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Objective To evaluate the clinical effect of proximal femoral nail anti-rotation Ⅱ (PFNA Ⅱ) internal fixation in the treatment of intertrochanteric fracture.Methods From September 2012 to April 2016,the clinical data of 37 patients with intertrochanteric fracture who were treated by PFNA Ⅱ internal fixation in Yuehua Hospital were retrospectively analyzed.Results All 37 patients were successfully operated,and the operation time was 40 ～120 min,with an average of 66 min.The amount of blood loss was 30 ～ 110 mL,with an average of 50 mL.During operation and after operation,X ray showed a good position and steady internal fixation.Three days after operation,patients exercised diseased side hip joint.Seven days after operation,patients exercised sitting on the bed.Fourteen days after operation,suture was dismantled and patients could get out of bed and walk with no weight or some weight.Lower limb deep venous thrombosis (DVT) was not observed.Through operative multiple reexamination,the fracture was healed and hip joint function was good.Conclusion PFNA Ⅱ has advantages of convenient operation,less trauma,stronger internal fixation,rapid recovery.It is an ideal method to treat intertrochanteric fracture.
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<p><b>BACKGROUND</b>Early detection of pulmonary tuberculosis (PTB) is a big challenge in smear negative and sputum scarce patients in China. Simultaneous amplification and testing methods for detection of the Mycobacterium tuberculosis (MTB) complex (SAT-TB assay) is a novel molecular technique established in our hospital. This method has a high sensitivity and specificity in the lab. In this study, the clinical diagnostic performance of this method in smear-negative or sputum-scarce PTB suspects was investigated and evaluated.</p><p><b>METHODS</b>Two hundred smear negative and 80 sputum-scarce patients were recruited in this study. Samples that included sputum or bronchial washing fluid were collected and sent for both bacteria culture and SAT-TB assay. Diagnosis for these patients was based on the comprehensive evaluation of chestX- ray/CT study, histology examination, lab results, and treatment response. Sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) for each diagnostic test were investigated and calculated using confirmed tuberculosis (TB) and non-TB cases. The time required for detection of MTB was also measured for each method.</p><p><b>RESULTS</b>Ninety-two patients (33%) were diagnosed as definitive TB, 112 patients (40%) were probable PTB, and 76 (27%) were non-TB. The sensitivity, specificity, PPV, and NPV of SAT-TB in smear-negative PTB suspects were 93% (95% CI, 84%-98%), 98% (95% CI, 90%-100%), 98% (95% CI, 91%-100%), and 93% (95% CI, 83%-98%). In sputum scarce PTB suspects, the sensitivity, specificity, PPV, and NPV of the SAT-TB assay on bronchial washing fluids were 90% (95% CI, 74%-98%), 100% (95% CI, 85%-100%), 100% (95% CI, 88%-100%), and 88% (95% CI, 69%-97%). The accuracy of the SAT-TB assay is consistent with the bacteria culture assay. The median time required for detecting MTB in the SAT-TB assay was 0.5 day, which was much faster than bacteria culture (28 days).</p><p><b>CONCLUSIONS</b>The SAT-TB assay is a fast and accurate method for the detection of MTB. It can be widely applied in the clinic and be an asset in early detection and management of PTB suspects, especially in those patients who are smear negative or sputum scarce.</p>
Subject(s)
Adult , Female , Humans , Male , Middle Aged , Young Adult , China , Mycobacterium tuberculosis , Genetics , Virulence , Nucleic Acid Amplification Techniques , Methods , Sputum , Microbiology , Tuberculosis, Pulmonary , DiagnosisABSTRACT
Objective To observe the effect of EGFR mutation on radiation induced DNA repair in pulmonary adenocarcinoma ceils.Methods A549 cells with wild-type EGFR and H1975 cells with mutated-type of EGFR were irradiated by 4 Gy of 6 MV X-rays.After irradiation,the formation of nuclear γ-H2AX foci was assayed with immunostaining method,the level of DNA-PKcs-EGFR interaction was detected with coimmunoprecipitation,and nuclear RAD51 expression and EGFR nuclear translocation were detected using Western blot.Results DNA repair in the H1975 cells was significantly lower than that in A549 cells.In the irradiated H1975 cells,there was no EGFR translocation with further nuclear DNA-PKcs binding,and the expression of nucleus RAD51 was not altered.But in the irradiated A549 cells,EGFRDNA-PKcs interaction and nucleus RAD51 were increased.Conclusions Lung adenocarcinoma cell line with mutations in the tyrosine kinase domain (TKD) of EGFR exhibits a high radiosensitivity due to the reduction of the non-homologous end-joining (NHEJ) and homologous recombination (HR) DNA DSB repair kinetics.