Objective:To investigate the factors affecting the outcome of surgical treatment for femoral intertrochanteric fractures.Methods:A retrospective case series study was conducted for 424 patients with intertrochanteric fractures admitted to four hospitals in Shanghai from January 2014 to December 2016. There were 200 males and 224 females, aged 45-98 years [(77.8±10.5)years]. Normal union was observed in 326 patients (normal union group), and abnormal union was founded in 98 patients including nonunion in 2 patients (abnormal union group). Data were recorded including the age, gender, injury side, AO classification, Evans-Jesen classification, thickness of femoral lateral wall, medial support, tip-apex distance, and screw position within the femoral head. Fracture healing was assessed. Univariate analysis was conducted to examine differences of the above factors between two groups, and Logistic regression was used to screen the main factors affecting fracture union. At the latest follow-up, the hip joint function was estimated according to the Oxford score system.Results:All patients were followed up for 1-3 years [(2.2±0.3)years]. Univariate analysis showed significant differences between two groups regarding the AO classification, Evans-Jesen classification, medial support, tip-apex distance, and screw position within the femoral head ( P<0.05). Multivariate regression analysis revealed that the simple fracture ( OR=1.030), medial support ( OR=0.395), tip-apex distance ≤25 mm ( OR=0.266) and inferior screw position ( OR=0.986) were significantly related to fracture union. The hip function in normal union group was (42.6±4.5)points, better than (35.4±3.2)points in abnormal union group ( P<0.05). Conclusion:The stability of intertrochanteric fracture is the most important factor for fracture union. The medial support, tip-apex distance ≤25 mm and inferior screw position are helpful to promote fracture healing and recovery of hip joint function.

Objective? To explore the effect of mindfulness-based stress reduction(MBSR) on cancer-related fatigue and mental status of patients with non-small-cell lung cancer(NSCLC) who receive chemotherapy. Methods? By convenience sampling, 67 patients with NSCLC receiving chemotherapy in the First People's Hospital of Lianyungang in Jiangsu Province were selected from June 2017 to December 2018 in this study. According to their admission time, they were divided into the observation group(n=34) and control group (n=33). Conventional nursing care was given for the control group, apart from that, the MBSR exercise was adopted for the observation group, once a week and 8 times in total. Cancer Fatigue Scale (CFS), Self-rating Anxiety Scale (SAS), and Self-Rating Depression Scale (SDS) were used to compare the scores of their cancer fatigue, anxiety and depression between the two groups. Results? Finally, 31 patients in the observation group and 32 patients in the control group completed the study. Before intervention, there was no statistical difference in CFS and each dimensional score in CFS, SAS and SDS scores between the two groups (P＞0.05); after 8 weeks' intervention of MBSR, the CFS score and each dimensional score in CFS, SAS and SDS scores of the observation group were lower than those of the control group, and the differences were statistically significant (P＜0.05). Conclusions? MBSR can effectively improve the NSCLC patients' cancer-related fatigue and reduce the level of anxiety and depression.

Objective To explore the value of multimodal magnetic resonance myocardial perfusion imaging (MR-MPI)in detecting myocardial viability of coronary heart disease.Methods 52 patients suspected or diagnosed coronary heart disease confirmed with SPECT myocardial perfusion and had MR-MPI examination were collected.MR-MPI protocol included double inversion T2WI fat suppressed imaging,diffusion weighted imaging(DWI),resting perfusion and dipyridamole myocardial perfusion.Results In 52 patients,the sensitivity,specificity,positive predictive value and negative predictive value of MR-MPI were 89.13%,66.67%,95.35% and 44.44% respectively.Conclusion MR-MPI can effectively detect myocardial viability in coronary heart disease.MR-MPI exhibits high clinical value for qualitative evaluation of degree of the myocardial ischemic coronary heart disease.

OBJECTIVETo compare the efficacy of the patients of xerosis conjunctivitis with liver and kidney yin deficiency among the combined therapy of acupuncture and Shi's manipulation, common acupuncture and artificial tears therapy.

METHODSOne hundred and eight patients were randomized into an acupuncture group, a SHI's manipulation group and an artificial tears group, 36 cases in each group. A total of 15 cases dropped out before the end of the study, including 4 cases in the acupuncture group, 6 cases in the SHI's manipulation group, and 5 cases in the artificial tears group. In the acupuncture group, acupuncture was applied to Jingming (BL 1) and Qiuhou (EX-HN 7) on the affected side, and the bilateral Sanyinjiao (SP 6) and Taixi (KI 3). The needles were retained for 20 min. In the SHI's manipulation group, on the basis of the treatment as the acupuncture group, Shuigou (GV26) was added and stimulated with SHI's acupuncture manipulation. In these two groups, acupuncture was given 3 times a week totally for 3 weeks. In the artificial tears group, sodium hyaluronate eye drops were used, 5 times a day, for 3 weeks totally. Separately, before treatment, at the moment after the 1st treatment and 3 weeks after treatment, the subjective symptom score, Schirmer I test, breakup time (BUT) of tear film were observed in each group.

RESULTS(1) Subjective symptom score: at the moment after the 1st treatment and 3 weeks after treatment, the scores in each group were all reduced significantly as compared with those before treatment (all P < 0.05). At the moment after the 1st treatment, the score in the SHI's manipulation group and the artificial tears group was reduced apparently as compared with that in the acupuncture group (both P < 0.05). In 3 weeks of treatment, the score in the SHI's manipulation group was reduced apparently as compared with the acupuncture group and the artificial tears group (both P < 0.05). (2) For Schirmer I test, at the moment of the 1st treatment, the result in the SHI's manipulation group and the artificial tears group was improved significantly as compared with that before treatment (both P < 0.05). In 3 weeks of treatment, the result in the acupuncture group and the SHI's manipulation group group was improved significantly as compared with that before treatment (both P < 0.05). At the moment of the 1st treatment, the result in the artificial tears group was improved significantly as compared with the acupuncture group and the SHI's manipulation group (both P < 0.05). In 3 weeks of treatment, the result in the acupuncture group and the SHI's manipulation group was better than that in the artifi-cial tears group separately (both P < 0.05). (3) For BUT, the result in the acupuncture group and the SHI's manipulation group was prolonged significantly as compared with that before treatment and was prolonged apparently as compared with that in the artificial tears group (both P < 0.05) in 3 weeks of treatment.

CONCLUSIONThe intervention of SHI's acupuncture manipulation relieves the subjective symptoms of xerosis conjunctivitis of liver and kidney yin deficiency and achieves the same efficacy as the common acupuncture and artificial tears treatment. It does not present the apparent advantages as the common acupuncture in the short term for promoting the tear secretion and tears film repair.

Acupuncture Therapy ; Adolescent ; Adult ; Conjunctivitis ; physiopathology ; therapy ; Dry Eye Syndromes ; physiopathology ; therapy ; Female ; Humans ; Kidney ; physiopathology ; Liver ; physiopathology ; Male ; Middle Aged ; Treatment Outcome ; Yin Deficiency ; physiopathology ; therapy ; Young Adult

The clinical and experimental publish literatures of the traditional acupuncture treatment for xerophthalmia were review and selected, and the acupoints and outcomes index were analyzed. The clinical studies demonstrated that acupoints around eyes, head and face were mainly coordinated with Zangfu organs and meridians; and the experimental studies showed the effect of acupuncture work through stimulation of the lacrimal gland secretion, repairing lacrimal gland structure, inhibition of apoptosis to increase the flow of tears, extending the breakup time of lacrimal film, and relieving eye related symptoms.

Objective To explore the effect of neural stem cells (NSCs) transplantation on neurogenesis in an alzheimer' disease mouse model and its related mechanism.Methods A total of 16 12-month old aPP/PS1 double transgenic aD mice were randomly divided into two groups:NSC group (receiving NSCs transplantation in the bilateral hippocampi,n=8) and PBS group as the negative control group (receiving an equal quantity of 0.01M/L phosphate buffer saline,n=8).another 8 wild type mice without any treatment were selected as the positive control group (Wt group).at five weeks after transplantation,the expressions of doublecortin (DCX) and nestin in the hippocampal dentate gyrus (DG) and subgranular zone (SGZ) were analyzed by immunofluorescence staining,the number of positive cells in these regions were counted by confocal microscopy,and Morris water maze (MWM) test was used to assess cognitive function in all mice.Results NSC group showed the enhanced spatial learning and memory ability in Morris water maze (MWM) as compared to PBS group,but it was still lower than that in Wt mice (both P＜0.05).Immunofluorescence staining showed NSCs induced the increased positive cells expressing DCX and nestin in the NSC group as compared with PBS group (F＝85.400 and 55.687,both P＜0.001).However,the number of DCX positive cells was still lower in NSC group than in Wt group (P＜0.05).There was no significant difference in the number of Nestin-positive cells between the NSC group and the Wt group (P＞ 0.05).Conclusions NSCs transplantation can promote endogenous neurogenesis via the increased expression of DCX-and Nestin positive cells in the hippocampal DG/SGZ in aD mice,which improves the cognitive abilities in aD mice in some extent.

Objective To make comparative study on the immediate stability of intra-articular calcaneal fractures fixed by crossing screws and by plate. Methods A set of foot CT images from a normal male were collected to construct 3D finite element models of Scander-III calcaneau fracture fixed by crossing screws and by steel plate, respectively. The regular pattern of stress and displacement distributions on these two fracture models under vertical load of 700 N was analyzed. Results For the screw-fixed model, the stress was concentrated at the connecting area between screws and fracture ends, and the maximum stresses were different for screws at different places. While for the plate-fixed model, the stress was concentrated at the connecting area between plate and screw. The highest stress was concentrated in anterior segment of the plate. The maximum stresses of plate, screw and calcaneus were all lower than their shear strength. The displacements of intact calcaneus and fractures were concentrated on the posterior subtalar joints, and a larger displacement appeared on the internal part of joint facet. Conclusions Both crossing screws and steel plate can be used to fix calcaneal fractures with a preferable initial stability. Functional exercise and rehabilitation are recommended at early time after operation.

Objective To explore the effect of behavior training on abilities of learning and memory in young SD rats received low doses of X-ray and their relevant mechanism.Methods A total of 48 SD rats aged 35 d were randomly divided into irradiated group,training group and control group (n=16);rats in the irradiated group and training group received X-ray once daily for seven d;rats in the training group also received behavior training.Abilities of learning and memory were detected by Morris water maze test;changes of N-acetyl aspartate/creatine (NAA/Cr) in the hippocampus were observed;the protein expression levels of cytochrome c oxidase Ⅳ (COXⅣ) in hippocampal regions were observed by immunofluorescence staining and Western blotting.Morphology of neurons in hippocampal CA1 region was detected by HE staining,and mitochondrial morphology was observed via transmission electron microscopy.Results (1) As compared with that incontrol group (1.873±0.032),the ratio of NAA/Cr in the irradiated group (1.611±0.013) was significantly decreased,while that in the training group (1.870± 0.018) was significantly higher than that in the irradiated group (P＜0.05).(2) The escape latency,times crossing the platform and duration of staying in the platform in rats of the irradiated group were significantly longer/fewer than those in the control group,while no significant differences were noted between the training group and control group (P＞0.05).(3) Immunofluorescence indicated decreased COXⅣ protein expression in the CA1 area of irradiated group and increased COXⅣ protein expression in the CA1 area of training group;Western blotting showed that the COXⅣ protein expression in the hippocampal regions of irradiated group (0.298±0.049) was significantly decreased as compared with that in the control group (0.998±0.056,P＜0.05),while no significant differences were noted between the training group (0.987±0.053) and control group (P＞0.05).(4) Karyopyknosis and more damaged mitochondria were found in the irradiated group,while more normal neurons were observed in hippocampal CA1 area of the control and training groups by HE staining.Conclusion Learning and memory abilities of SD rats received low doses of X-ray could be recovered by behavior training,which could be related to the increment of COXⅣ protein expression and mitochondria improvement by behavior training,and neuron damage in the hippocampus would be reversible in an extent.

Objective To observe the effect of silencing P2X7 receptor (P2X7R) by RNA interference on microglial releasing interleukin 1β (IL-1β),tumor necrosis factor-α (TNF-α) and nitric oxide (NO).Methods The small interfering RNA (siRNA) targeting P2X7R gene was observed.The primary microglial cells activated by amyloid-β (Aβ-42) were infected with the lipofectaminesiRNA.The groups were designated as Aβ-1-42,Aβ1-42/siNC,Aβ1-42/siP2X7R and blank control groups according to the different stimulus.After RNA interference for 48 hours,the microglial cells were collected.The survival rate of microglia was detected by CCK-8.The levels of P2X7R mRNA and protein were detected by Real-time PCR and Western blotting respectively.The microglial morphology and the P2X7R immune response were observed by immunocytochemistry staining.Then levels of IL-1β,TNF-α and NO in the supernatantwere measured.Results The Aβ1-42 and siRNA had no effects on the survival rate of microglia.After RNA interference silencing P2X7R,the expression levels of P2X7R mRNA and protein in Aβ1-42/siP2X7R group were decreased significantly,and in this group,the microglial activity and P2X7R immune response were all reduced.In Aβ1-42,Aβ1-42/siNC,Aβ1-42 /siP2X7R and blank control groups,the supernatant levels of IL-1β were (52.54±3.21) μg L,(54.94±2.54) μg/L,(28.70±3.58) μg/L,(24.55±4.34) μg/L,respectively and the supernatant levels of TNF-α were (64.40±4.80) μg/L,(60.94±1.63) μg/L,(25.69±3.13) μg/l,(19.21±1.97)μg/L,respectively.As compared with Aβ1-42 and Aβ-42/siNC groups,the levels of IL 1β and TNF-α in Aβ1-42 /siP2X7R group was decreased significantly (P＜ 0.05),and IL-1β level had no significant difference between Aβ1-42/siP2X7R and blank control groups.The same result was observed in the level of NOin the supernatant.The levels of NO were (1.33±0.19) μmol/L,(4.49±0.28) μmol/L,(4.78±0.33) μmol/L and (1.07±0.36) μmol/L in Aβ1-42/siP2X7R,Aβ1-42,Aβ1-42 /siNC and blank control groups respectively.Conclusions The silencing expression of P2X7 R by RNA interference effectively decreases the levels of IL-1β,TNF-α and NO released by microglia.P2X7 R can be used as an effective therapeutic target for RNA interference treatment of Alzheimer's disease.

OBJECTIVETo determine genetic cause for a patient with development delay and multiple congenital anomalies.

METHODSRoutine karyotype analysis was performed for the patient and his parents. Array comparative genomic hybridization (array CGH) was performed for the patient to detect cryptic chromosome aberration.

RESULTSKaryotype analysis revealed no obvious anomaly for the patient and his parents. Array CGH has detected a 2.8 Mb heterozygous deletion at 9q34.3 and an 8.1 Mb heterozygous duplication at 22q. Fluorescence in situ hybridization analysis of the patient revealed an unbalanced subtelomeric translocation 46, XY, der(9) t(9; 22) (q34.3; q13.2q13.33) mat, which has resulted in partial trisomy 22q and partial monosomy 9q. Clinical features of the patient included developmental delay, facial dysmorphism and multiple congenital anomalies. Upon subsequent pregnancy, FISH analysis revealed that the fetus has inherited the normal chromosomes 9 and 22 from his mother. Postnatal follow-up confirmed normal development milestone and physiques in the child.

CONCLUSIONAn unbalanced translocation involving 9q and 22q has been found in a child featuring multiple congenital anomalies, which is due to a balanced translocation 9; 22 in his mother. Array CGH and FISH have also helped with discovery of subtelomeric rearrangement. Prenatal diagnosis of this aberration in subsequent pregnancies with FISH can prevent the recurrence of this disease.

Abnormalities, Multiple ; genetics ; Chromosomes, Human, Pair 22 ; Chromosomes, Human, Pair 9 ; Female ; Humans ; Infant ; Intellectual Disability ; genetics ; Male ; Translocation, Genetic