Objective To observe the expression levels of IL-8,IL-4,TNF-α of neonatal mouse with systemic inflammatory response syndrome(SIRS) treated by different doses of dexamethasone.Methods A total of 50 neonatal mice were randomly divided into five groups:blank control group,saline control group and treatment group A,B,C.The saline control group and treatment groups were established into SIRS models,treatment group A:a single high-dose of dexamethasone (2 mg/kg),subcutaneous injection (SC) ; treatment group B:two doses of dexamethasone (1 mg/kg,q1 2 h,total 2 mg/kg,SC) ; treatment group C:four doses of dexamethasone (0.5 mg/kg,q 1 2 h,total 2 mg/kg,SC) ;saline control group:saline of the same volume (0.4 ml/kg,SC).All mice were detected IL-4,IL-8,TNF-α by ELISA 72 hours after animal models being completed.Results The levels of IL-4,IL-8,TNF-α in saline control group and treatment group A,B,C were higher than those in blank control group respectively (P ＜ 0.05,respectively).The levels of IL-4,IL-8,TNF-α in treatment group A,B,C were lower compared to those of saline control group respectively (P ＜ 0.05,respectively),levels of TNF-α,IL-8 in treatment group B and C were lower than those of treatment group A(P ＜ 0.05,respectively).There were no significant differences in the level of IL-4 among treatment group A,B,and C (P ＞ 0.05).Conclusion Dexamethasone could lower the expressions of pro-inflammatory cytokines IL-8,TNF-α and anti-inflammatory factor IL-8 of neonatal mouse with SIRS,and the effect of multiple low-doses of dexamethasone on SIRS is significantly better than a single high dose.

Objective:To summarize and analyze the clinical characteristics of different treatment in children with esophageal foreign bodies.Methods:This study collected 246 children with esophageal foreign bodies in our hospital from January 2016 to January 2020, which was divided into endoscopic group and operative group.The general and clinical data of children treated with different treatment were collected and statistical analyzed.Results:There were 222 children in endoscopic group and 24 children in operative group, respectively.The rate of surgery was 9.75%.There were no significant differences in gender and location of esophageal foreign bodies.However, the average age of operative group was(2.92±2.67) years, which significantly younger than that in endoscopic group(4.12±3.37)years( P=0.049). The residence time in operative group(median 29.10 h)was remarkable longer than that in operative group(median 11.80 h)( P<0.001). The proportion of sharpness(50.00%) and corrosive(45.83%) foreign bodies in operative group were more than those in endoscopic group[16.22% and 8.11%( P<0.001)]. Moreover, the occurrence rate of major complication in operative group was 83.33%, which was dramatically higher than that in endoscopic group(0.90%)( P<0.001). Conclusion:The younger and longer residence time of esophageal foreign bodies in children contribute to the rate of operative treatment.Additionally, the sharpness and corrosive foreign bodies increase the risk of surgery and serious complications.

Objective:The application of computer-rapid prototyping-assisted simulated hollow screw in the treatment of femoral neck fractures in fresh cadavers verified the reliability and accuracy of computer-rapid prototyping-assisted simulated hollow screw in the treatment of femoral neck fractures.Methods:The glass ion was labeled as a target for the treatment of femoral neck fracture with a cannulated screw. Three Kirschner pins were placed at the top and bottom of the greater trochanter. CT scan of the processed specimens. The scan data was imported into Mimics software, and the upper end of the femur was reconstructed three-dimensionally and the target of the femoral neck fracture was fixed with cannulated screws. The position of the cannulated screw in the femoral neck was designed. In Pro/E software, draw a guide that fits the three positioning Kirschner pins and cannulated screw guide needles on the upper end of the femur, and use rapid prototyping technology to make the guide. The navigation template was mounted on the positioning pin through the cannulated screw guiding hole, and the hollow screw guiding needle was drilled, and the hollow screw was inserted for the treatment of the femoral neck fracture to complete the positioning and guiding. According to the coordinates of the hollow screw guide needle and the target center in the Mimics software three-dimensional reconstruction coordinate system, the spatial distance calculation formula is used to calculate the distance between the hollow screw guide needle and the target center.Results:The coordinate analysis of the end point of the cannulated screw guide needle and the target can be obtained that the average distance between the end point of the cannulated screw guide needle for fixed femoral neck fracture and the target center point was 1.92 mm.Conclusion:The computer-rapid molding-assisted cannulated screw fixation of the femoral neck fracture is reliable and accurate, which provides a new idea and method for clinical individualization and precise fixation of the femoral neck fracture.

Objective: To compare the therapeutic effects between the anesthetic and non-anesthetic closed reduction protocols for distal radius fractures based on the concept of Enhanced Recovery After Surgery (ERAS). Methods: A prospective study was conducted in a cohort of 186 patients with distal radius fracture who had been admitted to the Department of Orthopaedic Trauma, Beijing Jishuitan Hospital from September 2018 to January 2019. The patients were divided into 2 groups depending on the choice by themselves. Of them, 72 (intervention group) underwent the standardized closed reduction under brachial block anesthesia based on the concept of ERAS while the other 114 (control group) conventional closed reduction under no anesthesia. The 2 groups were compared in terms of emergency reduction times, swelling scores, reoperation rate, splint removal time, functional outcomes by the Patient-Rated Wrist Evaluation (PRWE) and radiographic outcomes by the Lidström criteria. Results: The patients in both groups were followed up for 6 months. The reduction times were fewer in the intervention group than in the control group (1.1±0.1 versus 1.6±0.1, P<0.05). The reoperation rate was significautly lower in the intervention group than in the control group [2.8%(2/72) versus 12.3%(14/114), P< 0.05]. Reduction deteriorated the swelling condition. Compared with the control group, the swelling was significantly less in the intervention group (2.0±0.1 versus 2.6±0.1, P<0.05). The splint removal time for the intervention group (5.3±0.2 weeks) was significantly shorter than that for the control group (6.9±0.2 weeks) (P<0.05). The intervention group had significantly better PWRE scores than the control group (23.4±1.0 versus 30.3±1.1, P<0.05), but there was no significant difference between groups in the Lidström evaluation (P>0.05). Conclusion Compared with conventional closed reduction, the closed reduction under anesthesia based on the ERAS concept is an effective method for the emergency treatment of distal radius fracture, because it may minimize the patients’ pain experience, increase the rate of successful reduction, decrease the rate of reoperation, shorten the splint fixation time and gain better functional outcomes.