Objective To investigate the curative efficacy of fracture with closed reduction and percutaneous Kirschner wire fixation of the simple lateral injury for humeral supracondylar fracture of Gartland type Ⅱ and type Ⅲ in children by the emergency treatment and selective surgery. Methods From March 2010 to March 2012,sixty children with Gartland type Ⅱ and type Ⅲ fresh humeral supracondylar fracture were operated in Xianyang Center Hospital. Six-ty children were randomly divided into two groups:group A by emergency operation 8 hours after injury with closed re-duction method and lateral percutaneous Kirschner wire fixation only,group B initially treated with plast fixation,then undergoing surgery after 3 - 5 days of injury with the closed reduction and percutaneous pin fixation. The operation du-ration,frequency of intraoperative image intensifier,postoperative swelling,pain lasting time after injury and hospitaliza-tion cost were investigated in two groups. Results The average operation duration of group A was(18. 5 ± 12. 3)min, and that in group B was(20. 1 ± 15. 3)min,and there was a statistically significant difference between two groups(P ﹤0. 05). The frequency of intraoperative image intensifier was 6. 2 times on the average in group A,but 7. 3 times in group B,and there was a statistically significant difference between two groups(P ﹤ 0. 05). The postoperative swelling rate on 3,5,7 days after injury in group B was significantly higher than that of group A,and there was a statistically sig-nificant difference(all P ﹤ 0. 05). The duration of pain after injury in group A was(3. 44 ± 1. 23)days,but(5. 26 ± 1. 36)days in group B,which was significantly different;the nerve function recovery time of group A was(36. 5 ± 7. 0) d,and it was(36. 2 ± 7. 0)d in group B,which was not significantly different(P ﹥ 0. 05). The average hospitalization time and cost in group A was less than that in group B,which was significantly different(P ﹤ 0. 05). Finally there was no statistically significant difference in elbow joint function between two groups of children(P ﹥ 0. 05). Conclusions The emergency operation of closed reduction and percutaneous Kirschner wire fixation for the treatment of simple lateral injury in children with Gartland type Ⅱ and type Ⅲ fracture has the advantages over the selective surgery,including shorter operation time,less contact of X - ray intraoperatively,light postoperative swelling,short duration of pain in chil-dren,as well as the shortened hospitalization time,reduced costs,especially good efficacy for joint function recovery.

Objective To study the effect of extracellular signal-regulated kinase1/2 (ERK1/2)inhibitor U0126 on matrix metalloproteinase-9(MMP-9)in brain tissue after subarachnoid hemorrhage(SAH)in rats and to investigate the action mechanisms of ERK1/2 and M M P-9 in blood-brain barrier(BBB)injury and brain edema after SAH.Methods Seventy-two male Sprague-Dawley rats were randomly divided into four groups:SAH model,sham operation,U0126 intervention,and vehicle groups.A SAH model was induced by injection of autologous blood into cisterna magna once.The dry-wet weight method was used to detected brain tissue water content in order to evaluate cerebral edema.BBB permeability was evaluated by the Evans blue extravasation method.The immunohistochemical method was used to detect the expression of MMP-9 and phosphorylated ERK1/2.Results The expression of phosphorylated ERK1/2 and MMP-9 was lower in the sham operation group.The expression of both was up regulated at 24 hours after SAH.The brain water content and Evans blue content also increased.U0126 treatment decreased the phosphorylation of ERK1/2 and the expression of MMP-9,improved the BBB permeability,and alleviated brain edema.Conclusions MMP-9 is involved in the pathophysiological processes of early BBB injury and brain edema aft er SAH.ERK1/2 pathway may play a vital role in the expression of MMP-9.U0126 may protect BBB and reduce brain edema after SAH by inhibiting the phosphorylation of ERK1/2.

BACKGROUND: With the development of neural interventional therapy, the application of covered stents in neural intervention is becoming a topic of general interest.OBJECTIVE: To introduce the structure of stent-graft, and to summary the application of covered stents in clinical treatment of the neural interventional therapy and the shortage of covered stents.RETRIEVAL STRATEGY:The relevant articled were searched for in Pubmed database by researcher of this article with the key words of "stent graft, covered stents, cerebrovascular disease" in English, and with the key words of "covered stent, cerebrovascular disease" in Chinese in VIP database. 223 English and 196 Chinese articles were selected and reviewed primarily. Inclusive criteria: Articles having a close relation with the application of covered stents in neural intervention, especially in cerebrovascular disease, and the latest articles or articles published in authority journals in the same field were chosen. Exclusive criteria: articles with repetitive studies were excluded.LITERATURE EVALUATION: 223 English and 196 Chinese articles were primarily checked by reading titles and abstracts. Among the 31 collected articles, 4 are reviews, 3 are experimental studies and others are clinical studies.DATA SYNTHESIS: Covered stents show special advantages in neural interventional therapy and become a hot spot in present study. There are individual case reports or small group case reports on the application of covered stents in hemorrhagic cerebrovascular disease. It is reported that the covered stent effectively occludes aneurysm, dissecting aneurysm and arteriovenous fistula, keeps patency of the parent artery. The covered stent isolates ulcerated plaque via physical barriers, avoids the abscission of embolus, which can further reduce the development of embolism in percutaneous carotid artery stenting. After releasing covered stents, polytetrafluoroethylene makes the disepiment smooth. Its good biocompatibility reduces thrombosis, and then decreases the incidence of restenosis. Covered stents in vessel for cerebrovascular disease have achieved good effects, but there are some problems in clinic as follows. ①The main shortage of covered stents is to occlude small branch vessels. ②Thrombosis and restenosis occur after covered stenting. ③Covered stents increase the volume of the stent, reduce the compliance and flexibility of the stents, and increase the pushing difficulty and vascular injury. ④Covered stents cannot be used in vessels of less than 4 mm.CONCLUSION: Covered stents for intracranial ischemic and hemorrhagic diseases shows significant outcomes, but there are disadvantages. With the clarification of the related theories and the improvement of new material technology, there will be a brighter future of the application of covered stents for treatment of cerebrovascular diseases.

Objective To investigate the clinical efficacy,indications and complications of transcatheter arterial embolization for the treatment of traumatic hemorrhage of liver.Methods Retrospectively analyzed 33 cases of traumatic hemorrhage of liver admitted to West China Hospital from May 1996 to May 2006.Twenty-four cases underwent hepatic arterial angiography and were diagnosed as hepatic arterial pseudoaneurysms and followed by superselective embolization of the feeding vessel with gelatin sponge and/or spring coils.Results Embolization was succeeded technically in 28 pseudoaneurysms of 24 cases.Rebleeding occurred in 2 cases and a second embolization was performed with one recovered uneventfully.The other died of rebleeding and severe abdominal infection one week after the second embolization.Fever unrelated to embolization occurred in 9 cases.Conclusion Transcatheter arterial embolization is safe,prompt and effective for the treatment of hemorrhage due to hepatic injury.(J Intervent Radiol,2007,16:226-228)

Objective To study the mechanism of high intensity ultrasound (HIU) on COX-2 mRNA expression and apoptosis in breast cancer cell line MDA-MB-231 cells.Methods Human breast cancer cells MDA-MB-231 in vitro were exposed in HIU (50 w/cm2).RT-PCR was performed to detect the level of COX-2 mRNA before and after exposure.The ultrastructural changes in apoptotic cells were examined by transmission electron microscopy.Results The relative level of COX-2 mRNA decreased gradually along with the increase of exposure time and apoptotic bodies in MDA-MB-231 cells considerably increased under electron microscope.When exposure time was increased to 30 seconds,a few cells died.Conclusion HIU promotes apoptosis of breast cancer MDA-MB-231 cells in a COX-2 mRNA depended way.

We report a new approach of embolization in a 15-year-old boy that presented with a massive hemorrhage from a maxillary arteriovenous malformation. Re-bleeding occurred after emergent ligation of the external carotid artery. The bleeding was successfully controlled by embolization via the superficial temporal artery.
Adolescent ; Arteriovenous Malformations/*therapy ; Carotid Artery, External/surgery ; Embolization, Therapeutic/*methods ; Hemorrhage/etiology/therapy ; Humans ; Ligation ; Male ; Maxillary Artery/*abnormalities ; Temporal Arteries

Objective To develop a candidate reference method for the measurement of serum glucose based on isotope dilution liquid chromatography tandem mass spectrometry(ID-LC/MS/MS)Methods An internal standard [~(13)C_6]glucose was added to serum samples and equilibrated with endogenous glucose.Serum proteins were removed by a precipitation with anhydrous ethanol.Serum glucose and the internal standard were then reacted with 1-phenyl-3-methyl-5-pyrazolone and the formed derivatives were analyzed by liquid chromatography tandem mass spectrometry with multiple reaction monitoring(MRM).The method was calibrated with bracketing calibrators and serum glucose concentrations were calculated by comparing the peak area ratios of samples with that of the calibrators.Results The within-run,between-run and total coefficients of variation averaged 0.36%,0.47%and 0.61%,respectively.The analytical recoveries ranged from 99.0% to 100.9%.Results of analyzing the certified reference material SRM 965a showed an average biases of-0.20%.Conclusions An ID-LC/MS/MS method for measuring serum glucose has been developed.The method is highly precise and accurate and may be used as a candidate reference method.

Objective To exlore the influence of internal quality control and external quality control assessment(EQA) resulting from applicability of control samples in measurement of whole blood viscosity (WBV) through the analysis and comparison of applicability of 1 non-Newtonian fluid internal quality control sample in 3 viscometers. Methods Viscometer B, C and D were used to measure WBV of 30 blood samples in parallel under the shear rate(SR) of 1 s-1,30 s~(-1) and 200 s~(-1), then the blood SR-WBV curves of 3 viscometers were drawn according to the results. At the same time, viscometers B, C and D were used respectively to determine the WBV of control A 10 times in one day, then the control A SR-WBV curves were mapped. Three viscometers were used to measure the manufactory control samples and control A 5 times in one day for 4 days. Four groups of daily values of manufactory control samples and control A of each instrument were used to carry out F test to calculate whether 4 daily values are difference. Finally, the control A was dispensed in 49 laboratories nationwide chosen for measurement. On the basis of viscometer used, 20 laboratories were classified as group B, 20 laboratories were classified as group C and 9 laboratories were classified as group D. Then the data under SR of 1 s~(-1) were analyzed to calculate the coefficient of variation (CV) in the group. Results There was significant difference among the WBV of blood samples measured by the viscometers B, C and D. The results under SR of 1 s~(-1) declined in turn, and they were highest under SR of 30 s~(-1) followed by the values of viscometer D and B and they were (8.14±0.75), highest under SR of 30 s-1 followed by the values of viscometer B and D, and they were (7.35±0.07), daily values of manufactory control and control A of each instruments in four groups were compared. Under SR of 1 s~(-1), there was no difference between daily values of manufactory control and control A in viscometer B (F = 2.63, 1.37, P > 0.05), and there was no difference of daily values of manufactory control among viscometer C and D (F = 0.33,3. 14, P > 0.05), but significant daily difference existed when control A was tested by viscometer C and D (F = 5.76, 8.00, P < 0.05). Under SR of 30 s~(-1), there was no difference of daily values of manufactory control among 3 viscometers(F =0.31, 0.18, 2.26, P >0.05), and there was no difference of daily values of control A among 3 viscometers' (F = 1.03, 1.83, 2.40, P > 0.05); Under SR of 200 s~(-1), there was no difference of daily values of manufactory control among 3 viscometers (F =2.59, 0.68, 2.96, P > 0.05), and there was no difference of daily values of control A among 3 viscometers (F=2.31, 3.01, 2.28, P>0.05). When control A was tested under SR of 1 s~(-1) in 49 laboratories nationwide, the WBV values in groups of viscometer B, C and D were (18.47±1.30), (11.17±2.38), viscometer D and C were 63.75% and 21.3%. Conclusions Control A could fully mimic the properties of whole blood steadily on viscometer B, but partially mimic viscometer C and D, so the control A is most appropriate for viscometer B. Because current non-Newtonian fluid internal quality control could mimic rheological properties of whole blood under specifically conditions, laboratories should evaluate the consistent degree between control and whole blood, only the candidates which can mimic the properties of whole blood approximately could be chosen as quality control of WBV. When third-party control is chosen to be samples of EQA, its applicability should be in consideration. Pretest should be performed adequately to define applicability of third-party control, so as to reduce the difference among laboratories due to applicability of control and reflect detection quality of laboratories exactly.

Objective To develop a candidate reference method for the measurement of creatinine in human serum based on isotope dilution liquid chromatography tandem mass spectrometry (ID-LC/MS/MS). Methods An isotopically labeled internal standard [<'2>H<,3>] creatinine was added to the serum sample and equilibrated with the endogenous creatinine. The samples were treated with anhydrous ethanol to remove proteins by precipitation. After being washed with chloroform for further clean-up, the samples were analyzed by LC/MS/MS. Serum creatinine was quantified by a bracketing calibration. Results The within-run, between-run and total coefficients of variation ranged from 0.52% to 0.61%, 0.11% to 0.59% and 0.61% to 0.83%, and the averages were 0.57%, 0.43% and 0.73%, respectively. The analytical recoveries ranged from 99.09% to 101.13% with an average of 100.3%.The results of analyzing the certified reference material SRM 909b (Level Ⅰ and Ⅱ) and SRM 967b showed biases of less than 0.4%. Conclusions An ID-LC/MS/MS method for measuring serum creatinine has been developed. The method is highly precise and accurate and may be used as a candidate reference method for serum creatinine measurements.

Objective To evaluate the matrix effect of processed materials in serum total glycerol measurement and to assess the accuracy of routine test systems.Methods With an isotope dilution liquid chromatography tandem mass spectrometry method as the comparative method，matrix effects of 28 processed materials on 8 routine test systems were evaluated ccording to the NCCLS EP 14 protocol.The processed materials and 20 flesh patient specimens were analyzed with both the comparative method and each of the evaluated methods and results obtained with the two methods were plotted.Two-tailed 95% prediction intervals for the mean of the flesh patient specimen were computed and results on the processed aterials were compared with these intervals for evaluation of matrix effect.Results with the two methods on fresh samples were also compared for assessment of the accuracy of the routine test systems.Results Some of the processed samples showed matrix effects on some of the routine test systems.The observed matrix effects were system-specific and aused either positive or negative biases.Calibration biases were also observed on some test systems.Conclusion Matrix effect and calibration bias have been observed in serum total glycerol measurements.Continued efforts are needed for improving the accuracy of serum total glycerol measurements.