OBJECTIVE: To explore clinical effect of double plate technique in treating Neer 3 to 4 partial fractures of proximal humerus. METHODS: From May 2018 to December 2020, 38 patients with proximal humeral classified to Neer 3 to 4 partial fractures were treated with double plate technique and long head tendon fixation of biceps brachii, including 23 males and 15 females, aged from 41 to 89 years old with an average of (67.00 ± 9.76) years old;23 patients classified to Neer 3 fracture, 15 classified to Neer 4 fracture;the time from injury to operation ranged from 5 to 12 days with an average of (8.00±2.86) days. Degree of pain was evaluated by numerical rating scale(NRS) on the third day after operation; change of height of humeral head and angle of humeral neck stem were measured and compared between 2 days and 1 year after operation. Neer score was used to evaluate recovery of shoulder joint after operation at 1 year after operation. RESULTS: All 38 patients were followed up for 12 to 19 months with an average of (14.00±1.59) months. NRS score at 3 days after operation was (1.95±0.73) points. Fracture healing time ranged from 2.2 to 3.2 months with an average of(2.60±0.27) months. There were no significant difference in the height of humeral head and angle of humeral neck trunk between two days and 1 year after operation(P>0.05). Four Neer 4 fracture patients occurred absorption of greater tubercle of humerus and partial cystic change of humeral head, but the activity function of shoulder joint was good. Postoperative Neer score at 1 year was 89.50±5.19, and 20 patients got excellent results, 16 good, and 2 moderate. CONCLUSION Double plate technique and long head tendon fixation of biceps brachii were used to treat Neer 3 to 4 fractures of proximal humerus has good clinical effect, and postoperative pain was mild, without special instruments.
Adult ; Aged ; Aged, 80 and over ; Female ; Humans ; Male ; Middle Aged ; Bone Plates ; Fracture Fixation, Internal/methods* ; Humeral Head ; Humerus ; Pain, Postoperative ; Shoulder Fractures/surgery* ; Tendons ; Treatment Outcome ; Humeral Fractures/surgery*

Adult ; Female ; Humans ; Male ; Manipulation, Orthopedic ; methods ; Middle Aged ; Shoulder Dislocation ; therapy ; Shoulder Joint ; injuries ; Treatment Outcome ; Young Adult

OBJECTIVETo study therapeutic effects of internal fixation with Kirschner wires and biodegradable tension band through double small incisions for the treatment of humeral supracondylar fracture in children.

METHODSFrom 2006 to 2010,82 children with humeral supracondylar fractures were treated with internal fixation using crossed Kirschner wires combined with biodegradable tension bands. Among the patients, 53 patients were male and 29 patients were female, ranging from 5 to 12,with an mean of 7 years old. The elbow joint function and Carrying angle were observed before and after treatment. The Flynn criteria was used to evaluate therapeutic effects.

RESULTSAll the patients were followed up, and the duration was six months. The average limitation angle of elbow joint was (2.8 +/- 3.7) degrees,and the Carrying angle was (12.7 +/- 2.2) degrees. According to Flynn clinical evaluation, 80 patients got an excellent result, 2 good.

CONCLUSIONTreatment of child humeral supracondylar fracture with internal fixation using Kirschner wires and biodegradable tension bands through double small incisions is believed to be a good method, which has advantages of minimal trauma, reliable fixation, early exercises and rapid recovery.

Bone Wires ; Child ; Child, Preschool ; Female ; Fracture Fixation, Internal ; methods ; Humans ; Humeral Fractures ; surgery ; Male ; Orthopedic Fixation Devices

[Abstract ] Objective Chronic obstructive pulmonary disease (COPD) is closely related to pulmonary hypertension .This study was to investigate the correlation of the expression of high mobility group protein B 1 ( HMGB1) with its synthesis and secretion of interferon-γ( IFN-γ) in the distal pulmonary arterial smooth muscle cells ( PASMCs ) of COPD rats and its clinical significance . Methods We established COPD models in rats , primarily cultured and identified PASMCs , and detected the synthesis and secretion of cytokine in the PASMCs induced by cigarette smoke extract (CSE) and/or lipopolysaccharide (LPS).The PASMCs in the control, CSE, LPS, and CSE+LPS groups were cultured with anti-HMGB1 antibodies at 0.2 mL 1∶1000.At 12, 24, 48 and 72 hours of inter-vention, the expression of HMGB1 in the PASMCs was detected by Western blot and the concentrations of HMGB 1 and IFN-γin the cell culture supernatant were measured by ELISA , followed by a correlation analysis . Results Light microscopy manifested a peak -valley growth pattern or fusiform shape of the cells , which were identified as PASMCs by α-actin immunohistochemistry and immuno-fluorescence .Western blot and ELISA showed statistically significant differences in the expression of HMGB 1 and concentrations of cell supernatant HMGB1 and IFN-γat 12 hours between any two of the four groups (P<0.05).The HMGB1 expression level was positive-ly correlated with the concentration of IFN-γ(r=0.91), obviously decreased after 12 hours of intervention with anti-HMGB1 antibod-ies as compared with the corresponding experimental groups ( P <0.05).Western blot and ELISA showed no significant differences within the same group at 12, 24, 48 and 72 hours (P>0.05). Conclusion The expression level of HMGB1 was positively correla-ted with the synthesis and secretion of IFN-γin the distal PASMCs of the COPD model rats , and anti-HMGB1 antibodies provide a new in-tervention target for the clinical treatment of COPD and inhibition of its systemic inflammatory response .

OBJECTIVETo investigate the influences of varying lingual traction forces on the space-closing speed in a typodont model.

METHODSForty-two Angle Class I standard typodont models of bimaxillary teeth protrusion were divided into 7 equal groups. Four regions of the model were paired to groups, and in the odd-numbered models, the top left and bottom left regions served as the experimental group and the top right and bottom right regions as the control group; in the even-numbered models, the regions in the model were grouped oppositely. In the experimental group, the space was closed by niti wire extension spring in the buccal ridge combined with lingual elastic traction of 0, 5, 10, 15, 20, 25 and 30 g. In the control group, the space was closed by exclusive niti wire extension spring in the buccal ridge. The space-closing speed were analyzed in all the groups.

RESULTSThe space-closing speed was significantly lower in the control group than in the experimental groups with lingual traction forces of 5, 10, 15, 20 and 25 g (P<0.05), but a traction force of 30 g resulted in a significantly lower speed than that in the control group (P<0.05). The space closing speed was the greatest in the experimental group with a traction force of 15 g (P<0.05).

CONCLUSIONNiti wire extension spring in the buccal ridge combined with lingual elastic traction results in faster space-closing speed than traditional exclusive niti wire extension spring. The speed is the fastest by applying 15 g lingual traction, which is also associated with the lowest slip resistance.

Dental Models ; Dental Stress Analysis ; Tooth Extraction ; methods ; Traction

This study was aimed to investigate the prevalence and genotype distribution of heterozygotes in beta-thalassemia combining deletional alpha-thalassemia by using molecular detection and haematological methods. Three common deletions of alpha-thalassemia were detected by using gap-PCR. The mutations of beta-thalassemia were identified by using PCR with reverse dot blot hybridization. The routine analysis of blood cells was carried out. The results indicated that 15 cases from the 81 beta-thalassemia traits were found to be the compound heterozygosity for beta-thalassemia and alpha-thalassemia with 9 different types of gene defects with 18.52% detection rate. There were 6 cases (7.41%) of beta-thalassemia heterozygote combining alpha-thalassemia-1 gene (--(SEA)/alphaalpha), 8 cases (9.88%) combining with alpha-thalassemia-2 gene including 6 (7.41%) right ward deletion (-alpha(3.7)/alphaalpha) and 2 (2.47%) left ward deletion (-alpha(4.2)/alphaalpha), and 1 case (1.23%) combining deletional HbH gene (--(SEA)/-alpha(3.7)). No significant differences were found between beta-thalassemia heterozygotes combining deletional alpha-thalassemia and pure beta-thalassemia in all RBC parameters. It is concluded that the incidence of beta-thalassemia heterozygotes combining with deletional alpha-thalassemia is frequent in Wuzhou city. The hematological analysis can not give specificity for diagnosing these dual heterozygotes. Gap-PCR as a routine method for thalassemia screening has the advantages in reducing the possibility of failing to detect the combining heterozygosity for beta-thalassemia and alpha-thalassemia. It is more useful for genetic counselling and prenatal diagnosis of this disease.
Adolescent ; Adult ; Female ; Gene Deletion ; Genetic Carrier Screening ; methods ; Genotype ; Heterozygote ; Humans ; Male ; alpha-Thalassemia ; genetics ; beta-Thalassemia ; genetics

Objective To investigate the effect of taking medical students as standardized patients(SSP) on problem based leaming(PBL) teaching in clerkship.Methods Totally 161 students (grade 2008) selected from clinical medical department was divided into PBL group(n=81) and lecture-based learning(LBL) group(n=80).SSP was introduced into PBL teaching and LBL group was taught by LBL.After the clerkship,theory test was conducted in two groups and questionnaire was given to LBL group.Statistical analyses were conducted by SPSS 13.0,measurement data were analyzed by t test and enumeration data were described by frequency and constituent ratio.Results Theory test results showed that the average score of medical record analysis was (37.35 ± 5.95) in PBL group,much higher than (33.25 ± 4.89) in LBL group(P=0.001) ;the total score was (71.20 ± 8.67) in PBL group,much higher than that of (67.79 ± 9.87) in LBL group(P=0.018) as well.The average scores of choice question in 2 groups were (33.85 ± 5.05) and (34.24 ± 6.87),without significant differences(P=0.658).The constituent ratio of answer ‘OK' regarding 10 entries in questionnaire was more than 75％.The constituent ratio of answer ‘OK' regarding 3 entries(SSP matching degree,SSP without implied language or action,stimulating the learning interest) was more than 90％.Conclusions Introducing SSP PBL teaching can improve students' ability of clinical analysis and problem solving but not so effective for the basic theoretical knowledge grasp.SSP could replace standardized patients in PBL teaching.

OBJECTIVEThis study was aimed to investigate the diagnostic value of combined determination of Epstein-Barr virus (EBV) antibodies for nasopharyngeal carcinoma (NPC), including immunoglobulin (Ig) A against EBV capsid antigens (VCA), IgA against early antigens (EA), IgG against BRLF1 transcription activator (Rta) and IgA against EBV nuclear antigen-1 (EBNA1), assessed with receiver operating characteristic (ROC) curve based on logistic regression.

METHODSSerum samples derived from 211 untreated patients with NPC and 203 non-NPC ENT patients were examined for the presence of VCA/IgA and EA/IgA by immunoenzymatic assay, Rta/IgG and EBNA1/IgA by enzyme-linked immnunosorbent assay (ELISA). The different Logistic regression models were established for various combined determinations of antibodies, respectively. Using the predicted probability as the analyzed variable, ROC curve was applied to evaluate the diagnostic accuracy of different combined determinations.

RESULTSThe sensitivity of VCA/IgA (98.1%) and the specificity of EA/IgA (98.5%) were the highest while detecting solely. The results which were analyzed by ROC curve based on Logistic regression showed that the sensitivity and specificity were improved. In two-marker combinations, VCA/IgA + Rta/IgG whose area under ROC curve (AUC) was 0.991 had the highest diagnostic accuracy, and its sensitivity, specificity and Youden index were 94.8%, 98.0% and 0.928 respectively. No significant difference of AUC were found comparing VCA/IgA + Rta/IgG with VCA/IgA + Rta/IgG + EBNA1/IgA and four-marker combination( P > 0.05), of which sensitivity, specificity and Youden index were 94.8%, 98.5%, 0.933 and 96.7%, 97.0%, 0.937, respectively.

CONCLUSIONThe approach of ROC curve based on Logistic regression can improve synthetic efficiency for combined determination of multiple markers. The combined determination of VCA/IgA and Rta/IgG with a complementary effect is optimal for NPC serodiagnosis.

Adult ; Aged ; Aged, 80 and over ; Antibodies, Viral ; blood ; immunology ; Carcinoma ; diagnosis ; immunology ; virology ; Enzyme-Linked Immunosorbent Assay ; methods ; standards ; Female ; Herpesvirus 4, Human ; immunology ; Humans ; Logistic Models ; Male ; Middle Aged ; Nasopharyngeal Neoplasms ; diagnosis ; immunology ; virology ; Viral Proteins ; immunology ; Young Adult

OBJECTIVETo investigate the value of combined detection of Epstein-Barr virus (EBV) VCA/IgA, EA/IgA, Rta/IgG and EBNA1/IgA in serodiagnosis of nasopharyngeal carcinoma (NPC).

METHODSSerum samples obtained from 211 untreated patients with NPC and 203 non-NPC ENT patients were examined for the presence of VCA/IgA and EA/IgA by immunoenzymatic assay and for Rta/IgG and EBNA1/IgA by enzyme-linked immunosorbent assay (ELISA). The receiver operating characteristic (ROC) curve was generated to confirm the cutoff values of different antibodies. The evaluation indexes of combined detection of multiple antibodies used for serodiagnosis of NPC were calculated with compounded positive judgment method.

RESULTSCompared to a single antibody, combined detection achieved a higher sensitivity and specificity. The sensitivity of VCA/IgA + Rta/IgG + EBNA1/IgA (98.1%) was higher than the other 3 combinations with a specificity, accuracy, Youden index and positive predictive value (PPV) of 88.7%, 93.5%, 0.868 and 90.0%, respectively. The combination of EA/IgA+Rta/IgG+EBNA1/IgA had the highest specificity (95.1%), accuracy (94.9%), Youden index (0.899) and PPV (95.2%), with a sensitivity of 94.8%, suggesting its higher accuracy in the serodiagnosis of NPC. Combined detection of the 4 antibodies had the highest sensitivity (98.6%) with a specificity, accuracy, Youden index and PPV of 88.2%, 93.5%, 0.868 and 89.7%, respectively.

CONCLUSIONSCombined detection of Rta/IgG against immediate early antigens, EA/IgA against early antigens, VCA/IgA against late antigens, and EBNA1/IgA against latent antigens provides better understanding of the expression profiles of EBV lytic and latent antigens with excellent complementarity, and may serve as an optimal combination for NPC serodiagnosis.

Adult ; Aged ; Aged, 80 and over ; Antibodies, Viral ; blood ; Antigens, Viral ; immunology ; Capsid Proteins ; immunology ; Carcinoma ; Case-Control Studies ; Female ; Herpesvirus 4, Human ; immunology ; Humans ; Immunoglobulin A ; blood ; Immunoglobulin G ; blood ; Male ; Middle Aged ; Nasopharyngeal Neoplasms ; blood ; diagnosis ; Predictive Value of Tests ; Sensitivity and Specificity ; Serologic Tests ; Young Adult

OBJECTIVEThis study was aimed to investigate the clinical value of Epstein-Barr virus (EBV) Rta/IgG in the diagnosis of nasopharyngeal carcinoma (NPC).

METHODSSerum samples derived from 211 untreated patients with NPC, 413 subjects including 203 non-NPC ENT patients and 210 healthy volunteers as control were examined for the presence of antibodies directed against Rta/IgG by using enzyme-linked immnunosorbent assay (ELISA). Receiver operating characteristic (ROC) curve was applied to perform methodical evaluation of this tumor marker.

RESULTSThe rA value median of Rta/IgG in NPC group was significantly higher than one in control group (P < 0.001). The area under ROC was 0.933. The sensitivity and specificity of this marker were 90.5% and 90.1%, respectively, when the best cutoff value was defined.

CONCLUSIONRta/IgG detected with ELISA method is a new target of EBV, and may be one of important marker for NPC diagnosis.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Antibodies, Viral ; blood ; Carcinoma ; blood ; diagnosis ; immunology ; virology ; Case-Control Studies ; Child ; Diagnostic Tests, Routine ; methods ; Epstein-Barr Virus Infections ; blood ; diagnosis ; immunology ; virology ; Female ; Herpesvirus 4, Human ; immunology ; isolation & purification ; Humans ; Immediate-Early Proteins ; blood ; immunology ; Immunoglobulin G ; blood ; Male ; Middle Aged ; Nasopharyngeal Neoplasms ; blood ; diagnosis ; immunology ; virology ; Trans-Activators ; blood ; immunology ; Young Adult