Objective To compare the effect of proximal femoral intramedullary nail fixation and femoral retrograde intramedullary nail combined with hollow lag screw fixation in the treatment of ipsilateral femoral neck and shaft fractures.Methods Data of 42 patients with ipsilateral femoral neck and shaft fractures who were admitted in our hospital from January 2007 to January 2016 were retrospectively analyzed.According to different fixation methods,the patients were divided into two groups:single intramedullary nail group (SIN group) (20 cases,treated with single proximal femoral intramedullary nail,15 males and 5 females with an average age of 39.4);combined internal fixation group (CIF group) (22 cases,treated with femoral distal intramedullary nail combined with femoral neck hollow lag screw,17 males and 5 females with an average age of 42.2 years).In the SIN group,4 cases were type A,9 cases type B,7 cases type C according to AO classification.And 14 cases belonged to Ⅰ or Ⅱ (stable fracture),6 cases of type Ⅲ or Ⅳ (unstable fracture) according to Garden classification.In the CIF group,3 cases were type A,10 cases type B,9 cases type C according to AO classification.And 16 cases belonged to type Ⅰ or type Ⅱ,6 cases type Ⅲ or Ⅳ according to Garden classification.The incision length,operation time,intraoperative blood loss,fracture healing time,postoperative weight time,stability of internal fixation,hip function score,pain in the knee and postoperative complication rate were compared between the two groups.Results There was no significant difference in gender,age and fracture classification between the two groups.The operation time (75.0±10.2 min),intraoperative blood loss (150.6±80.4 ml),hip Harris score excellent rate (80％) of incidence of knee pain in postoperative 3 months (10.0％) of the SIN group were significantly lower than those of the CIF group (105.2±18.4 min,180.0±56.8 ml,86.4％ and 31.8％).The length of incision (8.3±1.4 cm) in the SIN group was significantly longer than that in the CIF group (4.0±0.6 cm).There was no significant difference in fracture healing time (SIN group 20.O±4.0 weeks,CIF group 19.6±4.2 weeks) and postoperative weight time (SIN group 8.2±4.0 weeks,CIF group 8.0±4.2 weeks) between the two groups.The main complications of the two groups were delayed union (3 cases of SIN group and 1 case of CIF group),nonunion of fracture (1 case of SIN group) and,coxa vara (1 case of SIN group).The complication of SIN group (30％) was significantly higher than that of CIF group (4.5％),which occurred mainly in unstable femoral neck fracture cases.Conclusion Both proximal femoral intramedullary nail fixation and femoral retrograde intramedullary nail combined with hollow lag screw can effectively treat femoral ipsilateral femoral neck and shaft fracture.Femoral retrograde intramedullary nail combined with hollow lga screw has more therapeutic advantages for unstable femoral neck fractures (Garden Ⅲ and Ⅳ).

Objective To observe the long-term efficacy of anti-infective reconstituted bone xenograft (ARBX) combined with external fixation of posttraumatic long bone infection in lower extremities.Methods This retrospective case series study included 36 patients with posttraumatic long bone infection in lower extremities followed up for more than 18 months after receiving one-stage ARBX bone grafting combined with ring external fixation from January 2004 to December 2013.There were 21 male and 15 female patients,at the age of 19-72 years (mean,35.8 years).Multiple fractures were seen in 24 patients and single fractures in 12 patients.Bone and functional results were evaluated using the association for the study and application of the method of Ilizarov (ASAMI) classification.Results Follow-up ranged from 18 to 72 months (mean,38 months).Bone union was seen in 33 cases in a mean period of 5.2 months,and infection was completely cured.Length of limbs in all patients reached the expected extension length with the bone extension length of 3-10 cm (mean,5.2 cm).All the extended areas showed bone healing.According to the ASAMI classification,bone result was excellent in 20 patients,good in 13 and fair in 3,with the excellent and good rate of 92％,and limb function recovery was excellent in 18 patients,good in 11 and fair in 7,with the excellent and good rate of 81％.Conclusion ARBX adjuvant external fixator treatment of posttraumatic long bone infection in lower extremities improves bone healing rate and limb function recovery rate and shortens bone healing time at one stage.

Objective To investigate the expression of extraeellular signal-regulated protein kinase (ERK1/2)pathway in rat brains with fluorosis and the effects of fluoride on learning and memory of the rats,and to reveal the mechanisms of damaged nervous system resulted from the toxicity of the ion.Methods Seventy-two SD rats were divided into 3 groups and 24 rats were in each group.Three groups were fed respectively with different concentrations of fluoride(NaF)for 6 months to establish rat models with fluorosis.Controls were fed with tap water (NaF＜0.5 mg/L):lower and higher concentration group were fed with water containing NaF(5,50 ms/L).Animals are sacrificed after 6 months of treatment with fluoride and the dissected brains were kept for analysis.The protein levels of ERK1/2 in rat brains were detected by Western-blotting and the mRNA level by RT-PCR. The spatial learning and memorizing ability was measured by Morris water maze test. Results The ERK1/2 protein in control group,lower and higher concentration group was 0.944±0.10,1.253±0.02,1.953±0.07,the differece being statistieally sighificant between any two groups (P ＜ 0.05). The phospho-ERKl/2 protein in control group,lower and higher concentration group was 0.73±0.08,0.77±0.07,1.28±0.11,the differece being statistieally sighificant between any two groups(P ＜ 0.05);the activation rate of phospho-ERK1/2 in lower and higher concentration group [(68.4± 3.8)%,(64.1±3.2)%] was decreased compared to control group[ (82.3±10.7)%],the differece being significant(P ＜ 0.05). In the navigation trial,longer escape latencies of lower concentration group on the second, the third,the fifth and the sixth day were observed[ (46.0±8.0),(24.0±2.7),(8.9±5.3),(7.4±4.1 )s] compared to the control[ (39.3±6.9),(19.1±9.1 ),(8.3±3.4),(4.8±2.7)s],the differece being significant (P ＜ 0.05 or ＜ 0.01 );the similar results were also observed in the higher concentration group[ (36.9±16.8),(37.7±12.9), (19.7±7.6),(12.2±5.7 )s],and the escape latencies of the higher concentration group on the third,the fifth and the sixth day were longer than that in lower concentration group. In the probe test,the rats took more time to reach the first cross in lower and higher concentration group[(1.17±0.75),(4.18±1.10)s] than control group[ (5.89± 0.56 ) s ],the differece being significant (P ＜ 0.05 or ＜ 0.01 ) ;stayed shorter [ ( 17.05±4.25 ),(18.20±4.57 ) s ] than control [(25.37±5.65 )s ] in platform area (P ＜ 0.01 );the activation rates of ERK1/2 were directly correlated with the time taken to reach the first cross platform located in the probe test(r = 0.364,P ＜ 0.05) and the activation rates were also directly correlated with the escape latencies on the sixth day(r = 0.497,P ＜ 0.05). Conclusion Long-term exposure of excessive fluoride induces the change of expression and activating rate of the ERK1/2 in rat brains,leading to the decreased capacity of learning and memory.

Objective To investigate the expression and distribution of the downstream substrate of extracellular regulated protein kinase(ERK1/2) pathway, ternary complex factor phospho-Elk-1, in rat brains with chronic fluorosis, and reveal the mechanism of the impaired learning and memory ability caused by chronic fluorosis. Methods Seventy-two SD rats, weighing 100 - 120 g, were randomly divided into 3 groups, 24 in each group (half male and half female). The rats in control group were fed with tap water (fluoride < 0.5 mg/L); low- and high-dose fluoride groups were fed with tap water with different concentrations of NaF(5.0,50.0 mg/L F-, respectively). After 6 months, body weight was weighed, dental fluorosis was determined by observation and urinary fluoride and bone fluoride were detected by fluorine ion-selective electrode; the learning ability of rats was measured by navigation test of Morris water maze, and memory ability by spatial probe test in Morris water maze; the expression and distribution of phospho-Elk-1 in different brain regions were detected by immunohistochemistry method. Results In low- and high-fluoride groups, the body weight of rat[(449.2 ± 77.1), (312.8 ± 89.7)g] was significantly decreased than that of control [(635.5 ± 76.2 )g, all P< 0.05], the varying degrees of dental fluorosis were observed(x2 = 7.83, P<0.05), urinary fluoride[(2.56 ±0.91),(5.73 ±3.14)mg/L] and bone fluoride[(709.2 ± 37.4) ,(1306.3 ± 102.4) mg/kg] were significantly higher than those in controls[(0.92 ± 0.30)mg/L,(348.5 ± 89.2)mg/kg, all P< 0.05]. The escape latency of low- and high-fluoride groups[ (7.4 ± 4.1), (12.2 ± 5.7)s] was longer than that of control [(4.8 ± 2.7 )s, all P < 0.05] and the escape latency in high-fluoride group was significantly longer than that in other groups (all P < 0.05); in spatial probe test, the time of first crossing platform was longer in rats with fluorosis [(4.18 ± 1.10),(5.89 ± 0.56)s] as compared to control[(1.17 ± 0.75)s, all P< 0.05]. Expressions of phospho-Elk-1 in the hippocampus CA1(167.4 ± 8.3,163.2 ± 9.4), CA2(175.7 ± 5.0,183.3 ± 4.2), CA3(165.2 ± 11.6,162.9 ± 4.4), CA4(168.7± 6.9,169.5 ±5.3), fascia dentate (185.2 ±4.0,193.1 ±6.1) and caudate putamen( 181.4 ± 3.8, 179.8 ± 5.5) in low- and high-fluoride groups were higher than those of controls(142.4 ± 8.1,144.9 ± 8.4,143.6 ± 5.8, 116.8 ± 9.1,140.2 ± 7.8,163.1 ± 13.1, all P< 0.05). Conclusion Chronic fluorosis can cause increased expression of phospho-Elk-1 in the hippocampus and caudate putamen region of rat brains, which might be related to the mechanisms of decreased learning and memory ability of rats overexposed to fluoride.

Objective To investigate the changes of oxidative stress level in brain tissues and serum, and learning and memory in rats with oxidative stress level in nerve damage in chronic fluorosis. Methods The rats were randomly divided into 3 groups according to the body weight, eight rats in each group, i.e., control group, drinking water containing less than 0.5 mg/L of fluoride; lower fluoride exposure group, drinking water containing 5 mg/L of fluoride; higher fluoride exposure group, drinking water containing 50 mg/L of fluoride. The animals were examined six months after initiating the experiment. The total antioxidant capacity (T-AOC) and malondialdehyde (MDA), as well as learning and memory, were measured. Results Escape latency in higher fluoride exposed group[ (14.37±3.48)s] was significantly higher than that of controls[ (5.84±1.87)s] and exposed te lower fluoride [ (7.18±1.42)s], the difference being statistically signifieant(P<0.05). As compared with controls[ (2.17±0.11)× 103 U/L , (0.79±0.11)×103 U/g Pr] ,the rats exposed to higher fluoride and lower fluoride exhibited lower levels of T-AOC [(1.37±0.27)×103 U/L,(0.24±0.06)×103 U/g Prand (1.20±0.14) x 103 U/L,(0.41 ~ 0.10)×103 U/g Pr], the difference being statistically signifieant(P<0.05). As compared with controls[ (2.34±0.16) mmoL/L, (2.97±0.11)mmol/g Pr] and low fluoride exposed group[ (2.68±0.33)mmoL/L, (3.38±0.21)mmol/g Pr], higher level of MDA were observed in higher fluoride exposed group[ (3.72±0.59)retool/L, (4.01±0.21)mmol/g Pr], the difference being statistically significant(P<0.05). Conclusion The results indicated that higher amount of fluoride induced an increased level of oxidation, which might result in the decreased capacity of intelligence of rats with fluorosis.

Objective To study CT-guided localization of additional pulmonary nodules with microcoils prior to video-assisted thoracoscopic surgery (VATS) resection in patients with suspected lung cancer.Methods Eleven patients suspected lung cancer underwent preoperative microcoils localization towards additional small pulmonary nodules.The head of microcoil was pinpointed adjacent to the target nodule while its end tail remained above the visceral pleura.VATS were performed within 24 hours, and comprehensive assessments were conducted according to surgical and pathological outcomes of primary and additional lesions, and suitable surgical processes were followed.Results All 11 localizing pulmonary nodules (4-15 mm in diameter) were successfully removed after VATS, 9 microcoils'' end tails of which were placed above visceral pleural surface.There were no serious complications related with localizing procedure.Other 16 lesions including 11 primary ones were resected.The surgical and pathological outcomes for lung lesions were utterly assessed.Conclusion Microcoil preoperative localization provides helpful orientation for complete resection and assessment of multiple pulmonary lesions in patients with suspected lung cancer.

OBJECTIVETo evaluate the value of the near infrared Raman spectroscope in diagnosing oral squamous cell carcinoma (OSCC).

METHODSNear infrared Raman spectra of ten normal mucosa, twenty OSCC and thirty oral leukoplakia (OLK) cases were collected in the research. Based on the previous researches, the information of the subtracted spectra of compared group was gained by the characteristic band in them. A Gaussian radial basis function support vector machine was used to classify spectra and establish the diagnostic models. The efficacy and validity of the algorithm were evaluated.

RESULTSBy analyzing the subtracted mean spectra, the increasing peak intensity in wavenumber range of 500-2 200 cm(-1) hinted us of the high contents of DNA, protein and lipid in OSCC, which elucidate the high proliferative activity. The increasing peak intensity in the wavenumber range of 500-2 200 cm(-1) hinted us of the high contents of DNA, protein and lipid in OSCC, which elucidate the high proliferative activity, but the difference between OLK and OSCC was not as much as that between normal and OSCC. The Gaussian radial basis function support vector machine showed powerful ability in grouping and modeling of normal and OSCC, and the specificity, sensitivity and accuracy were 100%, 97.44% and 98.81% correspondingly. The algorithm showed good ability in grouping and modeling of OLK and OSCC, the specificity, sensitivity and accuracy were 95.00%, 86.36% and 96.30%.

CONCLUSIONCombined with support vector machines, near infrared Raman spectroscopy could detect the biochemical variations in oral normal, OLK and OSCC, and establish diagnostic model accurately.

Carcinoma, Squamous Cell ; Humans ; Leukoplakia, Oral ; Mouth Mucosa ; Sensitivity and Specificity ; Spectrum Analysis, Raman

OBJECTIVEOver the last few decades, diabetic cardiomyopathy has been identified as a significant contributor in cardiac morbidity. However, the mechanisms of diabetic cardiomyopathy have not been clarified.

METHODSIn the present study, a diabetic rat model was induced by the intraperitoneal injection of streptozotocin. The myocardial CD147 expression and extent of glycosylation, as well as thematrixmetalloproteinases(MMPs) expression and activity, were observed in the diabetic and synchronous rats.

RESULTSThe results showed that CD147 located on sarcolemma of cardiomyocytes. The myocardial CD147 expression and glycosylation were significantly increased in the diabetic rats as compared with the control. Expression of MMP-2 protein, MMP-2 and MMP-9 activity were also increased in left ventricular myocardium in the diabetic rats. Tamoxifen only inhibited the enhanced expression of myocardial CD147 in the diabetic rats, but not in synchronous control rats. Tamoxifen inhibited glycosylation of myocardial CD147 in both diabetic and control rats. The inhibition of tamoxifen on CD147 glycosylation was stronger than on the expression in the myocardium. The extent of myocardial CD147glycosylation was positively related toMMP-2 and MMP-9 activity. Tamoxifen induced an inhibition of myocardial MMP-2 and MMP-9 activity in the control and diabetic rats.

CONCLUSIONThese results indicate that myocardial CD147 expression, especially the extent of glycosylation, regulates MMP-2 and MMP-9 activity, then accelerates cardiac pathological remodeling inducing diabetic cardiomyopathy. Tamoxifen inhibits myocardial CD147 glycosylation and further depress the activity of MMPs. Therefore, tamoxifen may protect the diabetic rats against diabetic myocardium.

Animals ; Basigin ; metabolism ; Diabetes Mellitus, Experimental ; complications ; Diabetic Cardiomyopathies ; drug therapy ; Glycosylation ; Heart ; drug effects ; Matrix Metalloproteinase 2 ; metabolism ; Matrix Metalloproteinase 9 ; metabolism ; Myocardium ; metabolism ; Myocytes, Cardiac ; cytology ; Rats ; Sarcolemma ; metabolism ; Tamoxifen ; pharmacology

This study was designed to explore the RNA interference technique in inhibition of the expression of the mouse fibrinogen like protein 2 (mfgl2), which has been reported to be involved in the development a variety of diseases including fulminant viral hepatitis. A plasmid named p-mfgl2shRNA,complementary to the sequence of mfgl2 was constructed, while another short hairpin RNA (shRNA)which was a mutated form of the mfgl2shRNA sequences was used as a control. A plasmid named pEGFP-mfgl2 expressing the mfgl2-EGFP fusion protein was also constructed for the screening of the effect of p-mfgl2shRNA on mfgl2 expression. By cotransfection of p-mfgl2shRNA and pEGFP-mfgl2 or pcDNA3.1-mfgl2 expression construct into CHO cells or HeLa cells, the inhibition of mfgl2 expression by mfgl2shRNA was analyzed by direct observation through fluorescent microscopy, FACS, RT-PCR and immunohistochemistry staining. The experiments showed the significant inhibitory effect of p-mfgl2shRNA on mfgl2 expression at 48h post-transfection in both CHO and Hela cell lines with the inhibitory efficiency as high as 80.1%. The study demonstrated that the construct of p-mfgl2shRNA successfully interfered with the mfgl2 expression in vitro.

Objective To study the application effect of day-parting appointment for elderly hypertensive contracted outpatients in community. Methods In May 2018 two groups (experiment and control) of 103 elderly hypertensive contracted outpatients, aged between 60 and 80 and looked after by the team of family doctors, who had been diagnosed with hypertension and with medication for at least one year were set up.The experimental group used self-made community hypertension visiting card for appointments, and the control group used the original way of treatment.Six months later, comparison was made in blood pressure control, the number of outpatients, the time consumed and the satisfaction between the two groups. Results It was found in comparison that the blood pressure standard-reaching rate of the experimental group was better than that of the control group (P < 0.05);outpatients′ visits and time consumed were less than those of the control group, the time used in the clinic room was longer than that in the control group; the differences in these aspects between the two groups were significant (P < 0.05);the satisfaction of the overall outpatient perception, attitude of family doctors, treatment technology, visits control, dosage, cost and safety of medication in the experimental group were better than in the control group; there were significant differences in these aspects between the two groups (P < 0.05). Conclusion Community day-parting appointment proves to be more convenient, more time-saving and safer for outpatients, greatly improving the medical quality and satisfaction for community outpatients.