OBJECTIVETo systematically review the effectiveness of bone substitute augmentation combined with internal fixation versus internal fixation alone in treating proximal femoral fractures in the elderly.

METHODSSubject term and keywords were searched from Pubmed, Cochrane databases and CNKI from database foundation to August 2015. Randomized controlled studies and qusi-randomized controlled studies on bone substitutes augmentation combined with internal fixation versus internal fixation alone for the treatment of proximal femoral fractures in the elderly were chosen. Postoperative re-displacement, re-operation rate, complications (infection and bone ununion), functional outcome, quality of life scores and muscle strength were seen as outcome indicators. Enumeration data were statistical analyzed by risk difference and 95% confidence interval. Measurement data were analyzed by standardized mean difference and 95% confidence interval. If the same measurement data were evaluated by different standards in different studies, standardized mean differences and 95% confidence interval were used. The methods of statistical analysis were used by Cochrane databases.

RESULTSEleven RCTs (677 patients) were included. Meta-analysis results indicated that bone substitutes augmentation combined with internal fixation occurred fewer re-displacement [SMD = -0.75, 95% CI (-1.03, -0.47)] and obtained better function [SMD = 0.40, 95% CI (0.20, 0.59)]. While there were no significant differences in reoperation rate [RD = 0.02, 95% CI (-0.05, -0.09)], pain at 1 week after operation [MD = -1.79, 95% CI (-13.55, -9.96)], pain ranged from 6 to 8 weeks [MD = -7.24, 95% CI (-20.07, -5.59)], postoperative pain at 12 weeks [MD = -0.32, 95% CI (-4.9, -3.55)], muscle strength [MD = 1.25, 95% CI (-6.98, -9.48)], bone ununion [RD = 0.02, 95% CI (-0.01, -0.05)] and postoperative complications [MD = 0.01, 95% CI (-0.03, -0.04)].

CONCLUSIONCompared with single internal fixation, bone substitutes augmentation combined with internal fixation for the treatment of proximal femoral fractures in the elderly less occur re-displacement and could obtain better functional recovery.

Aged ; Aged, 80 and over ; Bone Substitutes ; administration & dosage ; Female ; Femoral Fractures ; surgery ; therapy ; Fracture Fixation, Internal ; Humans ; Male ; Middle Aged ; Randomized Controlled Trials as Topic ; Treatment Outcome

Objective To investigate the influencing factors for knowledge,attitude and practice(KAP)of the Three-manager mode about hierarchical medical system of Chronic diseases of the community residents in Xiamen,and provide references for the implementation of hierarchical medical system.Methods Multi-stage random sampling method was adopted,and 400 residents were randomly sampled from 5 communities of Xiamen for questionnaire survey.The survey features the dependent variable of the community residents′ knowing and joining-in the Three-manager mode,the internal factors(social demographic characteristics),and the external factors(medical expenditure and healthcare insurance).On such basis,four logistic regression models were built for analysis of such influencing factors.Results 41.10% of the surveyed were aware of the Three-manager mode,and 39.71% of the hypertension/diabetes patients among them joined in the hypertension network or diabetes network.Age,education,medical expenditure and referral experiences were significant influencing factors for KAP level of the Three-manager mode,while the residents of older age,higher education and referral experiences were high in their KAP;those of lower per capita monthly income,hypertension or diabetes,with coverage of medical insurance and satisfied with medical consultation in community were high in their awareness of Three-manager mode.Conclusions The KAP level of Three-manager mode of the community residents in Xiamen is acceptable,yet expected of further improvement.Room of further improvement includes enhancement of synergy of the Three-manager mode,enhanced motivation of government financial support and medical insurance,better service functions of community institutions,and especially the construction of hierarchical medical system.

Background Normal ultrastructure is the anatomical basis of retinal pigment epithelial(RPE) cells to perform normal physiological function.At present the precipitation method is often used to detect the ultrastructure of RPE cells with transmission electron microscopy(TEM).Objective The aim of this study was to explore a simple and feasible approach to examine the ultrastructure of human embryonic stem cell-derived retinal pigment epithelial (hESC-RPE) cells.Methods hESCs were induced and differentiated into RPE cells by the spontaneous differentiation method,and the expressions of microphthalmia associated transcription factor MITF and paired-box gene 6 (PAX6),specific protein of RPE cells,in the cells were detected by immunofluorescence assay.hESC-RPE cells were inoculated into Transwell filter,and the ultrastructure of the cell sheet was examined under the TEM.Then the ultrastructure of the cell sheet specimens was compared with those of hESC-RPE cells from cell precipitation and RPE cell specimens of 90-day-old Long Evans rats.Results MITF and PAX6 were positively expressed in hESC-RPE cells.The normal ultrastructure were visible in the RPE cells of rats under the TEM,including apical microvilli,polarized melanin granules,cellular nucleus,basement membrane and intercellular junctions,and the ultrastructure of hESC-RPE cell sheet on Transwell was similar to the RPE cells in rats.However,only scatter melanin granules,nonpolar nucleus and scanty microvilli were observed under the TEM in the hESC-RPE cells by cell precipitation method.Conclusions Without digestion process,hESC-RPE cell sheet on Transwell can retain the normal ultrastructure of hESC-RPE cells under the TEM,with a more simple and reliable advantage.

This study is to investigate the anti-tumor effect in vitro of methotrexate modified by LH-RH peptide (LH-RH-MTX). LH-RH receptors highly expressing MCF-7 human breast carcinoma cell line and lowly expressing K562 human erythroleukemia cell line were served as the tested cells. The cell proliferation inhibition rates of LH-RH-MTX were detected by MTT colorimetric assay. The effects of LH-RH-MTX on the cell cycle and apoptosis rates were detected by flow cytometry. The inhibition rate of LH-RH-MTX on MCF-7 cells was much higher than that on K562 cells, and the inhibition rate of LH-RH-MTX on MCF-7 cells was much higher than that of free MTX at the same concentration. The inhibition rate of LH-RH-MTX on rat bone marrow mononuclear cells was less than that of free MTX. The number of MCF-7 cells in S phase increased after administration of LH-RH-MTX. The apoptosis rate of LH-RH-MTX group significantly increased compared with that of the control group and MTX group. The relative expression of LHRHR mRNA of LH-RH-MTX group markedly decreased compared with that of the control group and MTX group. LH-RH-MTX is realizable to reduce drug side effects, increase the therapeutic index and achieve tumor-targeted therapy.
Animals ; Antimetabolites, Antineoplastic ; chemical synthesis ; pharmacology ; Apoptosis ; drug effects ; Bone Marrow Cells ; cytology ; Cell Cycle ; drug effects ; Cell Proliferation ; drug effects ; Cells, Cultured ; Drug Delivery Systems ; Gonadotropin-Releasing Hormone ; chemistry ; pharmacology ; Humans ; K562 Cells ; Leukocytes, Mononuclear ; MCF-7 Cells ; Methotrexate ; chemical synthesis ; pharmacology ; RNA, Messenger ; metabolism ; Rats ; Receptors, LHRH ; biosynthesis ; genetics

The rhizome of Panax japonicus var. major have been used as the natural medicinal agent by Chinese traditional doctors for more than thousand years. Most of the therapeutic effects of P. japonicus var. major had been reported due to the presence of tetracyclic or pentacyclic triterpene saponins. In this study, Illumina pair-end RNA-sequencing and de novo splicing were done in order to understand the pathway of triterpenoid saponins in this species. The valid reads data of 15. 6 Gb were obtained. The 62 240 unigenes were finally obtained by de novo splicing. After annotation, we discovered 19 unigenes involved in ginsenoside backbone biosynthesis. Additionally, 69 unigenes and 18 unigenes were predicted to have potential function of cytochrome P450 and UDP-glycosyltransferase based on the annotation results, which may encode enzymes responsible for ginsenoside backbone modification. This study provides global expressed datas for P. japonicus var. major, which will contribute significantly to further genome-wide research and analysis for this species.
Gene Expression Profiling ; Panax ; genetics ; Saponins ; biosynthesis ; Sequence Analysis, RNA

Acute Disease ; Adult ; Altitude Sickness ; blood ; enzymology ; Glutathione ; blood ; Glutathione Peroxidase ; blood ; Humans ; Lipid Peroxidation ; Male ; Military Personnel ; Nitric Oxide ; blood ; Nitric Oxide Synthase ; blood ; Oxidoreductases ; metabolism ; Superoxide Dismutase ; blood

The purpose of this paper is to clarify the structure-activity relationship of anti-tumor activity of diosgenin derivatives in vitro. Study has found that diosgenin can inhibit the reproduction of tumor cells by inducing apoptosis and the main target spot of this effect is Bcl-2. Based on the characteristics of pharmacophoric points' of the three-dimensional pharmacophore for Bcl-2 inhibitors, we have docked lots of diosgenin derivatives with Bcl-2, then synthesized 31 compounds of them, finally assessed the anti-tumor activity of the diosgenin derivatives in vitro against A375, A549, HepG-2 and K562. Preliminary studies of SAR have indicated that the aliphatic esters, and aromatic esters of diosgenin without F ring have no anti-tumor activity in vitro. The triazole bromides of diosgenin all achieve fairly good anti-tumor activity in vitro, and those with larger hydrophobic group have the better activity. The stronger is the hydrogen bonding interaction and dipole-dipole interaction of the heterocyclic of diosgenin and diosgenin without F ring and the acid ester of diosgenin without F ring, the better is the activity of derivatives.
Antineoplastic Agents, Phytogenic ; chemical synthesis ; chemistry ; pharmacology ; Apoptosis ; drug effects ; Cell Line, Tumor ; Diosgenin ; analogs & derivatives ; chemical synthesis ; chemistry ; pharmacology ; Humans ; Proto-Oncogene Proteins c-bcl-2 ; antagonists & inhibitors ; Structure-Activity Relationship

As a novel form of programmed cell death different from cell necrosis, apoptosis, and autophagy discovered in recent years, pyroptosis is characterized by cell membrane rupture and release of cell contents and proinflammatory factors mediated by gasdermin, thus leading to cell death. Pyroptosis signaling pathways can be classified into classical pathways dependent on caspase-1 and non-classical pathways dependent on caspase-4/5/11; the activation of caspase-1 in classical pathways depends on the function of inflammasome, while the direct activation of caspase-4/5/11 is observed in non-classical pathways, which leads to the lysis of gasdermin D and induce the formation of membrane pores, the maturation and release of interleukin-1β and interleukin-18, and the rupture of cell membrane to cause pyroptosis. Latest research has shown that pyroptosis plays an important role in the development and progression of chronic liver diseases. This article introduces the mechanism of pyroptosis and summarizes the role of pyroptosis in the development and progression of nonalcoholic fatty liver disease, alcoholic liver disease, viral hepatitis, liver cirrhosis, and hepatocellular carcinoma, in order to provide new ideas and methods for the prevention and treatment of liver diseases in clinical practice.

OBJECTIVETo assess the current status on re-evaluation of marketed drug in China since the promulgation of drug law in 1985.

METHODSReview of literature on Chinese pharmaceutical abstract and CBMdisc from 1985 to 2001 year was done.

RESULTS4029 papers and 855 marketed drugs from 1985 to 2001 were included. Drugs on anti-infection agent, cardiovascular system and digestive system were the main drugs being re-evaluated, with the proportions of 27.1%, 20.1% and 11.1% respectively. The amounts of both marketed drugs and literature were increasing year by year. The method used for re-evaluation were random and non-random clinical trial. 41.4% of all the samples had a sample size of 50 - 100 research subjects. There were 13 papers with more than 5000 samples. The level on evidence based literature was assessed. 44 papers were graded as first class, and 182 papers the second, 2466 papers the third and 1337 papers the fourth. The quality of literature was improved year by year.

CONCLUSIONThe amount, quality as well as the sample size of literature being re-evaluated on marketed drug were increased from 1985 to 2001. However, the design and evaluation of those trials were not standardized.

Anti-Infective Agents ; therapeutic use ; Biological Products ; therapeutic use ; Cardiovascular Agents ; therapeutic use ; China ; Clinical Trials as Topic ; Cost-Benefit Analysis ; Evidence-Based Medicine ; Humans ; Product Surveillance, Postmarketing

BACKGROUNDAccording to the National Institutes of Health consensus criteria, gastrointestinal stromal tumors (GISTs) smaller than 2 cm in diameter with less than 5 mitotic figures per 50 high-power fields are considered very-low-risk GISTs, but these two indices alone cannot reliably predict a benign outcome during long-term follow-ups. Therefore, identification of additional parameters for predicting the clinical behavior of GISTs is necessary.

METHODSEighty-eight patients with tumors that meet the very-low-risk GIST criteria were retrospectively investigated and morphological parameters of tumors associated with the biological behavior of very-low-risk GISTs were evaluated in the present study. The Kaplan-Meier method was used to calculate disease-free survival rates.

RESULTSEighty-one patients were followed up for one to 16.3 years. Five cases of relapses were identified in the patients. Distinctive infiltrative growth patterns such as muscularis propria, muscularis mucosa, or nerve infiltration were identified by microscopy in 4 patients with the relapse, including three patients who experienced multiple recurrences. The infiltrative growth features became more obvious in multiple recurrent tumors compared to the single recurrent tumor, while only one developed relapse in 76 patients without infiltration (P < 0.0001).

CONCLUSIONMicroscopic infiltrative growth patterns of the tumor may have clinical significance in predicting the prognosis of very-low-risk GISTs.

Adult ; Aged ; Aged, 80 and over ; Disease-Free Survival ; Female ; Gastrointestinal Stromal Tumors ; pathology ; Humans ; Male ; Middle Aged ; Prognosis ; Retrospective Studies