ObjectiveTo observe the clinical effects of locking proximal humerus plate(LPHP) in the treatment of complex proximal humeral fracture of aged patients and to analyze the influencing factors. Methods Among 39 cases with complex humeral fractures (aged 60-83 years),there were 29 cases with three-part fractures and 10 with four-part fractures according to the Neer classification.They were operated by LPHP via deltoid-pectoral approach. Neer numerical rating system was employed to evaluate postoperative function of shoulders.Results39 cases were followed up for average of 16 months.According to Neer numerical rating system,the excellence rates of three-part fractures and four-part fractures were 86.2％ (25 cases) and 50.0％ (5 cases),respectively,with total excellence rate of 76.9％(30 cases). Age (OR =1.314, P＜0.05) and fracture type ( OR =1.295, P＜0.05)ofpatientswereindependentriskfactorsforprognosis of proximal humeral fracture of aged patients by multiple logistic regression. Conclusions LPHP is an effective implant for treating complex proximal humeral fracture of aged patients,with age and fracture types as important risk factors of prognosis.<英文关键词>=humeral fractures

Objective To study the analgesic sites and mechanism of total alkaloids in Papaver nudicaule (TAPN). Methods The sites of analgesic action of TAPN were observed by adopting Formalin test and two different routes of intracerebroventricular (icv), intrathecal (ith) in mice and rats and comparing ED 50 of TAPN in writhing reaction in mice induced by acetic acid by ip and iv administration. Results TAPN significantly lowered pain score of the early and late phase of Formalin response and was more sensitive in the late phase. Inhibition of TAPN at the same dose by ip administration in writhing reaction in mice induced by acetic acid was stronger than that by iv. The ED 50 value of TAPN at any time by ip administration was lower than that by iv administration. By means of central microinjection, TAPN by icv administration induced remarkable analgesic effect in mice, but TAPN by ith administration had no significant analgesic effect. Conclusion The sites of analgesic action of TAPN are mainly at periphery. TAPN has also central analgesic effect, and the site may be at the level above the spinal cord.

Objective To study the relationship between analgesic effect of total alkaloids in Papaver nudicaule(TAPN) and prostaglandins(PGs) with opium receptors.Methods The analgesic effect of TAPN was studied by hot-plate, writhing,electric-evoked methods of mice.The analgesic mechanisms of TAPN and PGs with opium receptors were studied by the writhing numbers induced by different substances(Ach,AA,MgSO_4),the PGE_2 level in celiac fluid in mice after treated by AA writhing test and the antagonistic experiment of Naloxone.Results The inhibitory effect of TAPN on the writhing induced by Ach and AA in mice was stronger than that induced by MgSO_4.TAPN could also lower the PGE_2 level in celiac fluid.In the antagonistic experiment of Naloxone,no antagonism to the analgesic effect of TAPN had been found by ip or icv Naloxone.Conclusion It may be the mainly peripheral analgesic mechanism that TAPN could lower the PGE_2 level in celiac fluid.Its central analgesic mechanisms are not related to opium receptors.

OBJECTIVETo assess the safety of repeated invasive prenatal diagnosis primarily due to failed culture of amniotic cells.

METHODSBetween January 2000 and October 2012, 167 cases required repeated invasive prenatal diagnosis among a total of 5304 amniocentesis cases. Clinical outcome and karyotypes were analyzed to calculate the rate of fetal loss.

RESULTSFor the 167 re-sampled cases, the indications have included failed amniocyte culture (121 cases), chromosome mosaicisms (23 cases), failed amniocentesis (21 cases), and request for confirmation (2 cases). No fetal loss has occurred. All samples were cultured successfully. Fourteen cases (8.38%) have been found with an abnormal karyotype. Four mosaic trisomic cases (2 mosaic trisomy 16, 1 mosaic trisomy 20, and 1 mosaic trisomy 8) were verified to be normal.

CONCLUSIONRepeated invasive prenatal diagnosis does not increase the rate of fetal loss. It can be recommended to cases with failed amniocyte culture. Caution should be undertaken when counseling prenatally detected mosaicism trisomies.

Adult ; Amniocentesis ; Female ; Fetal Diseases ; diagnosis ; genetics ; Humans ; Karyotyping ; methods ; Middle Aged ; Pregnancy ; Prenatal Diagnosis ; methods ; Trisomy ; Young Adult