Objective Probe into different method safe and effective fixation method,clinical result and cliniical to indications of different treatments in intertrochanter fracture of femur in the old elderly.Methods Adopting the femur near end dissecting type to lock the stencil plate fixation 14 of 58 cases of old intertrochanter fracture of femur separately.the hip screw of motive force(DHS) fixation was used in 24,femur near end stencil plate fixation in 20,and the blood loss,operation time,ossicle split off situation and fracture heal time were compared among the three groups.Sanders grade results and complications were followed up.Results Postoperative follow up Was done in all patients,from 8 months to 3 years,averaged 1.5 years.three groups of skill type fine rate of the three groups being 92.9%,92%,90%respectively.Conclusions Different methods showed good clinical results in treating the old intertrochanter fracture of femur,each having its indications.Operation should be done should follow based on fracture type,age,physique factors and patient's osteoporosis intensity,choosing the best healing solution by characteristics of intermal flxation while each combining.The hook board(ALHP)is suitable for old patients with serious osteoporosis,DHS for Evans Ⅰ,Ⅱ types and some Evans Ⅲ type,and femur near end dissecting type stencil plate for Ⅳ and Ⅴ types fractures.

Objective To investigate the relationship between vitiligo and thyroid diseases .Methods Chemiluminescence was used to detect serum levels of free triiodothyronine (FT3) ,free thyroxine(FT4) ,thyrotropic stimulating hormone(TSH) ,anti‐thy‐roglobulin antibody(TG‐Ab) and anti‐thyroperoxidase antibody(TPO‐Ab) in 289 vitiligo patients and 128 healthy subjects .All re‐sults were statistically analyzed .Results The abnormal rates of FT3 ,TG‐Ab and TPO‐Ab in vitiligo patients were higher than healthy subjects (P<0 .05) ,which might be correlated with the age and gender of vilitigo patients .Conclusion Levels of thyroid function and autoantibody might be abnormal in vilitigo patients ,which could be more obvious in male and adolescent patients .It could be advantageous to screen thyroid function and antibody levels in patients with vitiligo .

Objective:To study the feasibility of the early diagnosis of chronic periodontitis using near-infrared diffuse correlation spectroscopy(DCS).Methods:30 subjects were inclded.The relative gingival blood flow(GBF) at the labial,mesial and distal healthy gingiva(the control) or the gingiva with periodontitis of maxillary anterior teeth was respectively measured by DCS before periodontal treatment,a week and a month after treatment.Results:The GBF of healthy gingiva group,gingivitis group and periodontitis group was 129.73 ± 10.70,95.51 ± 11.83 and 67.84 ± 13.05 respectively.Periodontal indexes were decreased and the relative GBF increased significantly 1 week and 1 month after treatment.Gingival index and sulcus bleeding index were respectively correlated to relative GBF(r =-0.902,r =-0.893).Conclusion:Near-infrared diffuse correlation spectroscopy can non-invasively detect the relative gingival blood flow in different stages of chronic periodontitis,it may be a method of early diagnosis of chronic periodontitis.

Objectives:To analyze the prevalence and risk factors of chronic nephropathy among hospitalized gout patients.Methods:537 hospitalized gout patients in Tianjin Medical University Chu Hsien-I Memorial Hospital were enrolled. According to the levels of glomerular filtration rate (eGFR>90 ml/min, 60-90 ml/min and <60 ml/min), patients were divided into normal group, mild chronic nephropathy group and moderate-severe chronic nephropathy group. The height, weight, waist, hip and blood pressure of the patients were measured. Blood samples from elbow vein were collected to measure biochemical indexes. The 24-hour urine was collected to measure creatinine and uric acid. Multivariate regression analysis was used to analyze the related factors that may affect eGFR.Results:The prevalence of chronic nephropathy among gout patients was 46.76%(251/537), which the prevalence of mild chronic nephropathy was 34.82%(187/537), and moderate severe chronic nephropathy was 11.92%(64/537). With the decline of eGFR, the older the patients, the longer the course of gout and hypertension, the more the number of joints involved, the higher the blood uric acid, urinary microalbumin, urinary protein, white blood cell count, uric acid excretion fraction (FeUA), and the lower the red blood cell count, hemoglobin and serum albumin. Pearson correlation analysis of eGFR showed that age, duration of gout and hypertension, number of involved joints, hemoglobin, serum albumin, serum uric acid, urinary microalbumin, and FeUA were correlated with eGFR ( r=-0.43, -0.238, -0.25, -0.128, 0.155, 0.138, -0.169, -0.29, -0.372, respectively, P<0.01). Multivariate regression analysis showed that age, the course of gout, serum uric acid, microalbuminuria and FeUA were independent risk factors for eGFR decline ( P<0.01). Conclusions:Eldly, long course of gout, poor control of serum uric acid and increased excretion of uric acid and microalbumin are risk factors of gout.

ObjectiveTo investigate the finasteride application during the off-cycle of intermittent androgen blockade (IAB) in patients with advanced prostate cancer treated with IAB.MethodsEighty-seven patients with advanced prostate cancer were divided into two groups: forty-nine patients received IAB (group A), and thirty-eight patients underwent IAB and finasteride during the off-cycle of IAB (group B). The time of treatment cycle and the time to disease progression were compared between the two groups. ResultsThe patients in group A completed 89 treatment cycles and the mean cycle length was (12.8±5.4) months [treatment time and non-treatment time were (6.6±3.5) months and (7.1±4.8) months, respectively]. The patients in group B completed 85 cycles and the mean cycle length was (15.3±5.9) months [treatment time and non-treatment time were (6.9±3.2) months and (9.2v±3.9) months, respectively]. There was a significant difference between group A and B in the mean cycle length and the non-treatment time (P=0.0428,P=0.03).The 3-year progression rate was ( 34.8±3.5 )% in group A and ( 28.4±2.7)% in groups B ( P=0.035). ConclusionsThe application of finasteride during the off-cycle of IAB in patients with advanced prostate cancer treated with intermittent androgen blockade (IAB) can delay progression of advanced prostate cancer.

The mesaconitine and its major metabolites in the rat urine were identified by liquid chromatography and electrospray ionization tandem mass spectrometry. The rat urine was collected for consecutive 24 hours from the rat following intragastric infusion of mesaconitine, subsequently which were enriched and purified using solid phase extraction. The metabolites of mesaconitine in the rat urine were analyzed by the liquid chromatography and electrospray ionization tandem mass spectrometry. It is shown that the parent drug mesaconitine and its metabolites were found in the rat urine, such as hypo-mesaconitine glucuronic acid conjugate, 10-hydroxy-mesaconitine, 1-O-demethyl mesaconitine, deoxy-mesaconitine and hypo-mesaconitine. Among the five of metabolites, the hypo-mesaconitine glucuronic acid conjugate (m/z 766) was first discovered as the aconitine in rats phase II metabolites, which revealed a new way of mesaconitine metabolism in rats.

Objective To investigate the quality of life in man after treatment of advanced prostate cancer by surgical castration. Methods A total of 69 patients with advanced prostate cancer treated by sur-gical castration completed the European organization for research and treatment of cancer quality of life questionnaire (QLQ-C30) and QLQ-prostate specific 25-item (PR25) module third at a 12-month interval.The assessment points were preoporative,6 months postoperative and 12 months postoperative. Results Although there were improvement on pain relief (P ＜ 0.01 ) and symptom of urinary (P ＜ 0.01 ) and global health (P ＜ 0.01 ), the physical functioning (P ＜ 0.05 ), role functioning (P ＜ 0.01 ), emotional functioning (P ＜ 0.01 ), cognitive functioning (P ＜ 0.05 ), social functioning (P ＜ 0.05 or ＜ 0.01 ) were found significantly reduced , and insomnia (P ＜ 0.05) and fatigue (P ＜ 0.01 ) aggravated, treatment related symptoms (P ＜0.01 )appeared predominantly, especially deprivation of sexual functioning. Conclusion The surgical cas-tration when treating advanced prostate cancer did appear to impair the physical and psychological of patients, especially the sexual functioning.

Objective To determine the optimal dose of oxycodone for patient-controlled intravenous analgesia (PCIA) after gastrointestinal surgery when combined with dexmedetomidine in elderly patients.Methods Sixty patients of both sexes,aged 65-80 yr,weighing 50-75 kg,of American Society of Anesthesiologists physical status Ⅱ or Ⅲ,undergoing elective open gastrointestinal surgery,were divided into 3 different doses of oxycodone groups (group O1,group O2 and group O3,n=20 each) using a random number table.At 15 min before the end of surgery,oxycodone 0.1 mg/kg was intravenously injected,and PCIA pump was connected simultaneously.In O1,O2 and O3 groups,the PCIA solution contained dexmedetomidine 2.0 μg/kg and oxycodone 0.3,0.5 and 0.7 mg/kg in 100 ml of 0.9％ normal saline,respectively.The PCIA pump was set up to deliver a 0.5 ml bolus dose with a 15-min lockout interval and background infusion at 2 ml/h.Oxycodone 0.05 mg/kg was intravenously injected as a rescue analgesic after surgery,postoperative pain was assessed using a verbal rating scale,and the verbal rating scale score was maintained ≤4.The number of successfully delivered doses and requirement for rescue analgesics were recorded within 48 h after surgery,and the rate of rescue analgesia was calculated.The occurrence of adverse reactions such as nausea,vomiting,dizziness,respiratory depression,somnolence,bradycardia,hypotension and over-sedation was recorded.Patients' satisfaction with analgesia at postoperative 72 h and the length of postoperative hospital stay were also recorded.Results Compared with group O1,the rate of rescue analgesia after surgery and the number of successfully delivered doses were significantly decreased,and the degree of patients' satisfaction with analgesia was increased in O2 and O3 groups,and the incidence of nausea and somnolence was significantly increased in group O3 (P＜0.05).Compared with group O2,no significant change was found in the rate of rescue analgesia after surgery or the number of successfully delivered doses (P＞0.05),and the incidence of nausea and somnolence was increased in group O3 (P＜0.05).Conclusion When combined with dexmedetomidine 2.0 μg/kg,the optimal dose of oxycodone for PCIA is 0.5 mg/kg after gastrointestinal surgery in elderly patients.

Objective To evaluate the application value of combined detection of PCA3 and PSA mRNA in peripheral blood of patients with prostate cancer(PCa) for evaluation of mien)metastasis. Methods PCA3 and PSA mRNA were detected by duplex real time quantitative RT-PCR in a total of 49 PCa and 71 benign protatic hyperplasia (BPH) patients' peripheral blood. The diagnostic value was analyzed by receiver operative characteristic(ROC) curve. Results The levels of PCA3 mRNA in PCa patients were significantly higher than those in BPH patients [2 362( <30-7 421 ) copies/ml vs <30 copies/M, Z = -6. 66, P < 0. 01 ], and the same to PSA mRNA [3 425 ( 908-36 639 ) copies/ml vs < 200 copies/ml, Z = - 6. 40, P<0. 01 ]. The positive rate of PCA3 and PSA mRNA in peripheral blood was positively correlated with clinical stage[clinical stage B: 30.0% (3/10), C: 60.0% (9/15) and 86.7% (13/15), D: 91.7% (22/24) and 91.7% (22/24) ,Chi-square = 13. 534 and 16. 541, P <0. 01, respectively]. Meanwhile, the positive rate of PCA3 mRNA and PSA mRNA was also increased with the increase of Gleason score[ Gleason score of 2 to 4 : 20.0% (1/5) and 40. 0% (2/5) ;5 to 7 : 66.7% (12/18) and 72. 2% ( 13/18 ) ;8 to 10 : 84. 6% (22/26) and 92.3% ( 24/26 ) ;Chi-square = 8. 895 and 8. 015, P < 0. 05, respectively ]. ROC analysis showed that the sensitivities for PCA3 and PSA mRNA were 69. 4% (34/49) and 81.7% (40/49) and the specificities was 90. 1% (64/71) and 77.5% (55/71), respectively, when the cut-off value was 846 copies/ml for PCA3 mRNA and 280 copies/ml for PSA mRNA. Meanwhile, the sensitivity can reach to 85.7% (42/49) when the detection of PCA3 and PSA mRNA were combined. However, the specificity was decreased to 76. 1% (54/71). For the diagnosis of PCa micrometastasis, the sensitivity and specificity for PCA3 mRNA was 90.9% (20/22) and 84.7% (11/13), respectively. Conclusions PCA3 and PSA mRNA in peripheral blood are useful markers for PCa diagnosis. Simultaneous detection for PCA3 and PSA mRNA is more helpful for PCa diagnosis. Meanwhile, detection of PCA3 mRNA is a useful marker for diagnosing PCa micrometastasis.

Objective To explore hypermethylation of RARβ2, GSTP1 and DAPK gene in prostate cancer tissues, and to explore its correlation with clinicopathological features of prostate cancer and its diagnostic value. Methods Hypermethylation of RARe2, GSTP1 and DAPK gene was detected by nested methylation-specific PCR (NMSP) in 57 prostate cancer (PCa) tissues and 35 benign prostate hyperplasia (BPH) tissues. The correlation between hypermethylation and clinicopathological features of prostate cancer and its diagnostic value were analyzed. Results The hypermethylation frequencies of RARβ2, GSTP1 and DAPK gene in PCa were significantly higher than those in BPH (RARβ2: 52.6% vs. 0% GSTP1: 61.4% vs. 2.9%;DAPK: 43.9% vs. 8.6%;all P<0.01). The methylation rate of RARβ2 gene was directly correlated with distinct Gleason scores and clinical stage (4～7 score vs. 8～10 score: 34.8% vs. 64.7%;stage B, C vs. stage D: 37.0% vs. 66.7%;x2=4.927 and 5.004, P=0.026 and 0.025). The methylation rate of GSTP1 gene was significantly different in patients with different Gleason scores (4～7 score vs. 8～10 score: 43.5% vs. 73.5%;x2 =11.530, P=0.001), but had no difference in patients with distinct clinical stage (stage B, C vs. stage D: 51.9% vs. 70.0%;x2=1.975, P=0.16) . There was no difference in DAPK gene methylation rate among patients with different Gleason scores and distinct clinical stage (4 ～7 score vs. 8～10 score: 39.1% vs. 50.0%;stage B, C vs. stage D: 33.3% vs. 53.3%;x2= 1.290 and 2.309, both P～0.05). GSTP1 gene showed the highest sensitivity of 61.4% (35/57)with specificity of 97.1%(34/35), while RARβ2 gene had the highest specificity of 100% (35/35) with the sensitivity of 52.6% (30/57). The sensitivity and specificity of DAPK gene were 43.9% and 91.4% (25/57 and 32/35), respeetively. When the hypermethylation of RARβ2, GSTP1 and DAPK gene were detected together, the diagnostic sensitivity was increased, but the specificity was decreased. Conclusions The aberrant methylation of RARβ2, GSTP1 and DAPK gene is correlated with tumorigenesis and progression of prostate cancer, which may be used as an effective diagnostic marker for prostate cancer.