Population aging is a problem confronting many countries around the world and poses grim challenges to the conventional healthcare model.The measure proposal by WHO,the establishment of age-friendly community-based primary healthcare centers and medical institutions,is both practical and feasible,based on which many countries have formulated implementation frameworks.In China,it is of paramount importance to promote the development of age-friendly hospitals,especially geriatric specialty hospitals,rehabilitation hospitals and nursing homes,in the healthcare sector.Integrated care services offered by age-friendly hospitals can help reduce complications,improve care quality and patient satisfaction,and cut costs,benefiting elderly patients and their families and ultimately moving the healthcare reform forward.

OBJECTIVETo study clinical effects of inversive LISS (less invasive stabilization system, LISS) plate combined with steel wire for the treatment of Seinsheimer type V subtrochanteric femoral fractures.

METHODSFrom January 2009 to Janurary 2012, 11 patients with Seinsheimer type V subtrochanteric femoral fractures were treated with inversive LISS plate combined with steel wire, including 8 males and 3 females, ranging in age from 35 to 61 years old (averaged, 51 years old). Causes of injury: 8 patients caused by accident and 3 patients caused by falling down. According to X-ray examination, all the patients were type V subtrochanteric femoral fractures and were treated with LISS plate combined with steel wire. Merle d'Aubigne scores were used to evaluate therapeutic effects on hip.

RESULTSThe mean period of follow-up was 16 months (ranged, 12 to 28 months). All the patients obtained bone union for average 3.8 months (ranged from 3 to 4.3 months). There were no complications such as deep infection,deep vein thrombosis, pulmonary embolism and bone nonunion. According to Merle d'Aubigne scores, 7 patients got an excellent result and 4 good.

CONCLUSIONInversive LISS plate combined with steel wire for the treatment of Seinsheimer type V subtrochanteric femoral fractures is satisfactory, Which can provide stable fixation for fracture end and provide an ideal internal fixation method for treatment of this kind of fractures in the future.

Adult ; Bone Plates ; Bone Wires ; Female ; Fracture Fixation, Internal ; methods ; Hip Fractures ; surgery ; Humans ; Male ; Middle Aged

Purpose:To determine the impact of serum tissue polypeptide specific antigen (TPS) in the treatment for advanced cancer patients. Methods:Serum TPS was examined in 60 advanced cancer cases. 42 of the patients received hepatic arterial chemoembolization or chemotherapy. For those with tumors derived from digestive system, TPS monitoring was performed in serial during the therapeutic courses. Results:No significant differentiation was observed in terms of age, gender, disease or tumor stage. Patients with initial TPS lower than 300 U/L had the most favorable response rate to treatment (PR,CR or MR) of 52.94%, while those with initial TPS higher than 1000 U/L showed no evidence of remission after therapy. 55.56% of the latter developed into PD ( P

Objective To evaluate the effect of phacoemulsification on the corneal endothelium and thickness of diabetic cataract patients.Methods Cataract surgery of phacoemulsification with intraocular lens implantation was performed on together 348 eyes of 348 patients,including 96 eyes of 96 patients suffered from type 2 diabetes (diabetic group) and 252 eyes of 252 patients suffered from senile cataract (elderly group).Then,tear break-up time,basal tear secretion,corneal endothelial density and central corneal thickness were detected before surgery and 1 week,4 weeks and 8 weeks after surgery.Results There were significant difference in tear break-up time,basal tear secretion,corneal endothelial density and central corneal thickness before surgery and 1 week,4 weeks and 8 weeks after surgery between the two groups (all P ＜0.05).There were significant difference in corneal endothelial density (all P ＜ 0.05),but there was no significant difference in tear break-up time,basal tear secretion and central corneal thickness before and after surgery in the elderly group (all P ＞ 0.05).Intergroup comparison of tear break-up time,basal tear secretion,corneal endothelial density and central corneal thickness were significantly different before and after operation (all P ＜ 0.05).Conclusion Cataract surgery of phacoemulsification can achieve satisfying outcomes and it is crucial to protect the corneal endothelium and ocular surfacetissue intraoperatively and postoperatively for the patient with diabetic cataract.

Objective:To analyze the reasons for unplanned resection of soft tissue sarcomas and explore the treatment strategies for cancer surgery. Methods: The study included 105 patients with soft tissue sarcomas admitted to the First Affiliated Hospital of Xinjiang Medical University between October 2009 and December 2012. The average age of the patients was 52 years old. Among the patients, 65 were males and 40 were females. Up to 82 patients underwent planned resection (Group A) in our hospital, and 23 underwent unplanned resection (Group B) in other hospitals. Wide excision and radical resection were conducted in Group A, whereas extended resection was performed in Group B. General data, tumor location and size, resection margin, local recurrence and metastasis, and survival were statistically analyzed in the two groups. Results:The proportion attaining the margin of wide excision was obviously lower in Group A than in Group B (P＜0.05). The 3-year survival rate was significantly higher in Group B than in Group A (P=0.001). Within an average follow-up of 18 months (3 months to 36 months) in Group B, 12 patients died, including 9 with tumor metastasis and 3 with other diseases. Within an average follow-up of 23 months (5 months to 36 months) in Group A, 15 patients died, including 12 with tumor metastasis and 3 with other diseases. Conclusion:Compared with planned surgical operation, unplanned resection of soft tissue sarcomas often leads to inadequate resection margin, which results in a high incidence of local recurrence and an increased mortality. Thus, clinicians should attempt to avoid unplanned resection of sarcomas.

Objective To compare the clinical effects of intramedullary nails and locking compression plate in the treatment of femur shaft fracture.Methods The clinical data and follow-up records of 43 patients with femur shaft fracture treated by intramedullary nails and locking compression plate were retrospectively reviewed.Including 31 males and 12 females with an average age of 40.07 years(25 to73).According to AO classification:5 cases were type A,24 cases were type B,14 cases were type C.26 patients in group A treated by intramedullary nails and 17 patients in group B treated by locking compression plate.Operation time,fracture union time,blood loss and complications were compared between the two groups.The Karlstrom and Olerud result were compared and analyzed.Results All patients were followed up at an average of 15 months(range 5-24) after surgery.According to Karlstrom and Olerud score system,the excellent and good rate of group A was 88.4％,higher than the group B 82.3％.But there was no significant difference between the two groups.In group A:the operation time (113.77 ±20.14)min,the blood loss in the operation (386.74 ± 65.16) ml,clinical bone healing (15.52 ± 1.77) weeks.All these outcomes were better than group B (P ＜ 0.01).One case in group A appeared screw loose,but X-ray showed the nail stable,the bone wasn't displacement.One case in group B appeared broken plate 1 month after operation,and received twice operation,the clinical outcome was good as well.Another 1 case with fracture delayed union in group B,after internal fixation removed,we check the X-ray showed bone union.Conclusion Two methods of treatment femur shaft fracture can all reach the above requirement.Fixation of intramedullary interlocking nail is the preferred surgery than locking compression plate.

Objective To evaluate the effects of alpha-lipoic acid (α-LA)on autophagy in human skin fibroblasts (HSFs). Methods HSFs at passage 3 - 5 were divided into several groups to be cultured with α-LA at final concentrations of 0, 0.01, 0.05, 0.10, 0.15, 0.20 and 0.50 mmol/L for 4, 12 and 24 hours, respectively. Methyl thiazolyl tetrazolium(MTT)assay was performed to evaluate cellular proliferative activity, monodansylcadaverin(MDC)staining to determine autophagy levels, and Western blot to measure the expression of the microtubule-associated protein 1 light chain-3B(LC3-B). Results After incubation for 24 hours, there was a significant difference in the proliferative activity of HSFs among all the groups (F = 10.41, P < 0.05), while no significant differences were observed after incubation for either 4 or 12 hours (F = 2.85, 1.34, respectively, both P > 0.05). MDC staining also showed a significant difference in the percentage of autophagosome-positive cells among all the groups after 24-hour incubation (F = 8.03, P < 0.05), but no significant difference after either 4- or 12-hour incubation (F = 0.11, 0.10, respectively, both P > 0.05). Western blot revealed that the degree of conversion from LC3-Ⅰ to LC3-Ⅱ(LC3-Ⅱ/LC3-Ⅰratio)was significantly different among all the groups after 24-hour incubation (F = 37.49, P < 0.05), but similar after 4- and 12-hour incubation (F = 3.38, 2.13, respectively, both P > 0.05). Conclusion α-LA may inhibit basal autophagy in HSFs.

Objective To investigate the relationship between coagulation function and pediatric critical illness scores (PCIS) in children with severe pneumonia.Methods The PCIS were collected in 152 children with severe pneumonia (pneumonia group) admitted in our pediatric intensive care unit from Jan 2010 to Jul 2011,and 20 healthy children in the same period were selected as the healthy control group.The coagulation indicators of children in both groups were detected and the relationship between coagulation markers and severity of pneumonia was analyzed.Results There were significant differences in platelet count,fibrinogen,D-Dimer,soluble P-selectin between pneumonia group and healthy control goup [(185.74 ±116.26) × 109/L vs (287.10 ±90.01) × 109/L,(3.51 ±0.50) g/L vs (3.15 ±0.15) g/L,(1.39 ±2.18) μg/ml vs (0.36 ± 0.07) μ g/ml,(110.07 ± 83.47) ng/ml vs (33.74 ± 9.47) ng/ml,P ＜ 0.05].There were positive correlation between soluble P-selectin,D-Dimer and severity of disease and negative correlation between platelet count and severity of disease in children with severe pneumonia.Regression equation:y =1.154 +0.003 × soluble P-selectin + 0.089 × D-Dimer-0.001 × platelet count (P ＜ 0.05).As the children's critical condition getting worse,soluble P-selectin and D-Dimer levels increased (P ＜ 0.05).Hatelet count showed no significant difference between critical group and extremely critical group,which was significantly lower than that in non-critical group (P ＜ 0.05).Conclusion Soluble P-selectin,D-Dimer,and platelet count are associated with the severity of pneumonia.The children with severe pneumonia are easy to have coagulation disturbance.

Objective To investigate the methods of prevention and treatment of presacral venous plexus bleeding in pelvic operation.Methods The clinical data of 8 cases of presacral venous plexus bleeding in pelvic operation from 1998 to 2013 were analyzed.Results All 8 cases succeeded in controlling bleeding,The amount of bleeding was 1 000-4 000 mL,the average amount is 2 600 mL.Conclusions The key to prevention of presacral venous plexus bleeding was thorough familiar with pelvic anatomy and a dexterous technique of careful dissection.Massive hemorrhage occurred direct electric coagulation hemostasis was available,the method was simple.

To investigate the effects of anti-sense peptide nucleic acids (PNAs) targeting Ki-67 gene on modulation of the proliferation and apoptosis of human renal carcinoma cell lines, human renal carcinoma cell line 786-0 cells were treated with anti-sense PNAs at different concentrations (1.0 micromol/L, 2.0 micromol/L, 10.0 micromol/L). The Ki-67 expression of 786-0 cells was detected by immunohistochemical technique and Western blot method respectively. The proliferation of 786-0 cells was studied by cell growth curves and 3H-thymidine incorporation. The apoptosis of 786-0 cells was detected by TUNEL assay. The control groups were treated with anti-sense oligonucleotide (ASODNs) targeting Ki-67 gene. Our results showed that the Ki-67 expression of 786-0 cells treated with anti-sense PNAs (16.9+/-0.7) was significantly inhibited as compared with that of the control groups (28.6+/-0.4) (P<0.01). The Ki-67 protein rate of 786-0 cells treated with anti-sense PNAs (42.1 +/-2.2) was significantly reduced when compared with that of the control groups (83.6+/- 1.4) (P<0.01). Proliferation of 786-0 cells treated with anti-sense PNAs (20.7+/- 1.5) was significantly inhibited as compared with that of the control groups (58.6+/- 1.4) (P<0.01). The apoptosis rate of 786-0 cells treated with anti-sense PNAs (28.7+/- 2.3) was significantly increased higher compared with that of the control groups (13.8 +/- 1.0) (P<0.01). From these finds we are led to conclude that anti-sense PNAs targeting Ki-67 gene have stronger effects on the inhibition of the proliferation and induction of apoptosis of human renal carcinoma cells than ASODNs targeting Ki-67 gene. The strategies using anti-sense PNAs targeting Ki-67 gene may be a promising approach for the treatment of renal cell carcinoma.