Objective Anovel index based on frequency-domain analysis of heart rate variability (HRV) was tested on patients with reduced left ventricular systolic function.This index,namely VHFI,was defined as the very high frequency (VHF) component of the power spectrum normalized to represent its relative value in proportion to the total power minus the very low frequency component.Methods Patients (n=130) were divided into a study group,consisting 66 patients with decreased left ventricular systolic function,and a control group,consisting 64 patients with normal heart structure and function and without severe coronary artery stenosis (＜50%).Results VHFI in the study group was significantly higher than that in the control group (19.17±13.35 vs 11.37±10.77,P＜0.001).Cardiac events occurred in 18 patients during follow-up (33.34±3.26 months).Defining the positive test as VHFI =15 and negative test as VHFI ＜15,achieved a sensitivity of 57.58% and a specificity of 78.13% for predicting decreased left ventricular systolic function,and achieved a sensitivity of 66.67% and a specificity of 64.29% for predicting cardiac events.Univariate Cox regression analysis showed that positive VHFI test was an independent variable in predictive cardiac events.Conclusions The results suggest that VHFI is a useful tool for quick evaluation of left ventricular systolic function and prediction of prognosis.

Objective To investigate the effects of self-made Yishen Antai Decoction combined with progesterone in the treatment of recurrent spontaneous abortion (RSA) and the effect on pregnancy outcomes and blocking antibodies (BA). Methods 100 cases of patients with RSA were randomly divided into the observation group and the control group, 50 cases in each group. The control group was treated with progesterone and on the basis, the observation group was additionally treated with self-made Yishen Antai Decoction. Both groups were intervened till 12 weeks of gestation, and the clinical curative effect was evaluated. Results The total effective rate of treatment, the success rate of pregnancy and the positive rate of blocking antibody (BA) showed significant differences between the observation group and the control group (P< 0.05). After treatment, the total TCM symptom score and serum levels of interleukin-2 (IL-2) and interferon-γ (IFN-γ) were significantly lower while interleukin-10 (IL-10) level was significantly higher in the observation group than the control group (P< 0.05). There were no serious adverse reactions in the two groups. Conclusion Self-made Yishen Antai Decoction is effective and safe in the treatment of RSA. It can significantly improve the success rate of pregnancy and the positive rate of BA, which may be associated with the regulation of IL-2, IL-10 and IFN-γ levels.

Objective To make an evidence-based rehabilitation plan for a patient with osteogenesis imperfecta after external fixation. Methods Based on a comprehensive assessment for the patient's condition, the clinical problems were listed. Related articles were searched from National Guideline Clearinghouse (NGC), The Cochrane Library, PubMed, CBM, CNKI and Wanfang databases. And the reference list of each eligible article was also included. Finally the optimum rehabilitation program was designed with optimal clinical evidence, patient's conditions and relatives' willingness. Results 1 randomized controlled trial and 4 case reports were included. A progressive exercise program was developed and implemented. No new fractures occurred during the intervention. Muscle strength, gait, activities of daily living had been greatly improved. 20 weeks later, the Berg score was 43 and the Barthel index was 80. Conclusion The progressive rehabilitation exercise program developed from evidence-based practice is safe, effective and feasible.

Adult ; Female ; Humans ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Neurotoxicity Syndromes ; diagnosis ; Retrospective Studies ; Tomography, X-Ray Computed

Compared with hip replacement, internal fixation in the treatment of the elderly femoral neck fracture, especially the application of cannulated screws, is minimally invasive, easy to operate and economical. In recent years, it becomes the research focus in the field of orthopedic clinical research. However, configuration of cannulated screws is still controversial. Most clinicians believe that three cannulated screws being placed in parallel in an inverted triangle configuration is better than that in a triangular configuration in biomechanics and clinical effect. Nonparallel strong oblique nailing technique allows the screws to share more weight to reduce postoperative complications, so that it is more suitable for elderly patients with osteoporosis. However, the related complications of internal fixation such as nonunion, femoral neck shortening and other problems are still the focus of domestic and foreign scholars. Issues about how to control the indication of internal fixation surgery, understand related factors of the complications, and prevent complications are required to be further explored.
Aged ; Bone Nails ; Femoral Neck Fractures ; surgery ; Fracture Fixation, Internal ; adverse effects ; methods ; Humans ; Internal Fixators

Anti-neutrophil cytoplasmic antibodies( ANCA)-associated vasculitis ( AAV) has various clinical symptoms, thus various treatment schemes were used in clinics.To date, there has been no validated diagnostic criteria or treatment guideline for AAV.There are three aspects to be considered when assessing the treatment with AAV patients:staging of disease, distinction between disease activity and chronic damages, and quality of life ( QOL) .This review focuses on the latest classification of vasculitis, the rela-tion between disease stages and its severity, the importance of distinguishing active diseases from permanent damages, the therapeutic choices and the management of complications.

Feeding intolerance in preterm infants,which is an important issue that the neonatal pediatri-cians have to work out,leads to malnutrition of early preterm infants and growth restriction which have an impact on later behavioral and cognitive outcomes. Feeding intolerance is related to the immature of gastrointestinal function,perinatal asphyxia,infection and other diseases. Minimal enteral feeding,prokinetic agents and supple-mentation of the enteral probiotics,are used generally,but at present there is no guidelines for the prevention and treatment.

Abdominal incisional hernia is a common complication of abdominal surgery,of which the two major direct causes are surgery wound healing and intra-abdominal pressure.Therefore,the factors causing poor wound healing and intra-abdominal pressure are incisional hernia incentives.Surgery is the only radical method to cure it,including open surgery and laparoscopic surgery.This review contains two contents,the summary of the current research and the prospects.

Objective To investigate the effect of specific small interfering RNA (siRNA) targeting receptor of advanced glycation end products (RAGE) on the production of fibrosis markers (laminin,hyaluronic acid (HA) and N-terminal procollagen Ⅲ propeptide (PⅢ NP) in hepatic fibrosis (HF).Methods The expression vectors of specific siRNA targeting RAGE were constructed.Primary rat hepatic stellar cells (HSC) were isolated and cultured.The primary rat HSC were transfected with the recombinant vector.The blank control group and unspecific siRNA vector pAKD-NC-transfected group were as controls.The expressions of RAGE,laminin,HA and PⅢ NP at mRNA and protein levels were detected by real-time polymerase chain reaction and Western blot,respectively.Least-significant difference (LSD) and Student-Newman-Keuls (SNK) were performed to analyze standard normal distribution or homogeneous variance.Non-normal distribution and heterogeneity of variance data were analyzed by non-parametric Wilcoxon test.Results The expressions of RAGE at mRNA and protein levels in pAKD-GR126-transfected primary HSC were (42.32 ± 6.16)％,(43.24±7.50)％,(51.06±13.79)％ and (47.94±5.36)％ in blank control group and pAKDNC group (F=7.791 and 36.513,all P＜0.05).The expressions of laminin at mRNA and protein levels were (41.07±3.13)％,(40.59±5.87)％,(53.89±2.25)％ and (52.46±4.68)％ in blank control group andpAKD-NC group (F=225.111 and 88.039,all P＜0.05).The expressions of HA at mRNA and protein levels were (45.69 ± 0.87) ％,(46.08 ± 2.36) ％,(54.20 ± 0.56) ％ and (52.30±3.42)％ in blank control group and pAKD-NC group (F=178.317 and 180.646,all P＜ 0.05).The expressions of PⅢ NP mRNA at mRNA and protein levels were (56.10±4.18)％,(55.15±2.39)％,(54.40±2.79)％ and (53.58±6.18)％ in blank control group and pAKD-NC group (F=141.633 and 49.670,all P＜0.05).Conclusion RAGE specific siRNA could inhibit the expression of RAGE in primary rat HSC and could significantly lower the expression of fibrosis markers laminin,HA and PⅢ NP at mRNA and protein level.

Objective To explore the measurement of femoral neck shortening (FNS) after cannulated screwing for elderly femoral neck fractures and the effect of FNS on hip functional outcome.Methods Totally 214 elderly patients with femoral neck fracture were included in this study who had been treated by fixation with cannulated screws from June 2007 to October 2013.They were 71 males and 143 females,with an average age of 77.2 years.According to Garden classification system,65 cases were types Ⅰ and Ⅱ (undisplaced fractures),and 149 types Ⅲ and Ⅳ (displaced fractures).The postoperative X-ray and follow-up X-ray films were compared to observe whether the trailing end of screw shaft was exposed to the outer cortex of the proximal femur.We chose the screw which had the longest exposure of trailing end to measure the length of the exposed screw shaft as the length of FNS.FNS indexes were defined according to the ratio of the length of exposed screw shaft to the thickness of screw head.FNS degree 1:＜ 1 screw head; FNS degree 2:1 to 2 screw heads; FNS degree 3:＞ 2 screw heads.The relationships of the FNS length respectively with thefemur length decrease and Harris scores of hip functional outcome were analyzed statistically.Results FNS occurred in 78 cases,giving an incidence of FNS of 36.4％ (78/214).Of them,12 cases (15.4％)were defined as degree 1,24 cases (30.8％) as degree 2,and 42 cases (53.8％) as degree 3.There was a significant positive correlation between the FNS length and the femur length decrease(r =0.919,P =0.000).The average Harris score at 12 months postoperation for 180 cases was 77.3 points (ranging from 32 to 98 points).The average Harris score for those with FNS was significantly lower than that for those without FNS (t =9.904,P =0.000).There was a significant negative correlation between the FNS length and Harris scores (r =-0.707,P =0.000).Conclusions Our measurement of FNS and FNS indexes are easy to be used in clinic.Severe FNS can influence the function of hip joint.