Comparison of PFNA and DHS in the treatment of sarcopenia with Seinsheimer type V subtrochanteric fracture.

OBJECTIVE: We aimed at comparing the curative effect of proximal femoral nail antirotation (PFNA) and dynamic hip screw (DHS) in the treatment of Seinsheimer type V (type V) subtrochanteric fractures with sarcopenia. PATIENTS AND METHODS: A retrospective analysis was performed on 59 patients with type V subtrochanteric fractures complicated with sarcopenia admitted to the Department of Orthopedics of the affiliated Jiangning Hospital with Nanjing Medical University from January 2016 to December 2021. Sarcopenia was diagnosed based on grip strength and skeletal muscle index (SMI). According to different surgical methods, they were divided into PFNA group (32 cases) and DHS group (27 cases). The age, gender, time from injury to operation, SMI value, incision length, operation time, intraoperative blood loss, fluoroscopy times, perioperative blood transfusion, lower limb full weight-bearing time, visual analogue scale (VAS) for pain at 3 months after operation and at the last follow-up, Harris score as well as postoperative complications were compared between the two groups. RESULTS: There were no significant differences in age, gender, time from injury to operation, and SMI between the two groups. The length of surgical incision, blood loss and blood transfusion in the PFNA group were less than those in the DHS group; however, the number of intraoperative fluoroscopies was more than that in the DHS group. The PFNA group had earlier full weight-bearing time, lower VAS score and higher Harris score at 3 months after operation, while there was no statistically significant difference in VAS score and Harris score between the two groups at the last follow-up. The incidence of complications in the PFNA group was lower than that in the DHS group, and the difference was statistically significant. CONCLUSIONS: Both PFNA and DHS are effective methods for the treatment of type V subtrochanteric fractures complicated with sarcopenia. Strikingly, PFNA is preferred because of its short surgical incision, less blood loss, faster recovery, and lower incidence of complications.

A novel ribonuclease with antiproliferative activity from fresh fruiting bodies of the edible mushroom Hypsizigus marmoreus.

An 18-kDa ribonuclease (RNase) with a novel N-terminal sequence was purified from fresh fruiting bodies of the mushroom Hypsizigus marmoreus. The purification protocol comprised ion exchange chromatography on DEAE cellulose, affinity chromatography on Affi-gel blue gel, ion exchange chromatography on CM-cellulose and Q-Sepharose and gel filtration by fast protein liquid chromatography on Superdex 75. The starting buffer was 10 mM Tris-HCl buffer (pH 7.2), 10 mM Tris-HCl buffer (pH 7.2), 10 mM NH(4)OAc buffer (pH 5), 10 mM NH(4)HCO(3) buffer (pH 9.4) and 200 mM NH(4)HCO(3) (pH 8.5), respectively. Absorbed proteins were desorbed using NaCl added to the starting buffer. A 42-fold purification of the enzyme was achieved. The RNase was unadsorbed on DEAE cellulose, Affi-gel blue gel and CM-cellulose but adsorbed on Q-Sepharose. It exhibited maximal RNase activity at pH 5 and 70 degrees C. Some RNase activity was detectable at 100 degrees C. It demonstrated the highest ribonucleolytic activity (196 U/mg) toward poly C, the next highest activity (126 U/mg) toward poly A, and much weaker activity toward poly U (48 U/mg) and poly G (41 U/mg). The RNase inhibited [(3)H-methyl]-thymidine uptake by leukemia L1210 cells with an IC(50) of 60 microM.