Objective To explore the value of different surgical methods in the treatment of the displaced femoral neck fracture of the elderly. Methods An follow up study was done on 89 cases older than 65 years who were treated with internal fixation, femoral head arthroplasty and total hip joint replacement between 1998 and 2003 to compare the difference upon operation time, blood loss, duration of hospitalization, joint function evaluation one and two years after operation, complications and reversion rate. Results The internal fixation group had the shortest operation time and hospitalization and the least blood loss but the longest immobilization time, highest complication rate and reversion rate as well as the worst joint function. While the total hip joint replacement group had the least immobilization time, the lowest complication rate and reversion rate, best joint function but required better health condition. The femoral head arthroplasty group had the least operation injury but had relative higher reversion rate and worse joint function compared to the total hip joint replacement group. Conclusion Total hip joint replacement is suitable for the displaced femoral neck fractures of the elderly, especially those who are active have relative longer life expectancy and good general condition.

This study was aimed to assess the proportion and causes of misdiagnosis of pancreatic cancer (PC), and the effects of misdiagnosis on and treatment of PC, so as to sum up experiences and improve the diagnosis and treatment. 1027 cases with confirmed diagnosis of PC were retrospectively analyzed in detail. The patients were divided into misdiagnosed group and a group with correct diagnosis. The relevant data of the two groups were analyzed by stastical methods, and the differences between them were assessed. It was found that 586 cases (57 1%) were misdiagnosed.Fifty five diseases were involved in misdiagnosis, among them gastritis and duodenitis, peptic ulcer, virus hepatitis, cholecystitis and cholelithiasis, chronic pancreatitis wese the commonest. The differences of duration of diagnosis, main symptoms, resection rate, and half year survival rate between misdiagnosed group and correct diagnosis group were significant. It is concluded that PC is often misdiagnosed as other diseases. Early diagnosis and treatment is critical to the prognosis. The physician should be aware that PC may present a veriety of clinical manifestations, and therefore he or she should analyze comprehensively the symptoms and signs in order to improve diagnosis and treatment.

To study the clinical features of the pancreatic cancer (PC), clinical symptoms of 1027 diagnosed cases of PC were retrospectively analyzed in detail, including their dynamic changes with regards to the patients'sexes, ages, blood types, and tumor locations in the pancreas. The results showed that abdominal pain, jaundice and epigastric discomfort were the prevailing initial symptoms in these 1027 cases. Abdominal pain, jaundice, weight loss, and anorexia were the main symptoms. Unusual symptoms were seemed to be different in different patients. The clinical symptoms could be dramatically different with difference in patients′ age and tumor location. The blood type might also infhluence the clinical symptoms in certain degree. It is concluded that the clinical symptoms of the PC were atypical in general, but still there were some characteristics.The physician should grasp these characteristic symptoms in order to make an early diagnosis.

Objective To determine the effects of polymorphism of A9570G in angiotensin I converting enzyme 2 gene ( ACE2) gene on cardiac dysfunction and ventricular remodeling after myocardial infarction. Methods 252 patients with old myccardial infarction were included in this study. They were classified according to their polymorphisms of ACE 2 gene analyzed by polymerase chain reaction (PCR) and restriction fragment length polymorphism (RFLP). Echocardiograms were used to determine left ventricular end diastolic diameters (LVEDd) , Left ventricular mass index (LVMI) , mitral flow pattern early diastolic and late diastolic peak flow ratio (E/A) and left ventricular ejection fraction ( LVEF). Results In male, LVEDd, LVMI, and LVEF had significant difference among ACE2 genotypes ( t = 2. 609,3.527and 2.063, P =0.010,0.001 and 0.041), and no significant differences in E/A( t =0.689,P =0.492). In female,LVEDd, LVMI, E/A and LVEF had no significant difference among ACE2 genotypes( F =0. 848, 0.077,0. 985 and 1.611, P = 0. 432,0. 926,0. 377 and 0. 205 ). Conclusion The polymorphism of A9570G in ACE2 gene may be associated with cardiac dysfunction and ventricular remodeling after myocardial infarction in male. ACE 2 gene polymorphism may be a genetic factor on cardiac dysfunction and ventricular remodeling after myocardial infarction.

Objective To investigate the current status of iodine deficiency disorders in Lianyungang,Jiangsu Province,and to evaluate the effectiveness of prevention and control measures.Methods Using population probability proportional to size sampling method (PPS),in Lianyungang City,30 townships (towns) were selected,one primary school was selected in each township (town),fifty 8-10 years old students (half male and half female,uniformly distributed in age groups) were selected in each school,and goiter was examined; one random urine sample was collected to survey the urinary iodine content; household salt sample was collected to survey the salt iodine content.At the same time,30 students from Grade 5 in each school were selected,and health education questionnaire survey was conducted.In the village where the primary school located,5 housewives were selected and a questionnaire survey was conducted; salt samples were collected and salt iodine level was tested by semi quantitative detection on site; 2-5 drinking water samples were collected and the water iodine level was determined in the village.One random urine sample from twenty pregnant women and 10 lactating women in the township (town)was selected and urinary iodine was determined.The goiter was examined by palpation; urinary iodine was detected by arsenic cerium catalytic spectrophotometry (WS/T 107-2006); salt iodine was detected by direct titration,Sichuan salt and other fortified edible salt were tested by arbitration law (GB/T 13025.7-2012); water iodine was detected by the method suitable for iodine deficiency and high iodine areas (recommended method of reference laboratory of national iodine deficiency disorders).Results One thousand and five hundred children aged 8-10 years old were examined by palpation,18 children had goiter,and the goiter rate was 1.20％ (18/1 500).One thousand and five hundred urine samples of children aged 8-10 years old were tested,and the median of urinary iodine was 239.62 μg/L.A total of 1 500 salt samples were tested; the coverage rate of iodized salt was 96.73％ (1 451/1 500); the rate of qualified iodized salt was 93.53％ (1 403/1 500); and the non-iodized salt rate was 3.27％ (49/1 500).The number of question of the questionnaire survey of health education about iodine deficiency disorders among students and housewives was 2 697,450; the number of correct answer was 2 542,410; the pass rates were 94.25％ and 91.11％,respectively.Sixty-six drinking water samples were collected,water iodine median was 13.5 μg/L.Six hundred and one,two hundred and ninety-eight urine samples of pregnant women and lactating women were monitored,and the median of urinary iodine was 176.12 and 150.03 μg/L,respectively.Conclusion The status of iodine nutrition among residents in Lianyungang City has improved,the control effect of iodine deficiency disorders is significant,and the achievements are stable.

Objective To appraise the postoperative anti-reflux function of vertical esophagogastic valve-plasty anastomosis for cardiac cancer.Methods Forty patients with cardiac cancer were randomly divided into study group and surgery control group,with 20 patients in each group.The study group underwent vertical esopagogastric valve-plasty anastomosis,while the surgery control group underwent conventional esophagogastrostomy.Ten healthy volunteers were recruited as normal control group.A 24-hour esophageal pH monitoring and endoscopy check-up was carried out in all experimental subjects at 90 days postoperatively.Results All of the pH monitoring indexes in study and surgery control groups were higher than those in normal control group(P

Objective To detect the mRNA and protein expressions of desmoglein 1 (DSG1) and DSG3 in different types of keratinocytes (KCs).Methods Two keratinocyte cell lines HaCaT and A431,as well as primary keratinocytes from human abdomenal skin served as the object of this study.Direct immunofluorescence assay was performed to observe and quantify the expressions of DSG1 and DSG3,and quantitative PCR (qPCR) to determine the mRNA expressions of DSG1 and DSG3,in these cells.Results Both DSG1 and DSG3 were expressed in all the three types of keratinocytes,and the fluorescence intensity of DSG1 and DSG3 in HaCaT cells was higher than that in primary keratinocytes but lower than that in A431 cells.Similarly,all the keratinocytes expressed DSG1 and DSG3 mRNA,with the relative expression levels of DSG1 and DSG3 mRNA in primary keratinocytes being 291.7％ and 237.4％ of those in HaCaT cells respectively (both P ＜ 0.01),and those in A431 cells being 0.1％ and 18.8％ of those in HaCaT cells respectively (both P ＜ 0.05).Conclusions HaCaT cells,A431 cells and primary keratinocytes all can be used for the study of DSG1 and DSG3,of which,A431 cells show the strongest expressions of DSG1 and DSG3,and primary keratinocytes display the highest expressions of DSG1 and DSG3 mRNAs.

Objective To explore the feasibility of using irreversible electroporation (IRE)mediating HPV16 E6 shRNA into cervical cancer cell line SiHa,and to clarify the influence of their co-effect on the proliferation of SiHa cells and its mechanism.Methods A HPV16 E6 gene specific interference sequence was inserted in pGenesil-1 to build a interference vector.10 pulses of IRE with 800 V,100 μs,and 1 Hz were applied to the suspension of SiHa cells and vectors.According to the treatment factors,control group,IRE group,pGenesil-N group,pGenesil-N+IRE group,pGenesil-E6 group and pGenesil-E6 + IRE group were set up.The expression of green fluorescent protein (GFP)and transfection efficiency were confirmed by inverted fluorescence microscope 24 h after the vector was transfected by IRE,and the expression efficancy of GFP was calculated.The expression levels of E6 mRNA and protein were detected by RT-PCR and Western blotting method which was also applied to detect the expressions of P53 and PCNA.The proliferative activity of SiHa cells was determined by CCK-8 assay.Results Enzyme digestion and DNA sequencing verified that the vectors were correctly constructed.GFP was seen under inverted fluorescence microscope 24 h after IRE transfection.Compared with IRE group,the expression levels of E6 mRNA and protein were decreased detected by RT-PCR and Western blotting method after the vectors were treated with IRE,the P53 protein expression level was increased (P < 0.05),and the PCNA expression level was decreased (P <0.05).The CCK-8 assay results showed the proliferative activity of SiHa cells in pGenesil-E6+IRE group was decreased more obviously than that in pGenesil E6 group (P <0.05).Conclusion IRE can play the role of gene transfection of mediating HPV16 E6 shRNA into SiHa cells, and their co-effect can significantly inhibit the proliferation of SiHa cells.

OBJECTIVE To investigate the protective effects and mechanism of diterpene ginkgolides meglumine injection (DGMI) against oxidative stress induced by oxygen-glucose deprivation (OGD) in SH-SY5Y cells. METHODS SH-SY5Y cells were divided into five groups: normal control, model control (OGD group) and drug(25 mg · L- 1) administration groups including DGMI group, extract of ginkgo biloba leaves injection group (EGBLI) and lactones ginkgo biloba injection group (LGBI). The cells suffered from oxygen-glucose deprivation (OGD) for 4 h, followed by reoxygenation with drugs for 6 h. Then, cell viabilities were detect using CCK-8 assays, reactive oxygen species (ROS) levels using fluorescence probe DCFH-DA and superoxide dismutase (SOD) activities using WST-1 test. Western blotting was used to detected protein levels of hemeoxygenase-1(HO-1), NAD(P)H, quinone oxidore?ductase l (Nqo1), protein kinase B (Akt), phosphorylated Akt (p-Akt), nuclear factor-E2-related factor2 (Nrf2) and phosphorylated Nrf2 (p-Nrf2). The cells were induced by OGD for 4 h, followed by reoxygen?ation and DGMI for 1 h, combined with different concentrations of PI3K inhibitor (LY294002) (at the final concentration of 12.5, 25 and 50 μmol · L-1) before the protein levels of AKT, p-AKT, Nrf2 and p-Nrf2 were detected by Western blotting. RESULTS SH-SY5Y cells induced by OGD for 4 h resulted in an increase in ROS(P<0.01), but a decrease in cell viabilities(P<0.01), SOD activities(P<0.01), and antioxidant protein levels ( Akt, p-Akt, Nrf2, p-Nrf2, HO-1 and Nqo1) (P<0.01). Compared with OGD group, treatment with reoxygenation and drugs (DGMI,EGBLI and LGBI respectively) for 6 h resulted in a decrease in ROS (P<0.01), but an increase in cell viabilities, SOD activities and antioxidant protein levels of p-Nrf2, HO-1, Nqo1 and p-Akt(P<0.05,P<0.01). DGMI group showed the best efficiently. Moreover, after OGD for 4 h, compared with DGMI group, combining reoxygenation and DGMI with LY294002 for 1 h resulted in a concentration-dependent inhibition of the protein levels of p-AKT and p-Nrf2(P<0.01). CONCLUSION DGMI 25 mg · L-1 can inhibit oxidative stress in SH-SY5Y cells induced by OGD by increasing the activity and expression of Nrf2 through PI3K/Akt pathway, which may be one of the mechanisms by which DGMI protects neurons from stroke.

Aim To investigate the protective effects of Diterpene Ginkgolides Meglumine Injection(DGMI)on SY5 Y cells damaged by oxygen-glucose deprivation and its functional mechanisms.Methods After 4 h of OGD,the cells were treated with 25 mg·L-1 drugs for 1 h.Subsequently,cell viabilities were measured by cell counting kit-8(CCK-8 kit)and cell apoptosis was measured by flow cytometric analysis.Furthermore, the mitochondrial membrane potential was detected by rhodamine123 staining.The levels of phospho-p38, phospho-p53,Bcl-2,Bax and cleaved caspase-9/3 were evaluated by western blot.Results DGMI signif-icantly increased the cell viabilities of SY5 Y cells dam-aged by OGD,and reduced OGD-elicited dissipation of mitochondrial membrane potential and cell apoptosis. Furthermore,DGMI also reduced p-p38,p-p53,Bax/Bcl-2 ratio,cleaved caspase-9 and cleaved caspase-3. Conclusion DGMI shows good neuroprotective effects on SY5 Y cells after oxygen-glucose deprivation.The underlying mechanisms may be associated with the sup-pression of p38/p53/Bcl-2 /caspase-9/caspase-3 sig-naling pathway.