Objective To explore the effects of Magu Xujin capsule on hip fracture healing and stromal cell-derived factor-1/CXC chemokine receptor 4(SDF-1/CXCR4)signaling pathway in elderly hip fracture rats.Methods The hip fracture model of aged rats was established,and successfully modeled rats were randomly separated into the model group,the low-dose Magu Xujin capsule group,the high-dose Magu Xujin capsule group,the high-dose Magu Xujin capsule+pathway inhibitor group(the high-dose Magu Xujin capsule and AMD3100 group),with 12 rats in each group.An additional 12 healthy rats were selected as the control group.X-ray was used to observe the healing of hip fractures in rats,and Garrett score was performed.Enzyme-linked immunosorbent assay(ELISA)was applied to detect serum levels of inflammatory factors related to fracture healing,such as tumor necrosis factor-alpha(TNF-α)and interleukin-10(IL-10).CT scanning analysis was used to determine bone volume fraction(BV/TV)and bone surface area/volume ratio(BS/BV).Immunohistochemistry was applied to detect the expression of fracture healing factor insulin-like growth factor-1(IGF-1)and bone morphogenetic protein-2(BMP-2).Western blot assay was applied to detect the expression of SDF-1/CXCR4 signaling pathway related proteins.Results Garrett score,IL-10 level,BV/TV,BS/BV,the IGF-1,BMP-2,SDF-1 and CXCR4 expression were lower in the model group than those in the control group,while TNF-α level was higher(P＜0.05).Garrett score,IL-10 level,BV/TV,BS/BV,IGF-1,BMP-2,SDF-1 and CXCR4 expression were higher in the low-dose and high-dose Magu Xujin capsule groups than those in the model group,while TNF-α level was lower(P＜0.05).Garrett score,IL-10 level,BV/TV,BS/BV,IGF-1,BMP-2,SDF-1 and CXCR4 expression were lower in the high-dose Magu Xujin capsule+AMD3100 group than those in the high-dose Magu Xujin capsule group,while TNF-α level was higher(P＜0.05).Conclusion Magu Xujin capsule can promote hip fracture healing in aged rats,and its mechanism may be related to the activation of SDF-1/CXCR4 signaling pathway.

Objective To establish and test a 3-year prognosis model for elderly intertrochanteric fractures after intramedullary nail fixation.Methods A total of 205 elderly patients with intertrochoteric fracture of femur who underwent intramedullary nail fixation in our hospital from April 2019 to April 2021 were selected for observation study,followed up for 3 years after surgery,according to the Harris score,they were divided into the good group and the poor group.Univariate analysis was conducted to investigate the influencing factors of disease prognosis in the two groups 3 years after surgery.After the variables were screened by LASSO regression and cross-validation method,the independent influencing factors of the 3-year postoperative prognosis were analyzed by multi-factor Logistic regression,and the prediction model of the nomogram was built,and the model was evaluated and validated.Results Among 205 elderly patients with intertrochanteric fractures of the femur who underwent intramedullary nailing fixation,201 were followed up for 3 years.Among them,148 patients had a Harris score of ≥70 points,while 53 patients had a score of＜70 points.Univariate analysis results showed that the poor group had a higher proportion of patients with age,stroke,osteoporosis,Evans-Jensen type Ⅲ and Ⅳ fractures,poor intraoperative reduction,and a tip-apex distance of ≥ 30 mm compared to the good group,and had a lower lateral wall thickness than the good group,the difference was statistically significant(P＜0.05).LASSO regression analysis and cross-validation were used to screen variables.Multivariate Logistic regression analysis showed that stroke(OR=2.127,95％CI:1.478-3.061)and fracture Evans-Jensen classification Ⅲ(OR=1.149,95％CI:1.105-1.195)and type Ⅳ(OR=1.187,95％CI:1.143-1.233),intraoperative reduction was not good(OR=3.290,95％CI:2.319-4.668),apex distance ≥ 30 mm(OR=1.413,95％CI:1.066-1.874)was an independent associated risk factor for disease outcome 3 years after surgery,the external wall thickness(OR=0.600,95％CI:0.428-0.841)was an independent correlated risk factor for 3-year prognosis(P＜0.05).Based on the results of multiple factors,a nomogram prediction model was drawn,and the results showed that the model had certain predictive value for the disease outcome three years after surgery.The evaluation and verification results showed that when the threshold probability was 0-96％,the model had good clinical applicability and positive clinical net benefit.Conclusion Stroke,fracture Evans-Jensen classification Ⅲ and Ⅳ,poor intraoperative reduction,apical distance ≥30 mm,and lateral wall thickness are independent and relevant factors for 3-year prognosis of senile intertrochanteric fractures after intramedullary nail fixation.The establishment of a nematographic model has good predictive value for postoperative long-term prognosis and positive clinical net benefit.It can be used as an effective model to predict the long-term prognosis of postoperative disease.

Objective To establish and test a 3-year prognosis model for elderly intertrochanteric fractures after intramedullary nail fixation.Methods A total of 205 elderly patients with intertrochoteric fracture of femur who underwent intramedullary nail fixation in our hospital from April 2019 to April 2021 were selected for observation study,followed up for 3 years after surgery,according to the Harris score,they were divided into the good group and the poor group.Univariate analysis was conducted to investigate the influencing factors of disease prognosis in the two groups 3 years after surgery.After the variables were screened by LASSO regression and cross-validation method,the independent influencing factors of the 3-year postoperative prognosis were analyzed by multi-factor Logistic regression,and the prediction model of the nomogram was built,and the model was evaluated and validated.Results Among 205 elderly patients with intertrochanteric fractures of the femur who underwent intramedullary nailing fixation,201 were followed up for 3 years.Among them,148 patients had a Harris score of ≥70 points,while 53 patients had a score of＜70 points.Univariate analysis results showed that the poor group had a higher proportion of patients with age,stroke,osteoporosis,Evans-Jensen type Ⅲ and Ⅳ fractures,poor intraoperative reduction,and a tip-apex distance of ≥ 30 mm compared to the good group,and had a lower lateral wall thickness than the good group,the difference was statistically significant(P＜0.05).LASSO regression analysis and cross-validation were used to screen variables.Multivariate Logistic regression analysis showed that stroke(OR=2.127,95％CI:1.478-3.061)and fracture Evans-Jensen classification Ⅲ(OR=1.149,95％CI:1.105-1.195)and type Ⅳ(OR=1.187,95％CI:1.143-1.233),intraoperative reduction was not good(OR=3.290,95％CI:2.319-4.668),apex distance ≥ 30 mm(OR=1.413,95％CI:1.066-1.874)was an independent associated risk factor for disease outcome 3 years after surgery,the external wall thickness(OR=0.600,95％CI:0.428-0.841)was an independent correlated risk factor for 3-year prognosis(P＜0.05).Based on the results of multiple factors,a nomogram prediction model was drawn,and the results showed that the model had certain predictive value for the disease outcome three years after surgery.The evaluation and verification results showed that when the threshold probability was 0-96％,the model had good clinical applicability and positive clinical net benefit.Conclusion Stroke,fracture Evans-Jensen classification Ⅲ and Ⅳ,poor intraoperative reduction,apical distance ≥30 mm,and lateral wall thickness are independent and relevant factors for 3-year prognosis of senile intertrochanteric fractures after intramedullary nail fixation.The establishment of a nematographic model has good predictive value for postoperative long-term prognosis and positive clinical net benefit.It can be used as an effective model to predict the long-term prognosis of postoperative disease.

Objective To explore the effects of Magu Xujin capsule on hip fracture healing and stromal cell-derived factor-1/CXC chemokine receptor 4(SDF-1/CXCR4)signaling pathway in elderly hip fracture rats.Methods The hip fracture model of aged rats was established,and successfully modeled rats were randomly separated into the model group,the low-dose Magu Xujin capsule group,the high-dose Magu Xujin capsule group,the high-dose Magu Xujin capsule+pathway inhibitor group(the high-dose Magu Xujin capsule and AMD3100 group),with 12 rats in each group.An additional 12 healthy rats were selected as the control group.X-ray was used to observe the healing of hip fractures in rats,and Garrett score was performed.Enzyme-linked immunosorbent assay(ELISA)was applied to detect serum levels of inflammatory factors related to fracture healing,such as tumor necrosis factor-alpha(TNF-α)and interleukin-10(IL-10).CT scanning analysis was used to determine bone volume fraction(BV/TV)and bone surface area/volume ratio(BS/BV).Immunohistochemistry was applied to detect the expression of fracture healing factor insulin-like growth factor-1(IGF-1)and bone morphogenetic protein-2(BMP-2).Western blot assay was applied to detect the expression of SDF-1/CXCR4 signaling pathway related proteins.Results Garrett score,IL-10 level,BV/TV,BS/BV,the IGF-1,BMP-2,SDF-1 and CXCR4 expression were lower in the model group than those in the control group,while TNF-α level was higher(P＜0.05).Garrett score,IL-10 level,BV/TV,BS/BV,IGF-1,BMP-2,SDF-1 and CXCR4 expression were higher in the low-dose and high-dose Magu Xujin capsule groups than those in the model group,while TNF-α level was lower(P＜0.05).Garrett score,IL-10 level,BV/TV,BS/BV,IGF-1,BMP-2,SDF-1 and CXCR4 expression were lower in the high-dose Magu Xujin capsule+AMD3100 group than those in the high-dose Magu Xujin capsule group,while TNF-α level was higher(P＜0.05).Conclusion Magu Xujin capsule can promote hip fracture healing in aged rats,and its mechanism may be related to the activation of SDF-1/CXCR4 signaling pathway.

Objective:To quantitatively evaluate left ventricular myocardial work in patients with type 2 diabetes mellitus (T2DM) and nonalcoholic fatty liver disease (NAFLD) by pressure strain loop (PSL) technique.Methods:A total of 103 T2DM patients diagnosed at the Heping Hospital Affiliated to Changzhi Medical College from April 2022 to May 2023 were selected. They were divided into three groups based on their fatty liver ultrasound findings: group A (34 cases without NAFLD), group B (37 cases with mild NAFLD), and group C (32 cases with moderate to severe NAFLD). All patients underwent routine echocardiography, which measured the end diastolic left ventricular diameter (LVIDd), end systolic left ventricular diameter (LVIDs), end diastolic interventricular septum (IVSTd), left ventricular posterior wall thickness (LVPWTd), and end systolic left atrial diameter (LAD). The biplane Simpson method was used to measure left ventricular ejection fraction (LVEF), end diastolic left ventricular volume (LVEDV), and end systolic left ventricular volume (LVESV). PSL technology was applied to analyze the overall longitudinal strain (GLS), global work index (GWI), global effective work (GCW), global ineffective work (GWW), and overall work efficiency (GWE) of the left ventricular myocardium. We compared the conventional echocardiography parameters and myocardial work parameters among three groups, and analyzed the correlation between myocardial work parameters and GLS and glycosylated hemoglobin (HbA 1c). Results:The differences in body mass index (BMI), alanine aminotransferase (ALT), and aspartate aminotransferase (AST) between group B and group A were statistically significant (all P<0.05); There was a statistically significant difference in BMI, HbA 1c, and low density lipoprotein cholesterol (LDL-C) between group C and group B (all P<0.001); The differences in BMI, HbA 1c, ALT, AST, triglyceride (TC), high density lipoprotein cholesterol (HDL-C), and LDL-C between group C and group A were statistically significant (all P<0.05). The GWI and GCW in group B were lower than those in group A (all P<0.05), while the absolute GLS, GCW, GWI, and GWE in group C were lower than those in group A, and GWW was higher than those in group A (all P<0.05); The absolute values of GLS, GCW, GWI, and GWE in group C were lower than those in group B ( P<0.05). The correlation analysis results showed that GLS and HbA 1c were negatively correlated with GCW and GWI ( r=-0.571, -0.533, -0.273, -0.223, P<0.05). Conclusions:PSL technology can quantitatively evaluate left ventricular myocardial work in patients with T2DM combined with NAFLD, and can detect early impairment of left ventricular systolic function in patients. It has clinical reference value in evaluating overall and local cardiac function.

Objective To observe the clinical effect of sling exercise therapy(S-E-T)combined with drug treatment for cervical vertigo in elderly patients.Methods Forty-nine elderly patients with cervical vertigo admitted to our hospital between January 2011 and July 2014 were randomly divided into an observation group(n=27)and a control group(n=22).The observation group was given 80 mg Ginaton(Extract of Ginkgo Biloba Leaves Tablets)produced by German Dr.Willmar Schwabe GmbH & Co.KG three times a day,combined with S-E-T,including cervical stability and stretching training for 40min,focusing on the neck global muscle and local stabilize muscle rehabilitation,once every other day.The control group was provided with the same drug treatment.During the 6-month intervention,both groups were given health education by the same therapist.Both groups were assessed using the neck disability index(NDI),visual analogue scale(VAS)and evaluation scale for cervical vertigo(ESCV) before and after the intervention,as well as at the last follow-up visit.Before the treatment and at the last follow-up visit,the cervical X-ray examination and trigger point check were also conducted for both groups.Results All the forty-nine patients were followed up for 4.83 to 6.70 months,with an average of(6.01 ± 0.49)months.Significant improvement was observed in the average ESCV score for both groups after the treatment.Compared with before the treatment,there was significant improvement in the average NDI and VAS right after the treatment and at the last follow-up visit in the observation group,but only at the last follow-up visit in the control group.From the cervical X-ray,no significant differences were found in the vertebral osteophyte formation,facet joints and uncovertebral joint degeneration between the 2 groups(P＞0.05),while significant differences were observed in the number of the neck trigger points(P＜0.05).Conclusion The sling exercise therapy combined with drug treatment can significantly improve cervical function,relieve pain and vertigo symptoms in elderly patients with cervical vertigo.The effect is better than drug treatment alone.

Cell polarity is a common feature of many different types of cells,and it is essential to the normal differentiation and function of cells. Partitioning defective 6( PAR6)gene encodes PAR6 protein, which is crucial to asymmetric cell division and polarized growth. PAR6 protein as a member of the PAR6 polarity complex,affects the synthetic of centrosome and protein recruitment to the centrosome. The abnormal number of centrosomal and the loss of cell polarity may eventually lead to the occurrence of tumor.

Surgical operation is still the main means of thyroid carcinoma,especially the differentiated thyroid carcinoma. Postoperative endocrine therapy is considered as an important adjuvant therapy. Giving the corresponding endocrine therapy after the surgery,not only prevent the hypothyroidism,but also reduce the recurrence rate and mortality in postoperative patients with thyroid carcinoma.

ObjectiveTo evaluate the significance of flexion priority strategy and the principle of joint mobilization technique in the rehabilitation of posttraumatic stiffness of the elbow. Methods24 patients with posttraumatic stiffness of the elbow were divided into 2 groups, 12 patients in each group. The treatment group was treated with flexion priority strategy of joint mobilization technique only in the treatment of flexion contracture. In order to decrease the pain caused by joint mobilization training of extension and achieve the restoration of flexion as early as possible, the rehabilitation of extension was altered to self-exercise under the consultation of doctors combined with gentle passive traction by the therapist. The control group was treated with joint mobilization technique of both flexion and extension once a day. All the patients were measured the flexion range, extension range, and flexion-extension arc after 6 weeks of rehabilitation. Results6 weeks after rehabilitation, the treatment group got 124° of flexion (range 95°～135°), much better than the control group of 95° (range 80°～110°) （P<0.01）. There was no significant difference of extension degrees between the treatment group (15°, range 10°～35°) and the control group (16°, range 10°～30°) （P＞0.05）. The final arc of flexion and extension in the treatment group had an increase of 53°, significantly greater than 30° in the control group（P<0.01）. ConclusionFlexion priority strategy of elbow rehabilitation can significantly restore the flexion function of posttraumatic elbow stiffness.

Objective To observe the effect of progressive resistance exercise combined with alendronate sodium on bone mineral density(BMD)of lumbar spine in patients with postmenopausal osteoporosis.Methods 20 patients with postmenopausal osteoporosis were randomly divided into the A and B group with 10 cases in each group.The cases of the group A were treated with progressive resistance exercises combined with alendronate sodium.Those of the group B only took alendronate sodium orally.The course of two groups was 3 months.BMD of lumbar spine was measured by dual-energy X-ray absorptiometry before and 3 months after treatment.Results Before treatment,BMD of two groups was not different.After 3 months treatment,BMD of lumbar spine were significantly improved in group A(raised 4.520±0.68%)than group B(raised 0.100±0.01%),there was a significant difference between two groups(P<0.01).Conclusion Progressive resistance exercises combined with alendronate is more efficacious than alendronate alone in restoring lumbar spine BMD in patients with postmenopausal osteoporosis.