Homocysteine is associated with the progression of non-culprit coronary lesions in elderly acute coronary syndrome patients after percutaneous coronary intervention

脉管的光滑的肌肉房间的迁居和增长上的 homocysteine (Hcy ) 的 BackgroundThe 影响很好被建立了。然而， Hcy 的影响在非犯人的前进上铺平冠的损害(NCCL ) 是争论的。这研究试图评估 Hcy 的血浆水平是否与在在有急性冠的症候群(交流) 的老病人的经皮的冠的 stent 培植以后的 NCCL 的前进有关 223 个老病人的 .MethodsA 总数(&#x02265；65 岁) 与经历 stent 培植和后续的交流，冠的 angiography 被注册。为 Hcy 由血样品评估组成的实验室决心在基线前被执行冠的干预。病人根据血 Hcy tertiles 被分类进二个组(&#x02265；15 mmol/L 或 &#x0003c；15 mmol/L ) 。病人们被跟随在上面为 12.2 个月。NCCL 前进被三维的量的冠的 angiography.ResultsA 估计 NCCL 前进的显著地更高的比率与下面的集中与这个组相比在 15 mmol/L 上面与基线 Hcy 集中在这个组被观察 15 mmol/L (41/127， 32.3% 对 14/96， 14.6% ， P = 0.002 ) 。穆尔蒂瓦里伊特·考克斯回归分析证明 Hcy 和糖尿病 mellitus 是为 NCCL 前进的独立风险因素。为 Hcy 水平的 NCCL 前进的粗略的危险比率(HR ) 是 1.056 (95% CI：1.01-1.104， P = 0.015 ) 。为 Hcy 水平的 NCCL 前进的调整 HR 是 1.024 (95% CI：1.007-1.042， P = 0.007 ) 。为糖尿病 mellitus 的 NCCL 前进的调整 HR 是 1.992 (95% CI：1.15-3.44， P = 0.013 ).ConclusionsHcy 是为在 12 月在有交流的老病人的后续以后的 NCCL 前进的一个独立风险因素经历了经皮的冠的 stenting。

Three-dimensional mapping of intertrochanteric fracture lines

Background:Available research about the anatomic patterns of intertrochanteric fractures is lacking,and fracture mapping has not previously been performed on intertrochanteric fractures.This study aimed to determine the major trajectories of intertrochanteric fracture lines using computed tomography data from a series of surgically treated patients.Methods:In this study,504 patients with intertrochanteric fractures were retrospectively analyzed.Fracture patterns were graded according to Arbeitsgemeinschaft für Osteosynthesefragen(AO)classification.Fracture lines were transcribed onto proximal femoral templates and graphically superimposed to create a compilation of fracture maps that were subsequently divided into anterior,posterior,lateral,and medial fracture maps to create a three-dimensional(3D)pattern by reducing fragments in the 3D models.The fracture maps were then converted into frequency spectra.The major fracture patterns were assessed by focusing on the lateral femoral wall,lesser trochanter,intertrochanteric crest,and inner cortical buttress.Results:Anterior,posterior,lateral,and medial fracture maps were created.The majority of fracture lines(85.9%,433/504)on the anterior maps were along the intertrochanteric line where the iliofemoral ligament was attached.In the medial plane,the majority of fracture lines(49.0%,247/504)shown on the frequency spectrum included the turning point involving the third quadrant.In the posterior plane,the majority of fracture lines(52.0%,262/504)involved the intertrochanteric crest from the greater to the lesser trochanter.In the lateral plane,the majority of fracture lines(62.7%,316/504)involved the greater trochanter at the gluteus medius attachment.Conclusions:The fracture patterns observed in the present study might be used to describe morphologic characteristics and aid with management strategies.Further classifications or modifications that incorporate the fracture patterns identified in this study may be used in future research.

Medial support nail and proximal femoral nail antirotation in the treatment of reverse obliquity inter-trochanteric fractures(Arbeitsgemeinschaft fur Osteosynthesfrogen/Orthopedic Trauma Association 31-A3.1):a finite-element analysis

Background:The reverse obliquity inter-trochanteric fracture is a distinct fracture pattern that is mechanically different from most inter-trochanteric fractures and the optional treatment of it is still controversial.The purpose of this study was to compare differences in the efficacy of a novel nail(medial support nail[MSN-II])and proximal femoral nail anti-rotation(PFNA-II)in the treatment of reverse obliquity inter-trochanteric fractures(Arbeitsgemeinschaft fur Osteosynthesfrogen/Orthopedic Trauma Association[AO/OTA]31-A3.1)using finite-element analysis.Methods:Modeling software was used to establish a three-dimensional model of MSN-II and PFNA-II and an A3.1 inter-trochanteric fracture model.Abaqus software was used to implement different force loads to compare finite-element biomechanical parameters such as the maximum stress in implant and the displacement of fracture site.Results:The femoral stress,implant stress and fracture site displacement of MSN-II was less than that of PFNA-II.The results indicated that the maximal femoral stress was 581 MPa for PFNA-II and 443 MPa for the MSN-II.The maximum stress values in the PFNA-II and MSN-II models were 291 and 241 MPa,respectively.The maximal displacements of the fracture site were 1.47 and 1.16 mm in the PFNA-II and MSN-II models,respectively.Conclusions:Compared with PFNA-II for inter-trochanteric fracture(AO/OTA 31-A3.1),MSN-II which was designed with a triangular stability structure can provide better biomechanical stability.The MSN-II may be a feasible option for the treatment of reverse obliquity inter-trochanteric fracture.