OBJECTIVE: To evaluate the clinical effect of bridge combined internal fixation system in the treatment of periprosthesis fracture of femur after hip replacement. METHODS: From October 2016 to June 2018, 5 patients of periprosthesis fractures of femur classified type B1 and type C in Vancouver were treated by open reduction and bridging combined with internal fixation, including 2 males and 3 females, with ages of 68, 70, 74, 75, 79 years;type B1 fractures in 4 and type C fractures in 1. Causes of injury:1 case of traffic injury, 4 cases of fall. After the operation, the patients were followed up for complications and fracture healing time by clinical and imaging examination, and Parker activity score was performed. RESULTS: The wounds of 5 patients healed without infection. One case of DVT was confirmed by venography. Five patients were followed up, and the durations were 2, 8, 9, 10, 15 months. One patient died of myocardial infarction 2 months after operation. The average healing time was 12.5 weeks. No loss of reduction or failure of internal fixation was found. Two patients could walk without protection and 1 patient needed to rely on single crutch. One case of periprosthetic fracture had to walk with a single crutch before operation and move indoors with two crutches after operation. The average Parker activity score was 51.8% before operation. CONCLUSION The bridge combined internal fixation system can be used to fix the fracture after hip replacement with stable femoral prosthesis.
Aged ; Arthroplasty, Replacement, Hip ; Bone Plates ; Female ; Femoral Fractures ; surgery ; Fracture Fixation, Internal ; Fracture Healing ; Humans ; Male ; Periprosthetic Fractures ; surgery ; Radiography ; Reoperation ; Retrospective Studies ; Treatment Outcome

Purpose: Triple-negative breast cancer (TNBC) is highly malignant and has poor prognosis and a high mortality rate. The lack of effective therapy has spurred our investigation of new targets for treating this malignant cancer. Here, we identified RON (macrophage-stimulating 1 receptor) and MET (MET proto-oncogene, receptor tyrosine kinase) as a prognostic biomarker and therapeutic targets for potential TNBC treatment. Materials and Methods: We analyzed RON and MET expression in 187 primary TNBC clinical samples with immunohistochemistry. We validated the targeted therapeutic effects of RON and MET in TNBC using three tyrosine kinase inhibitors (TKIs): BMS-777607, INCB28060, and tivantinib. The preclinical therapeutic efficacy of the TKIs was mainly estimated using a TNBC xenograft model. Results: Patients with TNBC had widespread, abnormal expression of RON and MET. There was RON overexpression, MET overexpression, and RON and MET co-overexpression in 63 (33.7%), 63 (33.7%), and 43 cases (23.0%), respectively, which had poor prognosis and short survival. In vivo, the TKI targeting RON ant MET inhibited the activation of the downstream signaling molecules, inhibited TNBC cell migration and proliferation, and increased TNBC cell apoptosis; in the xenograft model, they significantly inhibited tumor growth and shrank tumor volumes. The TKI targeting RON and Met, such as BMS-777607 and tivantinib, yielded stronger anti-tumor effects than INCB28060. Conclusion RON and MET co-overexpression can be significant pathological characteristics in TNBC for poor prognosis. TKIs targeting RON and MET have stronger drug development potential for treating TNBC.

OBJECTIVE: To investigate the association between homocysteine and renal function as well as possible influencing factors in inpatient population. METHODS: From January 2014 to December 2015, a total of 27,025 hospitalized people who were admitted to the First Hospital of Peking University and were tested for plasma homocysteine were enrolled. Multiple linear regression model was performed to determine the relationship between homocysteine and eGFR. RESULTS: After excluding patients with cardiovascular disease and patients taking antihypertensive drugs, 6681 inpatient participants were included for analysis. After adjusting for age, blood pressure and other related factors, we found that eGFR decreased significantly(β=-0.53, SE=0.02, P<0.001) with the increase of homocysteine. Furthermore, the gender, age and renal functional state, had significant influence the relationship between homocysteine and eGFR. In women, those younger than 60 years old and renal impairment(eGFR<90 mL/[min·1.73 m~2]) population, the correlation was more significant. CONCLUSION: The association between homocysteine and eGFR is significant in inpatient population.

With the development of molecular pathology,many types of epidermal growth factor receptor (EGFR) mutations have been identified.The efficacy of EGFR tyrosine kinase inhibitors (EGFR-TKIs) in non-small cell lung cancer (NSCLC) patients with different types of EGFR mutations,especially in patients with single rare mutations or complex mutations (co-occurrence of two or more different mutations),has not been fully understood.This study aimed to examine the efficacy of EGFR-TKIs in NSCLC patients with different types of EGFR mutations.Clinical data of 809 NSCLC patients who harbored different types of EGFR mutations and treated from January 2012 to October 2016 at Renmin Hospital and Zhongnan Hospital,Wuhan,were retrospectively reviewed.The clinical characteristics of these patients and the efficacy of EGFR-TKIs were analyzed.Among these patients,377 patients had only the EGFR del-19 mutation,362 patients the EGFR L858R mutation in exon 21,33 patients single rare mutations and 37 patients complex mutations.Among these 809 patients,239 patients were treated with EGFR-TKIs.In all the 239 patients,the disease control rate (DCR) was 93.7％ with two patients (0.2％) achieving complete response (CR),the median progression free survival (PFS) was 13.0 months (95％ confidence interval [CI],11.6-14.4 months),and the median overall survival (OS) was 55.0 months (95％ CI,26.3-83.7 months).Subgroup analysis revealed that the DCR in patients harboring single rare or complex mutations of EGFR was significantly lower than in those with del-19 or L858R mutation (P＜0.001).Patients with classic mutations (del-19 and/or L858R mutations) demonstrated longer PFS (P＜0.001) and OS (P=0.017) than those with uncommon mutations (single rare and/or complex mutations).Furthermore,the patients with single rare mutations had shorter median OS than in those with other mutations.Multivariate Cox regression analysis identified that the type of EGFR mutations was an independent risk factor for PFS (hazard ratio [HR]=0.308,95％ CI,0.191-0.494,P＜0.001) and OS (HR=0.221,95％ CI,0.101-0.480,P＜0.001).The results suggest that the single rare or complex EGFR mutations confer inferior efficacy of EGFR-TKIs treatment to the classic mutations.The prognosis of the single rare EGFR mutations is depressing.EGFR-TKIs may be not a good choice for NSCLC patients with single rare mutations of EGFR.Further studies in these patients with uncommon mutations (especially for the patients with single rare mutations) are needed to determine a better precision treatment.

Objectives To investigate the effect of paeoniflorin(PF)in ameliorating the irritable bowel syndrome(IBS)such as diarrhea and bellyache,and the barrier function of PF on intestinal epithelial cell and inflammation.Methods The diarrhea model was conducted by exposing rat to restraint stress stimulation and bellyache model was conducted by subcutaneous injection of neostig?mine to mice.The Caco-2 monolayer cell model with barrier dysfunction was established by trypsin stimulation and the inflammatory Caco-2 cell model was established by interleukin-1β(IL-1β)stimulation.On the basis of these models,effects of PF at different doses (low 14 mg/kg·d,medium 28 mg/kg·d,and high 56 mg/kg·d)on IBS syndromes and Caco-2 cell function were investigated. Re-sults PF could significantly reduce the frequency of defecation in diarrhea rat model(P<0.05)and relieve abnormal bowel move?ments in bellyache mice model(P<0.05).PF significantly increased TEER value(P<0.01),decreased the transmittance of fluores?cein(P<0.01)and up-regulated the expression of tight junction(ZO-1)protein(P<0.01).The gene and protein expression of nucle?ar factor profilin kappa Bα(IκBα)in inflammatory Caco-2 cell model was significantly improved(P<0.01)when treated with PF. Conclusion Our study proves for the first time that PF significantly ameliorated the diarrhea and bellyache symptoms of IBS in the di?arrhea model and bellyache model.The PF intervention effect on ZO-1 and IκBα protein might be one of the molecular mechanism of ameliorating the symptoms of IBS.

Matrix-assisted laser desorption/ionization time-of-flight imaging mass spectrometry (MALDI-TOF-IMS) can analysis unknown compounds in sections and obtain molecule imaging by scanning biological tissue sections,which has become a powerful tool for the research of biomarker,lipid distribution and drug metabolism,etc.This article reviews the application of this technique in protein identification,clinical application,drug discovery,lipid research and brain injury.

Background:The information-motivation-behavioral skills (IMB) model of health behavior is an effective tool to evaluate the behavior of diabetes self-management.The purpose of this study was to explore behavioral factors affecting the practice of self-monitoring of blood glucose (SMBG) within the frame of IMB model of health behavioral among adult patients with type 1 diabetes in a single diabetes clinic in China.Methods:A questionnaire with three subscales on SMBG information,motivation,and behavioral skills based on IMB model was developed.Validity and reliability of the measures were examined and guaranteed.Adult patients with type 1 diabetes visiting our diabetes clinic from January to March 2012 (n =55) were consecutively interviewed.The self-completion questionnaires were administered and finished at face-to-face interviews among these patients.Both descriptive and correlational analyses were made.Results:Fifty-five patients finished the questionnaires,with the median duration of diabetes 4.5 years and the median of SMBG frequency 2.00.Specific SMBG information deficits,motivation obstacles,and behavioral skill limitations were identified in a substantial proportion of participants.Scores of SMBG motivation (r =0.299,P =0.026) and behavioral skills (r =0.425,P =0.001) were significantly correlated with SMBG frequency.The multiple correlation of SMBG information,SMBG motivation,and SMBG behavioral skills with SMBG frequency was R =0.411 (R2 =0.169,P =0.023).Conclusions:Adult patients with type 1 diabetes in our clinic had substantial SMBG information deficits,motivation obstacles,and skill limitations.This information provided potential-focused education targets for diabetes health-care providers.