BACKGROUND:Intertrochanteric fracture is one of the common complications in patients with senile osteoporosis.Internal fixation is a common method in clinical therapy.Different internal fixators are selected in different studies.However,there are few studies on influential factors for outcomes of internal fixation at present.OBJECTIVE:To investigate related influential factors for outcomes of internal fixation in elderly patients with osteoporotic intertrochanteric fracture.METHODS:A total of 86 elderly patients with osteoporotic intertrochanteric fracture,who were treated in the Guanghua Hospital from May 2011 to May 2014,were enroled in this study.They were divided into three groups according to different manners of fixation.There were dynamic hip screw group (n=34),proximal intramedulary nail group (n=41) and proximal femoral compression plate group (n=11).Rate of fixation failure was compared among the three groups.The relevant factors affecting fixation effects were analyzed using univariate and multivariate analysis.RESULTS AND CONCLUSION:Internal fixation failure was detected in 5 patients (15％) in the dynamic hip screw group,11 patients (26％) in the proximal intramedulary nail group,and 4 patients (36％) in the proximal femoral compression plate group.Results of univariate analysis revealed that Evanse genotyping of patients,whether fractures were found on outer arm side,degree of osteoporosis,quality of reduction,steeple distance,whether combined with internal medicine diseases and selection of fixator were associated with internal fixation effects (P＜ 0.05).However,the internal fixation effects were not correlated with gender,age,hospital stay and ambulation time (P＞ 0.05).Multivariate analysis results demonstrated that unstable fractures,severe osteoporosis,fractures of the lateral arm,medical ilness,steeple distance ＞ 25 mm,and different internal fixators are independent factors affecting internal fixation effects in patients.

Humans ; Tachycardia, Ventricular ; genetics

Objective To evaluate the efficacy of DSA-guided percutaneous transhepatic gallbladder catheter drainage (PTGCD) in treating aged patients with acute cholecystitis complicated by severe diseases. Methods The clinical data of 15 aged patients with acute cholecystitis or complicated by severe diseases, who were encountered at authors’ hospital in the past three years and were treated with PTGCD, were retrospectively analyzed. The clinical results were discussed. Results PTGCD was successfully accomplished with single procedure in all 15 patients. Abdominal pain was relieved within one to three days, and the abdominal symptoms and signs subsided or disappeared. Reexamination of routine blood test showed that the white blood cell count decreased to normal range in 1 - 2 weeks, and complete cure was achieved in some patients. Secondary surgery was carried out in some patients after the clinical condition was improved. During the follow-up period no complications occurred in all patients except one who developed biliary leakage after the catheter was retrieved two weeks after the treatment. Conclusion For the treatment of complicated acute cholecystitis in aged patients who are not suitable to receive surgery, DSA-guided percutaneous transhepatic gallbladder catheter drainage is an ideal therapeutic means as it can significantly relieve clinical symptoms.

Objective To examine the association between residual renal function at initiation of dialysis and prognosis in maintenance dialysis patients.Methods Incident patients with end-stage renal diseases initiating dialysis between 1 January 2005 and 30 September 2009,followed up to 31 March 2010 were enrolled in this study.Residual renal function was evaluated using eGFR estimated by the abbreviated MDRD equation.Patients were classified into four groups according to eGFR of ≥10.5,8 to ＜10.5,6 to ＜8,＜6 ml·min-1·(1.73 m2)-1.The outcome was all-cause and cardiocerebral vascular mortality.Results (1) A total of 562 patients were included.The median eGFR at initiation of dialysis was 5.60 (2.26-12.62) ml·min-1·(1.73 m2)-1.The median follow-up time was 17 (0-58) months from initiation of dialysis and 141 patients died within this period.The median survival time was 45.48 (43.05-47.90) months.With eGFR declined,Scr,BUN,serum uric acid,serum prealbumin,phosphorus,calcium and phosphate product,iPTH,mean arterial pressure (MAP) at initiation of dialysis increased (P＜0.05),and hemoglobin,proportion of male,proportion of diabetes comorbidity,proportion of the Charlson comorbidity index ≥5 decreased (P＜0.05).Though there was no significant difference among the four groups,the proportion of left ventricular hypertrophy comorbidity increased when eGFR declined.(2) There was no significant difference of all-cause mortality among four groups using Kaplan-Meire survival curve.Cox regression model indicated no significant difference of all-cause mortality in levels of eGFR (HR=1.012,95％CI 0.961-1.065,P=0.654).Without patients died in the first 3 months,the multivariate Cox regression model indicated eGFR at initiation of dialysis was the protective factor to 1 year survival (HR=0.791,95％CI 0.669-0.935,P＜0.01).(3) The multivariate Cox regression model indicated the risk of overall and 1 year cardiocerebral vascular death decreased with eGFR at initiation of dialysis increased (HR=0.868,95％CI 0.777-0.971,P＜0.05; HR=0.937,95％CI 0.851-0.992,P＜0.05,respectively).(4) The multivariate Cox regression model indicated eGFR at initiation of dialysis was benefit to survival of patients treated by peritoneal dialysis,with all-cause death risk decreased by 10％ when eGFR increased by 1 ml·min-1·(1.73 m2)-1 (HR=0.90,95％CI 0.81-0.99,P＜0.05).In hemodialysis patients,Kaplan-Meire survival curve was significantly different among the four groups (Log-rank test,P=0.047); the survival of the group of 8 to ＜10.5 ml·min-1·(1.73 m2)-1 was lower as compared to the groups of 6 to ＜8 (Log-rank test,P=0.033) and ＜6 ml·min-1(1.73 m2)-1 (Log-rank test,P=0.005); but the multivariate Cox regression model indicated no relationship between survival and eGFR.In the subgroup of chronic glomerulonephritis as primary renal disease,the eGFR at initiation of dialysis was the benefit factor,with all-cause death risk decreased by 16.6％ (HR=0.834,95％CI 0.736-0.946,P＜0.01) and cardiocerebral vascular death risk decreased by 18.2％ (HR=0.818,95％CI 0.669-0.999,P＜0.05) when eGFR increased by 1 ml ·min-1 ·(1.73 m2)-1.In the subgroup of chronic glomerulonephritis treated by peritoneal dialysis,the all-cause death risk decreased by 32.1％ with eGFR increased by 1 ml·min 1·(1.73 m2)-1 (HR=0.679,95％CI 0.535-0.862,P＜0.01).Conclusions Early initiation of dialysis may not be associated with improved overall survival,but may reduce cardiocerebral vascular and 1 year all-cause mortality,improve the survival of chronic glomerulonephritis patients and peritoneal dialysis patients.

Objective To elucidate the immunologic mechanism and clinical effect of high intensity focused ultrasound (HIFU) combined with dendritic cell and cytokine induced killer cell (DC-CIK) immunotherapy on patients with pancreatic cancer.Methods Seventy-two pancreatic cancer patients were divided randomly into 2 equal groups,one treated with HIFU only the other treated with HIFU and DC-CIK immunotherapy.Ultrasound imaging and a variety of immunological indexes were recorded before and after treatment and the clinical effects in the two groups were compared.Moreover,autogenous tumor cells were isolated from the combination therapy group and the killing activity of DC-CIK which loaded tumor antigen processed by HIFU on autogenous tumor cells was observed.Results Tumor antigen processed by HIFU can improve the killing activity of DC-CIK on autogenous tumor cells.After treatment,the immunological indexes,of all patients were better than before treatment.(58.26 ± 17.97 versus 52.15 ± 14.22 pg/ml with IL-12 22.14 ± 6.39 versus 17.36 ± 5.73 ng/ml with HSP70 and 0.94 ± O.34 versus 1.32 ± O.61 ng/ml with TGF-β,P ＜ 0.05 ) ; The combination group was significantly better than the HIFU group with regard to the average scores of quality of life (75.89 ± 19.65 versus 67.22 ± 16.34,P＜0.05),pain (3.15 ±0.82 versus 3.59 ± 1.04,P ＜0.05),tumor markers (107.55 ±27.58 versus 123.63 ±34.12 U/ml) and survival time (18.92±6.47 versus 13.36 ±5.78 mos).Conclusion HIFU can improve the immunologic status and anti-tumor response in patients with pancreatic cancer.HIFU combined with DC-CIK has good synergistic therapeutic effect for treating pancreatic cancer.

Objective To examine the correlation between metabolic acidosis and malnutrition in maintenance haemodialysis (MHD) patients. Methods Forty-four MHD patients were divided into 3 groups according to plasma bicarbonate concentrations (PHCO3) and pH values. The correlation between metabolic acidosis and nutritional parameters was studied. Results The mean PHCO3 was (19.1?0.9) mmol/L in group A (n=13), (24.0?1.3) mmol/L in group B (n=22) and (27.1?0.1) mmol/L in group C (n=9). The adequacy of dialysis (Kt/V) was comparable in three groups. As compared with group B, group A had significantly higher body mass index (BMI), triceps skin fold thickness (TSF), dietary protein intake (DPI), normalized protein catabolic rate (nPCR) , Scr, serum K+ and parathyroid hormone (PTH), meanwhile, group C had significantly lower DPI, nPCR, Scr and albumin. There was no significant difference in plasma inflammatory markers C-reactive protein (CRP) among three groups. There was significant negative correlation of PHCO3 to nPCR (P

The HPLC fingerprint differences ofRadix Platycodonis from different origins were studied to provide references for their quality control and production. The total platycodins were purified by DB101 macroporous resin. HPLC-ELSD fingerprints of the total platycodins for 39 batches ofRadix Platycodonis samples from 9 provinces were performed on an Agilent HC-C8 column (4.6 mm x 250 mm, 5μm) with gradient elution. The mobile phase was acetonitrile-0.5% acetic acid. The injection volume was 6μL. The flow rate was 0.5 mL·min-1. The temperature of drift tube was set at 90℃. And the gas flow (N2) was set at 1.2 mL·min-1. The results showed that there were large differences in the quality ofRadix Platycodonis from different origins with the common fingerprints of 6 batches of samples fromChifeng in Inner Mongolia as references. The quality ofRadix Platycodonis was closely related to the seeds, the ecological environment, the way of drying and storing and so on. It was concluded that it was important to strengthen the provenance base construction, standardization of the seeds, reasonable formulation of the regionalization, and standardization of the production processing for the cultivation and production ofRadix Platycodonis.

AIM: To establish the method for determing effective components of notoginsenoside in Compound Danshen Tablets(Radix et Rhizoma Salviae miltiorrhizae,Radix et Rhizoma Notoginseng,Borneolum Syntheticum) by RP-HPLC. METHODS: The contents of notoginsenoside R_1,ginsenoside Rg_1,ginsenoside Re and ginsenoside Rb_1 were simultaneously determined by an HPLC system with Kromasil C_(18)(5 ?m,250 mm?4.60 mm),the mobile phase was CH_3CN-0.05%H_3PO_4(CH_3CN 0-12 min:22%;12-20 min:22%-28%;20-60 min:28%-43%).The flow rate was 1 mL/min.The detection wavelength was set at 203 nm. RESULTS: The linear ranges of notoginsenoside R_1,ginsenoside Rg_1,ginsenoside Re and ginsenoside Rb_1 were 0.326-3.260 ?g(r=(0.999 7),) 0.890-8.900 ?g(r=0.999 8),0.144-1.440 ?g(r=0.999 6),0.940-9.400 ?g(r=0.999 8),respectively.Their average recoveries(n=6) were 99.08%,98.36%,97.54% and 96.07%,corresponding RSD were 4.41%,1.64%,2.77% and 1.12%,respectgively. CONCLUSION: The results indicate that the HPLC method is simple,accurate,highly selective and reproducible,thus it could be used as quality control in the preparation of Compound Danshen Tablets.

OJECTIVE: To explore the changes of serum IgE and tryptase caused by anaphylactic shock rats and discuss the relation to PMI and preservative environment of corpse and specimen. METHODS: Rats were used for establishing anaphylactic shock models and randomly divided into room temperature group, refrigeration group, frozen group, manual hemolysis group, specimen preservation group. And the control group was also established. The blood samples were collected after rats were sacrificed. The degree of hemolysis was graded according to the color of the upper layer of the serum. The mass concentration of IgE and tryptase in each group was detected by ELISA. RESULTS: The levels of serum IgE and tryptase in anaphylactic shock dead rats were higher than that of the control group. Room temperature and frozen made obviously differences on the levels of serum IgE and tryptase with various PMI. The levels of serum IgE and tryptase in refrigeration group showed relatively stable. The levels of serum tryptase and IgE were elevated with differently increasing hemolysis. The levels of serum IgE and tryptase showed no obvious changes during the specimen kept under different temperature conditions for 25 days. CONCLUSION Serum IgE and tryptase obviously increased in anaphylactic shock rats. However, the levels were influenced by PMI and environmental temperature, especially under the conditions of room temperature and frozen.
Anaphylaxis/blood* ; Animals ; Disease Models, Animal ; Enzyme-Linked Immunosorbent Assay ; Immunoglobulin E/blood* ; Rats ; Temperature ; Tryptases/blood*

Objective To establish and evaluate a gene microarray for determination katG mutations of Mycobacterium tuberculosis isolates associated with resistance to isoniazid(INH).Methods A panel of probes were designed and gene chips were prepared by dotting.Mycobacterium tuberculosis isolates resistance to 5 drugs was determined by proportional dilution methods.Amplicons of Mycobacterium tuberculosis isolates were detected by our chip and sequenced.Results The drug resistance rate of the isolates to at least one of the anti-tuberculosis drugs was 70.8%(97/137).45 strains out 137 Mycobacterium tuberculosis isolates was resistant to INH(32.8%).katG was successfully amplified from 100% of the susceptible strains and 88.9%(40/45)resistant strains.4 of 45 INH resistant isolates' katG were deleted.27 of 40(67.5%) katG has been detected to have katG 315 codon mutations.The mutations were 315 AAC(Asn,13/40), ACC(Thr,6/40),ACA(Thr,4/40),ATC(Ile,2/40),AGC(Arg,2/40).The mutation rate of katG analyzed by gene chips we prepared were identical to katG sequencing.Conclusion The gene microarray techniques we developed for determination of Mycobacterium tuberculosis resistance to INH are specific, sensitive and may be used as an alternative in clinical laboratory.