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Objective:To investigate the clinical effect of long-stem hemiarthroplasty in the treatment of unstable intertrochanteric fracture in elderly patients with severe osteoporosis.Methods:A retrospective analysis was performed on 48 elderly patients with unstable intertrochanteric fractures of the femur with severe osteoporosis in Liaocheng People′s Hospital from April 2017 to April 2019.Twenty three patients received long-stem hemiarthroplasty (LHA group). Twenty five patients were treated with proximal femoral nail anti-rotation (PFNA) (PFNA group). PFNA group was used as the control group.The operative time, intraoperative blood loss, perioperative blood transfusion volume, number of intraoperative fluoroscopy, weight-bearing time after operation, the incidence of postoperative complications, hospitalization time, and Harris hip score of 1, 3, 6, 12 months after surgery, to investigate the efficacy of the application of long-stem hemiarthroplasty.Results:In LHA group, 23 patients were followed up for (18.6±3.9) (range from 12.0 to 26.0) months, and 25 patients in the PFNA group were followed up for (17.8±3.3)(range from 12.0 to 24.0) months.There was no significant difference in follow-up time between the two groups ( Z=-0.552, P=0.581). The operation time of LHA Group (60 (55, 73) h) was longer than that of PFNA Group (55 (50, 60) h). The intraoperative blood loss in LHA Group ((179.35±63.47) mL) was more than that in PFNA Group ((122.80±49.03) mL). The number of fluoroscopy in LHA Group (2 (2, 2) times)was less than that in PFNA Group (16 (14.5, 19.5) times). The time of weight bearing in LHA Group (4 (3, 5) d) was earlier than that in PFNA Group (33 (30, 36) d), and the differences were statistically significant ( Z=2.459, t=3.470, Z=6.216, Z=5.959; all P<0.05). There were no significant differences in perioperative blood transfusion, hospital stay and postoperative complications between the two groups (all P>0.05). Harris hip function score was significantly higher in LHA Group ((76.70±5.96), (82.13±6.38), (85.96±7.16), (88.78±7.67) points) and PFNA Group ((63.80±3.46), (71.56±2.55), (81.60±3.38), (88.08±4.83) points) increased gradually with the increase of follow-up time ( Fintra-group=432.557, Pintra-group<0.001), and the score reached the highest 12 months after operation.Harris hip function score of LHA group was higher than that of PFNA group( Finter-group=25.437, Pinter-group<0.001). There was interaction effect between follow-up time point and operation mode( Finteraction=53.464, Pinteraction<0.001). Conclusion:For the elderly patients with unstable intertrochanteric fracture with severe osteoporosis, the application of lengthened stem hemiarthroplasty can get out of bed early, reduce the complications of bed rest, reduce the number of intraoperative fluoroscopy, and recover the function of hip joint earlier and better with satisfactory results.
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Objective: To summarize the application of distal fixated long stem in the treatment of intertrochanteric fracture (ITF) in the sequence of proximal femoral reconstruction, fixation materials, and other details after operation, in order to improve doctor's attention to the reconstruction of the proximal femur and reduce complications. Methods: The related literature about the application of distal fixated long stem in the treatment of ITF was extensively reviewed, summarized, and analyzed. Results: The sequence of reconstruction is divided into fracture reconstruction priority and prosthesis reconstruction priority. The former is mainly to provide an anatomical reference for the placement of joint prostheses, the latter is mainly to provide support for fracture fixation. The distal fixated cement long stem and cementless long stem have their own characteristics, and materials of reconstruction are used in combination. There is no uniform standard for the sequence and materials of reconstruction. Conclusion: Although the stability of the distal fixated long stem depends on the distal femur, the accurate reconstruction of the proximal femur is still worthy of attention.
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Recently the maintenance therapy of non-small-cell lung cancer (NSCLC) patients who completed required treatment cycles has caused widespread interests in the medical field. Traditional Chinese medicine may be a useful complement in maintenance treatment of mid-to-late stage NSCLC.
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Objective: To construct a liver targeting gene transfer vector using hepatitis B virus envelope particles. Methods: Hepatitis B viruses were obtained from the supernatant of HepG 2.2.15 cells by a PEG8000 system and were inactivated by ?-propiolactone to prepare hepatitis B virus envelope. The hepatitis B virus envelope was used to pack 5.3 kb pIRES_2-EGFP to assess their packing ability. Subsequently, the products were studied with ELISA, PCR, SDS-PAGE, and electron microscopy. Finally, the product was used to transfect HepG2 cells and the green fluorescent protein (GFP) expression was observed under a fluorescent microscope. The rate of GFP positive cells was determined by flow cytometer.Results: The acquired hepatitis B virus envelope retained the surface protein HBsAg+pre S_1+pre S_2, but with no virus DNA. The prepared envelope had high packing ability for GFP and the packed GFP had a high transfection rate in HepG2 cell. Conclusion: Hepatitis B virus envelope has been successfully obtained from the supernatant of HepG 2.2.15 cells with a PEG8000 system and ?-propiolactone.
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Objective To construct an expression vector containing Ewing's sarcoma EWS FLI 1 specific binding sequence and diphtheria toxin A chain (DTA) gene sequence to investigate the killing effect of DTA on cultured Ewing's sarcoma cells so as to provide proof for the exploration of new methods for gene therapy for cancer. Methods Expression vector (pS2 DTA) containing EWS FLI 1 specific binding sequence and DTA gene sequence was constructed by replacing the luciferase gene in pS2 with DTA gene at the points of Nco Ⅰ and Xba Ⅰ by molecular technique. After transfection of pS2 DTA into Ewing's sarcoma cells and the control cells, DTA expression and its killing effect on cells were detected. Results pS2 DTA was highly expressed in Ewing's sarcoma cell line, and the killing effect of DTA was much higher than that in the control cells. Conclusion pS2 DTA has selective killing effect on Ewing's sarcoma cells and can inhibit the growth of Ewing's sarcoma cells. So pS2-DTA has potential value in the treatment of Ewing's sarcoma.
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Objective To observe the specific expression of diphtheria toxin A chain gene(DTA) in Ewing's sarcoma nude mice models.Methods pS2DTA plasmid was constructed by the Lus gene in pS2 plasmid was replaced with the DTA gene in pIBI30 plasmid,and transformed into DH5?, then amplified.Five nude mice were injected with 2.4?10~(7) SKES1 cells,sacrificed on week 6,and the tumor tissues were implanted onto the back of another 20 nude mice.Till 6 weeks later the diameter of the tumor up to 0.8-1.0 cm,the Ewing's sarcoma nude mice models were successfully established and randomly assigned to receive the injection of 300 ?g lipidosome+100 ?l normal saline(control group) or 300 ?g lipidosome+100 ?l normal saline+100 ?g pS2DTA (experimental group) once a day for 5 d.On day 4 after the therapy finished,4 nude mice of each group were randomly sacrificed and the DTA expression in the tissue of tumor,liver and myocardium was detected by the immunohistochemistry and RTPCR.Results The immunochemical results showed DTA expression in the tissues of control group was all negative while the DTA expression in the experimental group was negative in the tissues of myocardium and liver,positive in tumor tissue.RTPCR showed DTA expression in control group was negative in all tissues while strongly positive in tumor tissue,weakly positive in liver tissue and negative in myocardiac tissue.Conclusion The pS2DTA regulated by the EWSFLI1 fusion gene has a specific expression in transplanted Ewing's sarcoma in mice.