ABSTRACT
Objective To compare the clinical effects of dynamic hip screw(DHS),Gamma interlocking intramedullary nail and proximal femoral nail antirotation (PFNA) in the treatment of intertrochanteric femoral fractures in elderly patients.Methods From January 2008 to June 2015,103 elderly patients with intertrochanteric femoral fracture were treated with DHS (DHS group,33 cases),Gamma nails (Gamma group,30 cases),or PFNA (PFNA group,40 cases).By the AO classification,there were 44 cases of type 31-Al,30 cases of type 31-A2 and 29 cases of type 31-A3.The 3 groups were compared in terms of incision length,operation time,intraoperative blood loss,fracture healing time,postoperative weight-bearing time,Harris scoring,and incidence of postoperative complications.Results PFNA group incurred significantly shorter incision length (5.4 ±0.5 cm) and operation time (70.8 ± 16.2 min) than DHS group (12.6 ±2.7 cm and 102.6±17.4min) and Gamma group (7.5±0.8 cmand93.0±35.9 min) (P ＜0.05).The intraoperative blood loss in PFNA group (163.2 ± 60.6 mL) was significantly less than in DHS group (280.5 ±89.8 mL) and in Gamma group (204.9 ±62.2 mL),and that in Gamma group was also significantly less than in DHS group (P ＜ O.05).PFNA group had significantly shorter weight-beating time (11.0 ± 0.8 weeks),fracture healing time(13.6 ± 1.5 weeks) and significantly higher Harris good to excellent rate (92.5％) than DHSgroup (13.3±1.0weeks,15.8 ± 1.2 weeks and 84.8％) and Gamma group (12.5±1.3 weeks,14.2 ± 1.0 weeks and 86.7％) (P ＜ 0.05).The incidence of postoperative complications in DHS group (21.2％)was significantly higher than in Gamma group(10.0％) and in PFNA group (7.5％) (P ＜ 0.05).Conclusions DHS,Gamma nail and PFNA are effective means for the treatment of intertrochanteric femoral fractures in the elderly.Intramedullary fixation,especially by PFNA,shows superiority in the clinical outcomes.
ABSTRACT
Objective To construct human acidic fibroblast growth factor (aFGF) recombinant eu karyotic expression vector and transfect it into muscle satellite cells(MSCs) of rat,in purpose of further study the method to set up cell bank.Methods The aFGF gene was cloned from human total RNA which was obtained from human skeletal muscle tissue by RT-PCR method.Human interleukin 2 (IL-2) signal peptide sequence (SPS) was obtained by direct chemosynthesis method.Then aFGF and SPS were fused to obtain SPS-aFGF.Finally,directional cloning SPS-aFGF into pEGFP-N1,the recombinant (pEGFP-N1-SPS-aFGF) was obtained.The recombinant was confirmed by endonuclease digestion and DNA sequencing.MSCs were purified by difference-speed adherence method and were ideontified by immunofluorescence assay.The correct cells were divided into 3 groups:Experimental group (aFGF +N 1),control group (N 1),blank group (blank).All the groups were transfected by Lipofectamine 2000TM Reagent,and pEGFP-N1-SPS-aFGF,pEGFP-N1 were respectively added in experimental group and control group while blank group was added none plasmid.Fluorescence microscope was employed to detect transfection efficiency tendency along with time changes.The expression of target gene was detected by fluorescent quantitation PCR and Western blot.Results (1) The sequencing of pEGFP-N1-SPS-aFGF was completely correct and the outcome of endonuclease was equal to actual ban s-ize.(2)The expression of GFP in transfected cells were observed by fluorescencemicroscope and transfection efficiency reached the peak at 72 h.(3)Real-time fluorescent quantitation PCR proved strong aFGF mRNA expression in transfected cells (the average relative expression of experimental group was 1464.95)with aFGF gene,while it was detected a little in the other groups (the average relative expression of control group was 1.016 and blank group was 1.000) (P ＜ 0.05).Western blot also proved strong expression in Experimental group then the other two groups.Conclusion aFGF eukaryotic expression vector was successfully constructed and transfected into MSCs.This study may be expected to obtain some specific functions cells.
ABSTRACT
BACKGROUND:We previously demonstrated that the acid fibroblast growth factor/fibrin gelatin implantation could greatly relieve denervated motor end-plate degeneration and myatrophy. OBJECTIVE:To study the effect of acid fibroblast growth factor/fibrin gelatin on preventing denervated motor end-plate degeneration using immunohistochemical method. DESIGN,TIME AND SETTING:A randomized controlled animal experiment was performed in Zhujiang Hospital,Southern Medical University from June to December 2006. MATERIALS:A total of 24 SD rats of clean grade were randomly divided into three groups:acid fibroblast growth factor/fibrin gelatin group,fibrin gelatin group,and blank control group,with 8 rats for each group. METHODS:Under the general anesthesia,right common peroneal nerves of rats in each group were cut off 1 cm away from the nerve muscle entry point. Acid fibroblast growth factor/fibrin gelatin group,perilemma was sutured and the compound was implanted into spatium intermusculare around denervated tibial muscle nerve region;fibrin gelatin group,perilemma was sutured and fibrin gelatin was implanted;perilemma was sutured without medication in the blank control group. MAIN OUTCOME MEASURES:After 6 weeks,neuromuscular junction of tibial muscle branch of common peroneal nerve and its peripheral muscles were separated. Acidic fibroblast growth factor receptor was detected by SP immunohistochemistry to observe expressive site of acidic fibroblast growth factor receptors,and count positive blood capillary. Gray scale of the acidic fibroblast growth factor receptor was detected using image analysis system. RESULTS:The acidic fibroblast growth factor receptor was mainly located in capillary vessel wall. High density of expressing area of acidic fibroblast growth factor receptor and intensive capillary vessels were in acid fibroblast growth factor/fibrin gelatin group. In contrast,low density of masculine expressing site of acidic fibroblast growth factor receptor in capillary vessel and rare capillary vessels were in fibrin gelatin group and blank control group. The positive percentage of acidic fibroblast growth factor receptor expression of capillary vessels in acid fibroblast growth factor/fibrin gelatin group was higher than fibrin gelatin group and blank control group. The expressing amount of acidic fibroblast growth factor receptor in acid fibroblast growth factor/fibrin gelatin group was also higher than fibrin gelatin group and blank control group CONCLUSION:Acidic fibroblast growth factor can protect motor end-plate by improving the surrounding blood circulation.