Objective To compare the outcome of proximal femoral nail anti-rotation (PFNA)versus anatomical locking plate (ALP) in treatment of unstable intertrochanteric fracture.Methods The study included 89 patients who had received PFNA fixation (PFNA group,n =45) or ALP fixation (ALP group,n =44) for unstable intertrochanteric fracture between February 2008 and September 2009.Operation time,amount of bleeding,drainage volume,postoperative complications,fracture healing time and hip joint score after fracture healing were compared between two groups.Results Mean operation time in PFNA group was obviously shorter than that in ALP group (61.4 minutes vs 114.8 minutes,P ＜0.01).Mean amount of bleeding and drainage volume were significantly lower in PFNA group than in ALPgroup (119.3 mlvs 136.8ml,P＜0.01; 74.9mlvs80.3 ml,P＜0.01).While,PFNA group was not significantly different from ALP group with regard to average fracture healing time and Harris hip joint score after fracture healing (4 months vs 4.1 months,P ＞ 0.05; 91.2 points vs 89.8 points,P ＞0.05).Two patients had poor fracture reduction in PFNA group,but all patients had good fracture reduction in ALP group.No obvious adverse postoperative complications occurred in PFNA group,but one patient had fracture nonunion in ALP group.Conclusions PFNA and ALP fixation of unstable intertrochanteric fracture present insignificant differences in fracture healing time,postoperative complications and hip joint function after fracture healing.Whereas,PFNA is more suitable for the elder patients on account of shorter operation time and less intraoperative bleeding.

Objective To investigate the medium-term efficacy of total hip replacement with CFP handle prosthesis.Methods Thirty-two patients (34 hips) undergoing total hip replacement with CFP handle prosthesis were selected.The preoperative diagnosis was:femoral neck fracture in 6 cases,femoral head necrosis in 12 cases,osteoarthritis in 10 cases,ankylosing spondylitis in 3 cases,and pigmentation villi nodular synovitis in 1 case.Ten days,1 month,6 months,and 1 year (a year later) after surgery,the hip joint function and X ray film performance were followed up.Results There was no complication such as infect and injury of blood vessel and nerve.Postoperative X ray film showed the femoral handle prosthesis position was good.The average Harris hip score was 32.6 (20-53) scores before surgery,and back to 95.3(90-100) scores after surgery,no patients needed revision surgery.Postoperative Engh score was above 10 scores after half a year.Conclusion The medium-term efficacy of total hip replacement with CFP handle prosthesis is good,and can be used as one of the choice of primary total hip replacement.

Objective:To study the clinical efficacy of botulinum toxin type A injection in the treatment of upper facial dynamic wrinkles.Methods:A total of 35 patients with upper facial dynamic wrinkles treated in our hospital from February 2016 to October 2016 were selected as research objects.All the patients were treated with botulinum toxin type A.The excellence rate of 30min after treatment,3 d after treatment and 7 d after treatment were evaluated and compared.The facial wrinkles severity index of the patients were evaluated by the facial wrinkles scale (FWS),and the differences of the FWS index before treatment,4 weeks after treatment and 6 months after treatment were compared.The adverse reactions,like upper facial tension,fatigue and local injection of ecchymosis after treatment were observed and compared.Results:The excellence rate of the patients after treatment of 30 min,3 d and 7 d were gradually increased.The excellence rate of the patients after treatment of 3 d and 7 d were significantly higher than that of after treatment of 30 min,and the excellence rate of the patients after treatment of 7 d were significantly higher than that of after treatment of 3 d (P＜0.05).The FWS index of the patients after treatment of 4 weeks and 6 months were significantly lower than those of before treatment,and the FWS index of the patients after treatment of 4 weeks were significantly lower than that of 6 months after treatment(P＜0.05).After treatment,only 4 patients had slight discomfort and all of these symptoms were disappeared after 3-4 days,there was no effect on their normal work and life.Conclusion:Botulinum toxin type A injection has a remarkable clinical curative effect in the treatment of patients with upper facial dynamic wrinkles,can maintain tor a long time,and also has good safety,it is worthy clinical application.

Objective:To investigate the curative effect of botulinum toxin type A combined with plastic operation of pouches on patients with eye skin relaxation and its impact on patients' satisfaction,and to provide reference for clinical application.Methods:A total of 60 patients with eye skin relaxation,who were treated in Baoji Central Hospital from June 2015 to June 2016,were selected as subjects and divided into control group (n=28) and treatment group (n=32) according to the patients' choices.The patients of control group were treated with plastic operation of pouches,while the patients of treatment group were treated with botulinum toxin type A combined with plastic operation of pouches.The two groups were followed up for 6 months.The improvement of crow's feet,the relief of pouches and the improvement of eye skin gloss of the patients after operation were observed and recorded.The incidence of complications were also observed.At the end of the follow-up,the satisfaction degrees of the patients were investigated with the self-made questionnaire.Results:After treatment,the improvement rate(100％) of crow's feet of the treatment group was significantly higher than that(60.71％) of the control group;the improvement rate (96.88％) of pouches of the treatment group was significantly higher than that (32.14％) of the control group;the improvement rate (87.50％) of eye skin gloss of the treatment group was significantly higher than that (53.57％) of the control group,and the differences were statistically significant (all P＜0.05).After treatment,there was no significant difference in the incidence of incision swelling,small amount of secretions and small hematoma between the two groups (P＞0.05),the operation eye swelling and incision bruises outer canthus in the control group were more than those in the treatment group (P＜0.05).The total satisfaction rate [93.75％ (30/32)] of the treatment group was significantly higher than that[67.86％ (19/28)] of the control group,the difference was statistically significant (P＜0.05).Conclusion:Botulinum toxin type A combined with plastic operation of pouches in the treatment of eye skin relaxation has a better efficacy and safety,which can significantly reduce the incidence of operation eye swelling and incision bruises outer canthus,and improve patients' satisfaction rate.It is worthy of clinical application.

This study was designed to evaluate the effect of Bazhen decoction on bone marrow depression induced by cyclophosphamide (CY) in mice. An experimental model of mouse bone marrow injury was established through cyclophosphamide induced and the following phenomena were observed. The techniques of culture of hematopoietic progenitor cell and hematopoietic growth factor assay were used. Bazhen decoction could obviously promote the proliferation of bone marrow cells of anaemic mice. The culture media of spleen cell, macrophage, lung and skeletal muscle treated with Bazhen decoction had much stronger stimulating effects on hematopoietic cells. The bone marrow cells of the anaemic mice could yield TNF through Bazhen decoction treatment. It was suggested that Bazhen decoction is clinically a hopeful drug used to cure bone marrow depression and attenuate the side effects of CY.
Anemia ; chemically induced ; drug therapy ; Animals ; Cyclophosphamide ; Drugs, Chinese Herbal ; pharmacology ; therapeutic use ; Hematopoiesis ; drug effects ; Hematopoietic System ; drug effects ; Mice ; Phytotherapy ; Tumor Necrosis Factors ; biosynthesis

Objective To systematically review the efficacy and safety of repetitive transcranial magnetic stimulation(rTMS)combined with agomelatine in the treatment of depression.Methods PubMed,Embase,Cochrane Library,Web of Science,CNKI,VIP,WanFang Data,SinoMed and Yiigle databases were electronically searched to collect randomized controlled trials(RCTs)of comparison between rTMS combined with agomelatine(combined group)and agomelatine or combined pseudostimulation(control group)in the treatment of depression from inception to May 10,2024.Meta-analysis was performed by using RevMan 5.4 software,GRADE grading system for evaluating the level of evidence for observational indicators,and TSA 0.9.5.lBeta software for trial sequential analysis.Results A total of 15 RCTs involving 1 196 patients were included.Meta-analysis showed that compared with control group,combination group had a higher effective rate(RR=1.24,95％CI 1.15 to 1.34,P＜0.001),lower depression scale score(SMD=-2.95,95％CI-3.71 to-2.19,P＜0.001),anxiety scale score(SMD=-2.21,95％CI-3.29 to-1.14,P＜0.001),PSQI score(MD=-1.69,95％CI-2.79 to-0.59,P=0.003).There was no statistical difference between the two groups in terms of NE level,5-HT level and incidence of adverse reactions(P＞0.05).GRADE quality grading of the evidence showed moderate-quality evidence for the effectiveness rate and incidence of adverse reactions,with the depression scale score and the NE level of the evidence being low-quality,and the level of evidence for the anxiety scale score,the PSQI score,and the 5-HT content was very low.The trial sequential analysis results showed that in terms of effective rate,the analysis results of combination group superior to control group were reliable,and the conclusion could exclude false positives.Conclusion The rTMS combined with agomelatine in the treatment of depression has advantages in improving effective rate,depression scale score,anxiety scale score and PSQI score compared with agomelatine alone or combined pseudostimulation,incidence of adverse reactions were equivalent to those of agomelatine aloneor or combined pseudostimulation.

OBJECTIVETo investigate the expression of TMEM16A in gastric carcinoma and its clinical implications.

METHODSA total of 72 surgical specimens of gastric carcinoma were collected for examination of TMEM16A expression with immunohistochemical staining.

RESULTSTMEM16A expression was detected in the cytoplasm and cell membrane of the tumor cells. Of the 72 specimens of the tumor tissues, the total positivity rate of TMEM16A expression was 80.56% (58/72), significantly higher than the rate in the adjacent tissues (4.17%, 3/72, P<0.005).

CONCLUSIONAberrant expression of TMEM16A occurs in the majority of gastric carcinoma cases. TMEM16A can be used as a new candidate target for diagnosis and treatment of gastric carcinoma.

Adult ; Aged ; Anoctamin-1 ; Carcinoma ; metabolism ; pathology ; Chloride Channels ; metabolism ; Female ; Humans ; Male ; Middle Aged ; Neoplasm Proteins ; metabolism ; Stomach Neoplasms ; metabolism ; pathology

OBJECTIVETo formulate a novel histological typing and grading-rated system for colorectal cancer (CRC) for evaluating the biological behavior of CRC and prognosis.

METHODSAccording to the highly heterogeneous histological features, WHO classification and histological differentiation criteria, and other biological behavior parameters of CRC, a novel histological typing and grading-scale system for CRC was designed. The histological typing and corresponding grading-scale of CRC was defined as the following: (1) No mucin-producing adenocarcinoma, including tubular adenocarcinoma, sieve-like acne adenocarcinoma, medullary carcinoma, serrated adenocarcinoma and micropapillary carcinoma, etc. (1-3 points); (2) Mucin-producing adenocarcinoma, including mucinous adenocarcinoma and signet ring cell carcinoma (3-4 points); (3) Squamous cell carcinoma (1-3 points); (4) Neuroendocrine tumors, including neuroendocrine tumors, neuroendocrine carcinoma (1-4 points); (5) The special type of CRC, including clear cell carcinoma, spindle cell carcinoma, etc. (4-points); (6) Undifferentiated carcinoma (5 points). The pathology report form was formatted based on the major histological type with the secondary histological type. The final total score of CRC was defined as the sum of the corresponding grading scores for different histological types. The total score of a single-structure CRC was defined as the corresponding grading score multiplied by 2. A total of 666 patients with advanced CRC were pathologically reviewed and analyzed to assess the correlation of the histological typing and grading scores with TNM staging and lymph node metastasis.

RESULTSThe results showed a significant correlation of the histological grading-scale and TNM staging and lymph node metastasis (P<0.05). The scores of CRC histological grading-scale increased synchronously with the TNM staging and lymph node metastasis rate.

CONCLUSIONThe novel histological grading system allows objective evaluation of the biological behaviors and prognosis of CRC for determining individualized postoperative treatment. This system still needs further revision and updates based on evidence from prospective, multi-centered, large-scale trials.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Colorectal Neoplasms ; pathology ; Female ; Humans ; Lymphatic Metastasis ; Male ; Middle Aged ; Neoplasm Grading ; methods ; Neoplasm Staging ; Prognosis ; Prospective Studies ; Young Adult

Objective To formulate a novel histological typing and grading-rated system for colorectal cancer (CRC) for evaluating the biological behavior of CRC and prognosis. Methods According to the highly heterogeneous histological features, WHO classification and histological differentiation criteria, and other biological behavior parameters of CRC, a novel histological typing and grading-scale system for CRC was designed. The histological typing and corresponding grading-scale of CRC was defined as the following:(1) No mucin-producing adenocarcinoma, including tubular adenocarcinoma, sieve-like acne adenocarcinoma, medullary carcinoma, serrated adenocarcinoma and micropapillary carcinoma, etc. (1-3 points); (2) Mucin-producing adenocarcinoma, including mucinous adenocarcinoma and signet ring cell carcinoma (3-4 points); (3) Squamous cell carcinoma (1- 3 points); (4) Neuroendocrine tumors, including neuroendocrine tumors, neuroendocrine carcinoma (1-4 points);(5) The special type of CRC, including clear cell carcinoma, spindle cell carcinoma, etc. (4-points);(6) Undifferentiated carcinoma (5 points). The pathology report form was formated based on the major histological type with the secondary histological type. The final total score of CRC was defined as the sum of the corresponding grading scores for different histological types. The total score of a single-structure CRC was defined as the corresponding grading score multiplied by 2. A total of 666 patients with advanced CRC were pathologically reviewed and analyzed to assess the correlation of the histological typing and grading scores with TNM staging and lymph node metastasis. Results The results showed a significant correlation of the histological grading-scale and TNM staging and lymph node metastasis (P<0.05). The scores of CRC histological grading-scale increased synchronously with the TNM staging and lymph node metastasis rate. Conclusion The novel histological grading system allows objective evaluation of the biological behaviors and prognosis of CRC for determining individualized postoperative treatment. This system still needs further revision and updates based on evidence from prospective, multi-centered, large-scale trials.

Objective To investigate the effect of thalidomide combined with infliximab(IFX)in treatment of refractory inflammatory bowel disease(IBD)and its effects on insulin-like growth fac-tor-1(IGF-1)and transforming growth factor-β1(TGF-β1).Methods A total of 120 patients with refractory IBD were randomly divided into experimental group and control group,with 60 cases in each group.The two groups were given conventional treatment(mesalazine),the control group was given IFX,and the experimental group was given IFX combined with thalidomide,continuous treat-ment for two months.The efficacy,intestinal flora disturbance rate,adverse reactions,Crohn's dis-ease activity index(CDAI),Lewis score,serum IGF-1,TGF-β1 levels and nutritional status indexes[albumin(ALB),transferrin(Tf)]before and after treatment for 1 month and 2 months of the two groups were compared.Results The total effective rate of the experimental group was significantly higher than that of the control group(P＜0.05).After one month and two months of treatment,CDAI and Lewis scores of the experimental group were significantly lower than those of the control group(P＜0.05);the serum levels of IGF-1,TGF-β1 as well as ALB and Tf in the experimental group were significantly higher than those in the control group(P＜0.05).The improvement of intestinal flora disturbance rate in the experimental group was significantly better than that in the control group(P＜0.05).There was no significant difference in the incidence of oral and nasal mucosa dryness,throat discomfort,nausea and vomiting between two groups(P＞0.05).Conclusion In the treat-ment of refractory IBD patients,thalidomide combined with IFX can regulate serum IGF-1 and TGF-β1 levels,effectively relieve clinical manifestations,inhibit inflammatory activities,and improve nutri-tional status and intestinal flora disorders of patients,and it has high safety.