Objective:To explore the clinical effectiveness of a self-designed robot reduction system for femoral intertrochanteric fractures.Methods:A retrospective study was conducted to analyze the 57 patients with intertrochanteric fracture who had been treated at Department of Orthopedics, The Fourth Affiliated Central Hospital of Tianjin Medical University from June 2022 to February 2023. The patients were divided into a robot group (using the self-designed robot reduction system to assist intramedullary nailing) and a traction bed group (using a traction bed to assist intramedullary nailing) based on their fracture reduction method. The robot group: 31 patients, 11 males and 20 females, with an age of (78.7±9.3) years; 16 left and 15 right sides; 17 cases of type 31-A1, 12 cases of type 31-A2 and 2 cases of type 31-A3 by the AO/OTA classification. The traction bed group: 26 patients, 12 males and 14 females, with an age of (78.7±7.7) years; 13 left and 13 right sides; 16 cases of type 31-A1, 9 cases of type 31-A2 and 1 cases of type 31-A3 by the AO/OTA classification. The 2 groups were compared in terms of reduction and operation time, intraoperative blood loss, fluoroscopy frequency, reduction quality, and VAS and Harris score at preoperation, 1 week and 6 months postoperation.Results:The 2 groups were comparable due to insignificant differences in their preoperative general data ( P>0.05). The robot group was significantly better than the traction bed group in reduction time [(4.4±2.2) min versus (9.4±3.2) min], operation time [(29.0±13.5) min versus (49.3±13.3) min], intraoperative blood loss [(76.5±30.5) mL versus (115.0±38.4) mL], fluoroscopy frequency [(10.2±2.6) times versus (14.8±3.2) times], and good/excellent rate of reduction [80.6% (25/31) versus 50.0% (13/26)] ( P<0.05). All patients were followed up for (6.8±0.3) months. Respectively, the VAS scores at preoperation and 6 months postoperation was (6.2±1.3) and (2.4±0.8) points for the robot group, and (6.3±1.3) and (2.7±0.8) points for the traction bed group, showing no statistically significant differences between the 2 groups ( P>0.05). However, the VAS score was (3.3±1.2) points for the robotic group and (4.8±1.5) points for the traction bed group at 1 week postoperation, showing a statistically significant difference between the 2 groups ( P<0.001). Respectively, the Harris scores at preoperation and 6 months postoperation were (35.3±3.0) and (88.7±3.4) points for the robot group, and (35.6±2.9) and (87.2±3.5) points for the traction bed group, showing no statistically significant differences between the 2 groups ( P>0.05). However, the Harris score was (57.3±3.7) points for the robotic group and (46.7±2.8) points for the traction bed group at 1 week postoperation, showing a statistically significant difference between the 2 groups ( P<0.05). The patient satisfaction rates in the robot and traction bed groups were 96.8% (30/31) and 92.3% (24/26), respectively, showing no statistically significant difference ( P>0.05). Conclusion:Our self-designed robot reduction for femoral intertrochanteric fractures can effectively shorten reduction and operation time, reduce bleeding and fluoroscopy frequency, and enhance anatomical reduction.

Objective To investigate the effect of ultrasound-guided erector spinae plane block(ESPB)on early postoperative respiratory function and inflammatory cytokines in patients with multiple rib fractures(MRFs).Methods Fifty-eight patients who underwent MRFs surgery,42 males and 16 females,aged 18-64 years,BMI 18.5-30.0 kg/m2,ASA physical status Ⅰ or Ⅱ,were selected from February 2019 to December 2021.The patients were divided into two groups using random number method:ESPB combined with general anesthesia group(group E)and general anesthesia alone group(group G),29 pa-tients in each group.All the patients in group E underwent ultrasound-guided ESPB in the lateral decubitus position after general anesthesia induction,and 0.5％ropivacaine 0.4 ml/kg was administered.Forced vital capacity(FVC),arterial blood gas analysis,VAS pain scores at rest and cough were recorded before anes-thesia induction,at discharge from PACU,24 and 48 hours after operation.The number of effective PCIA compressions during 0-24 hours and 24-48 hours after surgery and the number of rescue analgesia were re-corded.The concentrations of IL-6 and TNF-α were recorded before anesthesia induction,24 and 48 hours after operation.Results Compared with group G,the FVC was significantly higher,and the VAS score and PaCO2 were significantly lower in group E at discharge from PACU,24 and 48 hours after operation(P＜0.05).The number of effective PCIA compressions during 0-24 hours and 24-48 hours after surgery,the rate of rescue analgesia,the concentrations of IL-6 and TNF-α 24 and 48 hours after operation in group E were significantly lower than those in group G(P＜0.05).Conclusion Ultrasound-guided ESPB can pro-vide good postoperative analgesia,promote early postoperative recovery of respiratory function in patients with MRFs.

Objective:To evaluate the effect of femoral stable interlocking intramedullary nail (FSIIN) and proximal femoral nail anti-rotation (PFNA) in the treatment of anterograde intertrochanteric fractures.Methods:From June 2015 to December 2020, 68 cases with surgically treated of femoral intertrochanteric fractures were included. Among them, there were 37 cases (17 males and 20 females) in proximal femoral nail antirotation (PFNA) group, and the age ranged from 48 to 78 years (62.9±7.1 years); 18 cases were on the left and 19 cases on the right; AO/OTA classification: 16 cases of A1 type and 21 cases of A2 type. And there were 31 cases (18 males and 13 females) in FSIIN group without distal locking, the age ranged from 47 to 84 years (62.4±8.6 years); 15 cases were on the left and 16 cases on the right; AO/OTA classification: 11 cases of A1 type and 20 cases of A2 type. Fracture fixation time, incision length and number, intraoperative blood loss, fracture healing time, visual analogue scale (VAS) and Harris scores at the last follow-up were compared between the two fixation methods.Results:Both groups were followed up, and the follow-up time was 15.3±3.9 months in the FSIIN group and 15.7±3.9 months in the PFNA group, and the difference was not statistically significant ( t=0.42, P=0.675). In FSIIN group, the fracture fixation time was 26.6±11.5 min, the total incision length was 7.6±1.8 cm, the intraoperative blood loss was 107.6±42.8 ml and the fracture healing time was 10.1±1.3 weeks. In PFNA group, the fracture fixation time was 40.3±10.8 min, the total incision length was 12.2±1.8 cm, the intraoperative blood loss was 209.4±52.0 ml and the fracture healing time was 16.3±1.6 weeks. In FSIIN group, the fracture fixation time ( t=3.46, P<0.001), total incision length ( t=2.39, P=0.020), intraoperative blood loss ( t=3.16, P<0.001), fracture healing time ( t=2.80, P<0.001) were all less than those in PFNA group, and the difference was statistically significant. The VAS score of FSIIN group was 1.4±0.5 points, and that of PFNA group was 1.6±0.6 points, and the difference was not statistically significant ( t=0.68, P=0.503). The Harris score was 84.5±2.2 in FSIIN group and 83.3±2.5 in PFNA group, and the difference was not statistically significant ( t=0.63, P=0.530). At the last follow-up, 29 patients in the FSIIN group were very satisfied with the operation, and 2 patients were satisfied with the operation, with a satisfaction rate of 100%. In PFNA group, 30 patients were very satisfied with the operation, 7 patients were satisfied with the operation, and the satisfaction rate was 100%. Conclusion:Compared with PFNA, micro-invasive and micro-stress shielding methodes of FSIIN in the fixation of anterograde intertrochanteric fractures is more minimally invasive, simple, time-saving, less bleeding, less risk, less pain, minimal stress shilding and enhanced recovery after surgery. The effect of treatment is similar in FSIIN and PFNA group.

Objective:To evaluate the efficacy of femoral stable interlocking intramedullary nail (FSIIN) in the treatment of anterograde intertrochanteric fractures.Methods:FSIIN was invented to treat femoral intertrochanteric fractures. From January 2005 to February 2019, 36 cases of anterograde intertrochanteric fractures were retrospectively analyzed. Among them, 29 cases were from the Fourth Central Hospital Affiliated to Nankai University and 7 cases were from the Second People's Hospital of Hulunbuir City. 15 cases (6 males and 9 females) were treated with FSIIN distal locking fixation(distal locking group). The average age was 68.53±10.82 years (range, 48-80 years old); According to AO/OTA classification, there were 7 cases of 31-A1 type and 8 cases of 31-A2 type. 21 cases (12 males and 9 females) were treated by FSIIN distal fixation non-locking (distal unlocking group). The average age was 67.86±11.70 years (range, 46-85 years). there were 9 cases of 31-A1 type and 12 cases of 31-A2 type. The operation time, intraoperative blood loss, fracture healing time, visual analogue scale (VAS) and Harris scores at the last follow-up were compared between the two fixation methods.Results:Both groups were followed up for 10-24 months, and the mean time in the lock group was 16.73±3.41 months. The mean time in the non-locking group was 16.10±3.36 months. In the locked group, the operation time was 43.47±2.39 min, the intraoperative blood loss was 149.33±44.96 ml, and the fracture healing time was 14.57±1.50 weeks. In the non-locking group, the operation time was 33.29±5.30 min, intraoperative blood loss was 97.62±38.46 ml, and fracture healing time was 10.16±1.20 weeks. The operation time of the non-locking group was shorter than the locking group ( t=6.930, P<0.001), intraoperative blood loss was decreased than the locking group ( t=3.708, P<0.001), fracture healing time was reduced than the locking group ( t=9.818, P<0.001). At the last follow-up, the VAS score of the locked group was 1.60±0.63 and the non-locked group was 1.81±1.08, which showed no significant difference( t=0.673, P=0.506). There was no significant difference in Harris score between the locked group 84.33±2.53 and the non-locked group 84.90±2.19( t=0.724, P=0.474). Eight weeks after the operation, the proximal inferior locking nail was withdrawn 1 cm in 1 case. The fracture healed without treatment. Conclusion:Both FSIIN distal locking and non-locking are effective methods for the treatment of femoral intertrochanteric fractures. Compared with the distal locking group, the non-locking group had more simpler operation, more minimally invasive, and enhanced recovery after surgery.

OBJECTIVE: To investigate the incidence and influencing factors of hypertension among civil aviation pilots. METHODS: A total of 1 169 civil aviation pilots in Northern China were selected into the study by the method of convenient sampling. Physical examination, laboratory test and questionnaire survey were conducted. RESULTS: The prevalence of hypertension in Northern China was 4.7%(55/1 169). Multivariate regression analysis showed that the relative risk factors ranking from high to low were, age over 30 years [odds ratio(OR)=6.81, 95% confidence interval(95%CI) 3.57-12.98)], total flight hours over 1 000 hours(OR=4.24, 95%CI 2.14-8.41), flight hours over 500 hours in the past year(OR=2.91, 95%CI 1.57-5.40), obesity(OR=2.50, 95%CI 1.08-5.81), fasting blood glucose(OR=2.24, 95%CI 1.21-4.13), and frequent long-distance flight(OR=2.38, 95%CI 1.24-4.58). These factors were the risk factors of hypertension in civil aviation pilots(P<0.05). CONCLUSION: Age, total flight hours, flight hours in the past year, obesity, fasting blood glucose, frequent long-distance flight are related to the prevalence of hypertension in civil aviation pilots.

This article discussed the significance of clinical medical records in acupuncture teaching from these aspects:meridian and acupoint theory,syndrome differentiation theory,and therapeutic theory,hoping to illuminate acupuncture teaching.

Objective:Study on the expression of Fas and Fas ligand (FasL) in gastric cancer and its possible significance.Methods:Fifty-eight paraffin-embedded gastric cancer tissues and twenty-six non-cancer tissues were tested for the expression of Fas and FasL protein by immunohistochemistry.Results:The positive rate of Fas in cancer cells of gastric cancer tissues was significantly lower than that in gastric epithelial cells of the control tissues(19.0% and 61.5%,respectively;?~2=14.918;P=0.000).The positive rate of FasL showed no significant difference between cancer cells of gastric cancer tissues and gastric epithelial cells of the control tissues(63.8% and 53.8%,respectively).Conclusion:The Fas-FasL system is unbalanced.It may be related to the carcinogenesis of gastric epithelial cells and might be responsible for the immune excape of these cells.

Objective:To explore the mechanism of grape seed polyphenols (GSP) reverseing mutidrug resistance of GBC-SD cell lines.Methods:GBC-SD cell lines were used to determine the effect of GSP.MTT assay was adopted to evaluate the cytotoxity,RT-PCR was used to determine MDR1 mRNA,P-gp and cellular adriamycin was measured by flow cytometry.Results:IC50 of chemotherapeutic agents was reduced in GSP treated group (P0.05),GSP inhibited the expression of P-gh and MDR1 mRNA (P0.05) ,increased celluar accumulation of adriamycin (P0.05).Conclusions:GSP can reverse mutidrug resistance of GBC-SD cell lines,the potential mechanisms is that GSP decreases expression of P-gp、bcl-2 and MDR1 mRNA.

Objective: To study the expression of Fas, Fas ligand (FasL) and IFN ? in gastric cancer and its possible significance. Methods: Fifty eight gastric paraffin wax embedded cancer tissues and fifty three normal tissues adjacent gastric cancer were tested for the expression of Fas and FasL protein by immunohistochemistry and IFN ? mRNA by in situ hubridisation respectively. Results: The positive rate of Fas in cancer cells of gastric cancer tissues was significantly lower than that in gastric epithelial cells of the tissues adjacent cancer(19.0% and 64.2%, respectively; ? 2=23.46, P = 0.00). The positive rate of FasL in cancer cells of gastric cancer tissues was significantly higher than that in gastric epithelial cells of the tissues adjacent cancer(63.8% and 45.3%,respectively; ? 2=3.83, P =0.05). The positive rate of IFN ? in cancer cells of gastric cancer tissues was significantly lower than that in gastric epithelial cells of the tissues adjacent cancer(0.0% and 49.1%,respectively; ? 2=37.16, P =0.00). Conclusion: The Fas-FasL system was unbalanced, and the expression of IFN ? was low in gastric cancer cells in this study. These may be related to the carcinogenesis of gastric epithelial cells and might be responsible for the immune escape of these cells.

OBJECTIVETo study the immunogenicity and safety of recombinant yeast-derived hepatitis B vaccine (YDV) in adults.

METHODSOne hundred and twenty-four healthy teachers aged 22 approximately 58 years with serum negative HBsAg, anti-HBs, anti-HBc and with normal temperature were randomly selected from Beipiao city, Liaoning province. All the subjects were immunized with 5 microg/0.5 ml of YDV made by Beijing Institute of Biologic Products, for three doses at an interval of one and six months, respectively.

RESULTSThe positivity of serum anti-HBs was 35.0%, 83.3%, 65.5% and 32.7% with a geometric mean titre (GMT) of 12.6 mIU/ml, 402.0 mIU/ml, 70.3 mIU/ml and 20.3 mIU/ml, respectively, three, seven, 12 and 24 months after immunization. The positivity and GMT of serum anti-HBs appeared the highest seven months after immunization, then began to decrease sharply. The positivity and GMT of serum anti-HBs in women was higher than that in men either three, or seven, or 12, or 24 months after immunization. The positivity of serum anti-HBs in those of 35 years or over was lower than that less than 35 years, seven months after immunization, but no age difference could be found 12 months after immunization. No local or systematic adverse reactions were found in all the subjects within three days after immunization.

CONCLUSIONThe recombinant yeast-derived hepatitis B vaccine (YDV) is immunogenic and safe for adults, but the persistency of serum anti-HBs in after immunization should be followed-up further.

Adult ; Age Factors ; Hepatitis B Antibodies ; blood ; Hepatitis B Vaccines ; immunology ; Humans ; Immunization ; Middle Aged ; Sex Factors ; Vaccines, Synthetic ; immunology ; Yeasts ; genetics