BACKGROUND:Radial head re-dislocation is one of the alarming complications of old Monteggia fracture. Many treatment methods have described the necessary of fracture and annual ligament reconstruction during treatment, but stil unclear.
OBJECTIVE:To emphasize the practicality of annular ligament reconstruction through comparing the children’s treatment in two groups.
METHODS:Twelve patients with children’s old Monteggia fracture were included for retrospective analysis. Al the patients were treated with radial head open reduction and internal fixation. Among them, five cases received ulna extending osteotomy and annual ligament reconstruction, and seven cases received ulna extending
osteotomy without annual ligament reconstruction. The course was 3-18 months from damage to the clinical
manifestations (an average of 9 months). Ten cases with Bado type Ⅰ and two cases were Bado type Ⅱ andⅢ. The reliability of ligament reconstruction was evaluated before and after treatment with Kim standard.
RESULTS AND CONCLUSION:Al the 12 cases were fol owed-up for 22 months (8-26 months). Evaluation
according to the Kim standard after treatment showed excel ent in 10 cases without abnormalities and pain, the range of motion>250 °, and no elbow was limited, the activities of daily living was 25 points;good in two cases with mild deformity and mild or intermittent pain, the range of motion was 200°-250° with elbow limited, activities of daily living was 15 points;no poor (serious deformity, pain, range of motion<200°, elbow severely limited, activities of daily living was 0 points). Fol owed-up lasted for 22 months and found that the average healing time of ulnar
osteotomy was 8 weeks (6-14 weeks). The wounds were healed primarily without infection and nonunion. The
results indicate that ulna extending osteotomy has great significance in keeping stability of radial head, and annular ligament reconstruction is determined by the time of injury, surgical procedures and intraoperative radial head stability.

Objective To investigate the effects of ketamine on Na+ -K+ -ATPase and Ca2+ -ATPase activity Of cerebro cortex and thalamus in rats. Methods Thirty-two SD rats of both sexes weighing 200-300 g were randomly divided into 4 Groups: 1 control group; 2 anesthesia group; 3 recovery group 1 and 4 recovery group II . In control group normal saline 10 ml?kg-1 was administered intraperitoneally (ip) while in the 3 ketamine groups ketamine 100mg?kg-1 was administered ip. The animals were killed by decapitation when righting reflex was lost (group 2) or recovered (group 3) or when the animals were fully awake (group 4). Brain was immediately removed on ice. Bilateral cortex and thalamus were isolated homogenized and centrifuged. Na+ -K+ -ATPase and Ca2+-ATPase activity were assessed by spectrophotometric analysis. Results The Na+-K+-ATPase and Ca2+ -ATPase activity of cerebrocortex decreased by 32.8% and 26.2% and of thalamus decreased by 31.4% and 24.5% respectively in group 2 as compared with those in group 1. The Na+-K+-ATPase and Ca 2+-ATPase activity of the cerebrocortex and thalamus were recovered in group 3 and 4. Conclusions The Na+ -K+ -ATPase and Ca2+ -ATPase may play an important role in the mechanism of ketamine anesthesia.

Objective To evaluate the effects of preoperative continued dual antiplatelet therapy (DAPT) with aspirin and clopidogrel on early outcomes in patients underwent off-pump coronary artery bypass grafting (OPCABG). Methods A single-center study was conducted. The 279 unstable angina patients underwent first-time isolated OPCABG at our institution from January 2015 to May 2016 were divided into DAPT group (preoperative aspirin 100 mg/d and clopidogrel 75 mg/d were given until the time of surgery, n=148) and control group (stopped DAPT for 5 days before surgery, n=131). The total chest-tube output, blood-product transfusion requirements, re-exploration rate for bleeding, major adverse cardiac events (MACE) and other in-hospital outcomes were collected and compared between the two groups. Results There were no significant differences in demographic and preoperative clinical characteristics between the two groups. The total chest-tube drainage volume and perioperative transfusion requirements (rate and volume) including red blood cell, fresh plasma and platelets were statistically higher in the continued DAPT group than those of control group (P < 0.05). There were no significant differences in hemostatic re-exploration rate, length of operation, postoperative nonfatal myocardial infarction, ICU stay, ventilation time and duration of postoperative hospitalization between the two groups. Stroke and other severe outside chest bleeding and all-cause mortality were not observed in both groups during the postoperative period and prior to discharge. Conclusion Preoperative continued DAPT is associated with the increased chest-tube drainage and higher blood-product transfusion requirements but it does not increase the dection rate of thoracotomy because of bleeding. This antiplatelet strategy does not alter other investigated outcomes in primary isolated OPCABG patients. The preoperative DAPT may be able to be safely continued in patients referred for primary isolated OPCABG.

Objective To study the inhibitory effect on proliferation of Hela cells of podophyllotoxin,4'-demethylepi-podophyllotoxin and drug combination of different proportion of nano-sillca (SiO2) and 4'-demethylepi-podophyllotoxin in vitro,and discuss the mechanism.Methods Used ethyl silicate hydrolysis method to prepare 25 nm SiO2 sample,next carried 4'-demethylepi-podophyllotoxin after the surface modification,and measure cell campatibility by MTT method and Hoechst 33342.The inhibitory effect of podophyllotoxin,4'-demethylepi-podophyllotoxin and drug combination on proliferation of Hela cells was measured by MTT assay.Hoechst 33342 staining method was used to detect cell apoptosis.The effect ofdmg combination treatment on cell morphology was observed by inverted microscope.Western blotting technique was used to detected effect of 4'-demethylepi-podophyllotoxin and drug combination on expression of apoptosis related protein.Results Inhibitory effect onproliferation of Hela cells of 4'-demethylepi-podophyllotoxin is superior to podophyllotoxin,inhibitory effect of drug combination is superior to the single 4'-demethylepi-podophyllotoxin,the inhibition of drug combination with 0.125 μg/mL nano SiO2 and 6.25 μg/mL 4'-demethylepi-podophyllotoxin is the most obvious.MTT and Hoechst 33342 experimental results showed that the 25 nm SiO2 have good cell compatibility.Podophyllotoxin,4'-demethylepi-podophyllotoxin and drug combination can induce apoptosis.Western blotting results showed that 4'-demethylepi-podophyllotoxin and drug combination can up-regulate the ratio of Bax/Bcl-2 and the expression level of Caspase-3、P53 and P38.Conclusion In vitro experimental performance of drug combination is superior to single 4'-demethylepi-podophyllotoxin,it is may by effecting the expression of Bcl-2,Bax,Caspase-3,P53,and P38 and others apoptosis related protein to induce Hela cell apoptosis.

AIM: To investigate the effects of simvastatin on myocardial fibrosis and connective tissue growth factor (CTGF) in renovascular hypertensive rats. METHODS: The experimental rats were randomly divided into three groups, such as sham operation group rats, hyperpiesia rats and hyperpiesia rats treated with simvastatin (5 mg㎏kg -1 ?d -1 ). Systolic blood pressure (SBP) was measured and collagen concentration (Coll) was also detected in terms of hydroxyproline concentration. VanGieson and immunohistochemistry staining combined with computed morphometry were used to evaluate the total collagen volume fraction (CVF) and CTGF expression in left ventricular tissue. RESULTS: Compared with sham operation group rats, the SBP,CVF, Coll and CTGF expression increased markedly in hyperpiesia rats (P

Objective To investigate the effect of angiotensin 1-7(Ang 1-7) on renal proximal tubular epithelial cell(HK-2) transdifferentiation induced by high glucose.Methods All the raised HK-2 cells were divided into 5 groups: normal control group,high glucose group,high glucose with Ang1-7 group,high glucose with Ang1-7 and A779 group,high glucose with pioglitazone group.Expression of peroxisome proliferator activated receptor-γ(PPAR-γ) and α-smooth muscle actin(α-SMA) was detected by Western blotting,real-time PCR and immunofluorescence.Results The levels of PPAR-γ protein and mRNA in HK-2 cells were significantly increased after treatment with high glucose and Ang 1-7.Expression of α-SMA protein and mRNA was inhibited remarkably after treatment with high glucose and Ang 1-7.These effects of Ang 1-7 on HK-2 cells could be reversed by Mas receptor antagonist A779.Conclusion Ang 1-7 inhibits high glucose-induced expression of o-SMA in HK-2 cells,which is in part through the Mas.

10.3969/j.issn.2095-4344.2013.26.010

OBJECTIVETo discuss the therapeutic effect of free anterolateral thigh flap for the treatment of burn scar carcinoma.

METHODSFrom Jun. 2005 to Feb. 2013, 10 cases with burn scar carcinoma at craniofacial area and extremities underwent radical excision and transposition of free anterolateral thigh flaps for the leaving wounds.

RESULTSThe flaps in 10 cases survived completely and primarily without any complications. The operation time was 7 hours in average. The patients were followed up for 5 months to 2 years (1 year, in average) without no recurrence and no functional morbidity in donor sites. The cosmetic results were satisfactory in all the cases, even with hair growth in 6 cases.

CONCLUSIONThe free anterolateral thigh flap is suitable for the treatment of burn scar carcinoma.

Adult ; Aged ; Burns ; complications ; Cicatrix ; etiology ; surgery ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Surgical Flaps

To investigate the angiotensin I-converting enzyme (ACE) inhibitory activity of beta-chain hemoglobin fragments, 17 fragments were synthesized by microwave-assisted solid-phase synthesis method. Wang resin or Trt(2-Cl) resin, Fmoc and HBTU-HOBt were used as solid carrier, N-terminal amino acid protecting groups and coupling reagents, respectively. The ACE inhibitory, alpha-glucosidase inhibitory, antibacterial and antitumor activities of the synthesized fragments were assayed. In vitro, Val-Val-Tyr-Pro-Trp-Thr showed high ACE inhibitory activity (IC50 = 7.42 micromol x L(-1)). The results indicate that there are two active sites in Val-Val-Tyr-Pro-Trp-Thr-Gln-Arg-Phe, one consists of Val-Val-, and the other -Gln-Arg-Phe. Peptides showed high ACE inhibitory activity when the N-terminal was hydrophobic amino acid such as Val and C-terminal tripeptide contained Phe, Trp or Arg. Some of the fragments showed low a-glucosidase inhibitory activity. No antibacterial activity or antitumor activity was detected in vitro. The results indicate that these peptides have a potential antihypertensive effect and possible application in the treatment of hypertension.

Objective To investigate the clinical features of infantile diarrhea with intussusception,improve the level of diagnosis and treatment,reduce the misdiagnosis and delayed treatment.Methods The clinical data of 23 cases with infantile intussusception were retrospectively analyzed.Results Twenty-three cases of children with diarrhea symptoms at the beginning of the disease had different degree,12 cases characterized by vomiting,diarrhea,fever and other symptoms of acute gastroenteritis,5 cases stool were mucous pus blood,6 cases for blood in the stool.Five cases were confirmed within 24 h of the diagnosis (3 cases with air enema reduction of intussusception,2 cases with manual reduction),11 cases were confirmed at 24 h to 3 d of the diagnosis and operated,7 cases were confirmed more than 3 d of the diagnosis and operated.Except 1 cases was died from shock,22 cases were cured.Conclusion Infantile intussusception atypical symptoms,illness development is rapid,in critical condition,easy misdiagnosis,missed diagnosis,should actively improve the standard of diagnosis.,early diagnosis,so as not to delay treatment.