OBJECTIVETo study the clinical effect of the Gartland III humerus supracondylar fractures in children by manipulative reduction and Kirschner wire percataneous internal fixation.

METHODSFrom July 2010 and July 2013, 60 patients with Gartland III humerus supracondylar fracture were selected and divided into treatment group and control group. In the treatment group 32 patients were treated with traditional bone setting tetradeca-manipulative reduction and percataneous Kirschner wire internal fixation,included 18 males and 14 females with an average age of (7.8 +/- 2.7) years old ranging from 5 to 11; in the control group 28 patients were treated with open reduction and Kirschner wire internal fixation,included 16 males and 12 females with an average age of (7.2 +/- 3.0) years old ranging from 4 to 12. The motion range of the elbow joint,the time of fracture clinical healing, and the effect after 6 months of Flynm clinical functional assessment standards were observed and compared.

RESULTSThe average fracture healing time of the control group (5.01 +/- 0.43) weeks was longer than that of the treatment group (4.29 +/- 0.29) weeks (t = 7.49, P = 0.00). At 6 months after treatment,the elbow motion range of the treatment group (146.02 +/- 2.28) was more than that of the control group (140.76 +/- 4.42) (t = -5.67, P = 0.00). At 6 months after treatment, according to Flynn evaluation, in the control group,there were 7 cases as excellent, 16 as good, 4 fair, 1 poor; in the treatment group, excellent in 21, good in 9, fair in 2 (U = 3.09, P = 0.002).

CONCLUSIONManipulative reduction and Kirschner wire percataneous internal fixation for treatment of children's Gartland III humerus condyle fractures can shorten fracture clinical healing time and the clinical curative effect is better.

Bone Wires ; Case-Control Studies ; Child ; Child, Preschool ; Combined Modality Therapy ; Female ; Fracture Fixation, Internal ; methods ; Fracture Healing ; Humans ; Humeral Fractures ; physiopathology ; therapy ; Male ; Manipulation, Orthopedic ; methods

The safety of drugs has been the important issue that has caught the mutual attention of clinicians and patients. Kidney is one of the important organs in drug metabolism. The study is based on hospital information system (HIS) data from 20 nationwide general hospitals, indicated by Scr and BUN. Generalized boosted models (GBM) based on propensity score method were used to balance confounding factors. The study contrasts changes on renal function between used Shuxuening injection patients and the unused to explore whether Shuxuening injection affects renal function in clinical. The results showed that Shuxuening injection is likely to affect Scr in logistic regression (P value is 0.035); after the logistic regression based on propensity score method (P value became 0.513, 0.590), no differences were found between the two groups; before and after the logistic regression based on propensity score method (P value was less than 0.05), Shuxuening injection possibly affects BUN. Nevertheless, this study is a retrospective analysis. Logistic regression based on propensity score method can control the known confounding factors very well, while there may be the unknown ones. Therefore, the further exploration is required to monitor whether Shuxuening injection affects really BUN, which will provide clinical guidance for Shuxuening injection safe application.
Drugs, Chinese Herbal ; administration & dosage ; adverse effects ; therapeutic use ; Female ; Hospital Information Systems ; Humans ; Kidney ; drug effects ; metabolism ; Male ; Middle Aged ; Retrospective Studies

Objective To investigate the value of timely duodenal papilla fenestration for reducing the incidence of pancreatitis after endoscopic retrograde cholangiopancreatography (ERCP).Methods The clinical data of 181 patients with difficult biliary cannulatian during ERCP at the Xinhua Hospital of Shanghai Jiaotong University from July 2006 to December 2009 were retrospectively analyzed.Of the 181 patients,98 patients who received traditional incubation were in the control group,and the other 83 patients who received early duodenal papilla fenestration were in the test group.The success rate of selective incubation and incidence of pancreatitis were compared between the 2 groups.All data were analyzed using the t test,chi-square test or Wilcoxon rank sum test.Results The success rate of incubation,incidences of hyperamylasemia and pancreatitis were 85.7％ ( 84/98 ),7.1％ (7/98) and 10.2％ ( 10/98 ) in the control group,and 94.0％ ( 78/83 ),18.1％ ( 15/83 ) and 2.4％ (2/83) in the test group,respectively,and there were significant differences between the 2 groups (x2 =10.12,5.03,4.41,P＜0.05).The numbers of patients with mild,moderate and severe pancreatitis were 3,5 and 2 in the control group,and 1,1,0 in the test group,respectively,and there was a significant difference between the 2 groups ( Z =- 2.11,P ＜ 0.05 ).Conclusion Timely duodenal papilla fenestration is safe and effective in reducing the incidence of pancreatitis for patients with difficult biliary cannulation during ERCP.

Objective To observe the effect of ciclosporin(CsA) treatment on children with refractory nephrotic syndrome(NS).Met-hods Combination treatment of CsA[3-5 mg/(kg?d)] and prednisone were given 55 cases with refractory NS,in which including steroid-dependent NS(SDNS) 3 cases,steroid-resistant NS(SRNS) 22 cases,frequent-relapses NS(FRNS) 30 cases.Concentration of CsA was maintained 100-200 ng/L.Course of treatment was 10 months,the dose was tapered gradually in 4 months.Scr,BUN,Alb,ALT,Ccr,Chol,24 hours urine protein quantitation was measured before and after CsA treatment.Side effect of CsA was observed at the same time.SPSS 13.0 software was used to analyze the data.Results Forty-one cases(74.5%) were complete remission,6 cases(10.9%) were partial remission,total effective rate was 85.5%.Remission rate was 97.6% in simple type NS,50.0% in nephritis type NS,100% in SDNS and FRNS groups,63.6% in SRNS group.In group minimal change disease(MCD),the remission rate was 100.0%,while 60.0% in group mesangial prolife-rative glomerulonephritis(MsPGN),and 42.9% in group focal segmental glomerulosclerosis(FSGS).Fifteen cases(31.9%) relapsed when the dose of CsA was tapering.The adverse effects included hairiness(55 cases),gum hypertrophy(16 cases),hypertension(9 cases),gastroi-ntestinal tract reaction(8 cases),but no obvious nephric adverse effects were observed during the treatment process.Conclusion CsA is safe and effective on refractory NS children,especially to those with SDNS,FRNS and MCD.

Objective To analyze the incidence and related factors of acute radiation pneumonitis (RP) in patients with non-small cell lung cancer (NSCLC) who underwent three-dimensional conformal ra-diotherapy with concurrent chemotherapy. Methods From January 2006 to October 2008, 90 NSCLC pa-tients treated with concurrent chemoradiotherapy were retrospectively reviewed. The clinical characteristics and treatment plan parameters from dose-volume histogram (DVH) were analyzed. Results Grade 1, 2,3, 4 and 5 RP was found in 32.2%, 30.0%, 5.6%, 0% and 1.1% of the patients. Primary tumor loca-tion was the only significant clinical factor in univariate analysis. And significant differences were found when the groups was divided by the mean lung dose (MLD) of 17 Gy, V_(5) of 47% ,V_(10) of 36% ,V_(20) of 24%,V_(30) of 23% and V_(40) of 22%, respectively. Multivariate analysis showed the MLD was the only independent predictive factor of RP. Conclusions Some factors may contribute to the RP. MLD should be set below 17 Gy in three-dimensional conformal radiation, especially when the tumor locates in the lower lobe.

A total of 160 type 2 diabetic patients were divided into microalbuminuria(42 cases)and normoalbuminuria(118 cases)groups.Multivariate analysis demonstrated that the presence of microalbuminuria was independently associated with brachial-ankle pulse wave velocity(baPWV)and intima-media thickness(both P

Objective To study the change of vascular endothelial growth factor(VEGF) in myocardial tissue and serum of myocardial ischemia in rats.Methods Twenty SD rats were randomly divided into normal control group and test group. Test group was ligated coronary artery,and the control group was pulled on line but not ligated,then observed the change of VEGF.The histological and immunohistochemical method were used for observing the change of VEGF serum in myocardial ischemia in rats' heart.VEGF levels were measured by image analysis.Results Compared with control group,the expression of VEGF in the myocardial ischemia group was increased obviously(P

cycles.

Differences in gene expressions were compared by cDNA microarray in skeletal muscle of type 2 diabetic rats and normal rats.In diabetic rats,157 genes were down-regulated and 100 genes up-regulated. Some of these genes were related to insulin resistance,glucose and lipid metabolism.

Objective To demonstrate the diffusion tensor imaging(DTI)characteristics of multiple sclerosis(MS)plaques,periplaque white matter regions and normal appearing white matter (NAWM)regions in patients with MS,and to evaluate the clinical values of DTI and three-dimensional brain fiber tracking for the diagnosis of MS.Methods Conventional MRI and DTI were performed in 32 patients with MS and 32 age-matched control subjects.Fractional anisotropy(FA)and apparent diffusion coefficient(ADC)maps were generated and coregistered with T_2-weighted MR images,FA and ADC values were calculated in regions of interest in plaques,periplaque white matter regions,NAWM regions and white matter regions in control subjects.And three-dimensional brain fiber tracking maps were generated by using the DTI.Results TheADCwas(1.233?0.119)?10~(-3)mm~2/s in MS plaques,(0.973?0.098)?10~(-3) mm~2/s in periplaque white matter regions,(0.748?0.089)?10~(-3)mm~2/s in NAWM,and(0.620? 0.094)?10~(-3)mm~2/s in control subjects.The FA was 0.225?0.052 in MS plaques,0.311?0.050 in perip]aque white matter regions,0.421?0.070 in NAWM,and 0.476?0.069 in control subjects. Significant differences in FA and ADC values were observed among all white matter regions(P