Epithelial Wnt10a Is Essential for Tooth Root Furcation Morphogenesis

WNT10A (Wingless-type MMTV integration site family, member 10A) plays a crucial role in tooth development, and patients with biallelic WNT10A mutation and mice lacking Wnt10a show taurodontism. However, whether epithelial or mesenchymal WNT10A controls the initiation of the root furcation formation remains unclear, and the functional significance of WNT10A in regulating root morphogenesis has not been clarified. Here, we investigated how Wnt10a affects tooth root development by generating different tissue-specific Wnt10a conditional knockout mice. Wnt10a knockout in the whole tissue (EIIa-Cre;Wnt10a^flox/flox) and in dental epithelium (K14-Cre;Wnt10a^flox/flox) led to an absence of or apically located root furcation in molars of mice, a phenotype that resembled taurodontism. An RNAscope analysis showed that the dynamic epithelial and mesenchymal Wnt10a expression pattern occurred during root development. Immunofluorescent staining of E-cadherin and EdU revealed decreased epithelial cell proliferation at the cervical region of the molar in K14-Cre;Wnt10a^flox/flox mice at postnatal day 0 (PN0), just before the initiation of root morphogenesis. Interestingly, we found increased pulpal mesenchymal cell proliferation in the presumptive root furcating region of the molar in K14-Cre;Wnt10a^flox/flox mice at PN4 and PN7. RNA-seq indicated that among the Wnt ligands with high endogenous expression levels in molars, Wnt4 was increased after epithelial knockout of Wnt10a. The RNAscope assay confirmed that the expression of Wnt4 and Axin2 in the dental papilla of the presumptive root furcating region, where dental pulp overgrowth occurred, was increased in K14-Cre;Wnt10a^flox/flox molars. Furthermore, after suppression of the elevated Wnt4 level in K14-Cre;Wnt10a^flox/flox molars by Wnt4 shRNA adenovirus and kidney capsule grafts, the root furcation defect was partially rescued. Taken together, our study provides the first in vivo evidence that epithelial Wnt10a guides root furcation formation and plays a crucial role in controlling the organized proliferation of adjacent mesenchymal cells by regulating proper Wnt4 expression during root furcation morphogenesis.

Improving Performance of Tin-Doped-Zinc-Oxide Thin-Film Transistors by Optimizing Channel Structure

In this paper, we investigated the performance of thin-film transistors (TFTs) with different channel configurations including single-active-layer (SAL) Sn-Zn-O (TZO), dual-active-layers (DAL) In-Sn-O (ITO)/TZO, and triple-active-layers (TAL) TZO/ITO/TZO. The TAL TFTs were found to combine the advantages of SAL TFTs (a low off-state current) and DAL TFTs (a high mobility and a low threshold voltage). The proposed TAL TFTs exhibit superior electrical performance, e.g. a high on-off state current ratio of 2 × 10⁸, a low threshold voltage of 0.63 V, a high field effect mobility of 128.6 cm²/Vs, and a low off-state current of 3.3 pA. The surface morphology and characteristics of the ITO and TZO films were investigated and the TZO film was found to be C-axis-aligned crystalline (CAAC). A simplified resistance model was deduced to explain the channel resistance of the proposed TFTs. At last, TAL TFTs with different channel lengths were also discussed to show the stability and the uniformity of our fabrication process. Owing to its low-processing temperature, superior electrical performance, and low cost, TFTs with the proposed TAL channel configuration are highly promising for flexible displays where the polymeric substrates are heat-sensitive and a low processing temperature is desirable.

P2534Prevalence and risk factors of acquired LQTS among pregnancy: a single-center study

Background

Prolonged QT intervals have been observed in pregnant women, especially those with twin pregnancy, which predisposes them to a high risk of ventricular arrhythmias.

Purpose

To evaluate the prevalence of acquired long QT syndrome (aLQTS) in hospitalized parturient women with single and twin pregnancy and search for potential risk factors.

Methods

Information about age-matched parturient women with single and twin pregnancy were retrospectively collected in our hospital from January 2016 to June 2018. The prevalence of aLQTS was evaluated. The common risk factors for corrected QT (QTc) prolongation were compiled, and multivariable logistic regression analysis was used to evaluate how each factor was related to aLQTS in such population.

Results

Totally 293 parturient women (147 twin pregnancy, 50.17%) were included. The prevalence of aLQTS was 72.70% in all cases, 53.15% in the single pregnancy, 93.20% in the twin pregnancy. The proportion of severely prolonged QTc was 36.18% in all cases, 8.22% in the single pregnancy and 63.95% in the twin pregnancy. The QTc interval was much longer in the twin pregnancy than in the single pregnancy with significant difference. Differences in systolic blood pressure, diastolic blood pressure, total cholesterol, serum uric acid, fetal weight, QRS, RV5+SV1, Tp-Te, Tp-Te/QT have been revealed to be statistically significant between the QTc-prolongation group and the QTc-normal group. The incidence of gestational hypertension and twin pregnancy in the QTc-prolongation group were more prevalent than in the QTc-normal group with significant difference. In the multivariable logistic regression analysis, gestational hypertension, twin pregnancy, increase of diastolic blood pressure, high total cholesterol, high serum uric acid, and heavy fetal weight were identified to be associated with QTc prolongation in parturient women.

Table 1. Risk factors significantly correlated with QTc prolongation in parturient women Index P value OR (95% CI) DBP (mmHg) 0.033* 1.052 (1.004 to 1.101) TC (mmol/L) 0.001** 1.442 (1.165 to 1.785) UA (μmol/L) 0.007** 1.004 (1.001 to 1.008) Fetal weight (g) <0.001** 1.001 (1.001 to 1.001) Hypertention (%) 0.029* 2.561 (1.099 to 5.967) Twin (%) <0.001** 12.618 (6.145 to 25.909)

Conclusion

To our knowledge, this is the first clinical study to evaluate the prevalence of aLQTS between single and twin pregnancy. The prevalence of aLQTS is much higher in the parturient women, particularly in twin pregnancy.

[Detection and functional analysis of BMP2 gene mutation in patients with tooth agenesis]

OBJECTIVE

To screen for BMP2 mutation with functional impact in patients with congenital tooth agenesis and to make oral and skeletal phenotype record and functional analysis with in vitro experiments.

METHODS

We enrolled eighteen patients with congenital tooth agenesis. The medical and dental history was collected,and clinical and dental examinations including the X-ray examination of oral-facial and skeletal bone were performed for the phenotypic analysis. Blood samples were collected to extract DNA and whole exome sequencing was conducted. The genes involved in oral-facial development and congenital skeletal diseases were investigated for mutation screening. The mutations with functional impact were then investigated. In one patient, the BMP2 mutation with putative functional impact was selected for functional analysis. Wild type and mutant BMP2 plasmids with green fluorescent protein (GFP) tag were constructed and transfected into HEK293T cells. Subcellular protein distribution was observed under laser scanning confocal microscope. The activation of downstream SMAD1/5/9 phosphorylation by BMP2 was detected by Western blotting to investigate the functional impact and genetic pathogenicity.

RESULTS

BMP2 mutation NM_001200.3:c.393A>T (p.Arg131Ser), rs140417301 was detected in one patient with congenital tooth agenesis, while for other genes involved in oral-facial development and congenital skeletal diseases, no functionally significant mutation was found. The proband's parents didn't carry this mutation. The father had normal dentition, while the mother lacked one premolar, and both the parents showed normal palate and maxilla. The patient also had maxillary hypoplasia in both sagittal and coronal planes, palatal dysmorphology, and malocclusion, and was diagonsed with osteopenia after the X-ray examnination of his skeletal bone. Functional analysis showed this mutation had normal subcelluar localization but reduced phosphorylation of SMAD1/5/9 (reduction by 32%, 22%, and 27% in three independent replicates). Taken together with family co-segregation, this mutaion was considered as "likely pathogenic".

CONCLUSION

BMP2 mutation c.393A>T (p. Arg131Ser) affects bone morphogenetic protein signaling activity, and may affect the number of teeth, growth of maxilla and palate, and bone mineral density.

[Imaging progress of sinonasal mucosal malignant melanoma]

Summary Recent years,the incidence of sinonasal mucosal malignant melanoma increased,and imaging examinations have high values in diagnosing and staging,this article will review the imaging and pathological manifestation of sinonasal mucosal malignant melanoma ,then analyze and summarize the advantages and utilities of different examinations,as well as the differential diagnosis.The limitation of this article is the lack of clinical analysis,and it's relationship with imaging manifestation,which of both need futher investigation.

Baseline concentration of misfolded α-synuclein aggregates in cerebrospinal fluid predicts risk of cognitive decline in Parkinson's disease

BACKGROUND

The prognostic significance of misfolded α-synuclein (α-Syn) aggregates in Parkinson's disease (PD) has not been well investigated. The aim of this study was to reveal the relationship between misfolded α-Syn aggregate concentration in cerebrospinal fluid (CSF) and cognitive decline risk in PD.

METHODS

A total of 278 patients with PD were retrospectively included. They were diagnosed between 2011 and 2013. The end-point was 2016, and the follow-up period was 54.3 ± 10.0 months. Cognitive decline was defined as a 4-point decrease in the Mini-Mental State Examination score during follow-up. Misfolded α-Syn aggregate concentration in baseline CSF was measured using the protein misfolding cyclic amplification (PMCA) technique. Time to reach 50% of the maximum fluorescence value was recorded.

RESULTS

The PMCA technique successfully detected the level of misfolded α-Syn aggregates in CSF with a sensitivity of 85.3% and a specificity of 91.4%. The time to reach 50% of the maximum fluorescence value was shorter in the patients with cognitive decline than in the patients without cognitive decline (190.7 ± 40.1 h vs. 240.8 ± 45.6 h, P < 0.001). Multifactorial Cox regression analysis revealed that reaching 50% of the maximum fluorescence value in ≤219 h at baseline was associated with increased risk of cognitive decline during the follow-up (HR: 4.90, 95% CI: 2.75-8.74, P < 0.001).

CONCLUSION

Baseline concentration of misfolded α-Syn aggregates in CSF measured by the PMCA technique predicts risk of cognitive decline in PD.

[CT manifestations of squamous papilloma in adult nose, pharynx and throat]

Objective:Analyze the CT imaging characteristics of squamous papilloma in adult nose pharynx and throat to improve the diagnostic accuracy.Method:Retrospectively analyze clinical data and CT image data in 24 cases of squamous papilloma in adult nose, pharynx and throat, which were confirmed by endoscopic surgical pathology, and summarize CT imaging features including location, shape, enhancement, and its relationship with adjacent tissue, and so on.Result:The patients with squamous papilloma were characterized by diffusing thickening and uniform swelling of the mucosa of nose, pharynx and throat, narrowing near the cavity gap, swallow gap existing, and enhancement scanning manifested mild-to-moderate gradually uniform reinforcement (enhanced CT value with 20-45 HU), when accompanied with malignancy, apparent arterial enhancement (enhanced CT value >45 HU) was observed.Conclusion:The adult patients with papilloma of nose, pharynx and throat has special features in CT image, which can provide more information for clinical diagnosis.

Bi-layer Channel AZO/ZnO Thin Film Transistors Fabricated by Atomic Layer Deposition Technique

This letter demonstrates bi-layer channel Al-doped ZnO/ZnO thin film transistors (AZO/ZnO TFTs) via atomic layer deposition process at a relatively low temperature. The effects of annealing in oxygen atmosphere at different temperatures have also been investigated. The ALD bi-layer channel AZO/ZnO TFTs annealed in dry O₂ at 300 °C exhibit a low leakage current of 2.5 × 10^-13A, I _on/I _off ratio of 1.4 × 10⁷, subthreshold swing (SS) of 0.23 V/decade, and high transmittance. The enhanced performance obtained from the bi-layer channel AZO/ZnO TFT devices is explained by the inserted AZO front channel layer playing the role of the mobility booster.

Nine Novel PAX9 Mutations and a Distinct Tooth Agenesis Genotype-Phenotype

Tooth agenesis is one of the most common developmental anomalies affecting function and esthetics. The paired-domain transcription factor, Pax9, is critical for patterning and morphogenesis of tooth and taste buds. Mutations of PAX9 have been identified in patients with tooth agenesis. Despite significant progress in the genetics of tooth agenesis, many gaps in knowledge exist in refining the genotype-phenotype correlation between PAX9 and tooth agenesis. In the present study, we complete genetic and phenotypic characterization of multiplex Chinese families with nonsyndromic (NS) tooth agenesis. Direct sequencing of polymerase chain reaction products revealed 9 novel (c.140G>C, c.167T>A, c.332G>C, c.194C>A, c.271A>T, c.146delC, c.185_189dup, c.256_262dup, and c.592delG) and 2 known heterozygous mutations in the PAX9 gene among 120 probands. Subsequently, pedigrees were extended, and we confirmed that the mutations co-segregated with the tooth agenesis phenotype (with exception of families in which DNA analysis was not available). In 1 family ( n = 6), 2 individuals harbored both the PAX9 c.592delG mutation and a heterozygous missense mutation (c.739C>T) in the MSX1 gene. Clinical characterization of families segregating a PAX9 mutation reveal that all affected individuals were missing the mandibular second molar and their maxillary central incisors are most susceptible to microdontia. A significant reduction of bitter taste perception was documented in individuals harboring PAX9 mutations ( n = 3). Functional studies revealed that PAX9 haploinsufficiency or a loss of function of the PAX9 protein underlies tooth agenesis.

Comparison of irinotecan/platinum versus etoposide/platinum chemotherapy for extensive-stage small cell lung cancer: A meta-analysis

This meta-analysis was performed to compare the effects and toxicities between irinotecan/platinum (IP) and etoposide/platinum (EP) regimens as the fist-line treatment of patients with extensive-stage small cell lung cancer (E-SCLC). A systematic search was made of MEDLINE, Cochrane, ISI Web of Science and SCOPUS databases. Randomised clinical trials on treatment of E-SCLC with the IP regimens, compared with EP regimens, were reviewed. Studies were pooled to hazard ratio (HR), relative risk (RR) and odds ratio (OR), with 95% confidence interval (CI). Eight trials (enrolling 2089 participants) met the inclusion criteria. Overall survival (OS) and 1-year survival rate were superior in the IP group (HR 0.83; 95% CI 0.75 to 0.91 and RR 1.19; 95% CI 1.06 to 1.34). Grades 3 and 4 anaemia, leukopenia, neutropenia, thrombocytopenia and febrile neutropenia were less frequent in the IP regimens than that in the EP regimens. And grades 3 and 4 nausea/vomiting, diarrheal, anorexia and fatigue were less frequent in the EP regimens. IP combination chemotherapy achieved a superior OS and 1-year survival rate, compared with EP doublets, in patients with E-SCLC.

Combination therapy of orally administered glycyrrhizin and UVB improved active-stage generalized vitiligo

Glycyrrhizin has been used clinically for several years due to its beneficial effect on immunoglobulin E (IgE)-induced allergic diseases, alopecia areata and psoriasis. In this study, glycyrrhizin, ultraviolet B light (UVB) or a combination of both were used to treat active-stage generalized vitiligo. One hundred and forty-four patients between the ages of 3 and 48 years were divided into three groups: group A received oral compound glycyrrhizin (OCG); group B received UVB applications twice weekly, and group C received OCG+UVB. Follow-ups were performed at 2, 4, and 6 months after the treatment was initiated. The Vitiligo Area Scoring Index (VASI) and the Vitiligo Disease Activity (VIDA) instrument were used to assess the affected body surface, at each follow-up. Results showed that 77.1, 75.0 and 87.5% in groups A, B and C, respectively, presented repigmentation of lesions. Responsiveness to therapy seemed to be associated with lesion location and patient compliance. Adverse events were limited and transient. This study showed that, although the three treatment protocols had positive results, OCG and UVB combination therapy was the most effective and led to improvement in disease stage from active to stable.

Schisandrin B attenuates the inflammatory response, oxidative stress and apoptosis induced by traumatic spinal cord injury via inhibition of p53 signaling in adult rats

Schisandrin B is an active monomer of the Chinese magnolia vine (Schisandra chinensis) that can reduce transaminase activity in liver cells, inhibit lipid peroxidation, enhance antioxidant status, has protective effects in the liver and has antitumor effects. The present study investigated the potential protective effects of schisandrin B on the p53 signaling pathway in attenuating the inflammatory response, oxidative stress and apoptosis induced by traumatic spinal cord injury (TSCI) in adult rats. Behavioral examination, inclined plate test and spinal cord water content were used to evaluate the protective effect of schisandrin B in TSCI rats. The expression levels of superoxide dismutase (SOD), malondialdehyde (MDA), nuclear factor (NF)-κB subunit p65 and tumor necrosis factor (TNF)-α were examined using ELISA kits. Western blot analysis was performed to analyze the protein expression of caspase-3 and phosphorylated (p)-p53 in TSCI rats. In the present study, schisandrin B improved behavioral examination results and the maximum angle of inclined plate test, and inhibited spinal cord water content in rats with TSCI. Notably, schisandrin B reduced the activation of traumatic injury-associated pathways, including SOD, MDA, NF-κB p65 and TNF-α, in TSCI rats. In addition, schisandrin B suppressed the TSCI-induced expression of caspase-3 and p-p53 in TSCI rats. These results indicated that schisandrin B may attenuate the inflammatory response, oxidative stress and apoptosis in TSCI rats by inhibiting the p53 signaling pathway in adult rats.

Aminophylline Effect on Renal Ischemia-Reperfusion Injury in Mice

BACKGROUND

Aminophylline increases the intracellular concentration of cAMP and exerts an anti-inflammatory effect. The aim of this study was to investigate the effect of aminophylline on renal ischemia-reperfusion (I/R) injury in mice.

METHODS

Thirty C57BL/6 mice were divided into 3 groups. In the sham group (group S, n = 10), only right nephrectomy was performed. In the control group (group C, n = 10), after right nephrectomy, the mice were subjected to 30 minutes of left renal ischemia. In the aminophylline group (group A, n = 10), an intraperitoneal injection of aminophylline (5 mg/kg) was performed before renal ischemia. Twenty-four hours after reperfusion, the mice were euthanized, and plasma and kidney samples were obtained to analyze the serum creatinine, renal histology, and expression levels of nuclear factor-kappa B (NF-kB) and pro-inflammatory cytokines.

RESULTS

The serum creatinine concentration in group C was markedly elevated at 24 hours after reperfusion. Aminophylline treatment significantly reduced serum creatinine, compared with group C. Aminophylline also reduced the histological evidence of renal damage. The expression levels of NF-kB, tumor necrosis factor-α (TNF-α), monocyte chemoattractant protein-1 (MCP-1), macrophage inflammatory protein-2 (MIP-2), and intercellular adhesion molecule-1 (ICAM-1) mRNA were significantly increased in group C (P < .001). Group A showed lower expression of NF-kB, TNF-α, MCP-1, MIP-2, and ICAM-1 mRNA than group C (P < .01).

CONCLUSIONS

Aminophylline treatment improved the renal function and indexes of renal inflammation, which suggests that it provided reno-protection against renal I/R injury.

Flow reproducibility of whole blood and other bodily fluids in simplified no reaction lateral flow assay devices

The "no reaction" lateral flow assay (nrLFA) uses a simplified LFA structure with no conjugate pad and no stored reagents. In the nrLFA, the capillary-based transport time or distance is the key indicator, rather than the outcome of a biochemical reaction. Hence, the calibration and reproducibility of the nrLFA device are critical. The capillary flow properties of several membrane types (nitrocellulose, nylon, cellulose acetate, polyethersulfone, and polyvinylidene difluoride) are evaluated. Flow rate evaluations of MilliporeSigma Hi-Flow™ Plus (HF075, HF135 and HF180) nitrocellulose membranes on nrLFA are performed using bodily fluids (whole blood, blood plasma, and artificial sweat). The results demonstrate that fluids with lower viscosity travel faster, and membranes with slower flow rate exhibit higher capability to distinguish fluids with different viscosities. Reproducibility tests of nrLFA are performed on HF075, demonstrating excellent reproducibility. The coefficient of variation for blood coagulation tests performed with the nrLFA using induced coagulation was 5% for the plasma front and 2% for the RBC front. The effects of variation in blood hematocrit and sample volume are also reported. The overall results indicate that the nrLFA approach has a high potential to be commercially developed as a blood monitoring point-of-care device with simple calibration capability and excellent reproducibility.

Formation of high-molecular weight polyaminoborane by Fe hydride catalysed dehydrocoupling of methylamine borane

The complex [(PNHP)Fe(H)(CO)(HBH₃)] (PNHP = HN(CH₂CH₂Pi-Pr₂)₂) serves as a catalyst precursor for the selective dehydrocoupling of methylamine borane at room temperature, tentatively via an off-metal polymerisation pathway.

Numerical Analysis of the Influence of Low Frequency Vibration on Bubble Growth

Numerical simulation of bubble growth during pool boiling under the influence of low frequency vibration was performed to understand the influence of common vibrations such as those induced by wind, highway transportation, and nearby mechanical devices on the performance of thermal systems that rely on boiling. The simulations were done for saturated R123 boiling at 277.6 K with a 15 K wall superheat. The numerical volume-of-fluid method (fixed grid) was used to define the liquid-vapor interface. The basic bubble growth characteristics including the bubble departure diameter and the bubble departure time were determined as a function of the bubble contact angle (20°-80°), the vibration displacement (10 µm-50 µm), the vibration frequency (5 Hz-25 Hz), and the initial vibration direction (positive or negative). The bubble parameters were shown to be strongly dependent on the bubble contact angle at the surface. For example, both the bubble departure diameter and the bubble departure time increased with the contact angle. At the same vibration frequency and the initial vibration direction, the bubble departure diameter and the bubble departure time both decreased with increasing vibration displacement. In addition, the vibration frequency had a greater effect on the bubble growth characteristics than did the vibration displacement. The vibration frequency effect was strongly influenced by the initial vibration direction. The pressure contour, the volume fraction of vapor phase, the temperature profile, and the velocity vector were investigated to understand these dynamic bubble behaviors. The limitation of the computational fluid dynamics approach was also described.

[EDA mutation screening and phenotype analysis in patients with tooth agenesis]

OBJECTIVE

To screen the ectodysplasin A (EDA) gene mutation in the patients with non-syndromic tooth agenesis and ectodermal dysplasia, and to analyze the phenotype of missing teeth pattern in these two groups of patients.

METHODS

In the study, 174 patients with tooth agenesis (143: non-syndromic, 31: ectodermal dysplasia) and 451 health control volunteers were enrolled from the clinic, and the genome DNA was extracted from either peripheral blood or oral mucosal swab. The coding region of EDA gene was then amplified by PCR, sequenced and blasted to online NCBI database. The missing teeth were recorded for all patients, and the missing teeth from patients with EDA mutation were compared among the different dentition sites.

RESULTS

33 patients were identified with EDA mutation. In the non-syndromic patients, 13/143(9.09%) were identified with EDA mutation, while in patients with ectodermal dysplasia, 20/31(64.52%) were found with EDA mutation. Ten novel EDA mutations were identified (c.769G>C[p.G257R ],c.936C>G[p.I312M],c.223G>A[p.E75K], .1166C>T[p.P389L],c.133G>C[p.G45R],c.1109G>A[p.E370K],c.914G>T[p.S305I], c.916C>T[p.Q306X],c.602G>T[p.G201V],c.88-89insG[p.A30GfsX69]). For each dentition site there was no statistic difference in the number of missing teeth between the left and right sides, so the number from both sides were combined later in the analysis. In the patients with EDA mutation, the non-syndromic patients had fewer missing teeth (15.9±6.4 missing teeth for each, 207/364 in total) than the patients with ectodermal dysplasia (23.9±4.3, 478/560). In the non-syndromic patients with EDA mutation, the maxillay central incisors and first molars were less affected, with the same missing rate as 19.2% (5/26). While the mandibular central incisors (with a missing rate of 76.9%, 20/26), the maxillary lateral incisors (the missing rate: 88.5%, 23/26), the mandibular lateral incisors (the missing rate: 80.8%, 21/26), and the maxillary first premolars (the missing rate: 80.8%, 21/26) were more likely to be missing. In the ectodermal dysplasia patients with EDA mutation, only maxillary central incisors (the missing rate: 60%, 24/40), maxillary canines (the missing rate: 70%, 28/40), mandibular canines (the missing rate: 67.5%, 27/40), maxillary first molars (the missing rate: 65%, 26/40) and mandibular first molars (the missing rate: 72.5%, 29/40) had higher possibility of persistence. Teeth at other dentition sites were more likely to be affected (the minimum missing rate: 87.5%, 35/40).

CONCLUSION

The findings would help to reveal the EDA gene and its function in ectodermal organogenesis.

[Comparison of calcar replacement arthroplasty and Intertan nail in treatment of intertrochanteric fracture in the aged]

OBJECTIVE

To compare the clinical efficacy between calcar replacement arthroplasty and InterTan nail in treatment of intertrochanteric fractures in the aged.

METHODS

From January 2008 to July 2013, a total of 58 elderly patients with intertrochanterie fracture , had been treated in Department of Orthopaedics, Tianjin Occupational Diseases Control and Treatment Hospital, were retrospectively compared.Half of them were treated with calcar replacement arthroplasty and half with InterTan nails.In the calcar replacement arthroplasty group, there were 8 men and 21 women, with an average age of (85.3±4.9) years, there were 8 A1, 16 A2 and 5 A3 fractures according to the AO classification.In the InterTan nail group, there were 10 men and 19 women, with an average age of (86.1±5.6) years, there were 11 A1, 15 A2 and 3 A3 fractures according to the AO classification.The 2 groups were compared in terms of the duration of the operation, intraoperative blood loss, hospitalization time, time of off-bed activity, complications, mortality rate, Harris hip score, short form 36 questionnaire score and ADL score.

RESULTS

Twenty-seven patients in the calcar replacement arthroplasty group and twenty-six patients in the patients in each group were followed up InterTan nail group were follow-up for a period of 24 months.There were no significant differences between the 2 groups regarding hospitalization time, complications, mortality rate, Harris hip score, short form 36 questionnaire score and ADL score(P>0.05). However, the operative time, intraoperative blood loss, and the time of off-bed activity for the calcar replacement arthroplasty and InterTan nail groups was respectively (78±29) minutes vs (59±32) minutes, (316±185) ml vs (108±97) ml, and (15±5.8) days vs (32±12.7) days, all of them with a significant difierence(P<0.05).

CONCLUSION

The patients in the calcar replacement arthroplasty group suffered longer operative time and more blood loss, but they can obtain early off-bed activity.The hospitalization time, complications, mortality rate, hip function and quality of Life between the two were the same.