OBJECTIVETo compare the efficacy of internal fixation (including PFNA and PFN) versus hip replacement (including FHR or THA) in the treatment of trochanteric fractures in adults.

METHODSReports of studies using randomized controlled trials (RCT) to compare internal fixationg with hip replacement in the management of intertrochanteric fractures were retrieved (up to January 1, 2013) from the Cochrane Library, PUBMED Data, CNKI (China National Knowledge infrastructure), Elsevier, the Chinese Biomedical Database, Wanfang Data, and manually. Methodological quality of the trials was critically assessed, and relevant data were extracted. Statistical software RevMan 5.0 was used for data-analysis.

RESULTSSeven articles were included in the meta-analysis. The results showed that,compared internal fixation with hip replacement,there were statistical significance in the duration of surgery time [WMD = -2.66, 95% CI (-5.25,-0.06), P = 0.05], intra-operative blood loss [WMD = -24.20, 95% CI (-30.38, -18.02), P < 0.000 01], hospital stays time [WMD = -4.72, 95% CI (-5.18, -4.25), P < 0.000 01], bearing load time [WMD = -29.54, 95% CI (-30.77, -28.31), P < 0.000 01], total complications rate [WMD = 0.15, 95% CI (0.11, 0.22), P < 0.000 01], the good rate of Harris scores [WMD = 1.09, 95% CI (0.54,1.32), P < 0.05]. However, there were no statistical significance in the rate of deep venous thrombosis [WMD = 1.09, 95% CI (0.47, 2.55), P > 0.05]. CON- CLUSION: Hip replacement (containing FHR or THA) for the treatment of intertrochanteric fractures is superior to internal fixa- tion in regards to the duration of surgery time, the mean duration of hosipital stays, mean post-operative down time, intra-opera- tive blood loss, the rate of post-operative good Harris scores. But there is not enough evidence to show any difference between hip replacement (containing THA or FHR) and internal fixation in regards to the rate of deep venous thrombosis. However, internal fixation for the treatment of intertrochanteric fractures is superior to hip replacement (containing FHR or THA) in regards to total complications rate.

Arthroplasty, Replacement, Hip ; methods ; Fracture Fixation, Internal ; methods ; Hip Fractures ; surgery ; Humans

Objective To detect the gene expression of Pax6 in retinoblastoma (Rb).Design Experimental study.Participants Six cases of fresh Rb tumors and two established Rb cell lines.Six cases of retina tissues as normal control group.Methods Pax6 gene ex- pression was assessed in two established Rb cell lines,six primary tumors and six cases of retina tissues using the reverse transcriptase polymerase chain reaction (RT-PCR) and Western blot.Main Outcome Measures Expression of Pax6 gene in fresh retinoblastoma tis- sue and cell lines.Results The mRNA of Pax6 gene was positive in all two established Rb cell lines and the six primary Rb tumors using RT-PCR.The protein of Pax6 gene was also positive in Western blot.Pax6 mRNA and protein expression in the Rb tumors were increased compared with normal control group (P

Female ; Humans ; Immunohistochemistry ; In Situ Hybridization ; Infant, Newborn ; Lung ; metabolism ; pathology ; Macrophage Migration-Inhibitory Factors ; analysis ; genetics ; Male ; Respiratory Distress Syndrome, Adult ; blood ; genetics ; pathology

OBJECTIVETo retrospectivly compare the clinical efficacy of dynamic hip screw (DHS) with proximal femoral nail anti-rotation (PFNA) for the treatment of unstable intertrochanteric fractures in the elderly.

METHODSTotally 92 elderly patients with unstable intertrochanteric fractures were treated with DHS [including 27 males and 23 females with a mean age of (72.5 +/- 5.3) years old] and PFNA [including 22 males and 20 females with a mean age of (72.8 +/- 5.8) years old] from August 2008 to August 2012. The data of operation time,blood loss (obvious and hidden blood loss), bedridden time, down load time, postoperative complications and Harris hip function score were recorded and compared.

RESULTSBoth of two groups were followed-up for 10 to 18 months with an average of 13.5 months. PFNA was implanted with a significantly smaller incision and shorter clinical healing time, less blood loss,while hidden blood loss were more. Postoperative complications, therapeutic effects and Harris score in PFNA group were better than that of DHS group.

CONCLUSIONFor treatment of senile patients with unstable intertrochanteric fractures, PFNA was superior to DHS in reducing complication rates, recovering hip joint, while DHS could reduce perioperative blood loss in treating type II a, II b and III fracture.

Aged ; Aged, 80 and over ; Bone Nails ; Bone Screws ; Case-Control Studies ; Female ; Femur ; surgery ; Fracture Fixation, Internal ; instrumentation ; Hip Fractures ; surgery ; Humans ; Internal Fixators ; Male ; Middle Aged ; Retrospective Studies ; Treatment Outcome

Adolescent ; Adult ; Follow-Up Studies ; Fracture Fixation, Internal ; methods ; Humans ; Male ; Recovery of Function ; Tibial Fractures ; diagnostic imaging ; physiopathology ; surgery ; Tomography, X-Ray Computed ; Young Adult

Objective: To analyze the information of patients with acute myocardial infarction (AMI) in a single center during last 6 years, and to distinguish the clinical differences of patients between TakoSTubo cardiomyopathy (TTC) and ST-segment elevation myocardial infarction (STEMI). Methods: A total of 1042 consecutive patients with primarily diagnosed acute anterior ST-segment elevation (STEMI) admitted in our hospital from 2008-01 to 2014-04 were retrospectively enrolled. The relevant patients were studied in 2 groups:TTC group, the patients with coronary angiography (CAG) and the contrast study of left ventricle corrected TTC diagnosis, n=10, and STEMI group, the patients received CAG within 6 hours of on set with conifrmed left anterior descending singlevessel disease at the same period of time as TTC patients,n=32. The basic clinical characteristics, levels of blood lipids, MI related biomarkers, the incidence rate of pathological Q wave, QTc interval and negative T wave in 12-lead ECG were compared between 2 groups. Results: The percentage of corrected TTC diagnosis in patients with primarily diagnosed STEMI was 1.06%. The female gender in TTC group and STEMI group was 100% vs 9%,P<0.01, TTC group had more patients with stress history before on set than that in STEMI group (70% vs 22%,P=0.02), lower levels of MI related biomarkers as CK (486 ± 249) U/L vs (716 ± 132) U/L, CK-MB (13.5 ± 17.1) mg/L vs (47.5 ± 21.9) mg/L, cTnI (22.8 ± 16.3) ng/mL vs (56.4 ± 24.0) ng/mL, allP<0.01. The age of morbidity, the ratios of hypertension, diabetes mellitus and blood lipids were similar between 2 groups. The frequency of abnormal Q-wave in ECG was similar between 2 groups, while the QTc interval was different in TTC group and STEMI group (630 ± 117) ms vs (540 ± 62) ms,P=0.001, the negative T waves in ECG leads II, III, aVF, aVR and V6 were as (100.00% vs 3.13%), (60.00% vs 6.25%), (90.00% vs 3.13%), (100.00% vs 21.88%), (100.00% vs 46.88%), allP<0.05. Conclusion: TTC patients with the main presentation as ST-segment elevation are usually having emotional or physical stress before on set, with obviously prolonged QTc interval and more frequency of negative T waves in ECG.

OBJECTIVETo investigate the myocardial damage and changes of myocardial mitochondrial Mn-superoxide dismutase (Mn-SOD) activity in craniocerebral injured rats and the effect of Ginkgo biloba extract (GBE) on them.

METHODSCraniocerebral injured rats model was established by fluid-percussion and treated with GBE. The dynamical changes of electrocardiograph (ECG) in 24 h were monitored, the serum level of MB isoenzyme of creatine kinase (CK-MB) and the change of myocardial mitochondrial Mn-SOD activity as well as the pathologic changes of myocardium (HE staining) were observed.

RESULTSThe occurrence of ECG abnormality obviously increased in the injured rats, accompanied with increased serum CK-MB (P<0.05) and decreased myocardial Mn-SOD levels (P<0.05), and the Mn-SOD activity was negatively correlated with the level of CK-MB (r=-0.997, P<0.05). Pretreatment of GBE resulted in the decrease of ECG abnormality occurrence (P<0.01), serum CK-MB level (P<0.05), and degree of myocardial damage, as well as the increase of Mn-SOD activity in post-craniocerebral injured rats.

CONCLUSIONSCraniocerebral injury can result in distinct myocardial damage, which is possibly correlated with the lowering of anti-oxidation stress level of myocardial cellular mitochondria. GBE possesses the protective effect on myocardial damage after craniocerebral injury.

Animals ; Craniocerebral Trauma ; metabolism ; pathology ; Electrocardiography ; Ginkgo biloba ; Male ; Myocardium ; metabolism ; pathology ; Oxidation-Reduction ; Plant Extracts ; pharmacology ; Rats ; Rats, Wistar ; Superoxide Dismutase ; metabolism

BACKGROUND: The lower cervical pedicle screw fixation is the most stable internal fixation of the cervical spine in biomechanics, which can penetrate the anterior, middle and posterior columns of the spine, effectively restore the sagittal sequence of the cervical spine, provide strong internal fixation and high fusion rate. OBJECTIVE: To review the relevant information of the anatomical structure of lower cervical pedicle, the biomechanical property of screw fixation, and three-dimensional printing technology-assisted screw placement at home and abroad. METHODS: PubMed and CNKI databases were searched for the articles concerning lower cervical pedicle screw fixation from January 1990 to January 2017. The key words were "lower cervical, pedicle screw, 3D printing technology" in Chinese and English, respectively. Totally 193 articles were researched, and the repetitive research, case report and meta-analysis were excluded. RESULTS AND CONCLUSION: (1) Finally 52 eligible articles were enrolled for result analysis. (2) Although it has a very high risk to fix lower cervical pedicle screw, the risk could be minimized or avoided through fully individualized evaluation preoperatively and precise fixation intraoperatively. So the lower cervical pedicle screw fixation has high clinical value.

BACKGROUND: Thoracolumbar fracture is commonly seen in spinal injuries, which causes loss of stability of the spine, as well as spinal cord and nerve compression, even deformity and paralysis. The diagnosis and treatment of thoracolumbar fracture remain controversial.OBJECTIVE: To summarize the mechanism of thoracolumbar fracture based on finite element method, its classification and transpedicular screw fixation.METHODS: The first author retrieved CNKI and PubMed databases for the relevant literature published between January 2000 and December 2016. The keywords were "finite element method, thoracolumbar spine fracture,transpedicular screw fixation" in Chinese and English, respectively.RESULTS AND CONCLUSION: (1) The finite element analysis method can simulate the mechanism of thoracolumbar fracture and provides a reference for the studies on the occurrence, development and treatment of thoracolumbar fracture. (2) The classification of thoracolumbar fracture is beneficial for planning a rational treatment strategy and evaluating prognosis. (3) Compared with the traditional screw fixation, the transpedicular screw fixation holds advantages in biomechanical stability and postoperative correction effect. (4) There are various classifications for thoracolumbar fracture; differences in severity and cartilage injury are difficult to simulate completely. (5) The finite element analysis method shows certain application limitations due to long learning curve and modeling time as well as complicated calculations.

Adult ; Carcinoma ; virology ; Cervical Intraepithelial Neoplasia ; virology ; Female ; Human papillomavirus 16 ; isolation & purification ; Human papillomavirus 18 ; isolation & purification ; Humans ; In Situ Hybridization ; Middle Aged ; Papillomavirus Infections ; Uterine Cervical Neoplasms ; virology