Objective To investigate the therapy of DHS,PFNA and Intertan nail for the treatment in elderly patients with intertrochanteric femoral fractures.Methods One hundred and one elderly patients with intertrochanteric fractures were collected.Thirty-four cases of them were undertaken DHS (DHS group),33 cases for PFNA (PFNA group),and 34 cases for Intertan nail (INTERTAN group).Operative time,blood loss and complications were observed.Results The Operative time of patients in DHS,PFNA and Intertan groups were (85.1 ± 8.9) min,(63.1 ± 8.2) min,(57.9 ± 9.2) min respectively and the difference was significant (F=12.761,P＜0.001).The blood loss amount in DHS group were (350.1 ±80.2)ml,lower that those in PFNA and Intertan groups ((137.5 ± 35.4) ml and (125.2 ± 38.2) ml,F =20.462,P ＜ 0.001).Meanwhile,the postoperative drainage in DHS group was (125.3 ± 20.4) ml,significantly higher than PFNA group and INTERTAN group ((69.4 ± 9.2) ml and (74.6 ± 10.4) ml; F =15.871,P ＜0.001).Operative time,blood loss amount in INTERTAN group were less than that in PFNA group,but no significant difference (P ＞0.05).Nonunion in DHS group was significantly higher than the other two groups (8.82％ vs 0％ and 0％,x2 =6.092,P =0.047).Excellent rate in DHS group,PFNA group and Intertan group were 82.3％ (28/ 34),87.8％ (29/33),85.3％ (29/34) respectively,and there was no significant difference (x2 =0.591,P ＞ 0.05).Conclusion Compared with DHS,Intertan nail and PFNA have advantage of shorter operative time,stronger anti-rotation capability and less various postoperative complication rates,thus they are more suitable for elderly osteoporotic intertrochanteric fracture.

[ ABSTRACT] AIM:To study the effects of soybean isoflavones on mitochondrial ultrastructure, neuronal apopto-sis and expression of cytochrome C, caspase-9 and caspase-3 in the rats with cerebral ischemia/reperfusion.METHODS:Adult healthy SD rats ( n=60 ) were randomly divided into 3 groups: sham group, ischemia/reperfusion injury ( I/R ) group and soybean isoflavone ( SI) pretreatment group.Soybean isoflavones (120 mg· kg-1 · d-1 ) were fed by gastric lav-age for 21 d.The global ischemia/reperfusion model of the rats was established by blocking 3 vessels, and then reperfused for 1 h after 1 h of ischemia.The morphological change of the cerebral cortex cells was observed under light microscope. The mitochondrial ultrastructure of the cerebral cortex cells was determined by transmission electron microscope.The apop-totic rate of the cerebral cortex cells was detected by flow cytometry.The expression of cytochrome C, caspase-9 and caspase-3 in the cerebral cortex cells was determined by semi-quantitative RT-PCR and immunohistochemical techniques. RESULTS:Disintegration of mitochondria membrane and disappearance of the mitochondrial cristae were seen in I/R group.Compared with I/R group, the change of ultrastructure of mitochondria was significantly improved by soybean isofla-vone pretreatment, and the neuronal apoptotic rate was also significantly decreased (P<0.01).The mRNA expression and protein content of cytochrome C, caspase-9 and caspase-3 in I/R group were obviously higher than those in sham group ( P<0.01).Compared with I/R group, the mRNA expression and protein content of cytochrome C, caspase-9 and caspase-3 in SI group were significantly decreased (P<0.01).CONCLUSION: Soybean isoflavones attenuate cerebral ischemia/reperfusion injury by stabilizing the structure of mitochondria, preventing cytochrome C release to the cytoplasm, inhibiting the activation of caspase-9 and caspase-3 and decreasing cell apoptosis.

BACKGROUND: After acute spinal cord injury (SCI), edema of spinal cord is an important factor for inducing and deteriorating pathological changes of spinal cord tissue. After injury, noradrenaline (NE) instantly causes microvascular contraction, endothelial injury, increase of arterial permeability and participation in edema. Recently, many researches suggest that excitatory amino acids (EAA) are related to cellular edema.OBJECTIVE: To study the effect and mechanism of selective phenol aminergic neuron, 6-hydroxy dopamine (6-OHNA)and aspartic acid (ASP) on edema after acute SCI.DESIGN: Randomized controlled study.SETTING: Department of Spine Surgery, the Third Hospital of Hebei Medical University.MATERIALS: The experiment was carried out at the Experimental Animal Center of the Third Hospital of Hebei Medical University from March to September 2003. A total of 160 Wistar rats weighing 300-350 g of both genders were randomly divided into three groups: 6-OHNA group (n =60), MK-801 group (n =50) and control group (n =50).METHODS: Acute SCI was induced at the level of T13 vertebral body with the static lcad technique. Rats in 6-OHNA group were injected with 6-OHNA into subarachnoid space; rats in MK-801 group were injected with MK-801 into caudal vein; rats in control group did not receive any treatment. The extent of edema was compared in the three groups by means of neurological scoring, water content measurement, light microscopy and electron microscopy.MAIN OUTCOME MEASURES: Neurological scores and water content.RESULTS: All 160 rats were involved in the final analysis. ① After SCl, content of NE in 6-OHNA group was decreased from (217.45±4.26) ng/g to (29.37±2.61) ng/g, and the difference was significant (P＜ 0.01). Edema in spinal cord tissue was effectively inhibited for 24 hours. At 12 hours after SCl, function recovered remarkably and vascular-derived edema was the mildest. ② In MK-801 group, there was no significant suppression of the edema until 24 hours after injury. Early recovery of neurological function was not significantly different from that in control group (P ＞ 0.05), but functional recovery was obvious until 24 hours after injury (P＜0.05). The degree of cytotoxic edema was the lightest.CONCLUSTON: NE can inhibit vascular-derived edema at early phase of SCI, and EAA can inhibit cytotoxic edemas,which develops at a relatively later stage.

Objective:To study the effect of interleukin-18 on transdifferentiation in renal tubular epithelial cells(TECs).Methods:Human proximal tubular epithelial cell line(HK-2) was cultured in vitro.TECs were exposed to different concentrations(0,0.1,1,10 and 100 ng/ml) of IL-18 for 24,48 and 72 hours.At the end of each incubation,the expressions of the ?-SMA and TGF-?_1 mRNA were assessed by RT-PCR,the rate of ?-SMA expressing TECs was assessed by immunocytochemistry,and the expression of the ?-SMA protein was assessed by Western blotting.Results:(1)The expressions of ?-SMA and TGF-?_1 mRNA were increased significantly by a dose- and time-dependent manner when TECs were exposed to IL-18(P

Objective To investigate the clinical efficacy of a novel path of lymph node dissection combined with peripheral vascular occlusion for the treatment of gastric cancer in stage ⅢC.Methods The clinical data of 142 patients with gastric cancer in stage Ⅲ C who were admitted to the 175th Hospital of PLA from January 2006 to December 2009 were retrospectively analyzed.Seventy patients received novel path of lymph node dissection combined with peripheral vascular occlusion (combined group) and 72 patients received simple lymph node dissection via the novel path (simple group).The positive rate of mRNA expression of carcinoembryonic antigen (CEA) and the distal metastatic rate of tumor cells between the 2 groups were compared.Patients were followed up via outpatient examination,phone call and in-patient examination till January 2013.The measurement data and the enumeration data were analyzed using the t test and the chi-square test,respectively.Results The operation time,volume of blood loss and number of lymph nodes dissected were (184 ± 26) minutes,(282 ± 80) mL and 28 ± 5 in the combined group,(180 ± 28)minutes,(355 ± 85)mL and 27 ± 5 in the simple group,with no significant difference between the 2 groups (t =0.882,5.267,0.496,P ＞ 0.05).The positive rates of mRNA expression of CEA of the combined group and the simple group were 10.0％ (7/70) and 9.7％ (7/72),with no significant difference between the 2 groups (x2 =0.003,P ＞ 0.05).The positive rates of mRNA expression of CEA after lymph node dissection of the combined group and the simple group were 2.9％ (2/70) and 16.7％ (12/72),with significant difference between the 2 groups (x2 =8.240,P ＜ 0.05).The positive rates of mRNA expression of CEA after total gastrectomy of the combined group and the simple group were 4.3％ (3/70) and 4.2％ (3/72),with no significant difference between the 2 groups (x2=0.001,P ＞ 0.05).All patients were followed up at postoperative year 1,and 139 patients were followed up at postoperative year 3.The median time of follow-up was 33.5 month (range,12.0-42.0 month).The 1-year distal metastatic rate of the combined group and the simple group were 7.1％ (5/70) and 8.3％ (6/72),with no significant difference between the 2 groups (x2=0.070,P ＞0.05).The 3-year distal metastatic rate of the combined group and the simple group were 33.3％ (23/69) and 51.4％ (36/70),with significant difference between the 2 groups (x2=4.660,P ＜0.05).The distal metastatic rates of distal parenchymatous organs of the combined group and the simple group were 10.1％ (7/69) and 44.3％ (31/70),with significant difference between the 2 groups (x2=20.390,P ＜ 0.05).Conclusions Novel path of lymph node dissection combined with peripheral vascular occlusion can block the lymph node and blood backflow,and thus effectively reduces the distal metastatic rate of gastric cancer in stage ⅢC after operation.

Objective To profile the intraspecific type of Trichophyton mentagrophytes clinically isolated from different anatomical sites of patients, and to compare the performance of different target sites for the identification of Trichophyton mentagrophytes complex strains. Methods A total of 48 Trichophyton mentagrophytes strains, which were clinically isolated from Department of Dermatology, Wuhan No. 1 Hospital in the latest 3 years, were included in this study. The phenotypes of these Trichophyton mentagrophytes isolates were primarily determined by morphological observation and the urease test. PCR was performed to amplify the nuclear ribosomal internal transcribed spacer(ITS) region and the D1?D2 domains of the large?subunit ribosomal DNA(28S rDNA)followed by DNA sequencing. Then, Clustal X2 software and MEGA 6.0 software were used to analyze the ITS and D1?D2 sequences and to build phylogenetic trees by the maximum?likelihood method (bootstrap = 2000). Results As the ITS sequence?based phylogenetic tree showed, the probability that the 48 isolates were grouped into the Trichophyton interdigitale clade reached 92%. However, Trichophyton interdigitale could not be effectively differentiated from Trichophyton quinckeanum by the D1?D2 sequence?based phylogenetic tree. In addition, Trichophyton interdigitale showed various appearances, including woolen type, downy type, cream type, powdery type and granular type. Conclusions Trichophyton mentagrophytes can be identified to the species level based on the sequence of ITS region, which shows higher efficiency in identifying Trichophyton mentagrophytes complex than the D1?D2 domains. Morphological characteristics can not serve as the basis for intraspecific typing of Trichophyton mentagrophytes.

HLA-G belongs to non-classical HLA-class Ⅰ genes.It is expressed in the fetal-maternal interface on the extravillous cytotrophoblast and in such immune privilege tissues as the cornea and pancreas.However, under pathological conditions, such as tumor, inflammatory diseases and post transplantation, HLA-G is expressed abnormally.HLA-G can interact with its acceptors or immune cells and suppress the function of immune cells, which facilitates the escape of the surveillance of the human immune system and the consequent damage.In clinical studies,HLA-G is related to some clinical parameters.This review will focus on the expression, function and regulatory mechanisms of HLA-G in cancer immunology.

Objective To study the sonographic features of papillary thyroid carcinoma (PTC) associated with cervical lymph nodes metastasis for early diagnosis and prediction of the invaded cervical lymph nodes. Methods The sonographic features of 170 patients with pathologically confirmed PTC in First Afifliated Hospital of Harbin Medical University between 2011 and 2013 were retrospectively reviewed. There were 59 cases with neck lymph nodes metastases and 111 cases without neck lymph nodes metastases. Receiver operating characteristic (ROC) curve was aaplied to analyze the cut-off values of resistance index (RI) and peak systolic velocity (PSV) for judging the presence or absence of cercical lymph node metastasis. The Chi-square test and rank sum test were used to compare the different sonographic features between each group. The Logistic regression analysis was used to obtain the relevant factors of PTCs with cervical lymph node metastasis. Results ROC curve analysis showed that the cut-off values of RI and PSV were 0.735,13.95 cm/s. The primary tumor diameter, the existence of halo, the involvement of thyroid upper pole, the microcalciifcation, the blood suply classiifcation and the RI, PSV were statistically signiifcantly different between PTCs with and without cervical lymph node metastasis, whereas no statistical signiifcance was detected between the primary tumor echo pattern, boundary and the longitudinal/transveral ratio between the metastatic and nonmetastatic group. Logistic regression analysis showed that the PTC primary tumor diameter and PSV were independent factors coorelated with cervical lymph node metastasis. Conclusion Some sonographic features of PTC are closely correlated with lymph nodes metastasis, which are valuable in predicting the cervical lymph nodes metastasis in patients with PTC pre-operatively.

ObjectiveTo investigate the changes of non-linear dynamics characteristics of EEG during picture memory masks, and the application of non-linear dynamic analysis for memory research.MethodsEEGs of 30 healthy old volunteers were recorded under the states of opened eyes and picture memory. Correlation dimension (D2) was calculated for all subjects.ResultsD2 increased significantly during memory tasks compared with the rest state with eyes opened (P<0.05). In different memory tasks, the complexity of mental functions and the regions involved in the memory task were different.ConclusionNon-linear analysis is appropriate for the study of functional changes and working mechanism of brain during memory.

To investigate the RNA interference (RNAi) effect induced by vector-derived small interfering RNA (siRNA) targeting the three gatekeeper genes (Rad52, Ku70, Ku80) and screen the more effective target sites from candidates for further research, by using siRNA design tools online, we selected 2 candidate sequences directed to every gatekeeper gene. According to the sequences, six vector-derived siRNAs (denoted psiRNA1-6) and one mocking psiRNA7 were constructed. Among them, psiRNA1 and psiRNA2 targeted Rad52, psiRNA3 and psiRNA4 to Ku70, psiRNA5 and psiRNA6 to Ku80. The mocking psiRNA7 was used as control. After sequence identification, the seven plasmids were transfected into HepG2 cell line. siRNA-induced silencing of gatekeeper genes was determined by using RT-PCR at RNA level and Western Blot at protein level. The results showed that the six plasmids specifically targeting the coding region of gatekeeper genes were successfully designed and constructed. To some extent, the six plasmids could reduce the expression of target gene. Comparatively, the plasmid-derived siRNA psiRNA1, psiRNA4 and psiRNA5 were more effective than their counterparts. The results suggest that the gene silencing efficiency of siRNA is different, depending on their targeted region, and siRNA may provide us with practical tools for further study on the three gatekeeper genes, i.e. Rad52, Ku70, Ku80.