ABSTRACT
BACKGROUND: Hemiarthroplasty is widely recommended for the treatment of femoral neck fractures in elderly patients, but it is controversial in choosing cemented or cementless fixation types. OBJECTIVE: To compare the clinical effects of cemented hemiarthroplasty with cementless hemiarthroplasty for the treatment of femoral neck fractures in elderly and to provide a scientific basis for the selection of clinical prosthesis. METHODS: 167 elderly patients with femoral neck fractures undergoing hemiarthroplasty in the Foshan Hospital of Traditional Chinese Medicine from March 2013 to March 2015 were enrolled in this study. According to the type of prosthesis, patients were divided into cementless group (n=81) and cemented group (n=86). The operation time, intraoperative blood loss, hemoglobin levels 1 day after surgery, reoperation rate, mortality and complications at 1 year after surgery were compared. After surgery, clinical function of hip joint was assessed by Harris scoring system. The pain was evaluated by Visual Analogue Scale. RESULTS AND CONCLUSION: (1) All patients were followed up for ≥ 12 months. (2) The operation time in the cementless group was significantly shorter than that in the cemented group (P < 0.01). (3) There was no significant difference in the intraoperative blood loss and hemoglobin levels at postoperative 1 day (P > 0.05). (4) There were no significant differences in Harris hip scores and Visual Analogue Scale score at various time points between both groups (P > 0.05). (5) The incidence of thigh pain in cementless group was slightly higher than that in cemented group at 1 week, 1 and 6 months after operation, but the differences were not statistically significant (P > 0.05). Two patients died from myocardial infarct in the cementless group, and one patient died from pulmonary infection in the cemented group. The mortality was not significantly different at postoperative 1 year between the two groups (P > 0.05). No complications, such as prosthesis loosening and sinking, periprosthetic fracture, and periprosthetic infection, which needed to be refurbished, occurred in both groups. (6) Our findings suggest that both cemented and cementless hemiarthroplasties can obtain satisfactory effect in the treatment of femoral neck fractures in the elderly patients. Cementless hemiarthroplasty can significantly shorten operation time.
ABSTRACT
<p><b>OBJECTIVE</b>To investigate the sequence-dependent effect of combined use of gemcitabine and pemetrexed on the proliferation of human pancreatic carcinoma cell lines BXPC-3 and PANC-1 in vitro and explore the cellular mechanism.</p><p><b>METHODS</b>MTT assay was used to determine the proliferation of the two cells after addition of the two drugs in different sequences, and the cell cycle changes were analyzed by flow cytometry.</p><p><b>RESULTS</b>Both gemcitabine (10(-7)-10 mg/ml) and pemetrexed (10(-7)-10 mg/ml) significantly inhibited the proliferation of BXPC-3 and PANC-1 cells in a dose- and time-dependent manner. The effect of combined administration of gemcitabine and pemetrexed on the cell proliferation varied with the order of the drug delivery, and addition of gemcitabine 24 h after pemetrexed administration produced a significant enhancement of the inhibitory effect as compared with simultaneous drug administration (P<0.05) or the administration of the two drugs in a reverse order (P<0.05). Compared with the control group, combined administration of gemcitabine and pemetrexed caused obvious cell cycle arrest at G1 and S phases (P<0.05). Simultaneous administration of the two drugs resulted in significantly reduced G2-phase cells (P<0.05); addition of gemcitabine prior to pemetrexed caused cell cycle arrest in G1 phase (P<0.05), while the reverse caused cell cycle in S phase (P<0.05).</p><p><b>CONCLUSION</b>Both gemcitabine and pemetrexed can inhibit the proliferation of BXPC-3 and PANC-1 cells, and their synergetic effect depends on the sequence of their administration. The sequential administration of pemetrexed followed by gemcitabine produces significant synergetic effects against the cell proliferation, which might not be associated with their influence of the cell cycle.</p>