ABSTRACT
Objective To investigate the effects of hemiarthroplasty with different hip prostheses on the prognosis of unstable osteoporotic intertrochanteric fractures in elderly patients.Methods A retrospective case series study was conducted on the clinical data of 556 elderly patients with unstable osteoporotic femoral intertrochanteric fractures treated with hemiarthroplasty from January 2008 to December 2014.There were 142 males and 414 females,aged (83.1 ± 6.9) years (range,75-103 years).The T value of bone mineral density was-3.5--2.5 SD [(-2.8 ± 0.2) SD].There were 306 cases of type A2.2 and 250 cases of type A2.3 according to AO classification.There were 296 cases of cement type and 260 biological type according to prosthesis type.Operation time,blood loss,time for ambulation,Harris hip score,and incidence of perioperative major complications were used to compare the therapeutic outcomes between the two types of prostheses.Results The operation time [(75.5 ±9.2) minutes],blood loss [(992.9 ± 94.2)ml],and time for ambulation[(7.1 ± 1.8) days] in cement type group were all less than those [(86.1 ± 9.3) minutes,(1 139.5 ± 96.0) ml,and (8.6 ± 2.1) days]in biological type group,but the lung infection rate (19.9％),incidence of cardio-cerebrovascular complications (15.9％) and total death rate (7.1％) in cement type group were significantly greater than the those (13.5％,8.8％ and 1.9％) in biological type group (P ＜ 0.05).There was nosignificant difference in Harris score (73.6％ vs.82.7％) between the two groups (P ＞ 0.05).Conclusions In the treatment of unstable osteoporotic intertrochanteric fractures in elderly patients by hemiarthroplasty,the use of cement type prosthesis can reduce operation time,blood loss and bed rest time,but it will lead to significant increases of cardio-cerebrovascular complication and overall mortality.The prosthesis type has no significant effect on the improvement of hip function.
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Purpose To discuss the clinical pathological features, diagnosis and differential diagnosis, treatment and prognosis of pri-mary breast diffuse large B-cell lymphoma ( DLBCL) . Methods 7 cases of primary breast DLBCL were collected, their clinical path-ological characteristics and immunophenotypes were also observed, and the treatment and prognostic factors were discussed. Results All of the 7 patients were women, aged 28~75 years, with the median 51 years. 5 cases involved left breast, 2 cases were located in the right breast. Painless mammary mass and ipsilateral axillary lymphadenopathy were the commonest clinical manifestations. On mi-croscopic observation, tumor cells were large to medium-sized which characterized as diffuse infiltration between the lobules of mamma-ry gland, around the duct, interstitial and fat tissue, some were single file cord pattern. 1 case was ALK-1 positive DLBCL, 6 cases were DLBCL of the non special type. The immunophenotype showed 5 cases were of non-GCB, 2 cases were of GCB type. Ki-67 index were from 60% to 95%. According to Ann Arbor staging, 2 cases were stage I EA, 5 cases were stage II EA. IPI score:4 cases with 0 score, 3 cases with 1 score. Of 7 patients, one case was modified radical mastectomy, 4 cases were lumpectomy, 2 cases were diag-nosed by core needle biopsy. 2 patients died without chemotherapy, 5 patients were chemotherapy or radiotherapy for 4 to 6 cycles ( CHOP/R-CHOP) , 4 patients received complete response, one died. Patients were followed up from 1 to 114 months, the median fol-low-up time was 18 months. The 1 year OS rate was 57. 1%, 5 years OS rate was 14. 3%. Conclusion The diagnosis of primary breast DLBCL is confirmed by pathological biopsy and immunohistochemical markers. The immunophenotype was mainly non-GCB type. Comprehensive treatment including chemotherapy and radiotherapy is appropriate. The prognosis should be comprehensively eval-uated by multiple factors.
ABSTRACT
The abnormal expression of gastrins and their receptors have close relationship with the occurrenceand the development of some colorectal neoplasms.The high expression of gastrins and their receptors promote colorectal neoplasms cell proliferation and inhibit apoptosis.The biological behavior is mainly rely on the abnormal expression of protein.Using differential proteomics can screen differential expression protein of high expression of gastrin-based colorectal neoplasms in the occurrence and development process,and then with the regulation of specific proteins to achieve the prevention and treatment of colorectal neoplasms purposes.