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 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.

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 survival and prognostic factors in patients with gastrointestinal stromal tumors(GIST).Methods The histopathological slides from 153 patients with GIST were reviewed. The expression of CDllT,CD34,platelet-derived growth factor receptor alpha (PDGFR-a) and Ki-67 proteins were measured by immunohistochemical staining. The factors thatinvolved in the survival and prognosis were analyzed based on the clinical features and GIST biological behavior ranking.The Kaplan-Meier and Cox model were used to evaluate the effect of variant factors on survival and prognosis.Results The survival rate of 135 patients was 94.1% 76.3% and 65.9% at 1,3 and 5 years,respectively.On univariate analysis survival was predicted by tumor size (χ2= 40.565,P＜0.01),primary tumor location (χ2=13.245,P＜0.01),mitotic count (χ2= 22.626,P＜0.01),risk ranking (χ2=19.186,P＜0.01),necrosis (χ2==28.665,P＜0.01),incomplete resection χ2=2 =29.110,P＜0.01) and Ki-67 index (χ2=15.953,P＜0.01).Multivariate analysis demonstrated that thetumor size ＞ 10 cm,primary tumor location,mitotic count＞ 10/50 HPF,high risk subgroup,tumor necrosis and Ki 67 index ＞ 5 % were poor predictors of survival.Ki-67,tumor size and mitotic count were strong poor predictors of survival.Conclusions Fletcher's biological behavior ranking is a good approach to predict prognosis of GIST patients and has significant clinical value.It's better to combine itwith other factors such as Ki-67 index and primary tumor location in order to provide evidence for therapy.

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.

This study examined the association of problem behavior with neurotransmitter deficiency in adolescents, which would provide new insights into behavioral problems. A total of 1259 students of the seventh grade from 4 middle schools in Wuhan city located in the central China were recruited. With the approval of school and parents, they were invited to complete the Youth Self-Report (YSR) questionnaire and Symptom Scale of Neurotransmitter Deficiency (SSND) questionnaire. Pearson's bivariate correlation analysis showed that the correlation coefficients between each subscale of YSR and SSND ranged from 0.24 to 0.61 with all P<0.01. Canonical correlation analysis indicated that anxiety/depression was interrelated with insufficiency of GABA and 5-HT; aggressive behavior was associated with inadequate GABA; famine of DA influenced the attention problems. It was concluded that neurotransmitter deficiency may cause a series of behavioral and mental problems.

Objective To observe the changes of renal protein expression after electroacupuncture (EA) of "Taixi" (KI 3) of the Kidney Meridian of Foot-Shaoyin in healthy rats so as to explore the relationship between KI 3 and the Kidney. Methods Twelve adult male Wistar rats were randomly divided into normal control group (n=6) and EA group (n=6). EA (2 Hz/100 Hz,2-4 mA) was applied to bilateral KI 3 for 20 min,once a day for 7 days. Under anesthesia,the rats were perfused transcardiacally with ice saline and their kidneys removed for extracting the total proteins and assaying the differentially expressed proteins with two-dimensional gel electrophoresis (2-DE),Image MasterTM 2 D Platinum Software and matrix-assisted laser desorption ionization-mass spectrometry (MALDI-MS) MALDI-TOF-MS,respectively. Results Image MasterTM 2 D Platinum Software analysis showed that after EA,9 protein points of the kidney tissues expressed differentially above 3-fold in comparison with control group were upregulated,2 of which were identified to be NAD-dependent isocitrate dehydrogenase and Quinone reductase. No downregulated differentially expressed proteins were found in the kidney tissues. Conclusion EA of "Taixi" (KI 3) can increase the expression of NAD-dependent isocitrate dehydrogenase and Quinone reductase in the kidney tissue,suggesting an increase of energy metabolism after EA and a close correlation between the KI 3 (Source-point) and the Kidney.