BACKGROUND:Canada Montreal Scholar Mutch et al have recently proposed a new morphologic classification of fracture of greater tuberosity of humerus. They divided these fractures into three typeavulsion, split and depression.
OBJECTIVE:To compare the recovery of shoulder function after conventional plate-screw and hol ow-screw fixation for the repair of the split fracture of greater tuberosity of humerus.
METHODPatients with greater tuberosity of humerus, who were treated in the Department of Orthopedics of Yichang Yiling Hospital, China from January 2010 to January 2014, were classified according to Mutch’s classification. A total of 83 patients with split greater tuberosity of humerus after complete fol ow-up were retrospectively analyzed. Of them, 23 cases received plate-screw fixation as plate-screw group, and 60 cases received hol ow-screw fixation as hol ow-screw group. Visual Analog Scale, the United States Scores of Shoulder and Elbow Surgeons, and Constant and Murley Scoring Systems were utilized to assess the therapeutic outcomes. Patient’s pain and changes in shoulder function were analyzed before and after treatment.
RESULTS AND CONCLUSION:A total of 83 patients were fol owed up. Fixator was obtained at 1 year after surgery in al patients. No significant difference in Visual Analog Scale, the United States Scores of Shoulder and Elbow Surgeons, and Constant and Murley Scoring Systems was detected in both groups before treatment (P>0.05). Significant differences in Visual Analog Scale, the United States Scores of Shoulder and Elbow Surgeons, and Constant and Murley Scoring Systems were detectable in both groups at 16 months after removal of the fixator (P<0.05). Data were better in the hol ow-screw group than in the plate-screw group. Above results suggested that hol ow-screw fixation in the repair of split fracture of greater tuberosite of humerus is simple to be operated, with smal trauma, and is an ideal fixation method. Clinical repair effect is better than plate-screw fixation.

BACKGROUND:A single hemostatic material has been proved not to facilitate wound healing or to produce certain adverse reactions; while composites composed of two or three different materials can improve the
advantage and histocompatibility of hemostatic materials.
OBJECTIVE:To investigate the effect of gelatin sponge impregnated with hemocoagulase solution on amount of bleeding in patients with lumbar fractures undergoing posterior spinal decompression.
METHODS: Fifty patients with lumbar fractures who were scheduled for open reduction, pedicle screw fixation
and laminectomy were enroled, including 25 cases treated with gelatin sponge impregnated with hemocoagulase before surgical incision closure as test group and 25 cases treated with single gelatin sponge before surgical
incision closure as control group. Postoperative drainage volume, drainage time, length of stay, number of re-admissions and postoperative complications were compared between the two groups.
RESULTS AND CONCLUSION:The postoperative drainage volume, drainage time and length of stay in the test group were significantly less than those in the control group (P < 0.000 1). No infection, epidural hematoma, or
re-admission of patients was found, and there was no hemocoagulase-impregnated absorbable gelatin sponge- related adverse reaction. These findings indicate that posterior laminectomy with hemocoagulase-impregnated gelatin sponge can significantly reduce patients’ postoperative wound drainage and shorten the length of stay.

Objective To explore the application of the ultraviolet spectrophotometry method in detecting colchicine poisoning serum to provide the basis for clinical diagnosis and treatment of colchicine poisoning.Methods 0.5 mL of serum was taken and added with the extract solution(chloroform∶methanol=95 ∶5)4.0 mL.The sufficient oscillation extraction and high-speed cen-trifugation were performed.Then the organic layer was taken into another test tube for drying by nitrogen.0.2 mL of methanol dis-solved residue was taken and blended.50 μL of the mixed solution was taken for conducting ultraviolet scanning.Results The max-imum absorption peak of serum colchicine was (351 ±1)nm,the concentration within 5.0-40 μg/mL showed linearity,the regres-sion equation wasY =0.050 2X +0.001 3,the correlation coefficient was 0.999 5,the recovery rate was 83.8% -102.8%,the rel-ative standard deviation:3.3% -4.8%.The intra-day and inter-day were 3.22%-4.74% and 3.45%-4.66%,the lowest detec-tion concentration was 1 .0 μg/mL.Conclusion This method is simple to operate,fast in analysis,accurate in the detection result, which provides a simple and accurate detection method for clinical diagnosis of colchicine poisoning.

Objective To compare the clinical outcomes of pre-emptive renal transplantation and transplantation after dialysis, and to evaluate the safety and advantages of pre-emptive renal transplantation. Methods The data of 50 cases of pre-emptive renal transplantation between January 1999 and January 2003 in our hospital were analyzed.Another 50 cases of renal transplantation after dialysis were selected as control group.The 2 groups were matched in the following variables:age,gender,blood type,cold (warm) ischemic time of the grafts,human leukocyte antigen (HLA),primary diseases, and use of immunosuppressants. The patient/allograft survival,incidence of rejection and delayed graft function were compared. Results The control patients (32/50) were more likely to have received blood transfusion before transplantation than patients of pre-emptive renal transplantation (14/50) (64% vs 28%, P

Objective To analyze the dynamic flow of pediatricians from 2010 to 2015, their present deployment and workload as compared with physicians across the country, in order to provide reference for their effective allocation.Methods Selecting data indexes from Chinese Statistical Yearbook and China Health and Family Planning Yearbook, and using Excel for statistics of relevant index data.By means of horizontal and vertical comparisons, a dynamic analysis was made on such indexes as the number of pediatricians, that of pediatricians per thousand children, and the number of hospital admissions and the number of hospitalizations per pediatrician.Results The total of pediatricians only increased by 2.32% from 2010 to 2015.On the other hand, the number of pediatricians per thousand population only accounted for 23.42% of physicians per thousand population in 2015.These five years witnessed a 40.58% workload increase of outpatient/emergency visits per pediatrician, and 36.70% increase of discharged inpatients.Conclusions China is faced with the challenges of shortage and insufficient supply of pediatricians, worsened by excessive workloads.It is advisable to improve pediatrician development pattern, raise their remuneration, and ease their workload, for the sake of better healthcare for children.

OBJECTIVE:To improve the HPLC-fluorometric method in the determination of telmisartan in human plasma.METHODS:Using naproxen as internal standard,the plasma was extracted with ethyl acetate.The separation was performed on Symmetry C8 with mobile phase consisted of acetonitrile -0.01mol?L-1 potassium dihydrogen phosphate buffer solution(47∶53) at a flow rate of 1.0ml?min-1.The ?Ex was set at 305nm and the ?Em was set at 365nm,and the sample size was 20?L.RESULTS:The linear range of telmisartan was 2.5～200ng?mL-1(r=0.999 8),with the lowest detectable limit at 1ng?mL-1.The average recovery of extraction was (89.91?10.07)%.Both the intra-day RSD and inter-day RSD were less than 10%.The sample showed a good stability within 24 hours after three freeze-thaw cycles and extractions.CONCLUSI-ON:The method is simple,sensitive,accurate and reproducible,and suitable for the determination and pharmacokinetic study of telmisartan in human plasma.

Objective To investigate expression and suppressive function of CD39 + regulatory T cells (Treg) in kidney transplant recipients.Method Thirty recipients of first kidney transplants were treated with tacrolimus,mycophenolate mofetil and prednisone.Within 28 days posttransplantation,there were 14 patients subject to acute rejection (AR group),and the rest 16 patients had no episodes of acute rejections (NR group).Twelve healthy volunteers served as healthy controls (HC group).We collected peripheral blood from the three groups and separated PBMC by density gradient centrifugation,and sorted Tresp,CD39-Treg and CD39+ Treg by flow cytometry.We next analyzed the ratio of CD39 + Treg/CD4+ T cells.ELISA was used to determine the suppressive ability of CD39-Treg and CD39+ Treg on secretion of IFN-γ and IL-17 by Tresp.Results The ratio of CD39 + Treg/CD4 + T cells in AR group was significantly reduced as compared with HC group and NR group (P＜0.05).In HC group and NR group,the secretion of IFN-γ and IL-17 by Tresp was suppressed significantly (P＜0.05) by CD39+ Treg.CD39Treg could suppress secretion of IFN-γ but not IL-17 production by Tresp.CD39+ Treg in AR group AR could suppress the secretion of IFN-γ significantly (P＜0.01),but not to IL-17 production.Conclusion CD39+ Treg have important immunoregulation function.The relative amount of CD39+ Treg was reduced and their regulatory function was impaired in patients with acute rejection.

Objective To explore the association of arachidonic acid (AA) level in gastric cancer (GC) tissue with tumor differentiation and patients' gender.Methods The contents of AA in GC tissue and adjacent matched normal mucosa were measured using gas chromatography/mass spectrometry.The relationships of AA with GC differentiation and patients' gender were analyzed.Results The level of AA significantly decreased in GC tissue (0.190％ ± 0.255 ％) compared with normal tissue (0.274％ ± 0.254％,n =30,P =0.011 ),while the level of AA had no significant difference in the tissues of matched normal mucosa and different TNM stages or among different TNM stages ( all P ＞ 0.05).The AA levels in well and moderately differentiated adenocarcinoma (0.173％ ±0.244％ ) and in poorly differentiated adenocarcinoma (0.195％ ±0.264％) were significantly decreased when compared with those in the paired normal mucosa (0.334％ ± 0.170％,P =0.018; 0.256％ ± 0.275％,P =0.043,respectively),while no significant difference was observed between the different differentiated grades (P =0.895).The level of AA significantly decreased in male patients (0.137％ ± 0.209％ ) as compared with paired normal mucosa (0.275％:± 0.238％,P =0.010),while no positive correlation was observed in female patients as compared with normal group (P=0.477) or in the comparison between male and female groups (P =0.139).Conclusions The AA level remarkably decreases in GC tissue,which may be associated with differentiated grades and patients'gender.In addition,more AA is utilized in male GC patients than female patients.

Objective To summarize the clinical experience of combined liver and kidney transplantation (CLKT). Methods CLKT was performed on 22 patients. The orthotopic liver transplantation (LT) was preceded with the classic fashion in 10 patients and piggyback fashion in 12 patients. The renal allograft was implanted to the iliac fossa routinely. After operation, the patients received an induction therapy with anti-CD25 monoclonal antibody or antithymocyte globulin ( ATG) and a maintenance therapy with tacrolimus (Tac), mycophenolate mofetil and prednisone. Results The CLKT was successfully performed on all 22 patients, and the graft function was restored well postoperation. During the perioperative period, an acute rejection episode of liver occurred in one patient and acute renal allograft rejection episode in 2 patients. The Tac toxicity occurred in one patient. The hemorrhage of digestive tract occurred in one recipient and the hemorrhage of peritoneal cavity in one patient. The pleural effusion occurred in 6 recipients. The pneumonia occurred in 2 cases and the peritoneal infection in one patient During a follow-up period of 6 months to 7 years 11 months, three patients died because of cytomegalovirus pneumonia in 2 patients and acute myocardial infarction in, one patient, The 1-, 3-, 5-year survival rate of recipients was 86,4 %, 81.3 %, 72.7 % respectively. Conclusion The CLKT is an effective method for treatment of patients with end-stage liver djsease and chronic renal failure.

Humans ; Serum ; chemistry ; Spectrophotometry, Ultraviolet ; methods ; Sulpiride ; blood