PHARMACOLOGICAL RELEVANCE Indirubin (IR) is a key active ingredient in the traditional Chinese medication QingDai, also called indigo naturalis, which are extensively used in China to treat chronic diseases, such as inflammation and cancer. However, the function of IR in reducing chondrocyte inflammation in osteoarthritis (OA) is still unclear. AIM OF THE STUDY The aim of this research was to examine how IR inhibits arthritis and to highlight some of its cellular-level processes. MATERIALS AND METHODS Chondrocytes from the knee joint of C57 mice were gathered and grown for in vitro tests and used to determine the toxicity of IR toward chondrocytes using a CCK8 kit. Chondrocytes were treated with IL-1β and IR or with IL-1β alone, and western blotting was used to determine the expression levels of inflammatory mediators. Meanwhile, through the identification and examination of pertinent markers via quantitative PCR. By using PCR assays, western blotting, toluidine blue staining and safranin O staining, the expression of proteoglycan (AGG) and type II collagen (collagen II) was investigated. Furthermore, western blotting was used to detect activation of the NF-κB and MAPK signaling pathways, and immunofluorescence was used to detect p65 nuclear translocation. In an in vivo experiment, C57BL/6 mice were subjected to destabilization of the medial meniscus (DMM) surgery to produce an OA model, and IR was injected into the articular cavity for 8 weeks. Eventually, the mice were killed, and samples of the knee joints were obtained for histological examination and analysis. RESULTS IR significantly reduced the expression of inflammatory regulators in chondrocytes treated with IL-1β, including iNOS and COX-2. Inhibition of IL-1β induced production of the key catabolic enzymes MMP3, MMP13 and A5. Additionally, an improvement in the downregulation of collagen II and AGG expression was observed. Moreover, IR prevented the aberrant IL-1β-induced activation of the NF-κB and MAPK signaling pathways, which resulted in downregulation of p65 and p38 expression. Compared to the DMM group, the severity of cartilage injury in animals was dramatically lessened and OARSI scores were lower in the treated groups. CONCLUSION According to the above findings, IR is quite effective in preventing arthritis both in vivo and in vitro, suggesting that IR may be employed as a possible anti-arthritis drug.

缺氧是包括骨肉瘤在内的实体肿瘤的普遍特征.缺氧诱导因子是肿瘤细胞在缺氧条件下的重要调节因子.研究缺氧诱导因子在骨肉瘤的相关机制能为骨肉瘤的治疗提供新思路,本文就缺氧诱导因子的结构功能、缺氧诱导因子与骨肉瘤干细胞、缺氧诱导因子与骨肉瘤放疗抵抗、缺氧诱导因子与骨肉瘤多药耐药、缺氧诱导因子的抑制剂等相关研究进行综述.

目的 探讨HIF-3α在骨肉瘤侵袭转移中的作用,观察低氧对骨肉瘤MG-63细胞侵袭能力的影响.方法 收集15例骨肉瘤组织和15例骨软骨瘤组织,用免疫组织化学染色方法检测骨肉瘤组织和骨软骨瘤组织中HIF-3α的表达情况;MG-63细胞低氧刺激,用定量RT-PCR和Western Blot方法检测MG-63细胞中HIF-3α的表达情况;用细胞黏附实验、细胞迁移实验及细胞侵袭实验检测MG-63细胞的黏附、迁移及侵袭能力.在MG-63细胞中,敲降HIF-3α或过表达HIF-3α后,检测低氧对细胞的黏附、迁移及侵袭能力的影响.结果 免疫组化结果显示骨肉瘤组织中HIF-3α高表达而骨软骨瘤组织中HIF-3α低表达.与常氧条件相比,低氧促进MG-63细胞中HIF-3αmRNA和HIF-3α蛋白的表达,低氧增强MG-63细胞的黏附、迁移及侵袭能力.MG-63细胞中HIF-3α的敲降减弱了 MG-63细胞的黏附、迁移及侵袭能力而HIF-3α的过表达增强了 MG-63细胞的黏附、迁移及侵袭能力.结论 低氧促进了 MG-63细胞中的HIF-3α的表达,增强了 MG-63细胞的侵袭转移能力,HIF-3α在低氧诱导的MG-63细胞侵袭转移中具有重要作用.

目的 探讨矿化胶原改性骨水泥在骨质疏松性椎体压缩骨折经皮椎体成形术中的应用.方法 前瞻性研究2017年9月—2019年9月华中科技大学同济医学院附属梨园医院收治骨质疏松性椎体压缩骨折患者123例,男性70例,女性53例;年龄44～75岁,平均54.3岁.提物受伤63例,摔伤60例.按术中使用的骨水泥不同分为观察组(65例)和对照组(58例).观察组采用矿化胶原改性骨水泥治疗,对照组给予传统骨水泥治疗.比较两组患者手术进行情况指标、伤椎(前缘、中部、后缘)高度、视觉模拟评分(VAS)、Oswestry功能障碍指数(ODI)、并发症(骨水泥渗漏、邻椎骨折、切口感染、松动移位)发生率.结果 两组患者手术时间、术中出血量、住院时间比较差异无统计学意义.术后2d两组患者椎体前缘、中部、后缘高度均显著改善,但差异无统计学意义.两组患者术后3个月VAS与术前比较[(6.7±1.9)分vs.(1.6±0.6)分、(6.5±1.8)分vs.(1.9±0.6)分]均降低,术后3个月ODI[(33.1±8.0)分vs.(19.4±5.1)分、(32.5±7.9)分vs.(22.1±5.1)分]均降低,且观察组VAS、ODI均低于对照组[(1.6±0.6)分vs.(1.9±0.6)分、(19.4±5.1)分vs.(22.1±5.1)分,P＜0.05].观察组并发症发生率8％(5/65)低于对照组21％(12/58),组间比较差异有统计学意义(P＜0.05).结论 矿化胶原改性骨水泥在骨质疏松性椎体压缩骨折经皮椎体成形术中应用效果良好,能改善患者的疼痛程度、功能障碍评分,且能降低骨水泥的相关并发症,值得临床推荐.

BACKGROUND The Pfannenstiel approach, which provides good surgical exposure, has been used for the treatment of pubic symphysis diastasis and parasymphyseal fractures. However, it requires a medium-length incision and moderate soft-tissue dissection, resulting in potential damage to anatomical structures and inferior aesthetic outcomes. Here, we introduce a new concealed-incision extrapelvic approach for the internal fixation of pubic symphysis diastasis and parasymphyseal fractures. METHODS We retrospectively reviewed the records of 8 patients with pubic symphysis diastasis and parasymphyseal fractures that had been treated via the concealed-incision extrapelvic approach (the "Fu-Liu" approach). All patients presented for treatment during the period from January 2017 to November 2017. Six of the 8 patients had anterior column fractures, 1 patient had a double-column fracture, and 1 patient had parasymphyseal fractures. Operative time, the amount of blood loss, and postoperative radiographic and computed tomography (CT) findings were recorded. The degree of fracture-healing, complications, function, and satisfaction with the skin incisions were also evaluated. RESULTS All patients were followed for at least 21 months (range, 21 to 30 months). Postoperative radiographs and CT scans showed good positioning of plates and screws. The average time before surgery, operative time, and intraoperative blood loss (and standard deviation) were 7.8 ± 3.25 days, 41.9 ± 8.99 minutes, and 18.8 ± 7.8 mL, respectively. No complications (including internal fixation failure, vascular injury, nerve palsy, wound infection, and hernia) occurred in any of the patients, and all patients were satisfied with the appearance of the scar. CONCLUSIONS We can effectively stabilize pubic symphysis diastasis and parasymphyseal fractures with use of the Fu-Liu approach, which can also enable retrograde anterior column screw placement. The Fu-Liu approach is simple, safe, and minimally invasive, and the aesthetic outcome is more acceptable than that associated with the Pfannenstiel approach. LEVEL OF EVIDENCE Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.

目的 观察四肢骨折延迟愈合患者血清微小RNA-206 (miR-206)、胰岛素样生长因子-1(IGF-1)、可溶性细胞间黏附分子(sICAM-1)的水平变化,并探讨其对骨折延迟愈合的诊断效能.方法 159例四肢骨折患者,行钢板内固定或髓内钉固定术,分别于术前(T0)及术后第3天(T1)、第1周(T2)、第4周(T3)时采集静脉血,实时荧光PCR法检测血清miR-206,ELISA法检测血清IGF-1、sICAM-1.术后3个月时159例患者根据是否存在骨折延迟愈合分为89例骨折延迟愈合(延迟组),70例骨折正常愈合(正常组).采用单因素分析、Logistic逐步回归分析法分析骨折延迟愈合的危险因素.绘制受试者工作特征曲线(ROC),分析血清miR-206、IGF-1、sICAM-1及三者联合对骨折延迟愈合的诊断效能.结果 T0～T3时两组血清miR-206表达、IGF-1水平逐渐增高,sICAM-1水平逐渐降低(P均＜0.05).与正常组比较,T0、T1、T2、T3时延迟组血清miR-206表达、sICAM-1水平高,血清IGF-1水平低(P均＜0.05).骨质疏松、损伤类型、T3基线时血清miR-206、T3基线时血清IGF-1、T3基线时血清sICAM-1是骨折延迟愈合的危险因素(P均＜ 0.01).T3基线时,血清miR-206、IGF-1、sICAM-1诊断骨折延迟愈合的截断值分别为0.62、291.34 μg/L、202.43 ng/mL时,其诊断骨折延迟愈合的灵敏度分别为72.41％、79.31％、70.11％,特异度分别为72.86％、80.00％、84.29％,阳性预测值为76.83％、86.13％、77.22％,阴性预测值分别为68.00％、75.68％、66.67％,AUC分别为0.690(95％CI:0.606～0.773)、0.682(95％CI:0.596～0.767)、0.709(95％CI:0.626～0.793).血清miR-206、IGF-1、sICAM-1联合诊断骨折延迟愈合的灵敏度、特异度、阳性预测值、阴性预测值分别为91.95％、91.43％、93.02％、90.14％,AUC为0.895(95％ CI:0.837 ～0.95).T3时血清miR-206、IGF-1、sICAM-1水平联合诊断骨折延迟愈合AUC高于三者单独诊断(z分别为3.021、3.162、2.615,P均＜0.05).结论 手术固定患处的骨折延迟愈合患者血清miR-206、sICAM-1水平升高,IGF-1水平降低.血清miR-206、sICAM-1、IGF-1联合诊断四肢骨折患者术后骨折延迟愈合的准确性较高.

目的 探讨骨肉瘤组织中胰岛素样生长因子ⅡmRNA结合蛋白3(IMP3)表达及肿瘤微血管密度(MVD)与患者临床病理特征的关系.方法 选择骨肉瘤患者70例,利用SP免疫组化法检测骨肉瘤和癌旁组织中的IMP3和MVD.分析骨肉瘤组织中IMP3的表达和MVD与患者临床病理特征的关系.采用Spearman等级相关分析IMP3与MVD的关系.结果 骨肉瘤组织中IMP3的表达、MVD值高于癌旁组织(P均<0.05).骨肉瘤组织中IMP3表达与肿瘤直径、En-neking分期、肺转移有关(P均<0.05);MVD值与肿瘤直径、Enneking分期、肺转移有关(P均<0.05).骨肉瘤组织中,IMP3表达和MVD值呈正相关(r=0.493,P=0.001).结论 骨肉瘤组织中IMP3表达、MVD异常上调,与骨肉瘤的恶性程度密切相关,可作为骨肉瘤相关生物标记物的潜力.

Background: PCL has a long history as an industrialized biomaterial for preparing micro-spheres, but its hydrophobic property and slow degradation rate often cause drug degeneration, quite slow drug release rate and undesirable tri-phasic release profile. Materials and Methods: In this study, we used the blending material of PLGA-PEG-PLGA and PCL to prepare microspheres. The microspheres degradation and drug release behaviors were evaluated through their molecular weight reduction rate, mass loss rate, morphology erosion and drug release profile. The hydrophilic PLGA-PEG-PLGA is expected to improve the degradation and drug release behaviors of PCL microspheres. Results: Microspheres in blending materials exhibited faster erosion rates than pure PCL micro-spheres, forming holes much quickly on the particle's surface for the drug to diffuse out. A higher proportion of PLGA-PEG-PLGA caused faster degradation and erosion rates. The blending microspheres showed much faster drug release rates than pure PCL microspheres. Conclusion: With blending of 25wt% PLGA-PEG-PLGA, the release rate of microspheres speeded up significantly, while, with a further increase of PLGA-PEG-PLGA proportion (50%, 75%, 100%), it accelerated a little. The microspheres with PCL/PLGA-PEG-PLGA of 1/1 exhibited a linear-like drug release profile. The results could be a guideline for preparing microspheres based on blending materials to obtain a desirable release.

目的 探讨上臂前外侧入路双锁定钢板治疗肱骨干术后骨不连的临床疗效.方法 回顾2015年2月至2018年6月在我科行上臂前外侧入路双钢板治疗肱骨干骨折术后骨不连患者并随访获得完整资料的患者13例.其中,男8例,女5例;左侧4例,右侧9例;年龄21～75岁,平均50.2岁;肱骨干上1/3段骨折3例,中1/3段骨折8例,下1/3段骨折2例;10例患者钢板断裂失效,3例钢板完好.增生性骨不连9例,缺血性骨不连3例,萎缩性骨不连1例.记录患者基本信息和随访结果,肩关节Constant-Murley评分、肘关节Mayo评分、患侧上肢DASH评分来评定临床疗效.结果 13例患者随访获得完整随访资料,平均随访10.7个月(9～14个月),所有患者均获得骨性愈合,平均愈合时间6.2个月(4～11个月),1例出现术后一过性桡神经麻痹,该患者术后2个月恢复正常,并发症发生率为7.69％.患者肩关节Constant-Murley评分(术前67.2±5.7、术后末次随访81.2±4.4),肘关节Mayo评分(术前74.2±5.4、术后末次随访80.2±3.2),患侧上肢DASH评分(术前8.9±2.7、术后末次随访7.97±2.3).该三项评分术后末次随访较术前改善,与术前比较差异有统计学意义(P＜0.05).结论 上臂前外侧双锁定钢板治疗肱骨干骨折骨不连效果满意.

目的 探讨应用微创接骨板内固定技术(minimally invasive percutaneous plate osteosynthesis,MIPPO)治疗老年肱骨近端不稳定型骨折的临床疗效.方法 选取2015年7月至2017年8月本院采用微创接骨板内固定技术手术治疗并成功随访的34例肱骨近端不稳定型骨折老年患者,其中男12例,女22例;年龄69.2～81.5岁,平均年龄为73.5岁;右侧20例,左侧14例.骨折按Neer分型:二、三、四部分骨折分别为10例、17例、7例.受伤到手术时间3～7 d,本组患者均获得完整随访资料,分别记录手术时间、手术出血量、术中透视次数、骨折愈合时间、术后并发症发生率及术后12个月时肩关节功能Neer评分分析该手术方法的临床疗效.结果 所有患者均获随访,随访时间12～18个月,平均16个月.手术时间52.6～135.4 min,平均78.5 min;术中出血量45.6～135.4mL,平均75 mL;术中透视7～18次,平均9.7次;骨折愈合时间2.3～5个月,平均愈合时间3个月.2例出现内固定松动,经治疗后骨折均一期愈合.术后12个月时肩关节功能Neer评分:优22例,良8例,可3例,差1例,总体优良率88.2％.结论 微创接骨板内固定技术是治疗肱骨近端骨折的有效方法,创伤小、骨折愈合快,临床疗效满意.

Objective To research the curative effect of Aclasta in treatment of osteoporosis in menopausal women and the influence on serum bone metabolism markers,provide a clinical basis for effectively improving pain of patients,increasing bone density,predicting the risk of osteoporotic fracture,monitoring natural course of the disease,and improving bone metabolism markers.Methods A total of 280 menopausal women diagnosed as osteoporosis in Liyuan Hospital from January 2014 to January 2017 were selected and randomly divided into control group and observation group,140 patients in each group.The patients in control group were treated with calcium and vitamin D3,and the patients in observation group were treated with calcium,vitamin D3,and intravenous drip of Aclasta (zoledronate 5 mg).The levels of body mass density (BMD),serum bone turnover markers [alkaline pbosphatase (ALP),procollagen type Ⅰ N-propeptide (PINP),and C-terminal telopeptide of type Ⅰ collagen cross-linking (S-CTX)],and blood biochemical indexes [serum calcium,phosphorus,parathyroid hormone (PTH),and vitamin D3] at one month after treatment in the two groups were compared,all the patients were followed up for six months.The incidence rates of pain,fracture,and spine deformity in the two groups were compared.Results After treatment,the levels of BMD in the two groups increased compared with before treatment,the level of BMD in observation group after treatment was higher than that in control group,and the proportion of patients with BMD returning to normal in observation group after treatment was larger than that in control group,there were statistically significant differences (P＜0.05).There was no statistically significant difference in the levels of serum bone turnover markers between before and after treatment in control group,while the levels of serum bone turnover markers after treatment in observation group were statistically significantly lower than those before treatment and in control group (P＜0.05).In the two groups,there was no statistically significant difference in the levels of serum calcium,phosphorus,PTH,and vitamin D3 between before and after treatment (P＞0.05).The incidence rates of pain,fracture,and spine deformity in observation group were statistically significantly lower than those in control group (P＜0.05).Conclusion Aclasta is safe and effective in treatment of osteoporosis in menopausal women.

Objective To explore the problems existing in the postgraduate education of preventive medicine and the corresponding solutions.Methods Qualitative method was adopted;professional teachers and administrators of preventive medicine of colleges and universities in Wuhan,relevant persons in charge and managers from the employers,and graduates of 2011 ～2013 of preventive medicine were selected as the research subjects.Semi-structured in-depth interviews were used among the research subjects.Then based on the interview outline,QSR Nvivo 10.0 software was used to code the interview material.These tree nodes were modified and merged again and again before they finally became the mature ones.Results The main problems existing in the postgraduate education of preventive medicine were as follows:unreasonable teaching methods and contents;lack of sense of identity among students,formalized practice;inappropriate assessment of students;the neglect of teaching because of the excessive importance attached to scientific research.Conclusions Teaching methods and contents should be improved.Colleges should guide students to form clear self-localization.Besides,in order to successfully manage the practice of preventive medicine,more importance should be attached to it by universities and teaching bases.What's more,the indicators and models of assessment of students should also be improved.Lastly,enough emphasis should be placed on undergraduate teaching which can also be improved by scientific research.

Objective To investigate the change of MRI , transforming growth factor β1(TGF-β1) and col-lagen type Ⅰ,Ⅲ( COL-Ⅰ,Ⅲ) after sciatic nerve traction injury .Methods Fifty adult male SD rats were ran-domly divided into group A and B .In group A ( the control group ) the sciatic nerve of rats was exposed only .In group B( the traction injury group ) the sciatic nerve of rats was tracted by smooth forceps to produce traction injury . Electron microscopy , immunochemistry , RT-PCR and Western Blot were performed to observe the morphological changes of the tracted nerve tissue and to determine the level of TGF-β1,COL-Ⅰand COL-Ⅲat 3 days and 2,4,6, 8 weeks after the surgery ,respectively .Results The injured nerve was characterized as thickened in size and in-creased T1 and T2 relaxation time.The expression of TGF-β1 in the traction injury group was significantly higher than that of the control group (P<0.05).In the meanwhile,the contents of COL-Ⅰ,COL-Ⅲwere positively corre-lated in a certain period(P<0.05).Conclusion Peripheral nerve fibrosis can be caused by nerve traction injury which induces increased expression of COL-Ⅰ,COL-Ⅲin the nerve .TGF-β1 is significantly higher than that of the control group ,which suggests that TGF-β1 plays an important role in the process of neural injury and fibrosis .

Objective To investigate the clinical value of serum levels of MMP-3,RANK,RANKL and OPG in the diagnosis of early rheumatoid arthritis and osteoarticular injuries. Methods 195 cases of patients with rheumatoid arthritis(RA)in our hospital from May 2014 to May 2016 were selected ,including 116 cases of early RA and 79 cases of non early RA,and 85 cases of healthy people at the same period were selected as the control group,all patients had fasting venous blood extraction after admission to detect serum MMP-3,RANK,RANKL,OPG lev-els,and the comparative analysis of the expression of serological indexes in early RA osteoarticular injury and non injury patients was taken. Re-sults In admission,serum MMP-3,RANK and RANKL levels of the RA patients were significantly higher than those of the control group,there was significant difference between groups (P < 0. 05),and OPG level of the early RA patients was significantly lower than that of the non early RA group and the control group,the difference between groups was statistically significant (P < 0. 05). MMP-3,RANK and RANKL level of the early RA patients with osteoarticular injuries were significantly higher than those of the early RA patients without osteoarticular injuries group, but the level of OPG was significantly lower than that of the osteoarticular no injury group,inter group data were analyzed statistically and showed significant difference (P < 0. 05). There were significant differences in BMD levels at different sites in early RA patients (P < 0. 05). There was statistical significance in the incidence of osteoporosis between the early RA group (23. 28％)and the non early RA group (36. 71％)(P <0. 05). In addition,early RA patients'bone erosion score big rotor and total femur BMD showed a negative correlation (r =-0. 387,r =-0. 358,P <0. 05),and showed a strong positive correlation with Sharp scores (r = 0. 712,P < 0. 05);Tendinitis score and joint swelling number and joint tenderness number had positive correlation (r = 0. 372,0. 369. P < 0. 05). In addition,the expression level of OPG and MMP-3 and the num-ber of swollen joints and Sharp score had positive correlation (r = 0. 293,0. 315,0. 298,0. 468,0. 398,0. 689,P < 0. 05). Conclusion The detection of serum MMP-3,RANK,RANKL and OPG levels has important clinical value in the early diagnosis of RA,and has a certain relation-ship with osteoarticular injuries. It is worthy of clinical investigation.

Background:Schatzker Ⅱ-Ⅲ are common clinical types of tibial plateau fracture. By far, there is lack of the pro-spective study about utilizing minimally invasive percutaneous plate osteosynthesis (MIPPO) technique to cure above types of tibial plateau fracture. Objective:To evaluate the effect of MIPPO assisted with arthroscopy on Schatzker Ⅱ-Ⅲ types of tibial plateau fracture and long-term life quality of patients. Methods:A total of 81 patients with Schatzker Ⅱ-Ⅲ types of tibial plateau fracture treated in our hospital between April 2014 and March 2016 were selected and divided into experimen-tal group (MIPPO technique) and control group (traditional surgery) randomly. The data including operation duration, intra-operative blood loss, length of incision, volume of postoperative drainage, time of postoperative stay, healing time of inci-sion and fracture, early postoperative complications such as incision infection, joint infection and skin necrosis occurring with 30 days after operation and late postoperative complications such as bone delayed union, anchylosis and traumatic os-teoarthritis were collected and analyzed. The Rasmussen's knee function score and radiological index were utilized to assess the function recovery of knee joint. The short form 36 (SF-36) health survey was employed to evaluate the life quality of the patients in the two groups at both preoperation and 12 months after operation. Results:The data of length of incision, intra-operative blood loss, volume of postoperative drainage, time of postoperative hospital stay, healing time of incision and frac-ture in experimental group were all less than that in control group. The total occurrences of early postoperative complica-tions (5.0%vs 26.8%) and late postoperative complications (7.5%vs 26.8%) were lower in experiment group than in control group (P<0.05). In the experimental group, the function recovery of knee joint and long-term life quality of the patients were significantly higher than that in the control group (P<0.05). Conclusions:The new surgical method, MIPPO technique assisted with arthroscopy, has a lot of advantages over traditional surgery, such as minimally invasive, better curative effect, quick recovery and low incidence of postoperative complications. Moreover, the new technique can also help patients accel-erate knee joint function recovery and improve the quality of life.

Objective:To find out the difference of children's accompanying role and the rules in elderly parents attending a doctor so as to provide reference for improving the effect of clinical nursing.Methods:The contacts information for hospitalized patients was exported from the medical record management system,and the factors that resulted in the different companies selected in the process of medical treatment were explored.Results:Sons were more likely to accompany their parents to the hospital,and it was more common in those with cadres' health care (59.3％) and high hospitalization expenses (59.1％).There were significant statistic differences between old patients with different gender,age,medical payments,hospitalization days,and hospitalization expenses.Conclusion:It was more common that old people were accompanied by their son to the hospital.Compared with other elderly patients,it was obvious in patients of female,elderly,long stay in hospital,cadres,with medical insurance type and hospitalized with high total cost of hospitalization.It was of great reference significance to strengthen communication between patients and their families in the clinical nursing process.

Objective To analyze the clinical effect of autogenous bone graft combined with lengthened proximal femoral nail antirotation (PFNA) minimal invasive inner fixation in the treatment of proximal femur fracture.Methods Totally 168 cases of proximal femur fracture from January to December 2014 in Liyuan Hospital of Tongji Medical College of Huazhong University of Science and Technology were randomly divided into observation group and control group,with 84 cases in each group.The observation group had autogenous bone graft combined with lengthened PFNA minimal invasive inner fixation;the control group had autogenous bone graft combined with dynamic hip screw fixation.One year after operation,effective rate,patient satisfaction rate,incidence of postoperative complications and length of recovery period were analyzed.Results In observation group,effective rate and patient satisfaction rate were significantly higher than those in control group [90.5％ (76/84) vs 52.4％ (44/84),88.1％ (74/84) vs 53.6％ (45/84)] (P ＜ 0.05);the incidence of postoperative complications and length of recovery period were significantly less than that in control group [9.5％ (8/84) vs 29.8％(25/84),(58 ± 10)d vs (74 ± 10)d] (P ＜0.05).Conclusions PFNA shows advantages of minor injury,short recovery period and few complications.Lengthened PFNA minimal invasive inner fixation is safe and effective in the treatment of proximal femur fracture.

With the development of society and the economy, many Chinese cities are shrouded in pollution haze for much of the year. Scientific studies have identified various adverse effects of air pollutants on human beings. However, the relationships between air pollution and blood lipid levels are still unclear. The objective of this study is to explore the short and long-term effects of air pollution on eight blood lipid markers among elderly hypertension inpatients complicated with or without type 2 diabetes (T2D). Blood lipid markers which met the pre-established inclusion criteria were exported from the medical record system. Air pollution data were acquired from the official environmental protection website. Associations between the air quality index and the blood lipid indexes were analyzed by one-way ANOVA and further Bonferroni correction. In an exposure time of 7 days or longer, blood lipid markers were somewhat affected by poor air quality. However, the results could not predict whether atherosclerosis would be promoted or inhibited by poorer air condition. Changes of blood lipid markers of hypertension inpatients with or without T2D were not completely the same, but no blood lipid markers had an opposite trend between the two populations. The air quality index was associated with changes to blood lipid markers to some extent in a population of hypertension inpatients with or without T2D. Further studies are needed to investigate the potential mechanism by which air pollutants induce blood lipids changes.

Objective: To determine the expression of non-muscle myosin heavy chain 9 (MYH9) in osteosarcoma and its effect on the migration and invasion abilities of tumor cell.Methods: A total of 65 cases of osteosarcoma and 20 cases with benign osteochondroma who underwent resection operation in the Orthopaedics Department of our hospital from January 1st 2009 to January 1st 2015 were selected. Their mRNA levels of MYH9 were tested by qrt-PCR. Immunohistochemical method was used to examine the expression of MYH9 in osteosarcoma and the correlation between the positive expression of MYH9 and the clinicopathological features of patients was illustrated by statistical analysis. MYH9 was compounded artificially. The expression of MYH9 in SAOS2 osteosarcoma cells was decreased by siRNA. Scratch test was used to determine the change of SAOS2 cell migration ability after MYH9 silence. Transwell assay was employed to detect the change of cell invasion ability after MYH9 silence.Results: The expression levels of mRNA of MYH9 and protein in osteosarcoma tissues were significantly higher than those in benign osteochondroma tissues. The high expression of MYH9 in osteosarcoma tissues was apparently related to the high Enneking classification (III classification) and lung metastasis. SiRNA of MYH9 could evidently decrease the expression level of MYH9 in SAOS2. The down-regulated expression of MYH9 could inhibit the migration and invasion abilities of SAOS2 cells.Conclusions: MYH9 shows a trend of high expression in osteosarcoma tissues, and its high expression is associated with features such as tumor invasion and metastasis. The down-regulated MYH9 can realize an anti-tumor effect by inhibiting the migration and invasion of osteosarcoma cells.