Compared with hip replacement, internal fixation in the treatment of the elderly femoral neck fracture, especially the application of cannulated screws, is minimally invasive, easy to operate and economical. In recent years, it becomes the research focus in the field of orthopedic clinical research. However, configuration of cannulated screws is still controversial. Most clinicians believe that three cannulated screws being placed in parallel in an inverted triangle configuration is better than that in a triangular configuration in biomechanics and clinical effect. Nonparallel strong oblique nailing technique allows the screws to share more weight to reduce postoperative complications, so that it is more suitable for elderly patients with osteoporosis. However, the related complications of internal fixation such as nonunion, femoral neck shortening and other problems are still the focus of domestic and foreign scholars. Issues about how to control the indication of internal fixation surgery, understand related factors of the complications, and prevent complications are required to be further explored.
Aged ; Bone Nails ; Femoral Neck Fractures ; surgery ; Fracture Fixation, Internal ; adverse effects ; methods ; Humans ; Internal Fixators

Objective To compare the clinical outcomes between oblique and non-oblique fixation with cannulated screws for femoral neck fractures in the elderly patients.Methods Totally 189 patients of over 65 years old were treated for femoral neck fracture from June 2007 to October 2013 at our department.Oblique fixation with cannulated screws was used in 130 cases.They were 43 males aud 87 females with an average age of 77.8 ± 7.5 years.According to Garden classification,40 cases were of Garden types Ⅰ and Ⅱ (undisplaced fractures),and 90 of Garden types Ⅲ and Ⅳ (displaced fractures).Of them 26 were Pauwells type Ⅲ.Non-oblique fixation with cannulated screws was conducted in 59 cases.They were 24 males and 35 females with an average age of 75.5 ± 8.2 years.According to Garden classification,12 cases were of Garden types Ⅰ and Ⅱ (undisplaced fractures),and 47 of Garden types Ⅲ and Ⅳ (displaced fractures).Of them,15 were Pauwells type Ⅲ.The fracture union,postoperative complications,rate of reoperation and Harris scores at the last follow-up were compared between the 2 groups.Results All the 189 patients were followed up for 10 to 38 months (average,17.4 months).The oblique fixation led to a union rate of 99.2％ (129/130),a fixation failure rate of 3.1％ (4/130) and a femoral head necrosis rate of 2.3％ (3/130),which were not significantly different from those resulted from the non-oblique fixation [98.3％ (58/59),10.2％ (6/59) and 5.1％ (3/59) respectively] (P ＞ 0.05).However,the rate of femoral neck shortening [35.4％ (46/130)] and the reoperation rate [3.1％ (4/130)] in the oblique fixation group were significantly lower than those in the non-oblique fixation group [50.8％ (30/59) and 15.3％ (9/59) respectively] (P ＜ 0.05).The mean Harris hip score at the last follow-up for the oblique fixation(75.7 ± 14.3) was significantly higher than that for the non-oblique fixation (70.8 ± 16.7) (P ＜ 0.05).Conclusion As oblique cannulated screwing can reduce the rates of femoral neck shortening and reoperation to some extent,it may be a better fixation choice than the non-oblique cannulated screwing for femoral neck fracture in elderly patients.

Objective To explore the measurement of femoral neck shortening (FNS) after cannulated screwing for elderly femoral neck fractures and the effect of FNS on hip functional outcome.Methods Totally 214 elderly patients with femoral neck fracture were included in this study who had been treated by fixation with cannulated screws from June 2007 to October 2013.They were 71 males and 143 females,with an average age of 77.2 years.According to Garden classification system,65 cases were types Ⅰ and Ⅱ (undisplaced fractures),and 149 types Ⅲ and Ⅳ (displaced fractures).The postoperative X-ray and follow-up X-ray films were compared to observe whether the trailing end of screw shaft was exposed to the outer cortex of the proximal femur.We chose the screw which had the longest exposure of trailing end to measure the length of the exposed screw shaft as the length of FNS.FNS indexes were defined according to the ratio of the length of exposed screw shaft to the thickness of screw head.FNS degree 1:＜ 1 screw head; FNS degree 2:1 to 2 screw heads; FNS degree 3:＞ 2 screw heads.The relationships of the FNS length respectively with thefemur length decrease and Harris scores of hip functional outcome were analyzed statistically.Results FNS occurred in 78 cases,giving an incidence of FNS of 36.4％ (78/214).Of them,12 cases (15.4％)were defined as degree 1,24 cases (30.8％) as degree 2,and 42 cases (53.8％) as degree 3.There was a significant positive correlation between the FNS length and the femur length decrease(r =0.919,P =0.000).The average Harris score at 12 months postoperation for 180 cases was 77.3 points (ranging from 32 to 98 points).The average Harris score for those with FNS was significantly lower than that for those without FNS (t =9.904,P =0.000).There was a significant negative correlation between the FNS length and Harris scores (r =-0.707,P =0.000).Conclusions Our measurement of FNS and FNS indexes are easy to be used in clinic.Severe FNS can influence the function of hip joint.

A bacterial strain Eml isolated from contaminated soil of Shengli oil field was identified as Rhodococcus ruber according to its phenotype, physiological and chemical properties, and its 16S rRNA gene sequence. This strain could degrade various polycyclic aromatic hydrocarbons as well as alkanes in petroleum, and produce bioemulsifier. The results indicated that strain Eml could produce bioemulsifier efficiently when n-hexadecane was used as sole carbon source. The optimal conditions for the synthesis of bioemulsifier were as followed: 10g/L of n-hexadecane, 1g/L of yeast extract, media initial pH 7, and cultivation was carried out at 30℃ on a rotary shaker at 200 rpm. Under these conditions the surface tension of culture decreased to the lowest value, around 30 mN/m, after 1 day, and the emulsifying capacity was 100% . The concentration of bioemulsifier reached to the highest value, around 68 times of CMC , after 5 days' cultivation. The results also showed that the bioemulsifier produced by this strain should be lipid.

Using morphometry and impregnation technique of lanthanum nitrate,acomparative investigation on the epidermis structure of high and low electricresistance skin points was carried out in mice and rabbits at both light and electronmicroscope level,with special emphasis on the structure of gap junctions in epidermis.It was observed that the frequency of gap junctions in low resistance points wassignificantly higher,and their diameter was larger than that in high resistancepoints,while no difference was found in other structure parameters examinedbetween the two types of skin points.It is assumed that the gap junctions may bethe structure basis for the difference in skin electric resistance.

Ninety rats were divided into 8 groups. Group 1-5 were fed vitamin A free ration and each group was divided into 2 subgroups at the beginning and 12, 23, 36, 43, days after the experiment respectively. Group 6-8 were fed the ration containing 66, 132, and 198?g vitamin A per 100g diet respectively fer 30 days, and each group was also divided into 2 subgroups. The results showed that RBPR% was better than the serum vitamin A content in evaluating vitamin A nutritional status. It was suggested that the vitamin A nutritional status could be graded as follows: deficient(abore 70%)) mar-ginal(60-70%),normal (20-60%), and sufficient (under 20%)by RBPR%.

An improved microfluorimetric method for determination of serum vitamin A was presented. In this method, the excitation wavelength 345nm and emission maximum 480nm were selected, and cyclohexane as solvent for extraction of saponified vitamin A in the serum samples to be tested was used. The sensitivity was sufficient for measurement of vitamin A content in 20*l serum taken from normal fasting blood without elimination of interference. The recovery averaged 99.0% (93.0-105.5).When this method was applied to laboratory study or field work, practically, the results showed that the values of vitamin A obtained seemed to correlate with its nutritional status of experimental animals or subjects investigated. The procedure was simple, reproducible and easily acceptable, espicially in the field work.

35 rats were divided into 5 groups. Group 1-3 were fed rations containing 20, 12 and 6% caseien respectively, group 4 containing 12% mixed protein of soybean and gluten. The food of group 5 was the same as that of group 1 but the amount was only half of that of group 1. Every animal was given 8?g vitamin A by stomach tube daily for 3 weeks and then 25?g for 2 weeks. Afterward serum vitamin A values were determined in all animals, then 132?g vitamin A was administrated by stomach tube. After 3.5 hours, the vitamin A values in serum and liver were determind. The results showed that in group 3 and 5 serum vitamin A contents decreased and the liver values rose. It was suggested that the release of vitamin A from liver had been interfered by semistarvation or low protein intake. There is no difference between group 2 and 4.

Objective To clone human vacuolar protein sorting 4A gene(hVPS4A)and to construct its eukaryotic expressive plasmid.Methods Primers were designed to amplify the full length hVPS4A by PCR using cDNA of Huh7 cell as a template,then the target DNA was inserted into the eukaryotic vector pRK5.The recombinant plasmid was confirmed by PCR,restriction enzyme digestion and DNA sequencing.Results A 1 300 bp fragment was successfully amplified by PCR from the cDNA of Huh7 cells.Af-ter recycled,purified and ligated with the vector pRK5,the recombinant plasmid was transformed into E.coli DH5α.The positive re-combinant plasmid identified by PCR was selectred and digested by EcoRⅠto get a 5 900 bp fragment;and two fragments including 4 600 bp and 1 350 bp were obtained using EcoRⅠand HindⅢ digestion;the size of these two fragments were consistent with the pRK5 target fragment and the inserted hVPS4A as expected.Moreover,DNA sequencing results confirmed that the inserted frag-ment was in accordance with the hVPS4A reference sequence.Conclusion The eukaryotic expression vector containing hVPS4A gene is constructed successfully,which provides the condition for further study on the hVPS4A biological functions.

Objective To study the association between clinical symptoms,psychosomatic factors and autonomic nervous function in patients with gastroesophageal reflux disease (GERD).Methods Thirty-four patients with GERD diagnosed by reflux disease questionnaire (RDQ) and endoscopy and 15 healthy control subjects were enrolled in this study.All the subjects were divided into two groups,one with normal scores of Zung's self-rating anxiety scale (SAS) and Zung's depression scale (SDS) as GERD (-) and the other with abnormal scores of SAS and SDS as GERD (+).Reflux symptom score was recorded for both groups at the same time.Autonomic nervous function was assessed by their heart rate variability (HRV) on dynamic electrocardiogram (DCG).The time domain parameters analyzed included standard deviation (SD) of average R-R interval during 24 hours (SDNN),SD of average 5-minute sinus heart rate (SDANN),mean square root of the difference of adjoining two R-R interval (rMSSD),and proportion of the heart beats with difference of R-R interval more than 50 ms from the total heart beats (PNN 50),and the frequency domain parameters analyzed included low-frequency (LF),high-frequency (HF) and ratio of LF to HF.Results Average scores of SAS and SDS were significantly higher in patients with GERD than those in healthy controls (48?9 vs 38?6 and 48?11 vs 41?6,respectively,P