Objective To explore the clinical curative effect of locking plate in elderly patients with proximal humeral fractures. Methods Seventy elderly patients with proximal humeral fractures were selected, and all patients were treated with surgical treatment. Among them, application of locking plate was in 35 cases (locking plate group), and application of ordinary steel plate was in 35 cases (ordinary steel plate group). The operation time, intraoperative blood loss, fracture healing time and curative effect between 2 groups were compared. Results The operation time, intraoperative blood loss and fracture healing time in locking plate group were significantly lower than those in ordinary steel plate group: (61.3 ± 5.6) min vs. (78.3 ± 4.2) min, (190.5 ± 11.5) ml vs. (268.5 ± 21.2) ml and (12.6 ± 1.8) weeks vs. (16.5 ± 1.5) weeks, the excellent and good rate was significantly higher than that in ordinary steel plate group: 94.29% (33/35) vs. 74.98% (26/35), and there were statistical differences (P<0.05). Conclusions The curative effect of locking plate in elderly patients with proximal humeral fractures is accurate. Locking plate can be fixed firmly, and it is conducive to early recovery after surgery.

Background Proliferative vitreoretinopathy (PVR) is a a common cause of anatomic failure in retinal detachment surgery.Proteomics is the critical method to investigate the different proteins. Objective This study was to search for related vitreous proteins in rhegmatogenous retinal detachment patients with proliferative vitreoretinopathy (PVR)and screen for the related protein expression in the vitreous with PVR. Methods Vitreous samples were obtained from 8 moderate PVR (grade B)eyes and 8 severe PVR(grade C or D)eyes during pars plana vitrectomy (PPV)for the proteomics analysis by two-dimensional gel electrophoresis coupled with mass spectrometry.Normal vitreous from 8 healthy donor eyes served as control.First dimension isoelectric focusing (IEF) was performed with the Pharmacia IPGphor in solvent B using 18 cm non-linear pH 3-10 immobilized pH gradient (IPG)strips.IPG strips were rehydrated with sample,and then IEF was performed.The second dimension 12%sodium dodecyl sulfate (SDS) polyacrylamide gel electrophoresis (PAGE) was performed after the IPG strips were equilibrated.After silver staining,the gels were analyzed by the 2-DE gel analysis software.The matched spots were excised and tryptica digested in-gel.The peptides were analyzed by MALDI-TOF-MS and the MS/MS spectral were searched against the human protein databases using MASCOT.This study process complied with the Declaration of Helsinki.Wfitten informed consent was obtained from each patient prior to this trial. Results In the current study,a total of 47,184 and 336 protein spots were detected from the normal donor eyes,moderate PVR eyes and severe PVR eyes,respectively,by 2-DE gels.Among 13 protein spots with significant differences in the 3 groups,7 types of proteins were successfully identified.The results indicated that Enolase 2 was a specific protein for normal donor vitreous.whereas transthyretin monomer and retinol-binding protein(RBP) chain B were distinct proteins found in severe PVR vitreous.and prostaglandin D synthase and RBP3 precursor were common proteins with up-regulated expression in vitreous samples with moderate PVR,but down-regulated levels in vitreous samples with severe PVR.The levels of albumin and transferrin in vitreous showed dynamic elevation with the enhancement of severity of PVR.Conclusion The changes in the vitreous proteome imply that some types of vitreous proteins degrade and some common serum proteins are expressed in the vitreous body with PVR,which indicated the disruption of the blood retinal barrier in the pathogenesis of PVR.

0.05).Both SBP and DBP were declined significantly in both two groups(P0.05).Heart rate decreased from (81?9)b/min to (68?7)b/min in bisorpolol group.But there wasn't this effect in contrast group.It was superior to that of contrast group significantly too(P

Objective To explore the effect of nutritional intervention on nutritional status,weight,physical strength and quality of life of patients with head and neck cancer treated by radiotherapy.Methods 77 patients with head and neck malignant tumors treated by radiotherapy were divided randomly into two groups,nutritional intervention group (NI) had 38 cases and control group (CG) had 39 cases.The status of nutrition,weight,physical strength and quality of life before radiotherapy,the end of radiotherapy and 3 months after radiotherapy in two groups were compared.Results The nutritional risks in two groups had no difference before radiotherapy.At the end of radiotherapy,the assessment score of the nutrition in NI was significantly lower than that in CG [(5.41±2.36) scores vs.(6.92±2.74) scores,t =4.935,P ＜ 0.05],and the average weight in NI was significantly higher than that in CG [(57.07±8.01) kg vs.(46.53±9.82) kg,t =2.670,P ＜ 0.05].At the end of radiotherapy and 3 months after radiotherapy,the physical strength in NI [(57.07± 8.01),(41.48±7.92) kg] were significantly higher than those in CG [(36.43±6.48),(37.94±8.03) kg] (t =2.670,P =0.021;t =2.361,P =0.037);the index of quality of life in NI [(51.37±6.56),(52.07±6.23) scores] were also significantly higher than those in CG [(46.93±6.98),(48.13±7.12) scores] (t =2.292,P =0.041;t =2.076,P =0.037).Conclusion Nutritional intervention can effectively maintain the nutritional status of head and neck cancer patients with radiotherapy,and improve continuously the physical strength and the quality of life.

OBJECTIVE:To evaluate the economical efficiency of alogliptin for type 2 diabetes and provide clinical evi-dence for related researches. METHODS:Retrieved from Cochrane Library,Pubmed,EMBase,CNKI,VIP,Wanfang,CBM database up from the start of the database to Mar.,2014,RCTs about alogliptin combined with traditional antidiabetic agents regimen vs. traditional antidiabetic agents regimen in the treatment of type 2 diabetes mellitus were included. Based on the sec-ondary analysis method of literatures,Effectiveness indexes and treatment course were extracted from the literatures,from the perspective of patients,and daily treatment cost was used to calculate the cost;cost-effectiveness analysis was adopted to evalu-ate the economical efficiency of alogliptin combined with traditional antidiabetic agents regimen vs. traditional antidiabetic agents regimen. RESULTS and CONCLUSIONS:6 literatures which met inclusion criteria were included. When alogliptin com-bined with metformin treatment lasted for 12 weeks,the decrease value of HbA1c as effect index showed poor cost-effective-ness;when treatment course increased to 26 weeks,the rate of qualified HbA1c as effect index showed poor cost-effectiveness. When the price of alogliptin decreased by 10% or the effects of trial group was the upper limit of 95%CI,the cost-effective-ness was superior to metformin regimen group. 12 weeks of alogliptin combined with pioglitazone treatment showed better cost-effectiveness than pioglitazone alone using the decrease value of HbA1c as effect;when treatment course increased to 26 weeks,the treatment showed poor cost-effectiveness;when treatment conrse increased to 26 weeks,using the rate of qualified HbA1c as effect indes,the results of sensitirity analysis showed that cost-effectiveness of trial group was better than that of pio-glitazone alone group as the apper limit of 95% CI. When alogliptin combined voglibose treatment lasted for 12 weeks,the de-crease value of HbA1c as effect index showed superior cost-effectiveness to voglibose regimen group. It is suggested to develop alogliptin pharmacoeconomics research based on RCTs and pharmacoeconomics research about improving diabetes patients’ long-term living quality.

Objective To compare the influences of different routes of nutrition on the outcome and respiratory muscle strength of elderly patients in respiratory intensive care unit (RICU). Methods Totally 147 elderly patients in RICU were equally randomized into combined nutrition group ( combinination of parenteral nutrition and enteral nutrition), total enteral nutrition (EN) group, and total parenteral nutrition (PN) group. The changes of energy metabolism, respiratory muscle strength, and short-term outcome were observed or determined.Results Plasma albumin (ALB), hemoglobin (Hb), creatinine (Cr) levels, and nitrogen balance significantly increased in all group 7 days later ( all P ＜ 0. 01 ), while blood urea nitrogen (BUN) significantly decreased ( P ＜0.01 ). The increase of ALB, Hb, Cr levels, and nitrogen balance were significantly more remarkable than that in EN group and PN group (P＜0.05 or P＜0.01). The decrease of BUN level in the combined nutrition group was significantly more remarkable than that in EN group ( P ＜ 0. 05 ). After nutritional support, the maximum inspiratory pressure in the combined nutrition group (P =0. 021 ) and EN group (P = 0. 011 ) became significantly higher, and occlusion pressure at 0.1 second inspiration level in the combined nutrition group became significantly lower ( P =0. 025). The incidences of infectious and non-infectious complications in PN group were significantly higher than those in EN group (P = 0. 002 and 0. 017, respectively) and combined nutrition group ( P = 0. 005 and 0. 004, respectively). Gastric retention was more common in EN group than that in PN group ( P = 0. 035). The weaning time,length of RICU stay, length of hospital stay and 20-day-mortality were significantly decreased in the combined nutrition group than those in the other two groups ( all P ＜ 0. 05 ). Conclusion The effectiveness of the combined application of PN and EN is superior to PN or EN alone in improving nutritional status and respiratory muscle strength as well as in improving the short-term outcome in elderly patients in RICU..

Objective To investigate the healing mechanism of the rabbit's selerotomy sites undergoing the transconjunctival su- tureless vitrectomy(TSV),and to compare the wound healing effect of the different surgery procedures.Design Experimental study. Participants New Zealand white rabbits.Methods Thirty-two New Zealand white rabbits were divided into four groups:the core vitrec- tomy and fluid-air exchange (Group A),the core vitrectomy (Group B),the non-core vitrectomy and fluid-fir exchange (Group C) and the non-core vitrectomy(Group D).Intraocular pressure(IOP)was measured on the day preoperatively and the day 1,3,5,7,14 postopera- tively with Tonopen tonometers.Sclerotomy sites were investigated with the ultrasound biomicroscope(UBM)on the day 1,5 and 9 postoperatively,and the internal and the external diameter of the wound was estimated on the day 1 postoperatively.The pathological sections of the sclerotomy sites on the day 3,5 and 9 postoperatively were observed under the light microscope.Main Outcome Mea- sures IOP,the internal and external diameter of the wound.Results The IOP of Group A was obviously higher than the other groups on the day 1 postoperatively (P

Objective To observe the impacts of valsartan combined with amlodipine or hydrochlorothiazide regimen on blood pressure variability (BPV) in elderly hypertensive patients.Methods Eighty elderly patients with hypertension were randomized into valsartan and amlodipine (the amlodipine group, n=38) or valsartan and hydrochlorothiazide (the hydro-chlorothiazide group,n=37) group.The 24-hour dynamic blood pressure was monitored at baseline, 6-week and 12-week after treatment for the blood pressure and blood pressure variability. The control rate of blood pressure was calculated at 6-week after treatment, and side effects were observed during the treatment.Results Values of 24 h systolic blood pressure (SBP), daytime SBP, nighttime SBP, morning SBP and 24 h systolic blood pressure variability (SBPV) were significantly low-er at 6-week and 12-week than those of baseline in both two groups(P<0.05). There was an interaction between the group-ing factors and time on 24 h SBP, daytime SBP, nighttime SBP, 24 h SBPV and daytime SBPV (P<0.05). At the 6 and 12-week treatment, 24 h SBP, daytime SBP, nighttime SBP and daytime SBPV were significantly lower in amlodipine group than those in hydrochlorothiazide group (P<0.05). At 12-week treatment, 24 h SBPV was significantly lower in amlodipine group than tjat in hydrochlorothiazide group (P<0.01). There were no significant differences in control rate of blood pressure and side effects between two groups. Conclusion Valsartan in combination with amlodipine or hydrochlorothiazide can both ef-fectively control BPV in elderly hypertensive patients, and valsartan conbined with amlodipine has better effects on lowering blood pressure and BPV.

Background and purpose:Epirubicin is one of the fi rst line chemotherapy drugs in the treatment of breast cancer, and liposome doxorubicin is a new antitumor drug that has been reported to have less cardiotoxicity and myelosuppression compared to free doxorubicin. Dentritic cells (DC) play important roles in tumor immunity. Our experiment investigated the impacts of epirubicin and liposome doxorubicin on different human breast cancer cell lines and dentritic cells, and evaluated their roles in the treatment of breast cancer. Methods:Human breast cancer cell lines, Bcap37 and MDA-MB-231, along with human dentritic cells isolated and induced into maturation, were cultured with epirubicin and liposome adriamycin at different concentrations (0, 0.25, 0.5, 1.0, 2.0, 4.0, 10.0 ?g/ml), respectively. The inhibitory effects were detected by MTT method after 24, 48, 72 h. Results:Epirubicin and liposome adriamycin could inhibit the proliferation of Bcap37 cells, MDA-MB-231 cells, and human dentritic cells. Liposome adriamycin exhibited a lighter inhibition on dentritic cells than on human breast cancer cell lines (Bcap37 and MDA- MB-231) (F=22.208, P

From the angle of view of ecology morals,to explain the content and function of ecology moral education,to analyze the present situation and the origin of medico's ecology demoralization,discussesing its countermeasure.Pointed out that establishing ecology morals idea,we must enrich and widen the angle of view of medico's traditional moral education.Currently we should strengthen medico's ecology moral education from the ecology environment education,the ecology ethics education and the ecology morals practice education,and it has the the vital significance to the medico that Seting up the scientific ecology moral outlook,improving the ecology morals quality,promoting the forming of moral character and personality,cultivating well medical ethics.