OBJECTIVETo compare clinical efficacy of anatomic locking plate and Gamma nail in treating unstable femoral intertrochanteric fractures with external wall fractures.

METHODSFrom June 2010 to June 2014,clinical data of 44 patients with intertroehanteric fractures associated with lateral wall fractures (type 31A2.2-3.3) followed more than 12 months,which treated with Gamma nail or anatomic locking plate,were retrospective analyzed. Sixteen patients were treated with anatomic locking plate, including 6 males and 10 females aged from 32 to 83 years old with an average of 56.5 years old. Twenty-eight patients were treated with Gamma nail including 17 males and 11 females aged from 26 to 87 years old with an average of 60.4 years old. Operative time, intraoperative fluoroscopy times, blood loss (intraoperative and hidden blood loss), hospital stays were observed and compared. PPMS and HHS scoring were used to evaluate postoperative clinical effect.

RESULTSAll patients were followed up from 12 to 24 months with an average of 16.2 months. Operative time in Gamma nail was shorter than anatomic locking plate; while blood loss( intraoperative and hidden blood loss) and intraoperative fluoroscopy times in anatomic locking plate were less than that of in Gamma nail. There was no significant meaning in hospital stays between two groups. Postoperative full weight-bearing time in anatomic locking plate was prolonged than Gamma nail. At the final following-up, PPMS in Gamma nail was 7.50 ± 1.78 and 6.82 ± 1.38 in anatomic locking plate, and there was no obvious meaning between two groups (t = 2.341, P = 0.132); there was no significant differences in HHS score between Gamma nail (83.25 ± 11.18) and anatomic locking plate (86.14 ± 12.36) (t = 1.923, P = 0.243). The incidence of complications in Gamma nail was less than anatomic lock-ing plate (P = 0.005).

CONCLUSIONAnatomic locking plate for intertrochanteric fractures with external wall fractures could avoid re-injury of external wall, especially for severe comminuted fractures, difficult for intramedullary nailing, and there was no significant meaning in hip joint function compared with Gamma nail, while postoperative incidence of complications was higher than Gamma nail, so early weight-bearing was not stress.

Adult ; Aged ; Bone Nails ; Bone Plates ; Female ; Fracture Fixation, Intramedullary ; instrumentation ; methods ; Hip Fractures ; surgery ; Hip Joint ; surgery ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Young Adult

Objective To compare clinical efficacy of inverse less invasive stabilization system (LISS) and Gamma nail in treating unstable femoral intertrochanteric fractures combined with lateral wall fractures.Methods Fifty-two patients with intertrochanteric fractures associated with lateral wall fractures followed up for at least 12 months after surgical treatment between June 2010 and June 2013 were included in this retrospective cohort study.According to the different internal fixation,the patients were assigned to inverse LISS group [16 males and 8 females;(62.5 ± 12.4)years] and Gamma nail group [17 males and 11 females;(60.4 ± 18.6)years].According to the AO classification,there were 6 patients with A2.2 type,5 A2.3 type,5 A3.1 type,6 A3.2 type and 2 A3.3 type in inverse LISS group,and there were 4 patients with A2.2 type,7 A2.3 type,9 A3.1 type,5 A3.2 type and 3 A3.3 type in Gamma nail group.Opcration time,total blood loss (intraoperaive plus occult blood loss),hospital length of stay,bone healing,time of commencing full weight-beating and complication incidence were compared between the two groups.Harris hip score was recorded postoperatively.Results All patients were followed up for 24-36 months (mean,30.2 months).Operation time in Gamma nail group was shorter than that in inverse LISS group (P ＜ 0.05),while relatively more blood loss was found in Gamma nail group(P ＜0.05).There were no significant differences in hospital length of stay and bone healing timebetween the two groups (P ＞ 0.05).Patients in Gamma nail groups started earlier full weight-bearing than inverse LISS group (P ＜0.05).Harris score was (86.1-± 12.4)points in inverse LISS group one year after operation,not significantly different from (83.3 ± 11.2) points in Gamma nail group (P ＞ 0.05).Complication of one patient with coxa vara and one bone nonunion in inverse LISS,showing no significant from one patient with screw breakage and one femoral head osteonecrosis in Gamma nail group (P ＞ 0.05).Conclusions Both techniques are effective in treatment of intertrochanteric fractures combined with lateral wall fractures and achieve similar results in function recovery.But inverse LISS is eccentric fixation,so too early weight-bearing should not be over-emphasized.

Objective To investigate the levels of pro-inflammatory cytokine interferon (IFN)-γand anti-inflammatory cytokine interlenkin (IL)-10 in expressed prostatic secretions (EPS) of chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) and their clinical significance. Methods The levels of IFN-γ and IL-10 in EPS of 20 patients with CP (type Ⅲ A, group A ), 20 patients with CPPS (type Ⅲ B,group B) and 10 healthy men (control group) were measured using enzyme-linked immunosorbent assay (ELISA). The results were analyzed comparatively with NIH-chronic prostatitis symptom index (NIH-CPSI).Results The levels of IFN-γ in EPS of group A and group B were ( 14.92 ± 7.85 ), ( 13.74 ± 5.96) ng/L respectively, which were higher than that in control group [(7.47 ± 1.40) ng/L] (P ＜ 0.05 ). And the levels of IL-10 in EPS of group A and group B were (216.40 ± 33.65 ), (223.70 ± 45.21 ) ng/L respectively, which were higher than that in control group [( 162.10 ± 43.81 ) ng/L] ( P ＜ 0.05 ). There was no statistically significant difference between group A and group B. No correlation between NIH-CPSI and IFN- γ,IL-10 levels in EPS(P ＞ 0.05 ). Conclusion IFN-γ and IL-10 have a very important role in etiology of CP/CPPS and they can be the objective parameters in the diagnosis of CP/CPPS.

Objective To evaluate the security and efficacy of combination of epristeride and terazosin for treatment of benign prostatic hyperplasia (BPH). Method One hundred and eighty-four patients with BPH were treated by epristeride for 6 months and terazosin for 1 month, the efficacy and complication were observed. Results After 6 months treated, compared with before treated, the common symptoms improved, the residual urine decreased 20.74ml, maximum flow rate increased 3.76 ml/s, prostate volume grown downwards 6.70cm3 and the quality of life raised apparently(Pall＜0.05 ). Condusion Combinationof epristeride and terazosin for treatment of BPH is safe and effective.

Objective To investigate the effects of cefoprazone/sulbactam(CPZ/Sul)and dexamethasone(DXM) on serum IL-8,IL-10 in SD rats with severe pneumonia due to Klebsiella pneumoniae.Methods A rat model of severe pneumonia was induced by intratra- cheal instillation of Klebsiella pneumoniae with a dose of 3.6×108CFU(0.3ml).60 male SD rats were random divided into control group,model group,cefoprazone/sulbactam(CF-L/Sul)group and cefoprazone/sulbactam plus dexamethasone(DXM+CPZ/Sul)group.15 rats in each group were then divided into three subgroups and 5rats in each subgroup were examined at the 6th,8th and 10th day,respectively.Arterial gas analysis.total WBC and PMN cell counts in BALF were examined.ELISA method was used to detect the level of IL-8 and IL-10 in serum.RESULTSIn model group,PaO2 were progressively decreased while total WBC and PMN cell counts in BALF were markedly increased.In CPZ/Sul group,all parameters were alleviated,but there were no significant difference of serum IL-8 and IL-10 between model group and CPZ/Sul group.In DXM+CPZ/SUl group,all parameters were significantly alleviated including serum IL-8 and IL-10.Conclu sions Severe pneumonia of rat due to Klebsiella pneumoniae was characterized by significant elevation of serum IL-8 and IL-10,which suggested the imbalance of inflammatory/anti-inflammatory mediators during the course of severe pneumonia.DXM codd markedly decrease the production of inflammatory mediators and slightly decrease the production of anti-inflammatory mediators,which could restore the balance and contribute to the relief of severe pneumonia.

Objective: To study the protective effects and the mechanism of Salvia yunnanensis extract on hypoxia/reoxygenation injury in cultured rat H9c2 cardiomyocytes.Methods: The hypoxia/reoxygen (H/R) injury model was established in H9c2 cell strain with or without the extract of Salvia yunnanensis.The cultured H9c2 cardiomyocytes were randomly divided into 6 groups: the normal control (C) group, H/R group, H/R+verapamil (H/R+V) group, H/R+Salvia yunnanensis extract at low dose (H/R+L, 0.01 mg·L-1) group, medium dose (H/R+M, 0.1 mg·L-1) group and high dose (H/R+H, 1.0 mg·L-1) group.The cell viability was measured by MTT assay and the activity of malondialdehyde (MDA) and lactate dehydrogenase (LDH) was measured by a detection kit.Fluorescence absorbance (A) value was measured by a fluoroscopy to show the intracellular reactive oxygen species (ROS) levels.Results: Compared with that in the model group, the survival rate of myocardial cells was significantly higher in Salvia yunnanensis extract at low, medium and high dose groups (P＜0.05 or P＜0.01), and the intracellular LDH leakage (P＜0.05 or P＜0.01), the content of MDA in cytoplasm (P＜0.01) and the intracellular ROS levels significantly decreased in Salvia yunnanensis extract at high dose group (P＜0.05).Conclusion: The extract of Salvia yunnanensis has protective effect on hypoxia/reoxygenation injury in cultured rat H9c2 cardiomyocytes, and the mechanism may be related to the reduction of lipid peroxides and removal of cell oxygen free radicals.

No abstract available.
Craniocerebral Trauma* ; Head* ; Hematoma*

Objective To investigate the expression of macrophage migration inhibitory factor(MIF) in renal tissue of children with Henoch-Schonlein purpura nephritis(HSPN),and its correlation with clinical indexes and pathological changes,and to explore its effect on the pathogenesis of HSPN.Methods According to the clinical manifestation,60 children with HPSN were divided into only purpura group,mixed group and HSPN group.MIF concentration of Henoch-Schonlein purpura(HSP) groups and healthy control group were detected with enzyme linked immunosorbent assay(ELISA).MIF protein expression and the marker of human macrophage(CD68) in renal tissues of HSPN and normal control group were detected with immunohistochemistry method.The total urine protein for 24 hours and urinary N-acetyl-beta-D-glucosaminidase (NAG) level were detected with laboratory routine method.Results MIF concentration in mixed group and HSPN group were significantly higher than that in only purpura group and healthy control group(Pa

Objective To explore a new model of medical humanity education in new situation. Methods Extensive survey was carried out among medical students,and discussion and consultation were hold to faculty and education administers.A new teaching model was established. Results A curriculum system with 1 or 2 core courses supported by some elective courses and social practice is under the process of implementation and achieved preliminary success.Conclusion The medical humanity education should pay attention to the development of connotation instead of pursuing the extension of quantity blindly,which means that students' school work must be eased by focusing on self-study and self-education.Medical students'life path with high-minded personality training should be strengthened.

Aim To investigate the effect of astragalo-side IV ( ASIV) on myocardial energy metabolism and mitochondrial biosynthesis in myocardial cells of dia-betic rats induced by streptozotocin ( STZ ) . Methods
50 SD rats at 6 weeks of age were assigned to 5 groups,10 for each group:control group, model group, ASIV 10 mg·kg-1 ·d-1 group, ASIV 20 mg·kg-1 ·d-1 group, ASIV 40 mg·kg-1 ·d-1 group. Except the control group,the remaining 40 were used to estab-lish type 1 diabetes model by the tail vein injection of STZ (35 mg·kg-1 ) . At the end of 16 weeks of treat-ment, left ventricular systolic pressure ( LVSP ) , left ventricular diastolic final pressure ( LVEDP ) and left ventricular maximum rising/falling rate ( ± dp/dtmax ) were tested. Pathological section was observed by HE staining. ATP, ADP, AMP levels were detected by ELISA. The expressions of PGC-1α and NRF-1 protein were assessed by Western blot. The expressions of PGC-1α and NRF-1 mRNA were determined by RT-PCR. Results Compared with control group, model group markedly elevated LVEDP and decreased LVSP, ± dp/dtmax , ATP/AMP and ATP/ADP ratio. Com-pared with model group, low-dose ASIV group did not change significantly,middle-dose ASIV group and high-dose ASIV group obviously decreased LVEDP, and im-proved LVSP, ± dp/dtmax , ATP/ADP and ATP/AMP ratio. Meanwhile, the expressions of PGC-1α and NRF-1 protein and mRNA were increased in a dose-de-pendent manner. Conclusion ASIV could promote mitochondrial biosynthesis, improve energy metabolism in myocardial cells of type 1 diabetic rats by PGC-1αand NRF-1 .