Objective:To analyze the epidemiological features of geriatric humeral surgical neck fractures from 2010 through 2019 in The Third Hospital of Hebei Medical University.Methods:A retrospective study was conducted of the data of the inpatients aged ≥60 years who had been treated for humeral surgical neck fractures in The Third Hospital of Hebei Medical University from 2010 through 2019. The patients were divided into 2 groups by the year of admission: the former five-year group (group A from January 1, 2010 to December 31, 2014) and latter five-year group (group B from January 1, 2015 to December 31, 2019). The data of the patients were compared between the 2 groups to find the epidemiological characteristics and trends of the humeral surgical neck fractures in the 10-year period.Results:A total of 312 geriatric humeral surgical neck fractures were included, accounting for 1.2%(312/25, 764) of the upper limb fractures and 0.4% (312/88, 886) of all the fractures in the same period. There were 64 males and 248 females, giving a male/female ratio of 0.26∶1. Their ages ranged from 60 to 93 years. The peak age of the fractures was from 60 to 69 years for both males and females. Falls and indoor activity injuries accounted for the largest proportion (71.2%, 222/312). The common fracture types were 11-A2 and 11-A3. The proportion of overweight and obese patients by the body mass index (BMI) was the largest (58.7%, 183/312). There were no statistically significant differences between groups A and B in male/female ratio (0.37:1 versus 0.22:1) or in proportion of peak age patients [42.7% (38/89) versus 55.2% (123/223)] ( P>0.05). There were statistically significant differences between the 2 groups in injury causes, fracture types and BMI distribution ( P<0.05). Conclusions:The geriatric humeral surgical neck fractures accounted for 1.2% of the upper limb fractures and 0.4% of all the fractures in the same period. There were more female patients than male ones. Falls and indoor activity injuries were the most common causes. The proportions of complex fractures and overweight and obese patients increased.

Objective To investigate the changes of brain edma and expression of blood high mobil-ity group box 1(HMGB1) and calcium binding protein S100B after traumatic brain injury (TBI) in IL-4 knockout (IL-4 KO) mice,and to explore the effects of IL-4 on traumatic brain injury. Methods Twenty male wild type ( WT) or twenty male IL-4 KO BALB/cJ mice were randomly divided into WT sham TBI group,WT TBI group,IL-4 KO sham TBI group and IL-4 KO TBI group(n=10 in each group).The model of traumatic brain injury was established by the free falling body epidural impact method,then the brain water content was measured. The expression of aquaporin-4 ( APQ4) and HMGB1 in injured brain of each group was detected by Western blot,and the concentration of HMGB1 and S100B in serum was detected by ELISA assay. Results ( 1 ) The brain water content of injured lateral brain of BALB/cJ mice with IL-4 gene knockout was significantly higher than that of wild type mice with brain injury model (WT group: (80.03± 0.35)％;IL-4 KO group:(81.93±0.41)％;P<0.05).(2) The Western blot showed that the expression of AQP4 and HMGB1 in brain tissue of BALB/cJ mice with IL-4 gene knockout was significantly higher than those in wild type mice after traumatic brain injury. ( 3) The results of ELISA showed that the levels of HMGB1 and S100B in the serum of IL-4 knockout BALB/cJ mice were significantly higher than those of wild type mice (HMGB1:WT group:(9.21±0.74)ng/ml;IL-4 gene knock-out group:(13.39±1.33)ng/ml,P<0.05;S100B protein:WT group:(11.11±0.84)pg/ml;IL-4 KO group: (18.11±2.02)pg/ml,P<0.05 ). Conclusion The brain tissue water content and the expression of APQ4 are increased in IL-4 KO TBI mice.The expression of HMGB1 in brain issue and serum and S100B in serum are also up-regulated.

Objective To compare and analyze the epidemiological features of adult patients with distal femoral fracture between the east and west areas in China from 2010 to 2011.Methods The data of adult patients with distal femoral fracture treated from January 2010 through December 2011 in 63 hospitals were collected through the PACS system and case reports checking system.The data from 35 hospitals in the east area were classified as group A and those from 28 hospitals in the west area as group B.The analytic items included gender,age and AO classification.Results A total of 2,523 adult distal femoral fractures were collected,involving i,544 males and 979 females,with a male to female ratio of 1.58:1.The adult femoral fractures predominated in an age range from 41 to 50 years (18.94％) and their high-risk type was 33-A (50.18％).In group A of 1,650 cases,there were 1,027 males and 623 females,with a male to female ratio of 1.65:1 and a median age of 48 years;in group B of 873 cases,there were 517 males and 356 females,with a male to female ratio of 1.45:1 and a median age of 45 years.There were no significant differences in the age distribution and gender proportion between groups A and B (P ＞ 0.05).The age distribution showed that the peak ranges were from 31 to 60 years in both groups.The proportion of type 33-A was the most and that of type 33-B the least in both groups.The proportion of type 33-A in group B (53.49％) was significantly higher than in group A (48.42％) while that of type 33-B in group B (16.84％) was significantly lower than in group A (21.39％) (P ＜ O.05).Conclusions Adult distal femoral fractures were common in middle-aged males and their high-risk type was 33-A.Their peak age was from 31 to 60 years in both east and west areas in China.They were more common in men.The predominant fracture type was 33-A in both areas.The east area witnessed a significant higher proportion of type 33-B and a significant lower proportion of type 33-A than the west area.

Objective To analyze the epidemiological features of Galeazzi fractures from 2003 through 2012 in The Third Affiliated Hospital to Hebei Medical University. Methods We retrospectively analyzed the data of Galeazzi fractures between January 2003 and December 2012 in the Third Affiliated Hospital to Hebei Medical University. The data from 2003 through 2008 were defined as group A and those from 2008 through 2012 as group B. The general information was compared between the 2 groups. The epi-demiological characteristics and trends during the 10 years were analyzed concerning gender, age and fracture type of the patients. Results A total of 153 Galeazzi fractures were recorded, accounting for 0. 81％ of ulnoradial fractures and 0. 12％ of all fractures. There were 109 males and 44 females, with a male/female ratio of 2. 48:1. The age range from 11 to 20 years had the highest constituent ratio ( 22. 22％) and type Ⅱthe highest proportion ( 76. 47％) . There were 74 cases in group A, with a male/female ratio of 2. 22:1. There were 79 cases in group B, with a male/female ratio of 2. 76:1. There was no significant difference between the 2 groups concerning the male/female ratio ( P > 0. 05 ) . The median age for group A was 29 years, significantly younger than that for group B ( 34 years ) ( P <0. 05 ) . The high risk age was from 11 to 20 years in group A (32. 43％) and from 21 to 50 years (22. 78％) in group B. Compared with group A, the constituent ratio of age range from 11 to 20 years in group B was significantly lower and the constituent ratio of age range from 41 to 50 years significantly higher ( P <0. 05 ) . There were no significantly differences between the 2 groups concerning the constituent ratio of each fracture type ( P> 0. 05 ) . Conclusions Galeazzi fractures accounted for 0. 81％ of ulnoradial fractures and 0. 12％ of all fractures. There were more male patients than female ones. The age range from 11 to 20 years and typeⅡhad the highest constituent ratios. Compared with the first 5 years, the latter 5 years witnessed increased mean age.

Objective To investigate the epidemiological features and trends of humeral intercondylar fractures at our hospital from 2003 through 2012.Methods The clinical data were retrospectively analyzed of all the patients with humeral intercondylar fracture who had been treated between January 2003 and December 2012 at our institute.The patients' age,gender,fracture site and AO classification were documented.The data between 2003 and 2007 were classified as group A while the data between 2008 and 2012 as group B.The epidemiological characteristics during the 10 years concerning age,gender and fracture type were compared between the 2 groups.Results A total of 303 humeral intercondylar fractures were recorded,accounting for 5.29％ of the distal humeral fractures,3.39％ of the elbow fractures and 0.24％ of the total fractures at the same period.They involved 197 males and 106 females,with a male/female ratio of 1.86∶ 1.The high-risk age group was adolescent and middle-aged adults,accounting for 63.70％.The high-risk type was type 13-C2,accounting for 44.00％.There were 171 and 132 cases in group A and group B,accounting for 5.40％ and 5.17％ of the contemporary distal humeral fractures,3.72％ and 3.05％ of the contemporary elbow fractures,and 0.26％ and 0.22％ of all the contemporary fractures,respectively,showing no significant differences between the 2 groups(P ＞ 0.05).In groups A and B respectively,the male/female ratios were 1.44∶1 and 2.67∶ 1,the proportions of adolescents and the middle-aged 58.48％ and 70.45％,the proportions of type 13-C1 35.83％ and 18.10％,and the proportions of type 13-C3 14.17％ and 44.76％,showing significant differences between the 2 groups in all the above comparisons (P ＜ 0.05).Conclusion The humeral intercondylar fractures were common in the adolescent and middle-aged patients,with a male predominance (about twice more in males).Compared with the first five years,the latter 5 years witnessed increased proportions of males,adolescent and middle-aged patients,and type 13-C3 but a decreased proportion of type 13-C1.

Objective To investigate the epidemiological features and trends of adult fractures at the base of the first metacarpal bone in The Third Mfiliated Hospital to Hebei Medical University from 2003 through 2012.Methods The data of human fractures treated between January 2003 to December 2012 at our hospital were collected through the PACS system and case reports checking system.Adult fractures at the base of the first metacarpal bone were included in the present study and assigned into 2 groups,group A containing the data between 2003 and 2007 and group B the data between 2008 and 2012.Comparison and analysis was done with analytic items of gender,age and fracture type.Results A total of 378 adult fractures at the base of the first metacarpal bone were included,accounting for 1.92％ of hand fractures and 0.35％ of the total adult fractures at the same period.The fractures involved 311 males (82.28％) and 67 females (17.72％).The youth group had 254 fractures with the highest constituent ratio (67.20％).The right side was involved in 286 cases (75.66％) and the left side in 92 (24.34％).There were 198 cases of extra-articular fracture with the highest constituent ratio (52.38％).Group A had 200 fractures,a male to female ratio of 6.14∶ 1,a median age of 34 years,the highest constituent ratio in youth (73.50％) and in type A1 fractures (53.50％);group B had 178 fractures,a male to female ratio of 3.56∶ 1,a median age of 40 years,the highest constituent ratio in youth (60.11％) and in type A1 fractures (51.12％).Compared with group A,group B had a higher constituent ratio of females,older ages,a higher constituent ratio of elderly patients,a lower constituent ratio of youth,and a lower constituent ratio of type C1 fractures.All these differences between the 2 groups were statistically significant (P ＜ 0.05).Conclusions During the 10 year,the adult fractures at the base of the first metacarpal bone accounted for 1.92％ of hand fractures and 0.35％ of the total adult fractures at the same period.The fractures occurred mostly in men and in the age range of 16 to 44 years.About 3/4 of them occurred on the right side.Compared with the first 5 years,the latter 5 years witnessed increasing trends of female and elderly patients and decreasing trends of young patients and type C1 fractures.

Objective To investigate the epidemiological features and trends of supracondylar humeral fractures from 2003 to 2012 at The Third Affiliated Hospital to Hebei Medical University.Methods The data of the patients with supracondylar humeral fracture who had been treated between 2003 and 2012 at our hospital were collected through the PACS system and case reports checking system.The data between 2003 and 2007 were classified as group A and those between 2008 and 2012 as group B.The data concerning gender,age and fracture type were statistically analyzed and compared between the 2 groups.Results Atotalof3,111 supracondylar humeral fractures were treated,accounting for54.4％ (3,111/5,723) of the distal humeral fractures,34.8％ (3,111/8,932) of the elbow fractures and 2.5％ (3,111/126,479) of the total fractures.They were 2,018 males (64.9％) and 1,093 females (35.1％).The age range from 1 to 10 years obtained the highest constitute ratio for both genders,77.0％ (1,554/2,018) for males and 78.2％ (854/1,093) for females.The extension type and flexion type had 2,693 (86.6％) and 418 (13.4％) cases,respectively,and their male to female ratios were 2.0:1 and 1.2:1 respectively,all showing significant differences (P ＜ 0.001).There were 1,902 cases in group A and 1,209 cases in group B,accounting for 60.0％ (1,902/3,168) and 47.3％ (1,209/2,555) of the distal humeral fractures,41.4％ (1,902/4,199) and 27.9％ (1,209/4,333) of the elbow fractures,and 2.9％ (1,902/65,267) and 2.0％ (1,209/61,212) of the total fractures,respectively,all showing significant differences between groups (P ＜ 0.001).The male to female ratio was 1.9:1 for group A and 1.8:1 for group B,showing an insignificant difference (P ＞ 0.05).The age range from 1 to 10 years had a constitute ratio of 75.0％ (1,426/1,902) for group A and that of 81.2％ (982/1,209) for group B,showing a significant difference (P ＜ 0.001).The proportion of extension type was 85.4％ (1,624/1,902) for group A and 88.4％ (1,069/1,209) for group B,showing a significant difference (P ＜ 0.05).Conclusions The current investigation has revealed the epidemiological features and trends of supracondylar humeral fractures which had been treated between 2003 and 2012.They were mostly seen in children from 1 to 10 years old.The extension type predominated.Compared with the first 5 years,the proportion of age range from 1 to 10 years and the extension type increased in the latter 5 years.

Objective:To analyze the epidemiological characteristics of all the patients with intertrochanteric fracture admitted to the Third Hospital of Heibei Medical University in the past 10 years.Methods:Data of patients with intertrochanteric fracture admitted to our hospital from January 1, 2010 to December 31, 2019 were retrospectively analyzed. According to the year of admission, all the patients were divided into two groups: the first five years (group A) and the last five years (group B). Gender, age, injury cause, Evans classification, complicated diseases, length of hospital stay and whether surgical treatment or not were compared.Results:A total of 6,125 patients with intertrochanteric fracture were included in the study, including 2,664 males and 3,461 females with a male to female ratio of 0.77∶1. The peak age was 70-79 for males and 80-89 for females. There were 2,314 cases in group A (male to female ratio was 0.91∶1) and 3,811 cases in group B (0.70∶1), showing significant differences between the 2 groups in the male to female ratio ( χ2=25.265, P< 0.05). The peak age ranged from 70 to 80 years (31.9%,739/2,314) in group A and from 80 to 90 years (34.5%, 1,313/3,811) in group B. There were significant differences between the 2 groups in the sex ratios of age groups from 70 to 79 years ( χ2=0.024, P< 0.05). In all the 6,152 patients with a definite injury cause, the fall and indoor activity accounted for the highest proportion (83.9%, 5,140/6,125), and the proportion of group A was 75.4% (1,745/2,314) while the proportion of group B was 89.1%(3,395/3,811) showing a significant differences between the 2 groups in injury cause ( χ2=14.363, P< 0.05). Based on X-ray films or computer tomography (CT) of 3,560 patients, the Evans type II and III were the most common types. Type II accounted for the highest proportion in group A (38.1%, 239/628) while type III did in group B (39.5%, 1,159/2,932) . There were significant differences between the 2 groups in the proportion of Evans classification ( χ2=183.569, P< 0.05). Of all the 6,125 fracture cases, 4,846 fracture patients (79.1%) were complicated with medical diseases. There was a statistically significant difference between the 2 group of the patients who were complicated with medical diseases ( χ2=8.916, P< 0.05). A total of 5,148 patients were treated by operation and 1,925 patients were in group A while the other 3,259 cases were in group B. In group A, the median hospitalization was 14 days and the quartile interval was 8 days. In group B, the median hospitalization and the quartile interval was 12 days and 8 days respectively. There were significant differences between the 2 groups in length of hospital stay for patients treated by surgery ( Z=-9.909, P<0.001). Conclusion:The intertrochanteric fractures admitted to the Third Hospital of Heibei Medical University in the past 10 years were more common in females than in males. Fall and indoor activity was the most common injury cause. Evans types II and III prevailed. The fractures showed an aging trend by comparing the former 5 years and latter 5 years. The number of intertrochanteric fracture patients complicated with medical diseases increased significantly, but the total days of hospitalization was on the decline.

Purpose: Fibroblast growth factor receptor 4 (FGFR4) plays a critical role in cancer progression involving in tumor proliferation, invasion, and metastasis. This study clarified the role of FGFR4-Arg388 variant in gastric cancer (GC), and more importantly highlighted the possibility of this single nucleotide polymorphism (SNP) as potential therapeutic targets. Materials and Methods: FGFR4 polymorphism was characterized in advanced GC patients to perform statistical analysis. FGFR4-dependent signal pathways involving cell proliferation, invasion, migration, and resistance to oxaliplatin (OXA) in accordance with the SNP were also assessed in transfected GC cell lines. Results: Among 102 GC patients, the FGFR4-Arg388 patients showed significantly higher tumor stage (p=0.047) and worse overall survival (p=0.033) than the Gly388 patients. Immunohistochemical results showed that FGFR4-Arg388 patients were more likely to have higher vimentin (p=0.025) and p-STAT3 (p=0.009) expression compared with FGFR4-Gly388 patients. In transfected GC cells, the overexpression of FGFR4-Arg388 variant increased proliferation and invasion of GC cells, increasing resistance of GC cells to OXA compared with cells overexpressing the Gly388 allele. Conclusion The exploration mechanism may be through FGFR4-Arg388/STAT3/epithelial to mesenchymal transition axis regulating pivotal oncogenic properties of GC cells. The FGFR4-Arg388 variant may be a biomarker and a candidate target for adjuvant treatment of GC.

OBJECTIVETo analyze the gender, age, fracture classification and variation trend of adult intertrochanteric fractures treated in a single-center hospital in ten years.

METHODSThe data of adult (age ≥ 16 years) intertrochanteric fractures admitted to the Third Hospital of Hebei Medical University from January 2003 to December 2012 were collected retrospectively. All the fractures were acute and the pathological or periprosthetic fractures were excluded. The radiography of fracture were classified by same experienced orthopedic resident and verified by two orthopedic deans and one radiologist. The gender, age and fracture classification were analyzed and compared between January 2003 to December 2007 and January 2008 to December 2012.

RESULTSA total of 3 201 cases were collected. The adult intertrochanteric fractures accounted for 2.97% of all adult fractures and 43.76% of adult proximal femoral fractures. Of all fractures 64.98% were elderly ( ≥ 60 years) and 35.02% were middle-aged (16-59 years). In elderly, female were common (57.78%) while in middle-aged were male commonly (79.13%). According to Evans classification, instable fractures were more common (68.92%). According to AO classification, the most common type was A2 (49.67%) and the least was A3 (15.93%). Comparing between January 2003 to December 2012 and January 2008 to December 2012, the proportion of intertrochanteric fracture of adult fracture was decreased by 0.31% (χ² = 9.29, P = 0.002)and the proportion of intertrochanteric fracture of adult proximal femoral fractures was decreased by 3.15% (χ² = 7.35, P = 0.007). The proportion of elderly patients, female and stable fractures was increased by 14.35% (χ² = 71.98, P < 0.01), 4.04% (χ² = 8.16, P = 0.004) and 5.62% (χ² = 11.7, P = 0.001), respectively. The proportion of AO classification was not significantly verified (χ² = 3.24, P = 0.198).

CONCLUSIONSThe intertrochanteric fractures are most common in elderly patients, A2-type of AO Classification and stable (Evans III, IV, V) in Evans classification. Compared with the previous five years, the proportions of female, elderly and stable (Evans I, II) fracture increase in last 5 years.

Adolescent ; Adult ; Aged ; China ; epidemiology ; Female ; Femoral Fractures ; diagnostic imaging ; epidemiology ; surgery ; Hip Fractures ; diagnostic imaging ; epidemiology ; surgery ; Humans ; Male ; Middle Aged ; Periprosthetic Fractures ; Radiography ; Retrospective Studies ; Young Adult