OBJECTIVETo investigate the applications of percutaneous screw fixation for the treatment of pelvic fractures and its related surgical considerations.

METHODSFrom June 2010 to June 2012,19 patients with pelvic fractures were treated with percutaneous hollow screws. There were 13 males and 6 females, with an average age of 41 years (ranged from 22 to 58 years). Fractures were caused by traffic accidents in 11 cases, by falling down from high place in 8 cases. Based on the Tile classification, there were 15 cases of Tile C type and 4 case of Tile B type. The indexes such as screw inserting time, intraoperative blood loss, complications, functional recovery and reduction conditions were observed. Fixation methods included sacroiliac screws, cannulated screw fixation of the pubic ramus and cannulated screw fixation of the pubic symphysis separation.

RESULTSAnatomical reduction achieved in 7 cases, satisfactory reduction 11 cases, and unsatisfactory reduction 1 case. Union time of fracture union ranged from 8 to 12 weeks (mean 10 weeks). Wound infection,ununion of fracture and nerve injuries were not found. According to the Majeed standards, 12 patients obtained an excellent results, 6 good and 1 fair.

CONCLUSIONPercutaneous screw fixation for the treatment of pelvic fractures under fluoroscopy has several advantages such as less trauma, less blood loss, fewer rates of complications, reliable fixation and no blood transfusion, which can reconstruct the stability of the pelvic ring, but it needs adequate preoperative preparation and high requirements for the surgeon.

Adult ; Bone Screws ; Female ; Fracture Fixation, Internal ; Fractures, Bone ; diagnostic imaging ; surgery ; Humans ; Male ; Middle Aged ; Pelvic Bones ; diagnostic imaging ; injuries ; surgery ; Radiography ; Young Adult

OBJECTIVETo investigate the clinical outcomes of cannulated screw combined with buttress plate in treating transarticular shear fractures of the distal humerus.

METHODSFrom July 2008 to December 2011, 17 patients with shear fractures of the distal humerus were treated with cannulated screw combined with buttress plate. Among them, included 10 males and 7 females aged from 20 to 59 years old (mean 36.5). All the fractures were classified into type I (8 cases), type II (1 case), type III (3 cases) and type IV (5 cases) according to Bryan-Morrey and McKee classification. According to AO/ASIF classification, 10 cases were type 13B3.1, 7 cases were type 13B3.3; according to Dubberley classification, 5 cases with type 1A, 2 cases with type 1B, 2 cases with type 2A, 2 cases with type 2B, 4 cases with type 3A, 2 cases with type 3B. There were 12 cases with fresh injuries, 4 cases with old injuries. All fractures were closed injuries. Complications and range of motion of elbow were observed, and clinical efficacy were evaluated by Broberg-Morrey standard.

RESULTSAll patients were followed up with a mean time of 21.3 months (ranged, 18 to 24). All fractures obtained bone healing from 10 to 15 weeks with a mean of 12.5 weeks. No malunion or delayed healing occurred. Two cases occurred ossification in lateral collateral ligament attachment. 2 cases occurred heterotopic ossification in the capitellum in front of capsule joint. The range of elbow extension was (16 +/- 7) degrees, flexion was (115 +/- 9) degrees, the average are of pronation and supination was (65 +/- 5) degrees and (60 +/- 5) degrees respectively. According to Broberg-Morrey standard, there were excellent in 7 cases, good in 8 cases, fair in 2 cases, and average score was 92.44 +/- 4.64.

CONCLUSIONFor transarticular shear fractures of the distal humerus, classification should be performed according to preoperative X-ray and CT, cannulated screw and buttress plate combined and early function rehabilitation could recover elbow function.

Adult ; Bone Plates ; Bone Screws ; Female ; Fracture Fixation, Internal ; methods ; Humans ; Humeral Fractures ; physiopathology ; surgery ; Male ; Middle Aged ; Range of Motion, Articular

OBJECTIVETo investigate the therapeutic efficacy of bone-setting manipulative reduction and small splint fixation combined with micro-movement theory exercise for treatment of humeral shaft fractures.

METHODSFrom March 2011 to February 2014, 64 cases of humeral shaft fractures were treated by bone-setting manipulative reduction and small splint fixation including 28 males and 36 females with an average age of 38.1 years old ranging from 22 to 67 years old. According to the classification of AO/OTA, there were 10 cases of type A1, 12 cases of type A2,11 cases of type A3,10 cases of type B1,12 cases of type B2, 7 cases of type B3, 2 cases of type C1, 1 case of type C2, 1 case of type C3. After close reduction early functional exercise performed according to micro-movement theory. All patients had no other parts of the fractures, neurovascular injury, and serious medical problems. Patients were followed up for fracture healing, shoulder and elbow joint function recovery, and curative effect.

RESULTSAll patients were followed up from 10 to 12 months with an average of 10.3 months. Of them, 2 cases had a small amount of callus growth at 3 months after close reduction, so instead of operation; 2 cases appeared radial nerve symptoms after close reduction ,so instead of operation. Other patients were osseous healing, the time was 8 to 12 weeks with an average of 10.2 weeks. After osseous healing, according to Constant-Murley score system ,the average score was (93.5 ± 3.2) points, the result was excellent in 29 cases, good in 29 cases, fair in 6 cases, excellent and good rate was 90.3%; according to the Mayo score system, the average score was (93.7 ± 4.2) points, the result was excellent in 35 cases, good in 23 cases, fair in 6 cases, excellent and good rate was 91.9%.

CONCLUSIONBone-setting manipulative reduction and small splint fixation combined with micromovement theory exercise for treatment of humeral shaft fractures has advantage of positive effect, easy and inexpensive method, the treatment has relevant scientific basis and practical value, it can effectively reduce complications, promote patients early recovery.

Adult ; Aged ; Exercise Therapy ; Female ; Fracture Healing ; Humans ; Humeral Fractures ; physiopathology ; therapy ; Male ; Manipulation, Orthopedic ; methods ; Middle Aged ; Movement ; Splints

Glucoamylase overproducing A. niger T21 was mutated by UV mutagensis. An extracellular acid protease-deficient mutant, A. niger T21-201, which produced only 0.76% extracellular acid protease activity of the parent strain, was screened by casein-degradating plate and determination of protease activity. Moreover, the growth properties and the ability to secrete glucoamylase of A. niger T21-201 are identical to these of starting strain T21. The comparison of expression-secretion levels of heterologous gene in A. niger T21-201 and T21 was carried out with bacterial vhb as reporter, the level of expression-secretion of VHb in A. niger T21-201 was 6-7 times higher than that in T21, but the transcriptional levels of vhb gene in both strains were similar revealed by Northern blot. Therefore, it was demonstrated that the deficiency of acid protease of recipient T21-201 has significant effect on the protection of heterologous protein.
Aspergillus niger ; enzymology ; genetics ; Glucan 1,4-alpha-Glucosidase ; biosynthesis ; genetics ; Mutation ; Recombinant Proteins ; biosynthesis

BACKGROUNDBoth benign prostatic hyperplasia (BPH) and primary hypertension are common in the elderly men. The purpose of this study was to investigate the possible effect of primary hypertension on the hematuria in patients with BPH.

METHODSAll patients who underwent transurethral resection of prostate or opening operation had confirmed diagnoses of BPH histologically. comparative analysis of packet was used to analyze the incidence of hematuria in 423 BPH patients with or without hypertension. Immunostaining of CD34 and vascular endothelial growth factor (VEGF) was carried out in tissues of 50 cases of simple BPH and 50 cases of BPH accompanied with hypertension.

RESULTSThe incidence of hematuria in the BPH with hypertension was significantly higher than that in the simple BPH (P < 0.01). Furthermore, the incidence of hematuria in patients who had hypertension for more than 10 years was clearly higher than that in the patients who had hypertension for less than 10 years (P < 0.01). Both microvessel density (MVD) based on CD34 immunostaining and VEGF expression were significantly higher in the BPH tissues of patients with hypertension than that in the simple BPH (P < 0.01, P < 0.05).

CONCLUSIONSLong-term hypertension may significantly increase the incidence of hematuria in patients with both BPH and hypertension. Increased MVD level and VEGF expression may account for the higher incidence of hematuria in these patients.

Aged ; Aged, 80 and over ; Hematuria ; metabolism ; pathology ; Humans ; Hypertension ; metabolism ; physiopathology ; Immunohistochemistry ; Male ; Microvessels ; pathology ; Middle Aged ; Neovascularization, Pathologic ; metabolism ; pathology ; Prostatic Hyperplasia ; complications ; metabolism ; pathology ; Vascular Endothelial Growth Factor A ; metabolism

Adolescent ; Adult ; Aged ; DNA, Viral ; Female ; Hepatitis B Core Antigens ; genetics ; Hepatitis B virus ; genetics ; Hepatitis B, Chronic ; genetics ; Humans ; Male ; Middle Aged ; Mutation ; Young Adult

OBJECTIVETo investigate the clinical results of arthroscopic surgery for the treatment of stiff elbow.

METHODSFrom October 2010 to December 2012, 27 patients with stiff elbow were treated with arthroscopic debridement and joint capsular releasing. There were 18 males and 9 females, ranging in age from 24 to 54 years old, with an average of 35.7 years old. Analgesia and rehabilitation were necessary after operation. Mayo criteria system was used to evaluate therapeutic effects.

RESULTSAll the patients were followed up, and the duration ranged from 12 to 18 months, with a mean of 13.5 months. The mean maximum flexion angle of patients improved from preoperative (61.5 ± 30.1) degrees to postoperative (102.5 ± 20.1) degrees; and the mean maximum extension angle improved from preoperative (34.8 ± 12.1) degrees to postoperative (16.3 ± 16.1) degrees; the average total range of motion improved from preoperative (34.2 ± 21.0) degrees to postoperative (84.9 ± 9.2) degrees. According to the Mayo criteria system, the average score increased from preoperative 60.5 ± 13.4 to postoperative 88.7 ± 6.3; ten patients got an excellent result, 13 good and 4 fair.

CONCLUSIONArthroscopic surgery to treat elbow stiffness has such advantages as minimal invasion, less blood loss, fast recovery, and clear visualization, which is effective to improve elbow joint functions with less complications.

Adult ; Arthroscopy ; methods ; Elbow Joint ; physiopathology ; surgery ; Female ; Humans ; Joint Diseases ; physiopathology ; surgery ; Male ; Middle Aged ; Treatment Outcome ; Young Adult

OBJECTIVETo determine the relation between the apolipoprotein E(apoE) promoter -427C/T polymorphism and Alzheimer's disease (AD) in a Chinese Han population in Shanghai.

METHODSThe apoE promoter -427C/T polymorphism in 104 AD cases and 110 healthy subjects was detected using polymerase chain reaction method and restriction fragment length polymorphism genotyping technique. The differences in polymorphic distribution between the two groups were tested, and odds ratio was computed.

RESULTSNo differences in apoE -427C/T genotypic distribution were observed between AD cases and controls (P>0.05). Even after stratification according to apoE epsilon 4 stratum, there was not any polymorphic distribution difference when epsilon 4 carriers or non epsilon 4 carriers were compared with controls (P>0.05). The association between AD and apoE epsilon 4 appeared in the TT group(OR=3.94,95%, CI:22067038, chi-square=21.48, P<0.05), but not in CT or CC group.

CONCLUSIONApoE -427C/T polymorphism was not a susceptibility factor for AD in this Han population in Shanghai.

Aged ; Aged, 80 and over ; Alzheimer Disease ; genetics ; Apolipoproteins E ; genetics ; Asian Continental Ancestry Group ; genetics ; China ; ethnology ; Female ; Gene Frequency ; Genotype ; Humans ; Male ; Middle Aged ; Polymorphism, Genetic ; Promoter Regions, Genetic ; genetics

OBJECTIVETo observe the variation and significance of natural killer T (NKT) cells in patients with severe multiple injuries.

METHODSPeripheral blood was drawn from 30 patients with severe multiple injuries and 20 healthy individuals. NKT cells and the subsets of NKT cells were stained and analyzed on fluorescence activated cell sorter (FACS) using Cellquest software. The level of IL-4 and IFN-gamma in blood serum was detected by ELISA.

RESULTSThe proportion of NKT cells was significantly increased. CD4+ NKT cells was increased (t equal to -3.11, P less than 0.01) and CD4+CD8+NKT (double negative NKT, DN NKT) cells decreased in patients with severe multiple injuries compared with healthy controls (t equal to 2.99, P less than 0.01). There was a positive correlation between the proportion of NKT cells and injury severity score (ISS) by Spearman correlation analysis (r equal to 0.70, P less than 0. 01). The level of IFN-gamma was significantly decreased and the level of IL-4 significantly increased in patients with severe multiple injuries.

CONCLUSIONSWe demonstrate that human NKT cells are increased in trauma patients. Most significantly, there is an association between ISS and NKT cells. The increased CD4+NKT cells may contribute to the reduction of Th1 cytokine production and the growth of Th2 cytokine production, leading to the suppression of immunity after injury.

Cytokines ; blood ; Humans ; Multiple Trauma ; immunology ; Natural Killer T-Cells ; immunology ; T-Lymphocyte Subsets ; immunology ; Th1 Cells ; immunology ; Th2 Cells ; immunology ; Trauma Severity Indices

OBJECTIVEThis study was to investigate an operation, in which removing breast cysts of foreign body resulted from augmentation with polyacrylamide hydrogel injection was performed simultaneously with silicone prosthesis implantation under SEPS endoscope in order to relieve tissue injury and increase the accuracy of clearance.

METHODSEight patients were included in this study. Preoperative type B ultrasound examination was performed to mark the mass. Through an axillary approach, the cysts of foreign body that were distributed in the subcutaneous tissue, breast or muscle were separated and ablated under SEPS endoscope. After removal of the foreign body, a silicone implant was located submuscularly for breast augmentation.

RESULTSThe operations were completed without hematoma and infection. Follow-up of the eight patients for 3 to 12 months showed that preoperative symptoms relating to the injected material, such as breast pain, lump and asymmetry, have no longer existed. The shapes of the breasts were satisfactory.

CONCLUSIONSWe believe that endoscope-assisted mammoplasty offers more satisfactory clinical results with less injury, less morbidity, less scars, more accuracy and greater patient acceptance.

Acrylic Resins ; Adult ; Breast Implantation ; methods ; Breast Implants ; Endoscopy ; Female ; Follow-Up Studies ; Foreign Bodies ; Humans ; Mammaplasty ; methods ; Silicone Gels ; Treatment Outcome ; Young Adult