Objective:To compare the efficacy of proximal femoral nail antirotation (PFNA) with metaphyseal expansion or non-expansion in the treatment of femoral intertrochanteric fracture in the elderly.Methods:A retrospective cohort study was conducted to analyze the clinical data of 349 elderly patients with femoral intertrochanteric fracture, comprising 168 males and 181 females, aged 60-84 years [(73.5±8.6)years]. According to AO fracture classification, 108 patients were classified as type A1, 164 type A2, and 77 type A3. Of them, 168 patients received PFNA with metaphyseal expansion (expansion group), while 181 received PFNA with metaphyseal non-expansion (non-expansion group). The operation time, intraoperative blood loss, recessive blood loss, postoperative drainage volume, total blood loss, intraoperative blood transfusion rate and length of hospital stay were compared between the two groups. Visual analogue scale (VAS) scores preoperatively, at 2 and 6 weeks postoperatively of the two groups were detected. The neck-shaft angle and tip-apex distance were measured preoperatively, immediately after surgery, and at 6 months postoperatively. Harris hip score was evaluated at 1, 3, and 6 months postoperatively. Additionally, time to weight-bearing ambulation, fracture healing time, and postoperative complication rate were compared between the two groups.Results:All the patients were followed up for 6-10 months [(7.8±1.2)months]. The operation time for the expansion group was (69.6±12.4)minutes, significantly longer than (65.3±11.5)minutes of the non-expansion group ( P<0.01). Intraoperative blood loss, recessive blood loss, postoperative drainage volume and total blood loss were (124.8±16.9)ml, (684.1±95.3)ml, (123.9±25.1)ml and (932.8±125.4)ml respectively, which were more than those of the non-expansion group [(96.3±12.6)ml, (623.4±87.4)ml, (110.6±29.7)ml, and (830.3±112.6)ml] ( P<0.01). The intraoperative blood transfusion rate was 50.0% (84/168), higher than 38.1% (69/181) of the non-expansion group ( P<0.05). There was no significant difference in the length of hospital stay between the two groups ( P>0.05). There was no significant difference in VAS scores between the two groups before surgery, at 2 and 6 weeks after surgery ( P>0.05). The VAS scores of the two groups at 2 and 6 weeks after surgery were lower than those before surgery, and there were significantly lower scores at 6 weeks after surgery when compared with those at 2 weeks after surgery ( P<0.05). There were no significant differences in neck-shaft angle and tip-apex distance of the two groups before surgery, immediately after surgery and at 6 months after surgery ( P>0.05). In both groups, the neck-shaft angle immediately after surgery and at 6 months after surgery decreased while the apex distance increased when compared with those before surgery ( P<0.05). Furthermore, significantly lower neck-shaft angle and larger apex distance were observed at 6 months after surgery when compared with those immediately after surgery ( P<0.05). There was no significant difference in Harris hip scores at 1, 3 and 6 months after surgery between the two groups ( P>0.05). In both groups, the Harris hip scores at 3 and 6 months after surgery were higher than those at 1 month after surgery ( P<0.05) and the Harris hip scores at 6 months after surgery were higher than that those at 3 months after surgery ( P<0.05). There were no significant differences in time to weight-bearing ambulation, fracture healing time and total postoperative complication rate between the two groups ( P>0.05). Conclusions:For the elderly patients with femoral intertrochanteric fractures, PFNA with proximal metaphyseal expansion or non-expansion is equally effective in shortening hospital stay, relieving pain, improving reduction quality, promoting hip function recovery and reducing complication rate. However, PFNA with non-expansion treatment can shorten the operation time, reduce intraoperative blood loss, recessive blood loss, postoperative drainage volume and total blood loss, and lower intraoperative blood transfusion rate.

Multi-Efficacy of One Drug (MEOD) refers to the traditional Chinese medicines (TCM) with diverse efficacies.MEOD,one of the important characteristics of TCM,is regarded as the basis of clinical rational drug use.However,there have been few reports on the MEOD research so far.In this paper,with rhubarb selected as a typical model drug,metabolomics and network pharmacology analysis are integrated to investigate the mechanisms of MEOD with the employment of the two animal models of constipation and jaundice.Then,the biological target network of MEOD is established for promoting the precision of the quality control and clinical use of TCM.

Objective To establish the quality standard for Haijinhuwei powder. Methods Corydalis Rhizoma, Angelicae Dahuricae Radix, Angelicae Sinensis Radix were identified by TLC. The content of tetrahydropalmatine was determined by HPLC. Results TLC spots were clear and specific.There was a good linear relationship between peak area and concentration of tetrahydropalmatine at the range of 10.78-107.8μg.mL-1(r=0.999 9).The average recovery rate was 96.57% and RSD was 1.40%(n=6). Conclusion All these results indicated that the developed TLC-HPLC method was proved to be reliable, accurate and specific, which could be used for the quality control of Haijinhuwei powder.

Objective:To explore the effect of inherent depression on chronic visceral hypersensitivity. The differences of visceral sensitivity, colitis, and brain activation between Fawn-Hooded ( FH/Wjd) and Sprague-Dawley( SD) rats were identified after neonatal colon acetate stimulation.Methods:The specific pathogen free Fawn-Hooded (FH/Wjd) and Sprague-Dawley(SD) rats were used to establish irritable bowel syndrome (IBS) model.The visceral sensitivity was measured by colorectal distension (CRD). The expression of 5-hydroxytryptamine (5-HT), mast cell (MC), indoleamine 2,3-dioxygenase (IDO) in colon and IDO in specific cerebral regions were detected through immunohistochemistry.Results:Ab-dominal withdrawal reflex ( AWR) scores showed that visceral sensitivity of acetate-enema groups was sig-nificantly higher than that of saline-enema groups ( FH/Wjd:2.44 ±0.04 vs.1.96 ±0.07, P<0.05;SD:1.75 ±0.13 vs.1.32 ±0.05, P<0.05).Furthermore, FH/Wjd rats of IBS group scored signifi-cantly higher than SD rats of IBS group (2.44 ±0.04 vs.1.75 ±0.13, P<0.05).The MC amounts of both SD and FH/Wjd IBS group rats were significantly more than those of their control groups ( FH/Wjd:43.24 ±1.72 vs.24.92 ±1.38, P <0.01.SD:23.80 ±1.28 vs.14.24 ±0.92, P <0.01).
Besides, the MC amounts of control and IBS group of FH/Wjd rats were significantly more than that of SD IBS group rats ( P<0 .01 ) .The IDO and 5-HT positive cells in colonic mucosa of IBS group of both SD and FH/Wjd rats were significantly more than those of their control groups, respectively(P <0.01). The IDO, 5-HT positive cells in colonic mucosa of both control and IBS group of FH/Wjd rats were significantly more than those of both control and IBS group of SD rats ( control:IDO,24.64 ±2.22 vs. 15.52 ±1.39;5-HT,21.32 ±1.26 vs.12.72 ±1.12.IBS: IDO,44.92 ±2.31 vs.20.85 ±1.72;5-HT, 31.84 ±1.57 vs.19.65 ±1.09.P <0.01).The expression of IDO in prelimbic cortex (PrL) areas of FH/Wjd IBS rats was significantly higher than that of IBS group of SD rats (49.60 ±4.31 vs. 35.60 ±2.42, P <0.01) , and the expression of IDO in rostral anterior cingulate cortex ( rACC) areas of FH/Wjd IBS rats was significantly more than that of FH/Wjd control rats (45.44 ±1.16 vs.34.08 ± 2.76, P <0.01) .Conclusion:Inherent depressive FH/Wjd rats were more sensitive to neonatal colon acetate stimulation, presenting as visceral hypersensitivity which maybe associated with increased MC amounts and over-expression of 5-HT and IDO in colon, suggesting that depression disorder may aggra-vate functional disturbance of gastrointestinal tract by regulating the response to inflammatory stimulation.

OBJECTIVE:To know about the hot point and development tendency of traditional Chinese medicine (TCM) in the nearest 20 years and provide reference for the further study. METHODS:Totally 5 000 papers of cited top 1% with the“TCM”themes in CNKI from 1994 to 2013 were collected. With the indicators of cited times and download times,Excel software analysis function,the CiteSpace citation analysis function and bibliometrics were adopted to statistically analyze the research field,main items,chemical constituents,pharmacological activities,published journals,personnel and units,etc. RESULTS:The papers about TCM research quantity in CNKI were increased exponentially in last 20 years,and might enter the platform period hence-forth;totally 15 main research fields,50 TCM and 60 chemical components/portions with strong activity and development prospect were highly noticed and cited;the study of pharmacological activities was the core and the most active area of TCM research,and mainly related to the major diseases and diseases with TCM advantages;totally 60 papers for highly cited were greater than 500 times,devoting 58.8%highly cited papers;40 authors and units screened from annually top 50 cited papers had wider academic in-fluence. CONCLUSIONS:Analyzing the hot point and development tendency of TCM research in the nearest 20 years based on the CNKI highly cited papers can accurately grasp the industry focus,thereby provide a certain reference and data support for tradition-al Chinese medicine research.

This study aims at trying to establish a novel method of sterility test for injections based on biothermodynamics, in order to overcome the deficiencies of routine sterility tests such as long detecting cycle, low sensitivity and prone to misjudgments. A biothermodynamics method was adopted to rapidly detect the microorganism contamination of injections by monitoring the heat metabolism during the growth of microbe. The growth rate equal to or greater than zero and the heat power difference of P(i) and P(0) with three folds higher than the noise of baseline were chosen as indexes to study the heat change rule of microbe. In this way, the effectiveness of the new method to detect strains required by conventional sterility test or in injection samples was also investigated. Results showed that the Gram-positive bacteria, Gram-negative bacteria and fungi demanded by sterility testing methodology could be detected by biothermodynamics method within 10 hours, with the sensitivity lower than 100 CFU x mL(-1). Meanwhile, this method was successfully applied to the sterility test of Compound Yinchen injection (FFYC), Shuanghuanglian powder injection (SHL) and Compound Triamcinolone injection (TAND) which were sterilized with different degrees. Therefore, the biothermodynamics method, with advantages of fast detection and high sensitivity, could be a complementary solution for conventional sterility tests.

The paper is to report the establishment of a method for quickly evaluating compatibility of Chinese medicines injections. Isothermal titration calorimetry (ITC) was used to evaluate compatibility of Yiqifumai (YQFM) and vitamin C injection (Vc)/5% glucose injection (5% GS). The diversification of Gibbs free energy (deltaG), enthalpy (deltaH) and entropy (deltaS) were used to decide reaction types of colliquefaction procedures of different injections. The reactive profiles were used to determine signs and quantity of heat. And high performance liquid chromatography (HPLC) was used as a supportive method for ITC. Then, feasible binding sites were analyzed based on the information of spatial structures of major compositions. During the colliquefaction procedure of YQFM and Vc, [deltaH] > T[deltaS], so, the reaction is enthalpy-driving. And the reactive profile showed that a big deal of heat was given out during the procedure. Obviously, chemical reactions happened and the major compositions changed. On the other side, the reaction of YQFM mixed with 5% GS was entropy-driving, because [deltaH] < T[deltaS]. The reactive profile showed there was a little heat gave out. So, non-chemical reactions happened, and the major compositions did not change. The conformity existed between the results of ITC and HPLC. ITC could be used to evaluate the compatibility of Chinese medicines injections because of the advantages of ITC, such as real time, fast, sensitive and having more parameters.

One hundred and twenty one patients on maintenance hemodialysis ( MHD) from Januaury 2004 to Januaury 2009 in our hospital were enrolled in the study. Demographic characteristics, clinical data and causes of disease were documented, the survival probability was estimated with Kaplan-Meier method and the prognostic factors were analyzed with Cox regression model. The median follow-up duration was 28. 9 months. The 1,3, 5-year survival rates were 93. 0% , 66. 5% and 45. 8% respectively. By Kaplan-Meirie analysis, cardiovascular disease (x2 =6. 582, P =0. 010) , age of starting dialysis (x2= 12.439, P= 0.002), urea clearance index Kt/V ( x2 =7.633, P=0.006) and albumin levels ( x2 = 4.512, P= 0.034) were closely related to prognosis. Cox regression analysis showed Kt/V, cardiovascular disease and age of starting dialysis were independent prognostic factors ( relative risk were 3. 204, 2. 994, 2. 543 respectively).

Objective To explore the feasibility of inherent depressive Fawn-Hooded (FH/Wjd)rats as a comorbidity model of mental disorder and irritable bowel syndrome (IBS) by comparing visceral sensitivity of FH/Wjd rats and Sprague-Dawley (SD) rats. Methods Depression trait of FH/Wjd rats was validated through forced swimming test (FST) and sucrose preference test (SPT).Visceral sensitivity to colorectal distention (CRD) under various pressures was assessed by abdominal withdrawal reflex (AWR). The expression of 5-HT in rats' colon,c-fos expression in colon and brain areas of infralimbic cortex (IL),prelimbic cortex (PrL) and rostral anterior cingulated cortex (rACC)was tested with immunohistochemistry. Results FST indicated that the immobility time of FH/Wjd rats was significantly longer than that in SD rats (t=-8. 931,P＜0. 01). SPT showed that the ratio of sucrose water in total liquid consumed was significantly lower in FH/Wjd rats than that of SD rats(t=4. 155,P=0. 01). At each CRD pressure gradient (20,40,60 and 80 mm Hg,1 mm Hg=0. 133kPa),AWR score was all significantly higher in FH/Wjd rats than that of SD rats (t=-2. 697,-3.464,-6.822 and -3. 976,P=0. 022,0.006,0.000 and 0.003). The expression level of 5-HT in FH/Wjd rats' control group was significantly higher than that of SD rats' control group (t=-11.371,P=0. 000). Compared with their own control group,5-HT expression increased both in FH/Wjd rats dilated groups and SD rats dilated groups,and the expression level in FH/Wjd rats was higher than that of SD rats (t= -3. 364,P= 0. 007). There was no significant difference of c-fos expression in colon and prefrontal brain areas between FH/Wjd rats' control group and SD rats'control group (colon:t=-0. 129,P= 0. 900;IL:t=-1. 316,P= 0. 218;PrL:t=1. 241,P = 0. 243;rACC:t=2. 151,P = 0. 057). Compared with their own control group,the expression of c-fos in colon and prefrontal brain areas significantly increased both in FH/Wjd rats dilated groups and SD rats dilated groups,and the expression level in FH/Wjd rats was higher than that of SD rats (colon: t=- 5.864,P= 0.000;IL:t=-2. 530,P = 0. 030;PrL:t=-7. 039,P= 0. 000;rACC:t=-6. 489,P=0. 000). Conclusions Inherent depressive FH/Wjd rats present visceral hypersensitivity. Meanwhile,the expression of 5-HT in colon is high,and with hyperreactivity to visceral noxious stimuli in colon and brain IL,PrL,and rACC areas. FH/Wjd rats might be a comorbidity animal model of mental disorder and IBS.

This paper is aimed to provide the methods of quality control and bioassay of traditional Chinese medicine injections including bioassay method. Shuanghuanglian freeze-dried powder for injection (SFPI) was chosen as study object. HPLC-ELSD fingerprints of SFPI had been established and the samples were differentiated by similarity calculation. Meanwhile, biological profiles of SFPI on Escherichia coli had been established by microcalorimetry. The similarity values were calculated using the correlation coefficient, based on quantitative thermo-kinetic parameters (T2m, Tj, I%). The results indicated that HPLC-ELSD fingerprints, which showed content changes of chemical components, could not monitor minimal variation of different samples, especially that of biological pollutants, while biological profiles could sensitively detect antibiotic activity alterations of the samples, which were kept under specific conditions. In conclusion, characterized by two-dimension, microcalorimetry could supply thermograms as biological profiles characterized to describe the bioactivity of drugs. This study could clearly demonstrate that the correlative detection was proposed as an efficient strategy for quality control of SFPI, based on HPLC-ELSD fingerprints and biological profiles, which could detect quality fluctuation of samples early and quickly and predict the potential adverse drug events (ADE) for ensuring clinical safety.