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 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 explore the clinical efficacy of nasal continuous positive airway pressure ventilation and conventional mechanical ventilation in the treatment of neonatal respiratory failure (NICU).Methods 68 cases of neonatal respiratory failure in our hospital from June, 2014 to June, 2016 in neonatal intensive care unit, according to the random number table method were divided into two groups: The observation group involved 34 patients with nasal continuous positive airway pressure, the control group 34 patients with conventional mechanical ventilation treatment.The changes of arterial blood gas analysis, clinical effect and complication were compared between the two groups.Results The PCO2 of the two groups was significantly decreased (P<0.05), and the observation group was higher than the control group (P<0.05).There was no significant difference in PO2 between the two groups (P>0.05).However, pH value was significantly increased, and the observation group was smaller than the control group (P<0.05).The total effective rate was 94.12% in the observation group and 67.65% in the control group (P<0.05).The time of ventilation and incidence of comorbidities in the observation group was significantly shorter than that in the control group (P<0.05).Conclusion Nasal continuous positive airway pressure ventilation for treatment of neonatal respiratory failure can more significantly improve the efficacy than conventional mechanical ventilation, shorten the time on the machine and reduce the relevant complications.So it is worth promoting.

Purpose　The aim is to establish a simple method to extract superoxide dismutase(SOD) from pig blood red cells.Methods　A combined method-microwave heating and adding Cu2+ into the suspension-was used to extract SOD from the red cells. Results　The undesired proteins were denatured by microwave heating and SOD was partly purificated in comparison with hemolysis. The processing time of the former was much shorter than the latter. Conclusion　A novel cell disruption microwave heating, was a rapid and effective technique for the primary extraction of SOD.

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.

Objective To explore the MRI findings of ovarian cancer peritoneal carcinomatosis (PC).Methods MRI findings of 34 cases with advanced ovarian cancer and PC confirmed by operation and pathology were reviewed retrospectively.MRI protocols included T1 WI,T2 WI,MRH,DWIBS,and gadolinium-enhanced 3D THRIVE sequences.The type of ovarian tumor and MRI manifestations of PC were analyzed.Results All of the ovarian tumors and PC lesions were high signal intensity in DWIBS.All of the ovarian tumors were shown as mixed cystic solid masses,including type Ⅱa in 12 cases,type Ⅱb in 7 cases,and type Ⅱc in 1 5 cases.The MR manifestations of PC were described as follow:linear thickening of the peritoneum (n=2),irregular linear thickening of the peritoneum (n=27);smudged thickening of the omentum (n=1 9),cake-like thickening of the omentum (n=1 1);fouling-appearance of the mesentery (n=4);plaque,nodule and mass in the abdominal cavity (n= 34),cystic mass (n=8).PC lesions were detected in the Douglas’space in 31 cases,paravesical interspace in 24 cases,omentum in 20 cases,paracolic gutter in 9 cases, right subdiaphragmatic / parahepatic space in 1 1 cases,and left subdiaphragmatic / parasplenic space in 10 cases.The primary and PC tumors invaded the rectum in 26 cases,sigmoid in 22 cases,and uterus in 1 6 cases.Ascites and lymphadenectasis in abdomen were seen in 33 and 7 cases,respectively.Conclusion Ovarian cancer PC can be diagnosed accurately by combing DWIBS and con-ventional MRI.

Objective Applying color Doppler ultrasonic test on the first dorsal metatarsal arteries,to acquire relevant Doppler bloodstream parameters,and in the end,to explore the clinical value of this approach.Methods Applying GE-LOGIQ-400 color Doppler high-frequency ultrasonic test on the first dorsal metatarsal arteries of 100 diabetes patients,contrasting to those of 60 normal persons,observing the origination,trend,smooth of bloodstream,angioplerosis Status,analyzing bloodstream spectrum(including the interior diameter of blood vessel,spectrum status,bloodstream speed,drag index,erc.),and contrasting the resuits.Results The first dorsal metatarsal arteries of diabetes patients have narrower interior diameter,faster bloodstream speed,higher drag index than those of non-diabetes patients.Conclusion The high-frequency color Doppler ultrasonography can provide objective clinical evidence on the test of the first dorsal metatarsal arteries diseases.

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.

10.3969/j.issn.2095-4344.2013.26.010

Objective To evaluate the role of haeme oxygenase-1 (HO-1) in remote limb ischemic preconditioning (RLIP)-induced attenuation of lung ischemia-reperfusion (I/R) injury in rabbits.Methods Twenty-four Japanese White Rabbits,aged 4-5 months,weighing 2.0-2.5 kg,were randomly divided into 4 groups (n =6 each) using a random number table:sham operation group (S group),I/R group,RLIP group and zinc protoporphyrin (ZnPP,an inhibitor of HO-1) plus RLIP group (ZnPP + RLIP group).Lung I/R was produced by 60 min occlusion of the left lung hilum followed by 180 min of reperfusion in I/R,RLIP and ZnPP + RLIP groups.RLIP and ZnPP + RLIP groups received 3 cycles of 10 min ischemia followed by 10 min reperfusion in the bilateral hind limbs immediately before occlusion of the left lung hilum.In ZnPP + RLIP group,ZnPP 10 μmol/kg was injected intravenously 10 min prior to hind limb ischemia and the rest of the procedures were similar to those previously described in RLIP group.At the end of reperfusion,arterial blood samples were collected for blood gas analysis.The animals were then sacrificed and pulmonary specimens were obtained for microscopic examination of the pathological changes which were scored (lung injury score,LIS) and for determination of wet/dry lung weight ratio (W/D ratio),myleoperoxidase (MPO) activity,malondialdehyde (MDA) content and expression and activity of HO-1 in the lung tissues.Results Compared with group S,PaO2 was significantly decreased,and LIS,W/D ratio,MPO activity,MDA content,and HO-1 expression and activity were increased in I/R group (P ＜ 0.01).Compared with I/R group,PaO2 and HO-1 expression and activity were significantly increased,and LIS,W/D ratio,MPO activity and MDA content were decreased in RLIP group (P ＜ 0.01).Compared with RLIP group,PaO2 and HO-1 expression and activity were significantly decreased,and LIS,W/D ratio,MPO activity and MDA content were increased in ZnPP + RLIP group (P ＜ 0.01).Conclusion RLIP up-regulates HO-1 expression and enhances HO-1 activity,thus reducing lung I/R injury in rabbits.