operative complications from Gamma nail fixation appeared to be higher than that from compression screw and side plate fixation but not higher than that from compression hip screw (relative risk 1.41; P=0.02). We also found an obvious increase in the relative risk of fracture of femoral shaft between Gamma nail and compression hip screw (relative risk 6.99; P=0.00). Patients treated with Gamma nail had a higher rate of revision compared with those with compression hip screw, but there was no significant difference between the two groups (relative risk 1.85; P=0.20). In addition, wound infection, operative blood loss and functional recovery were similar between the tow groups(relative risk 0.98 for wound infection and 1.02 for function). Operating time for Gamma nail patients was significantly less than that for DHS/Richard ones (P

Air Pollution, Indoor ; statistics & numerical data ; Hong Kong ; Noise, Occupational ; statistics & numerical data ; Restaurants ; statistics & numerical data ; Temperature

Adult ; Fluoroscopy ; Foreign Bodies ; therapy ; Humans ; Male ; Trauma, Nervous System ; therapy ; Wounds, Penetrating ; therapy

Aged ; Aged, 80 and over ; Calculi ; chemistry ; diagnosis ; Genital Diseases, Male ; diagnosis ; Humans ; Male ; Scrotum

Objective To investigate the clinic characters and diagnosis of superficial siderosis in the central nervous system (SSCN).Methods One patient was systematically studied by the authors. Results SSCN was a rare entity,resulting in the deposition of ferric pigments and ions on the surface of the central nervous system.The clinical features included progressive sensorineural hearing loss,cerebellar ataxia and pyramidal sign,widespread hypointensity band at surfaces of the cerebral or cerebellar hemispheres,the brain stem and the spinal cord on Gradient Echo T_2~*-weighted images (GRE-T_2~* WI) of MR,elevation of the levels of ferritin in the cerebrospinal fluid.Conclusions This disease can be identified at early stage with history and physical examination.GRE-T_2~* WI and some related cerebrospinal fluid tests will contribute to diagnosis.

OBJECTIVETo review retrospectively the experience of surgical repair of sinus of valsalva aneurysm (SVA) in 70 patients.

METHODSBetween September, 1988 and October, 2003, Seventy patients with SVA underwent surgical repair by the aid of general anesthesia and cardiopulmonary bypass, comprised 1.4% (70/4960) of all open-heart operation. Forty-five were male and 25 female. Age ranged from 3 to 69 years old [mean (29 +/- 15) years]. The aneurysms ruptured into the right ventricle in 46 patients, right atrium in 23 and left ventricle in 1 respectively. The aneurysms originated from right and noncoronary sinus in 61 patients (87%) and 9 patients (13%) respectively. The most common associated cardiovascular lesions were ventricular septal defect (VSD, n = 34) and aortic valve incompetence (n = 21). Repairs were achieved through an incision in right atriotomy, right ventriculotomy or aortotomy only or both aortotomy and right atriotomy (or right ventriculotomy). The defects in the sinus of valsalva was repaired with either direct sutures (n = 43) or a patch (n = 27). The aortic valve was replaced in 6 patients.

RESULTSThere were no deaths in early time after repair. Postoperative hospital stay was 8 approximately 33 days [mean +/- standard deviation, (14.3 +/- 6.4) days] before 1997 and 6 approximately 15 days [mean +/- standard deviation, (9.1 +/- 2.6) days] after 1997 respectively. Complications included infection (n = 4), hemorrhage (n = 4), pneumothorax (n = 1), arrhythmia (n = 4) and residual shunt (n = 1) of VSD. Fifty-three (76%) patients (2 months approximately 13 years) were followed-up [mean +/- standard deviation, (6.6 +/- 3.8) years]. All patients survived except that one died of rupture of dissecting aortic aneurysm 7 years after operation.

CONCLUSIONSThe ruptured sinus of valsalva aneurysm and unruptured sinus of valsalva aneurysm with ventricle septal defect or(and) aortic valve regurgitation should be repaired surgically as soon as the diagnosis was confirmed. Long-term results are associated with preoperative aortic valve regurgitation.

Adolescent ; Adult ; Aged ; Aortic Aneurysm ; complications ; surgery ; Aortic Rupture ; surgery ; Aortic Valve Insufficiency ; complications ; surgery ; Child ; Child, Preschool ; Female ; Heart Septal Defects, Ventricular ; complications ; surgery ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Sinus of Valsalva ; surgery ; Treatment Outcome

BACKGROUNDMicroRNAs (miRNAs) control gene expression by destabilizing target transcripts and inhibiting their translation. Aberrant expression of miRNAs has been described in many human diseases, including schizophrenia. However, the effects on miRNA expression in response to antipsychotic treatment in peripheral circulation have not been thoroughly examined.

METHODSUsing quantitative real-time PCR (qRT-PCR), We quantified the expression of seven candidate miRNAs in plasma samples of 40 first-episode schizophrenics before and after antipsychotic treatment. The patients were all treated with risperidone and achieved remission in 1 year.

RESULTSCompared with the baseline, the expression levels of miR-365 and miR-520c-3p were significantly down-regulated after 1 year of risperidone treatment (P < 0.001). There were no significant correlations between the clinical symptoms and the expression levels of these two miRNAs (P > 0.05).

CONCLUSIONSThis study analyzed possible circulating miRNAs in response to antipsychotic monotherapy for schizophrenia, the further mechanism need to be confirmed.

Adult ; Antipsychotic Agents ; therapeutic use ; Female ; Humans ; Male ; MicroRNAs ; blood ; Risperidone ; therapeutic use ; Schizophrenia ; drug therapy ; genetics

OBJECTIVETo observe the expression of Runx2 in osteoblasts in response to centrifugation in vitro and discuss the function of bone morphogenetic protein (BMP) signal transduction pathway in this course.

METHODSCells were divided into four groups, group A, B, C and D, pretreated with DMEM containing 10% fetal bovine serum, 10% fetal bovine serum, 100 ng x mL(-1) Noggin and 100 ng x mL(-1) Noggin for 24 hours separately. 271 x g centrifugation was loaded for 5 min to these groups except group A and C, other conditions were the same. The total RNA of each group were extracted, and reversed transcription to cDNA after 30 min. The expression of Runx2 in response to centrifugation in vitro was analyzed by quantitative real time PCR.

RESULTSThe expression of Runx2 mRNA in group B was significantly higher than that in group A (P < 0.05). The expression of Runx2 mRNA in group D was significantly lower than that in group B (P < 0.05). There was no statistically significant difference among group A, C, D (P = 0.692).

CONCLUSIONBMP signal transduction pathway plays an important role in the response of osteoblasts to mechanical stimulations. It may also play a central role in the cascade information dissemination of osteoblasts.

Bone Morphogenetic Protein 2 ; Bone Morphogenetic Proteins ; Cell Differentiation ; Centrifugation ; Core Binding Factor Alpha 1 Subunit ; Gene Expression Regulation ; Humans ; In Vitro Techniques ; Osteoblasts ; RNA, Messenger ; Signal Transduction

OBJECTIVETo prospectively study clinical features and etiology in patients with incident Budd-Chiari syndrome (BCS) in China.

METHODSTaking consecutive case series of patients with incident BCS as who were diagnosed in our hospital, enrolled from September 2010 to January 2012 as the object of research, and the follow-up was lasting until June 2012. Taking records for all patients' symptoms, signs, laboratory findings, radiology findings, treatment, interventional treatment survival and symptom-free period.

RESULTSThere are total 149 incident cases of BCS. In which, the median age was 46 years old (range 10 to 82); 61.7% of them were male patients, 38.3% were female patients; 85.9% of them were chronic, the other patients (14.1%) were diagnosed during acute or subacute periods; the median duration of symptoms before diagnosis was 96 months (range 1 day to 360 months). In terms of causes, 30.9% of the patients caused by hepatic venous block, 5.4% of them resulted from inferior vena cava block, and the rest 63.8% were suffered from combined hepatic venous and inferior vena cava block. 80.5% patients have at least one etiological factor, Furthermore, the most common cause was the web (61.1%), only 4.8% have myeloproliferative diseases (JAK2 V617F mutation), and none Factor V Leiden mutation cases was found. 144 patients were treated by percutaneous transluminal angioplasty, the technical success rate was 95.1%, and took oral anticoagulation therapy for 12 months. At 18 months, The survival rate and the symptom-free survival rate after percutaneous transluminal angioplasty were 97.8% and respectively.

CONCLUSIONWeb is the most prevalent etiological factor for BCS in China. It is different in western countries; the common reasons of BCS are risk factors related to thrombosis, such as myeloproliferative disease and Factor V Leiden mutation, etc., which are seldom found in Chinese BCS patients. In China, most chronic BCS patients were treated with percutaneous transluminal angioplasty and have excellent clinical outcome.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Budd-Chiari Syndrome ; diagnosis ; etiology ; Child ; Female ; Humans ; Male ; Middle Aged ; Young Adult

OBJECTIVETo investigate the transvesical approach to the surgical treatment of seminal vesicle mass.

METHODSTransvesical removal of seminal vesicle mass was performed for 5 patients aged 45-69 (mean 51) years. The clinical symptoms included those involving the lower urinary tract such as frequent micturition and urgency in 3 cases (1 accompanied with dyschezia), hematospermia in 1, and lower abdominal and perineal malaise in the other. Two masses were in the left side and the other 3 in the right, ranging from 3 to 10 cm (mean 5 cm) in size, detected by transrectal ultrasonography, CT, MRI or digital rectal examination. The mean course of disease was 9 (2-18) months.

RESULTSAll the 5 patients were treated successfully and uneventfully, with a mean operation time of 75 minutes, a mean blood loss of 140 ml and a mean hospital stay of 10 days. Pathological examinations revealed 2 cases of seminal vesicle cyst with infection, 1 cystadenoma, 1 phyllode tumor and 1 prostatic hyperplasia. A 3-72 months follow-up showed that all the patients were free of symptoms and had normal sexual function.

CONCLUSIONTransvesical removal of seminal vesicle mass, with small incisal opening, good visual field and easy operation, is an effective surgical procedure for seminal vesicle disease.

Aged ; Follow-Up Studies ; Genital Diseases, Male ; surgery ; Humans ; Male ; Middle Aged ; Seminal Vesicles ; surgery ; Treatment Outcome ; Urinary Bladder ; surgery