Risk factors for one-year mortality in elderly patients with femoral intertrochanteric fracture following multidisciplinary treatment by intramedullary nailing / 中华创伤骨科杂志

Objective:To analyze the risk factors for postoperative one-year mortality in elderly patients with femoral intertrochanteric fracture following multidisciplinary treatment (MDT) by intramedullary nailing.Methods:The clinical data were retrospectively analyzed of the 158 elderly patients with femoral intertrochanteric fracture who had undergone MDT by proximal femoral intramedullary nailing between January 2018 and August 2020 at Department of Orthopedics, Trauma Center, Zhongda Hospital Affiliated to Southeast University. There were 41 males and 117 females with an average age of 82.5 years (from 65 to 95 years). By the modified Evans classification, there were 15 cases of type Ⅰ, 16 cases of type Ⅱ, 35 cases of type Ⅲ, 81 cases of type Ⅳ, and 11 cases of type Ⅴ. The one-year mortality was documented in the patients after surgery. To screen for risk factors, univariate analysis was conducted of gender, age, body mass index (BMI), modified Evans classification of fractures, time from injury to operation, American Society of Anesthesiologists (ASA) classification, Charlson comorbidity index (CCI) and comorbidities, as well as preoperative hemoglobin (Hb), serum albumin (ALB) and total lymphocyte count (TLC). The factors with P<0.05 were included in the multivariate logistic regression model analysis to determine the risk factors. Results:A total of 13 patients died within one year after surgery, yielding a mortality of 8.2% (13/158). Univariate analysis showed significant differences in age, body mass index, modified Evans classification of fractures, CCI and Hb between the surviving and dead patients ( P<0.05). Multivariate logistic regression analysis showed that age >85 years ( OR=0.122, 95% CI: 0.018 to 0.834, P=0.032), BMI>23.9 kg/m 2 ( OR=0.083, 95% CI: 0.013 to 0.510, P=0.007), CCI≥3 points ( OR=0.051, 95% CI: 0.090 to 0.275, P=0.001) and preoperative Hb<90 g/L ( OR=4.733, 95% CI: 1.036 to 21.624, P=0.045) were the independent risk factors for postoperative one-year mortality in the elderly patients with intertrochanteric fracture following MDT by proximal femoral intramedullary nailing. Conclusions:After MDT by proximal femoral intramedullary nailing of femoral intertrochanteric fractures, the geriatric patients with an age >85 years, BMI>23.9 kg/m 2, CCI≥3 points and Hb<90 g/L are likely to die. Therefore, special care should be taken for them.

The effectiveness of Beraprost sodium in elderly patients with diabetic peripheral neuropathy and its influence on serum nitric oxide and endothelin-1 levels / 中华老年医学杂志

Objective To evaluate the effectiveness of Beraprost sodium and its impact on vascular endothelial dysfunction in elderly patients with diabetic peripheral neuropathy (DPN).Methods A total of 86 elderly patients (age≥60 years) with DPN were recruited and randomly assigned into a control group (n=43) and a treatment group (n=43).Both groups received regular treatments including drug treatment such as glucose-lowering,lip-lowering,anti-platelet and neurotropic medications,and non-drug treatment measures such as smoking cessation and foot massage.In addition,the treatment group was given 40 μg oral Beraprost sodium three times a day for 90 days.Data on vibrating perception threshold (VPT),transcutaneous oxygen (tcpO2),ankle-brachial index (ABI),liver and kidney function,hemoglobin A1c (HbA1c),serum nitric oxide (NO) and endothelin-1 (ET-1) were collected before and after treatment.Results No adverse reaction was observed during the experiment.After 90-day treatment,both the control group and the treatment group showed decreased VPT values (F =23.06,195.13,both P ＜0.01),increased tcpO2 values (F =304.65,594.33,both P＜0.01),increased ABI (F=119.24,336.60,both P＜0.01),increased serum NOlevels (F =375.48,741.20,both P＜0.01),and decreased serum ET-1 levels (F=49.07,211.24,both P＜0.01).Compared with the control group,the value of VPT (F=25.16,P＜0.01)and the level of ET-1(F=61.83,P＜0.01) were significantly lower,while the level of NO and the values of tcpO2 and ABI were significantly higher (F =24.06,62.82,21.46,all P ＜ 0.01) in the treatment group.Conclusions Oral beraprost sodium can be effectively and safely used in DNP patients,and it can also alleviate endothelial dysfunction.

Effect of rosiglitazone on oxidative stress and collagen metabolism in rat cardiac fibroblasts induced by advanced glycation end products / 中国糖尿病杂志

Objective To investigate induction effect of AGE on oxidative stress and type Ⅰ ,Ⅲcollagen synthesis in rat cardiac fibroblasts and interference effect of RGZ during the course. Methods Incubate rat cardiac fibroblasts with AGE of different concentration ,add RGZ to interfere for 48 h ,and then collect supernatant fluid .Superoxide dismutase (SOD) activity and malondialdehyde (MDA) content were detected by SOD kit and MDA kit separately ,and type Ⅰ ,Ⅲ collagen contents were measured by ELISA. Results When incubating cardiac fibroblasts with RGZ and 200 mg/L AGE together for 48 h , with the rise of RGZ concentration(0.1 ,1 and 10 mol/L) ,SOD activity in the supernatant fluid of cultured cardiac fibroblasts gradually increased [(21.564 ± 1.614) ,(22.323 ± 1.260) ,(23.661 ± 1.562) vs (19.320 ± 0.896) nU/ml ,P<0.05 or P<0.01] ,MDA content gradually decreased [(1.325 ± 0.048) ,(1.279 ± 0.032) ,(1.229 ± 0.045 ) vs (1.629 ± 0.043 ) nmol/ml ,P< 0.01 ] and type Ⅰ ,Ⅲ collagen Contents gradually decreased [(79.17 ± 3.25) ,(60.42 ± 3.58) ,(42.71 ± 5.11) vs (85.54 ± 2.28) ng/ml ,P<0.01 ;(37.52 ± 3.43) ,(27.09 ± 4.75) ,(20.81 ± 3.26) vs (40.75 ± 2.70) ng/ml ,P<0.01] as compared with 200 mg/L AGE group. Conclusion AGE can induce oxidative stress in cardiac fibroblasts and increase type Ⅰ ,Ⅲ collagen contents .RGZ can inhibit oxidative stress in cardiac fibroblasts and synthesis and secretion of type Ⅰ ,Ⅲ collagen induced by AGE. This finding indicates that RGZ may play an important role in the prevention of diabetic myocardial fibrosis.

Construction of secretory expression vector of rhKD/APPvar and expression and purification of its recombinant protein in Pichia pastoris / 吉林大学学报(医学版)

Objective To construct the engineering bacteria expressing the recombinant human Kunitz protease inhibitor domain of amyloid protein precursor variant (rhKD/APPvar)in Pichia pastoris,and to establish the methods suitable for large-scale fermentation and purification of rhKD/APPvar.Methods The rhKD/APPvar expression vector was constructed based on the rhKD/APPvar-pPICZαexpression vector. Two restriction enzyme loci (ApaⅠ and SacⅡ)were added to two flanks of KD/APP and human KD/APP activity center RAM was replaced by the active site of BPTI KAR.After the rhKD/APPvar-pPICZαexpression vector was transformed into Pichiapastoris,optimized expression and purification of rhKD/APPvar was performed.The rhKD/APPvar was purified with cation exchange chromatography and desalting.Results The results of digestion identification and DNA sequencing analysis demonstrated that the recombinant plasmid rhKD/APPvar-pPICZα was successfully constructed and transfected into pastoris X-33. The SDS-PAGE analysis results indicated that rhKD/APPvar expressed after the induction of methanol and the relative molecular weight was 6 700.After a series of experiments the optimal expression conditions of rhKD/APPvar were obtained as follows:the optimal pH was 6.0 and the optimal induction time point was about the 5 th day for the strain.After purified the purity of rhKD/APPvar was about 95%.Conclusion KD/APPvar-pPICZ is successfully constructed;after expression in Pichia pastoris and purification,the rhKD/APPvar protein is obtained.

Effects of beraprost sodium on serum nitric oxide in elderly patients with lower extremity arteriosclerotic occlusive disease / 中华老年医学杂志

Objective To investigate the therapeutic effects and safety of beraprost sodium on vascular endothelial dysfunction in elderly patients with lower extremity arteriosclerotic occlusive disease (LEAOD).Methods A total of 80 patients with LEAOD were randomly divided into 2 groups:the treatment group and the control group (n=40 each group).All patients were treated with conventional antihypertensive,antidiabetic,hypolipidemic,antiplatelet drug therapy and non-drug therapy such as smoking cessation,foot care.In addition,patients in the treatment group received 40 μg oral beraprost sodium at a dose of 120 μg/day,3 times/day for 30 days.The changes in symptoms,vital signs,the function of liver and kidney,hemorheology,and serum nitric oxide (NO)were observed before and after the treatment.Results No adverse reactions happened among all patients.After 30 days treatment,there was a significant difference in the total efficacy between the treatment and control groups (80％ vs.35％,x2 =19.60,P＜0.01).The levels of plasma viscosity,erythrocyte aggregation index and serum NO in the control group were (1.70±0.19) mpas.s,5.69±1.08,(43.86±5.20) μmol/L,respectively before the treatment and (1.36±0.14) mpas.s,3.23±0.67,(56.84 ± 7.05) μmol/L,respectively after the treatment.The levels of plasma viscosity,erythrocyte aggregation index and serum NO in the treatment group were (1.71 ±0.18) mpas.s,5.70±1.04,(44.24±5.40) μmol/L,respectively before the treatment and (1.10±0.12) mpas.s,2.80 ±0.52,(64.00±8.15) μmol/L,respectively after the treatment.Compared with pretreatment,the levels of plasma viscosity and erythrocyte aggregation index in the two groups were significantly decreased and serum NO level was increased after the treatment (t=9.07,12.17,17.85,15.76,9.38,12.78,respectively,all P＜0.05).Compared with the control group,the levels of plasma viscosity and erythrocyte aggregation index in the treatment group were significantly decreased and serum NO level was increased (t =8.91,3.27,4.21,all P＜0.05).Conclusions The oral beraprost sodium can effectively and safely improve the hemorheologic and endothelial function in elderly patients with LEAOD.

Effects of comprehensive geriatric assessment intervention on depression and anxiety in patients with benign prostatic hyperplasia / 中华老年医学杂志

ObjectiveTo investigate the effects of comprehensive geriatric assessment (CGA) intervention on depression and anxiety in patients with benign prostatic hyperplasia (BPH).Methods90 patients with BPH (aged 65 years and over) from June 2009 to June 2010 were randomly assigned to control(n= 45) and CGA (n = 45) group.Control group received conventional therapy,while CGA group was given CGA and consultation therapy as well as conventional therapy.The scores of international were assayed and compared between two groups before and 6 months after treatment.ResultsThe scores of international prostate symptom score (IPSS),quality of life scale (QOLS),self-rating depression scale (SDS) and self-rating anxiety scale (SAS) in control (t= 11.0,5.84,7.08and 9.68,respectively) and CGA (t= 14.0,10.4,9.16 and 6.1,respectively)group 6 months after treatment reduced as compared with those before treatmen (all P ＜ 0.01).After 6 months of treatment,the scores of IPSS,QOLS,SDS and SAS in CGA group were lower than in control group (t= 4.25,5.55,3.45 and 2.88,respectively,all P＜0.01).ConclusionsCGA intervention can improve the quality of life in BPH patients and alleviate their depression and anxiety.

Changes in posterior cingulated cortex functional connectivity of resting-state functional magnetic resonance imaging in mild Alzheimer's disease / 中华神经科杂志

Objective To investigate how functional connectivity changes within default-mode network related to posterior cingulated cortex employing resting-state functional MRI (tMRI). Methods fMRI was compared between 16 mild Alzheimer' s disease (AD) patients and 16 normal elder subjects. Regions of functional connectivity to posterior cingulated cortex were gathered by calculating temporal correlations in low frequency fMRI signal fluctuations. SPM2 was applied to calculate significant differences of connectivity between group and within group. Significance threshold was set up at the corrected P <0. 01, pixel extent > 5. A random effect two-example t test was performed by SPM2 to achieve significant difference of functional connection between groups ( P < 0. 01, corrected, t = 2. 47, pixel extent > 5 ). Results Regions showing disrupted connectivity to posterior cingulated cortex were: ventral medial prefrontal cortex (MPFC), bilateral visual cortex, infero-temporal cortex (ITC), and left hippocampus, right thalamus, right dorsal-lateral prefrontal cortex ( DLPFC), and precuneus. There were also regions showing increased connectivity with leftward asymmetry, these regions included: MPFC, left ITC, bilateral DLPFC, left pre- central motor cortex and left basal ganglia. Conclusions Impairments of memory and high visual-related functions in AD can be explained by functional disconnection in resting-state. Remoldability is reserved in mild AD to compensate for brain function which is taxed by left hemisphere preferentially. Our findings suggest that resting-state fMRI might be an appropriate approach for evaluating AD brain mechanism.

Effects of homocysteine on matrix metalloproteinase-1 and tissue inhibitors of metalloproteinase-1 in vascular smooth muscle cells / 中国组织工程研究

BACKGROUND: Homocysteine (HCY) has been verified as an independent risk factor of atherosclerosis and atherothrombosis of cardiovascular disease.OBJECTIVE: To observe the effects of HCY on the secretion and activity of matrix metallopotinase-1 (MMP-1) and tissue inhibitors of metalloproteinase-1 (TIMP-1) in vascular smooth muscle cells (VSMCs).DESIGN : Auto-control observation.SETTING: Pathology Room, Institute of Regeneration Medical Sciences, Jilin University.MATERIALS: In vitro cultured vascular smooth muscles cells (VSMCs) of rats were obtained from male Wistar rats with the body mass of about 150 g from weeks 4-6 supplied by Laboratory of Animals, Norman Bethune Medical Sciences Division, Jilin University.METHODS: The experiment was performed at the Pathology Room, Institute of Regeneration Medical Sciences, Jilin University from May 2001 to May 2003. VSMCs ofin vitro cultured rats were adopted and divided into 5 groups, 0(control group), 0.10, 0.25, 0.50 and 1.00 mmol/L HCY were added, respectively for 48 hours. Effect of HCY on activity of MMP-1 was observed with zymography. The secretions of MMP-1 and TIMP-1 and their mRNA expressions were studied with Western blot and semi-quantitative reverse transcription polymerase chin (RT-PCR).MAIN OUTCOME MEASURES: Activity of MMP-1, secretions of MMP-1 and TIMP-1 and their mRNA expressions.RESULTS: ①Secretions of MMP-1 and TIMP-1: The secretion of MMP-1 in the 0.25, 0.50 and 1.00 mmol/L HCY groups was lower significantly than that in the control group (P ＜ 0.05-0.01). The secretion of TIMP-1 in the 0.10, 0.25, 0.50 and 1.00 mmol/L HCY groups was higher than that in the control group (P＜ 0.05-0.01). ②The MMP-1 activity decreased with the increase of HCY, but reduced obviously in the 0.50 and 1.00 mmol/L HCY groups (P ＜ 0.01). ③The expression of MMP-1 mRNA in the 4 HCY groups was lower markedly than that in the control group (P ＜ 0.01). The expression of TIMP-1 mRNA in the 0.25 mmol/L HCY group was higher than that in the control group (P ＜ 0.05), and it was higher remarkably in the 0.50 and 1.00 mmol/L HCY groups than that in the control group (P ＜ 0.01).CONCLUSION: HCY can inhibit enzyme activity, decrease collagen degradation and induce collagen accumulation by inhibiting the secretion of MMP-1, which indicates that reduction of collagen degradation induced by HCY is one of the pathogenesies of atherosclerosis.

Computer software for prevention and treatment of diabetes mellitus / 中国组织工程研究

At present, the computer administration and network system for diabetes still need exploration in China. A management software for the prevention and treatment of diabetes has been developed, taking the advanced MS SQL SERVER system as background database, while PowerBuilder 9.0 as foreground development tool. Both personal version and net version are configurable at random. This software includes six parts, namely the general data of patients, conventional physical examination of patients, treatment proposal, knowledge management, data query and statistical analysis, and system maintenance, in which they contact and conjugate with each other for the convenience of the whole processing. Good effects are obtained in the practical application of this software, and a regional network of the preventive and therapeutic information for diabetes is set up combining with other medical units, which can share the individual information, improve the ability of cooperative and follow-up study of diabetes, promote the data transferring and diagnosing quality of primary medical services, and is beneficial for both patients and physicians.

Expressions of COX-2 in primary tumor and axillary lymph node tissues of breast cancer and significance / 吉林大学学报(医学版)

Objective To detect COX-2 expressions in primary tumor and axillary lymph node tissues of breast cancer,and to study the relationship between COX-2 expression in breast cancer and lymph node metastasis.Methods The expressions of COX-2 in 9 normal breast tissues,50 primary breast cancer tissues,19 positive axillary lymph nodes and 31 negative axillary lymph nodes were detected with immunohistochemistry S-P method.Results COX-2 staining was granular and localized to the cytoplasm of tumor cells.In normal breast tissues,COX-2 staining was granular and localized to mesenchymocyte.In negative lymph nodes,COX-2 staining was granular and localized to macrophagus cytoplasm.The positive expression rates of COX-2 in normal breast tissues,primary breast cancer tissues,positive axillary lymph nodes and negative axillary lymph nodes were 11.1%,60.0%,84.2%,and 32.3%,respectively.There were significant differences of COX-2 positive expression rates between normal breast tissues,primary breast cancer tissues and positive axillary lymph nodes(P