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 .

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

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

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.

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

This study was purposed to investigate the relationship between HLA-A, B allele polymorphisms and red blood cell parameters of patients with --(SEA/αα) subtype of α(0)-thalassemia in Han ethnic population of Wuzhou city. The HLA genetic polymorphisms were determined by polymerase chain reaction-sequence-based typing (PCR-SBT) in 57 patients with --(SEA/αα) subtype of α(0)-thalassemia of Han ethnic population in Wuzhou city, Guangxi province, China. Mean corpuscular volume (MCV), hemoglobin (Hb), mean corpuscular hemoglobin (MCH) and mean corpuscular hemoglobin concentration (MCHC) were detected by automatic blood analyzer system. HbA2 were detected by electrophoretic method. The statistical analysis was performed by ordinal polytomous logistic regression. The results showed that Hb and HbA2 levels were significantly lower in patients positive for HLA-A*33:03, B*15:01 or B*55:02, and were significantly higher in patients positive for B*15:02 (P < 0.05). It is concluded that several HLA alleles may be associated with Hb level of --(SEA/αα) subtype of α(0)-thalassemia of Han ethnic population in Wuzhou city. This result has the value for understanding phenotype-genotype relationships in thalassemia.
Adolescent ; Adult ; Alleles ; Child ; Child, Preschool ; China ; epidemiology ; Erythrocytes ; cytology ; Ethnic Groups ; genetics ; Female ; Genotype ; HLA-A Antigens ; genetics ; HLA-B Antigens ; genetics ; Hemoglobins, Abnormal ; genetics ; Humans ; Male ; Middle Aged ; Young Adult ; alpha-Thalassemia ; blood ; classification ; epidemiology ; genetics

To build up an identification method on cardiac glycosides in Taxillus chinensis and its Nerium indicum host, and evaluate the influence on medicine quality from host to T. chinensis, ultra-performance liquid chromatography coupled with quadrupole-time-of-flight tandem mass-mass spectrometry(UPLC-Q-TOF-MS/MS)was applied. The samples of T. chinensis(harvested from N. indicum)and its N. indicum host were collected in field. The samples of T. chinensis(harvested from Morus alba)and its M. alba host was taken as control substance. All samples were extracted by ultrasonic extraction in 70% ethanol. Chromatographic separation was performed on an ACQUITY UPLC HSS T3 C_(18)(2.1 mm×100 mm,1.8 μm)column at 40 ℃. Gradient elution was applied, and the mobile phase was consisted of 0.1% formic acid water and acetonitrile. The 0.5 μL of sample solution was injected and the flow rate of the mobile phase was kept at 0.6 mL·min~(-1) in each run. It was done to identify cardiac glycosides and explore the chemical composition correlation in T. chinensis and its N. indicum host by analyzing positive and negative ion mode mass spectrometry data, elemental composition, cardiac glycoside reference substance and searching related literatures. A total of 29 cardiac glycosides were identified, 28 of it belonged to N. indicum host, 5 belonged to T. chinensis(harvested from N. indicum host), none of cardiac glycoside was identified in T. chinensis(harvested from M. alba host). The result could provide a reference in evaluating the influence in T. chinensis medicine quality from host. It was rapid, accurate, and comprehensive to identify cardiac glycosides in T. chinensis and its N. indicum host by UPLC-Q-TOF-MS/MS.
Cardiac Glycosides ; analysis ; Chromatography, High Pressure Liquid ; Drugs, Chinese Herbal ; chemistry ; Loranthaceae ; chemistry ; Nerium ; chemistry ; Phytochemicals ; analysis ; Tandem Mass Spectrometry