Objective To evaluate the clinical value of application of supracondylar locked intramedullary nail under arthroscope for supracondylar femoral fractures. Methods Sixteen patients with supracondylar femoral fracture were treated by supracondylar locked intramedullary nail. After mini-incision open reductions were completed, the nails were inserted retrogradely into femoral intercondylar notch under arthroscope. Results Bony union was obtained in all the patients within 3 months. Follow-up for 6～18 months showed ranges of motion (ROM) of their knee joints were 110?or above. Conclusions Application of this nail for supracondylar femoral fracture is characterized by mini-invasion, reliability and rapid recovery. There is no need for traditional open operations on the knee joint, and no need for external fixation.

Objective To introduce a new technique of treating tibial spinal fractures in children under arthroscope, and to assess its clinical outcomes. Methods From February 2001 to July 2003, 6 child patients with tibial spinal fracture were treated arthroscopically. The reduction and fixation were completed under the arthroscope. The wire was linked with the suture outside the joint, and then was pulled into the joint to fix the fracture fragment through the fundus of anterior cruciate ligament (ACL). Results The patients were followed up for 6 to 20 months. All the fractures healed without displacement 4 weeks after operation. 3 months postoperatively, the motion range of the knee returned to normal, and no knee instability was observed. The results of ADT (anterior drawer test) and Lachmanns sign were negative. Conclusion This technique is the first choice in treatment of tibial spinal fracture in children, because it facilitates the diagnosis and treatment of complicated knee problems and provides accurate reduction and reliable fixation. Besides, it is minimally invasive, simple and convenient.

The prevention of myocardial and brain dysfunction induced by positive acceleration (+Gz) exposure is the focus in the field of aerospace medicine research topic .The characteristics and mechanisms that +Gz exposure caused damages to vital organs such as heart and brain remain to be further elucidated .The research literature about +Gz acceleration exposure-induced heart and brain injuries in experimental animals and its mechanisms at home and abroad was reviewed in this paper .

Objective To investigate the treatment effects of different fixation for fracture and dislocation of ankle joint and to sum up the experience for clinical treatment.Methods One hundred and fifty patients with fracture and dislocation of ankle joint using 5 different internal fixation surgeries were involved with this research:simple cross Kirschner wire fixation,intramedullary fixation ordinary screws,cancellous lag screw fixation,4 holes common plate fixation,tension band fixation.Patients were followed up and evaluated by the American Orthopedic Foot and Ankle Society Score for scoring,and investigated the postoperative recovery and the occurrence of postoperative infections and complications in patients.Results After followed up from 12 to 24 months with an average follow-up time of 19 months,of 150 patients,there were 29 cases with excellent result,65 cases with good result,44 cases with general and 12 cases with poor result,the excellent and good rate was 62.6％ (94/150).One case with nonunion,6 cases with malunion,7 cases with traumatic arthritis,10 cases with wound pain,the incidence of postoperative complications was 16.0％ (24/150).There were 10 cases with shallow infection,5 cases with deep infection,and 11 cases with severe skin irritation; The incidence of postoperative infection was 17.3％ (26/150).Conclusion Surgical treatment is the main treatment of fracture and dislocation of ankle joint,5 different methods of internal fixation of ankle fractures had good therapeutic effect.

Objective To study the effect of rhodiola crenulata compound on serum corticosterone and myocardial glucocorticoid receptor ( GR) in rats exposed high sustained +Gz.Methods Seventy-two healthy SD rats were randomly divided into six groups: blank control group, stress control group, +10 Gz stress group and low, medium, high dose drug group, with twelve rats in each.20 mL/kg menstruum was fed to each rat once per day for 14 days.Low, medium and high dose drug group were fed with rhodiola crenulata compound at doses of 0.75 g/kg, 1.5 g/kg and 3.0 g/kg respectively, the other three groups were fed with equal volume saline.Rats were exposed to high +Gz in 15th day.The concentration of corticosterone in the serum of each group rats was detected with ELISA. Western blot was used to detect the expressions of GR in the myocardium of each group rats .Results The content of corticosterone was significantly elevated in +10Gz stress group, while the expression of GR in the myocardium was markedly declined (P <0.01,P <0.05).However, compound preconditioning could decrease concentration of corticosterone in the serum and enhance the expression of GR in the myocardium from rats after +10 Gz exposure. The corticosterone concentration of medium and high dose drug groups was significantly lower and the level of GR expression in the myocardium was significantly higher than that of +10 Gz stress group ( P <0.05 , P <0.01 ) . Conclusion Rhodiola crenulata compound preconditioning could regulate the concentration of corticosterone in the serum and the level of GR expression in the myocardium of the rats exposed +10 Gz, which may be related with its protective effect on high sustained +Gz-induced injury of myocardium.

Objective To explore the factors influencing postoperative function of elbow in adults with C-type fracture of distal humerus.Methods From March 2005 to June 2009,23 patients with C-type fracture of distal humerus were treated with open reduction and internal fixation.The function of the elbow was evaluated with Mayo elbow performance index.Related factors such as age,fracture classification,internal fixation method and initial time of postoperative rehabilitation were analyzed with Logistic regression model.Results The followed up time was 8 -36 (18.3 ± 2.1 ) months,the results demonstrated 6 excellent,8 good,4 fair and 5 poor,the excellent and good rate was 60.9%( 14/23 ).The excellent and good rate in the age ≤40 years old and ＞40 years old were 61.5%(8/13) and 60.0%(6/10)(P＞0.05);in C1,C2,C3 type fractures were 77.8% (7/9),62.5% (5/8),50.0% (3/6) respectively (P ＜ 0.05 );in plate patients and in Kirschner patients were 75.0% (9/12) and 54.5% (6/11)(P ＜ 0.05);in postoperative functional exercise ≤3 weeks and ＞ 3 weeks were 71.4%(10/14) and 55.6%(5/9 )(P＜ 0.05 ).Conclusions The fracture classification,internal fixation method and the initial time of postoperative rehabitation affect the functional restoration of distal fracture of humerus,and proper stable fixation with early suitable exercises according to the fracture classification will help improve the functional restoration.

Objectives: To observe the roles of nuclear factor ?B(NF ?B) in corticosterone injured hippocampal neurons. Methods:Two groups of primary hippocampal neurons were cultured for 8～10 days. One group was treated with 1?10 -5 mol/L corticosterone. The total cellular nuclear protein levels were extracted at 0.5,1,2 and 4 hours, respectively. Electrophoresis mobility shift assay (EMSA) was used to detect the expression of NF ?B activation. Another group was treated with ?B decoy DNA(25 ?mol/L) to inhibit the activity of NF ?B for 2 hours before 1?10 -5 mol/L corticosterone was intervened. MTT was used to observe the effects of corticosterone induced neurons injury after 6,12,24 and 48 hours. Results:The activity of NF ?B became significantly lower than that in the control group after corticosterone acted on neurons for 1 hour. As time went on, its effects became more conspicuously. The injury of hippocampal neurons aggravated when the activity of NF ?B was inhibited by ?B decoy DNA. Conclusions: NF ?B plays a protective role in corticosterone induced hippocampal neuron injury.

Objective:To explore the optimal pulse oxygen saturation (SpO 2) range during hospitalization for patients with sepsis. Methods:A case-control study design was employed. Demographic information, vital signs, comorbidities, laboratory parameters, critical illness scores, clinical treatment information, and clinical outcomes of sepsis patients were extracted from the Medical Information Mart for Intensive Care-Ⅳ (MIMIC-Ⅳ). A generalized additive model (GAM) combined with a Loess smoothing function was employed to analyze and visualize the nonlinear relationship between SpO 2 levels during hospitalization and in-hospital all-cause mortality. The optimal range of SpO 2 was determined, and Logistic regression model along with Kaplan-Meier curve were utilized to validate the association between the determined range of SpO 2 and in-hospital all-cause mortality. Results:A total of 5?937 patients met the inclusion criteria, among whom 1?191 (20.1%) died during hospitalization. GAM analysis revealed a nonlinear and U-shaped relationship between SpO 2 levels and in-hospital all-cause mortality among sepsis patients during hospitalization. Multivariable Logistic regression analysis further confirmed that patients with SpO 2 levels between 0.96 and 0.98 during hospitalization had a decreased mortality compared to those with SpO 2 < 0.96 [hypoxia group; odds ratio ( OR) = 2.659, 95% confidence interval (95% CI) was 2.190-3.229, P < 0.001] and SpO 2 > 0.98 (hyperoxia group; OR = 1.594, 95% CI was 1.337-1.900, P < 0.001). Kaplan-Meier survival curve showed that patients with SpO 2 between 0.96 and 0.98 during hospitalization had a higher probability of survival than those patient with SpO 2 < 0.96 and SpO 2 > 0.98 (Log-Rank test: χ2 = 113.400, P < 0.001). Sensitivity analyses demonstrated that, with the exception of subgroups with smaller sample sizes, across the strata of age, gender, body mass index (BMI), admission type, race, heart rate, systolic blood pressure, diastolic blood pressure, mean arterial pressure, respiratory rate, body temperature, myocardial infarction, congestive heart failure, cerebrovascular disease, chronic liver disease, diabetes mellitus, sequential organ failure assessment (SOFA), simplified acute physiology score Ⅱ (SAPSⅡ), systemic inflammatory response syndrome score (SIRS), and Glasgow coma score (GCS), the mortality of patients with SpO 2 between 0.96 and 0.98 was significantly lower than those of patients with SpO 2 < 0.96 and SpO 2 > 0.98. Conclusions:During hospitalization, the level of SpO 2 among sepsis patients exhibits a U-shaped relationship with in-hospital all-cause mortality, indicating that heightened and diminished oxygen levels are both associated with increased mortality risk. The optimal SpO 2 range is determined to be between 0.96 and 0.98.