OBJECTIVE: To investigate the short-term clinical effect of closed reduction single arm external fixator combined with percutaneous needle fixation in the treatment of C1 distal radius fracture in elderly patients. METHODS: Between December 2022 and December 2023, a total of 60 elderly patients diagnosed with type C1 distal radius fractures were treated, comprising 9 males and 51 females. The age ranged from 65 to 84 years old, with an average of (72.69±8.14) years old. Among them, there were 18 cases on the left side and 42 cases on the right side. There were 55 cases of falling injury and 5 cases of traffic accident injury. According to the different surgical methods, the patients were divided into observation group and control group, with 30 cases in each group. The control group underwent manual reduction and unilateral external fixator fixation, consisting of 4 males and 26 females. The mean age was (72.54±8.67) years old. The body mass index (BMI) was (20.61±2.17) kg·m^-2. There were 10 cases on the left side and 20 cases on the right side. Among them, there were 27 cases of falling injury and 3 cases of traffic accident injury. The observation group was treated with manual reduction and unilateral external fixator combined with percutaneous Kirschner wire fixation, including 5 males and 25 females. The mean age was (72.76±7.23) years old. BMI (20.82±2.03) kg·m^-2. The left side was involved in 8 cases and the right side in 22 cases. There were 28 cases of falling injury and 2 cases of traffic accident injury. The changes in radial height, ulnar declination, palmar inclination angle parameters and patient-rated wrist evaluation (PRWE) were assessed on X-ray films before surgery, 2 days after surgery, and 12 weeks after surgery between the two groups. RESULTS: All surgical procedures were successfully completed in both groups without any significant complications. All patients were followed up for a duration from 12 to 20 weeks with an average of(14.50±2.78) weeks. The two groups exhibited significant differences in radial height, palmar inclination angle, and ulnar deviation angle at 2 days and 12 weeks post-operation (P<0.05). However, there was no statistically significant difference observed in radial height, palmar inclination, and ulnar deviation between the two groups at 2 days after the operation (P>0.05). There were significant differences in radial height, palmar inclination angle, and ulnar deviation between the two groups at 12 weeks after operation (P<0.05). At 2 days and 12 weeks after the operation, there were significant differences in PRWE scores of the two groups compared with preoperative scores(P<0.05). At 2 days after the operation, there was no significant difference in PRWE score between the two groups (P>0.05). The PRWE score showed a significant difference between the two groups at 12 weeks post-operation(P<0.05). CONCLUSION The combination of closed reduction and unilateral external fixator, along with percutaneous pin fixation provides move stable fixation for type C1 distal radius fractures. Gradual removal of external fixator further facilitatse the recovery of wrist joint function.
Humans ; Male ; Female ; Radius Fractures/surgery* ; External Fixators ; Aged ; Aged, 80 and over ; Bone Wires ; Fracture Fixation/instrumentation* ; Wrist Fractures

Isoflavones are widely consumed by people around the world in the form of soy products, dietary supplements and drugs. Many isoflavones or related crude extracts have been reported to exert pain-relief activities, but the mechanism remains unclear. Voltage-gated sodium channels (VGSCs) play important roles in excitability of pain sensing neurons and many of them are important nociceptors. Here, we report that several isoflavones including 3'-methoxydaidzein (3MOD), genistein (GEN) and daidzein (DAI) show abilities to block VGSCs and thus to attenuate chemicals and heat induced acute pain or chronic constriction injury (CCI) induced pain hypersensitivity in mice. Especially, 3MOD shows strong analgesic potential without inducing addiction through inhibiting subtypes Na1.7, Na1.8 and Na1.3 with the IC of 181 ± 14, 397 ± 26, and 505 ± 46 nmol·L, respectively, providing a promising compound or parent structure for the treatment of pain pathologies. This study reveals a pain-alleviating mechanism of dietary isoflavones and may provide a convenient avenue to alleviate pain.
Analgesics ; administration & dosage ; chemistry ; Animals ; Humans ; Isoflavones ; administration & dosage ; chemistry ; Male ; Mice ; Mice, Inbred C57BL ; Pain ; drug therapy ; genetics ; metabolism ; Voltage-Gated Sodium Channel Blockers ; administration & dosage ; Voltage-Gated Sodium Channels ; genetics ; metabolism

OBJECTIVETo study the relationship between the change of coagulation and the clinicopathologic characteristics in patients with gallbladder cancer.

METHODSThe 64 gallbladder cancer patients (GBC group) and 60 cholecystitis patients (control group) had been reviewed from January 2007 to June 2013. The prothrombin time (PT), activated partial thromboplastin time (APTT), fibrinogen (Fib), and thrombin time (TT) had been measured and compared between patients of GBC group and control group. The relationship of coagulation function and prognosis were analyzed.

RESULTSCompared with control group, APTT in GBC group ((29.0 ± 4.2) s) was significantly shortened (t = -4.265, P = 0.000) and PT ((11.5 ± 1.4) s), TT ((15.3 ± 3.5) s), Fib ((4.1 ± 0.9) g/L) were significantly increased in GBC group (t = 2.521, 4.147 and 4.365, all P < 0.05). The level of Fib was higher in patients with medium or poor-differentiated tumor cells (F = 4.069, P = 0.022), lymph metastasis (t = 2.640, P = 0.010) and advanced staging (II-IV) (t = 3.003, P < 0.01) than those of well-differentiated, non-lymph metastasis and early staging (0-I). The ratio of gallbladder cancer with hyperfibrinogenemia (32/64) was significantly higher than control group (11/60, χ(2) = 13.709, P < 0.01). In GBC group, compared with normal Fib patients, hyperfibrinogenemia patients showed significantly difference in clinicopathologic characteristics (χ(2) = 5.851-10.573, P < 0.05). The average survival period of hyperfibrinogenemia patients and normal Fib patients were 8.63 months and 16.73 months. The 1-, 3-year survival rate of patients with hyperfibrinogenemia were significantly lower than those with normal Fib (64.7%, 14.9% vs. 74.9%, 21.1%, P < 0.05).

CONCLUSIONPreoperative plasma level of Fib might be a new promising biomarker in patients with gallbladder cancer for evaluating disease progression and prognosis.

Adult ; Aged ; Aged, 80 and over ; Blood Coagulation ; Case-Control Studies ; Female ; Fibrinogen ; metabolism ; Gallbladder Neoplasms ; physiopathology ; Humans ; Male ; Middle Aged ; Prognosis ; Prothrombin Time

Objective To analysis the effect of subthalamic nucleus deep brain stimulation (STN-DBS) on Parkinson's disease (PD) and the regulatory strategies of these stimulation parameters.Methods Six patients with PD,admitted to and received STN-DBS in our hospital from February 2012 to December 2012,were chosen in our study; the clinical symptoms of all patients were evaluated by Unified Parkinson's Disease Rating Scale (UPDRS) before and 1 mouth after STN-DBS operation;stimulation parameters were also recorded.Results The UPDRS Ⅰ scores of these patients were not significantly different between before and 1 month after STN-DBS (P＞0.05).As compared with those before surgery,the UPDRS Ⅱ,Ⅲ and Ⅳ scores of these patients 1 month after STN-DBS were significantly decreased (P＜0.05).All patients received unipolar stimulation with stimulus frequencies of equal to or greater than 130 Hz,stimulus voltages of 1.97±0.23 V and stimulus pulses of 90-120 μs.Follow-up was performed for 2～8 months,showing stable symptoms and no stimulation-related complications in all the patients.Conclusion STN-DBS could significantly improve the motor function and living quality on medium-late term PD patients; under high-frequency stimulation,the voltage and pulse width could be programmed by the energy per pulse (V· μs) value.

OBJECTIVETo investigate the expression of RRM1 and ERCC1 genes in tumor tissues and peripheral blood lymphocytes of advanced non-small cell lung cancer (NSCLC).

METHODSTissue and peripheral blood samples were collected from 49 advanced NSCLC patients treated with gemcitabine plus carboplatin. The expressions of RRM1 and ERCC1 mRNA in tumor tissue and peripheral lymphocytes were detected by real-time fluorescent quantitative PCR. The relationship of gene expression with clinical characteristics,chemotherapy response and prognosis was analyzed.

RESULTSThe RRM1 expression in tumor tissues was positively correlated with that in peripheral blood lymphocytes,while no significant correlation was observed between ERCC1 expression in tumor tissues and that in peripheral blood (rs=0.332 and 0.258; P=0.020 and 0.073, respectively). The expression of RRM1 and ERCC1 in tumor tissues peripheral lymphocytes was synchronous (rs=0.634 and 0.351; P<0.001 and 0.013, respectively). There was no significant correlation of gene expression with gender, age, smoking status, performance status, clinical stages and histological types of patients (P>0.05). Significant difference was found in response rate to chemotherapy (P<0.05,P<0.01,P<0.05),median survival time (P<0.05,P<0.01,P<0.05) and 1-year survival rate (P<0.01,<0.05,P<0.05) between patients with low RRM1 and ERCC1 expression levels in tumor tissues or low RRM1 expression levels in peripheral blood and those with high RRM1 and ERCC1 expression levels. The patients with low ERCC1 expression levels in tumor tissues gained higher 2-year survival rate (P<0.05). There was no correlation of the expression of ERCC1 in peripheral blood with the response to chemotherapy and prognosis (P>0.05).

CONCLUSIONThe expression of RRMI and ERCC1 genes in tumor tissues and RRM1 in peripheral blood lymphocytes is closely correlated with the response to chemotherapy and prognosis of patients with advanced NSCLC treated with gemcitabine plus carboplatin.

Carcinoma, Non-Small-Cell Lung ; drug therapy ; metabolism ; DNA-Binding Proteins ; metabolism ; Endonucleases ; metabolism ; Humans ; Lung Neoplasms ; drug therapy ; metabolism ; Prognosis ; Tumor Suppressor Proteins ; metabolism

BACKGROUNDThe clinical significance of ischemic chest pain before acute ST-elevation myocardial infarction (STEMI) remains an interesting issue of investigation particularly in the era of percutaneous coronary intervention (PCI). This study aimed to assess the impact of angina prior to STEMI on short-term clinical outcomes in patients with acute STEMI undergoing primary PCI.

METHODSAmong a total of 875 consecutive patients with STEMI undergoing primary PCI, 292 had episodes of angina within 24 hours of STEMI (PA group) and the remaining 583 were free of anginal symptoms (non-PA group). Clinical characteristics, angiographic and procedural features, and in-hospital and 30-day outcomes were compared between the two groups.

RESULTSDiabetes was less common (17.5% vs. 23.3%, P = 0.04) and symptom-to-door time was shortened ((191.6 ± 96.8) minutes vs. (357.2 ± 341.9) minutes, P < 0.001) in the PA group than in the non-PA group. Patients with angina prior to STEMI had fewer totally or nearly totally occluded infarct-related artery (TIMI flow grade 0 - 1) at initial angiography (75.0% vs. 90.7%, P < 0.001), and achieved more TIMI flow grade 3 after primary PCI (84.2% vs. 78.2%, P = 0.04). These were associated with higher rates of overall procedural success (95.9% vs. 91.8%, P = 0.02) and of complete ST-segment resolution at 90 minutes after the procedure (51.7% vs. 40.3%, P = 0.001). During a 30-day clinical follow-up, the left ventricular ejection fraction was significantly improved ((53.0 ± 8.6)% vs. (51.1 ± 9.7)%, P = 0.002) and the primary endpoint of major adverse cardiac events was reduced in the PA group (7.2% vs. 12.7%, P = 0.01).

CONCLUSIONPresence of angina prior to acute STEMI is associated with better outcome at a 30-day clinical follow-up in patients undergoing primary PCI.

Acute Coronary Syndrome ; therapy ; Aged ; Angina, Unstable ; physiopathology ; Angioplasty, Balloon, Coronary ; Coronary Angiography ; Electrocardiography ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Myocardial Infarction ; therapy ; Prospective Studies

Objective Intravascular ultrasound(IVUS)was used to compare the effects on neointimal hyperplasia inhibition between national made Firebird stents and Cypher stents in patients with coronary artery disease.Methods From May 2003 to March 2007,215 patients with 317 native lesions received either Firebird stent(147 lesions of 108 patients,Firebird group)or Cypher stent implantation (138 lesions of 107 patients,Cypher group).Quantitative coronary angiography(QCA)and IVUS were performed at one-year follow-up.Results The baseline clinical and angiographic characteristics between the two groups were similar,but post procedural minimal lumen diameter was significantly lager in Firebird group than that in Cypher group[(2.88±0.43)mm vs.(2.78±0.33)mm,P＜0.05].follow-up QCA results showed that in-stent late loss[(0.17±0.29)mm vs.(0.16±0.27)mm,P＞0.05]and in-segment late loss[(0.18±0.36)mm vs.(0.20±0.32)mm,P＞0.05]was similar between Firebird group and Cypher group,while stent cross sectional area(CSA)[(6.99±2.25)mm~2 vs.(6.46±1.71)mm~2,P＜0.05],lumen CSA[(6.89±2.30)mm~2 vs,(6.36±1.73)mm~2,P＜0.05],stent volume[(162.5±68.9)m~3 vs.(140.8±57.9)mm~3,P＜0.01],lumen volume[(160.4±69.5)mm~3 vs.(138.6±57.6)mm~3,P＜0.01]and minimal stent CSA[(5.40±1.85)mm~2 vs.(4.92±1.43)mm~2,P＜0.05]were larger in Firebird group than those in Cypher group.IVUS analysis showed that there was no significant difference in neointimal hyperplasia volume[(2.09±5.46)mm~3 vs.(2.23±6.50)mm~3,P＞0.05]and percentage of volume obstruction[(1.68±5.84)%vs.(1.59±4.10)%,P＞0.05]between the two groups.Conclusion Implantation of Firebird stent was associated with low restenosis rate and both Firebird and Cypher stents equally and effectively inhibited neointimal hyperplasia.

Objective The impact of late incomplete stent apposition(ISA)post sirolimus eluting stent(SES)implantation in patients with acute coronary syndrome(ACS)on long-term clinical outcomes remainB controversial.The alm of the present study was to eva]uate the association between late ISA and clinical outcomes in patients with ACS compared with that with stable angina(SA).Methods From February 2005 to March 2007,54 ACS patients and 83 SA patients were enrolled in this study,late ISA was determined by meallS of threc-dimensional volumetric intravaaculair ultrasound(IVUS)analyses one year after SES implantation and clinical outcomes one year post IVUS were obtained in these patients.Results In 219 treated lesions of the 137 patients,late ISA wag documented in 25 lesions in 16 patients(20 ISA in 12 ACS patients vs.5 ISA in 4 SA patients,P＜0.001).Thoush lunlen area in reference and stented segment,neointimal hyperplasia(NIH)area and percentage of NIH in stented segment,and external elastic membrane(EEM)area in reference segment were similar between two groups,EEM area in stented segment [(15.34±5.44)mm2vs.(13.83±4.51)mm2,P=0.026],stented/reference segment EEM area ratio (1.13±0.22 vs.1.02±0.18,P＜0.001),plaque and media area[(8.43±3.93)mm2vs.(7.01±2.93)mm2,P=0.002]was significantly lager in ACS group than that in SA group.Multivariable logistic analysis showed that ACS(OR 6.477 with 95%CI from 2.297 to 18.263,P＜0.001)and stent length≥23 mm(OR 3.680 with 95% CI from 1.181 to 11.469,P=0.025)were main independent factors of occurrence of late ISA.Incidence of main adverse cardiac events(MACE)one year post IVUS Wag similar between the two groups.Conclusion Compared with patients with SA,ACS patients had larger stented segment EEM area,plaque and media areaas well as increased incidence of ISA.However,the incidence of MACE was similar in ACS and SA patients one year after IVUS.

BACKGROUNDMultiple randomized clinical trials have demonstrated that drug eluting stents can significantly reduce the rates of restenosis and subsequent adverse events across lesion and patient. We investigated the medium term clinical efficacy and safety of Firebird sirolimus eluting stent (SES) in coronary artery disease.

METHODSThe sample was 509 consecutive patients with coronary artery disease (CAD) who were treated by Firebird SES and finished three-year clinical follow-up. The occurrences of major adverse cardiac events (MACE) and Academic Research Consortium defined stent thrombosis (ST) were evaluated in patients with and without diabetes mellitus.

RESULTSThree hundred and thirty three patients (65.4%) were treated by Firebird SES by off label indications. Angiographic success was achieved in 98.3% of the lesions. MACE and target vessel revascularization rates at 6-month, 1 year's and 3 years' clinical follow-up were 2.4% and 1.4%, 4.1% and 2.8%, 7.9% and 5.1%, respectively. The cumulative 3-year MACE free survival rate was 92.1%. After 3 years, DM patients had significantly higher rates of MACE (13.7% vs 6.4%, P < 0.05) and TVR (9.8% vs 4.0%, P < 0.05) and the cumulative MACE free survival rate was very significantly lower in the DM group (86.4% vs 93.6%, P < 0.05). ST occurred in 7 patients (1.4%) at the end of 3 years' follow-up, 5 of them had definite ST with 4 cases presenting with myocardial reinfarction and 1 with unstable angina, the other 2 with probable ST had reinfarction in the stented coronary territory without angiographic follow-up. There was no difference in occurrence of ST between off label (1.5%) and on label groups (1.1%, P = 0.07).

CONCLUSIONSIn daily practice, about 2/3 of patients were treated by Firebird SES by off label indications. Medium term clinical follow-up of 3 years indicated CAD patients treated by Firebird SES had a low MACE and acceptable ST rate. DM patients had higher rates of adverse events and than non DM.

Adult ; Aged ; Angioplasty, Balloon, Coronary ; adverse effects ; Aspirin ; therapeutic use ; Coronary Angiography ; Diabetes Complications ; etiology ; Drug-Eluting Stents ; adverse effects ; Female ; Humans ; Male ; Middle Aged ; Sirolimus ; administration & dosage ; adverse effects ; Thrombosis ; etiology