OBJECTIVERadial corrective osteotomy is an established but challenging treatment for distal radial malunion. There is an ongoing discussion about whether an opening or closing-wedge osteotomy between should employed. The purpose of the present study was to retrospectively compare the clinical and radio graphic results between conventional opening-wedge osteotomy and closing-wedge technique.

METHODSFrom January 2004 and December 2012,42 patients with extra-articular distal radial malunion were managed with corrective osteotomy and were followed for a minimum of one year. Twenty-two patients (5 males and 17 females, ranging in age from 25 to 75 years old) were managed with radial opening-wedge osteotomy and implanting of interpositional bone graft or bone-graft substitute, and twenty patients (4 males and 16 females, ranging in age from 19 to 79 years) were managed with simultaneous radial closing-wedge and ulnar shortening osteotomy without bone graft. The selection of the surgical procedure was determined by the surgeon. Each patient was evaluated on the basis of objective radio graphic measurements, and functional outcomes were determined on the basis of clinical examinations, including range of wrist motion, grip strength, pain-rating score, Mayo wrist score, and Disabilities of the Arm, Shoulder and Hand (DASH) score.

RESULTSThe mean duration of follow-up was 36 months (ranged, 12 to 101 months) for the opening-wedge cohort and 28 months (ranged, 12 to 87 months) for the closing-wedge cohort. The two techniques were comparable in terms of complications. Post-operative volar tilt and ulnar variance were improved significantly in each cohort. The ulnar variance was more frequently restored to within defined criteria (22.5 to 0.5 mm) in the closing-wedge cohort than that in the opening-wedge cohort. The post-operative mean extension-flexion are of the wrist and Mayo wrist score were significantly better in the closing-wedge cohort. Differences in the pronation-supination arc, grip strength, pain-rating score, and DASH scores between these two cohorts were not significant.

CONCLUSIONThe closing wedge osteotomy technique is an effective reconstructive procedure for the treatment of extra-articular distal radial malunion. It is significantly better than the opening-wedge osteotomy technique in terms of the restoration of ulnar variance, the extension-flexion arc of wrist motion, and the Mayo wrist score.

Adult ; Aged ; Bone Nails ; Case-Control Studies ; Female ; Fracture Fixation, Internal ; Humans ; Male ; Middle Aged ; Osteotomy ; Radius Fractures ; surgery ; Range of Motion, Articular ; Retrospective Studies ; Wrist Joint ; surgery ; Young Adult

Objective To study the effects of four cytotoxicity evaluation methods on the inhibition rate of shikonin (SK) in vitro, and to compare the pseudo-negative phenomenon often found in the evaluation of cytotoxic activity of natural pigments represented by naphthoquinones in Lithospermum erythrorhizon. Methods SK was co-cultured with its high-sensitive strain HL-60 cells and low-sensitivity strain A549 cells, trypan blue method, sulforhodamine B (SRB) method, Cell Counting Kit-8 (CCK-8) and MTT cytotoxicity test were used for parallel experiments to determine the dose-effect relationship curve of SK (0.4-128 μmol/L) inhibiting the growth of cells. Results The half-inhibitory concentration (IC50) of shikonin on HL-60 cells was determined by trypan blue method, SRB method, CCK-8 method, and MTT method, which was 0.57, 0.77, 1.36, and 1.01 μmol/L, respectively. For A549 cells, the IC50 was 6.30, 10.38, 13.48, and 15.24 μmol/L, respectively. When the concentration of shikonin was below 3.2 μmol/L and 32 μmol/L, the inhibition rate of the two kinds of cells increased linearly by the four methods, followed by differences. Among them, the results of the trypan blue method and the SRB method are in good agreement, while the MTT method and the CCK-8 method have lower inhibition rates. At 12.8 μmol/L, the inhibitory rate of SK on HL-60 cell measured by CCK-8 was 81%, while the inhibitory rate measured by trypan blue method was 96%, and at 128 μmol/L the inhibitory rate of SK on A549 cells measured by MTT method was 89%, however, the inhibitory rate measured by trypan blue method was 99%. The absorption spectrum of SK overlapped with formazan at the wavelength from 400 to 600 nm, with the maximum overlap peak from 550 to 570 nm, and CCK-8 reagent had a synergistic inhibitory effect on HL-60 with SK. The results of trypan blue method showed that SK at the highest dose almost completely killed cells in the plate wells, which was significantly different from the control group, but both MTT method and CCK-8 method resulted in a pseudo-negative phenomenon. Conclusion Therefore, cytotoxicity test of natural pigments represented by naphthoquinones in L. erythrorhizon, MTT method, and CCK-8 method are not recommended, while SRB method and trypan blue method are suggested.

AIM To study the effects of Danggui Buxue Decoction total glycosides combined with Hirudo in the treatment of pulmonary fibrosis in rats and its mechanism.METHODS One hundred and twenty male SD rats were selected,eighteen of which were taken as normal group (normal saline),the remaining 102 rats were used to establish model for pulmonary fibrosis.Seventy-two modeled rats were randomly divided into model group (normal saline),Danggui Buxue Decoction total glycosides group (13 mg/kg),Hirudo group (Hirudo powder,4 g/kg) and combination group (Danggui Buxue Decoction total glycosides,13 mg/kg;Hirudo powder,4 g/kg),eighteen rats in each group with intragastric administration.RESULTS On the 7th,14th and 28th days after modeling,alveolar inflammatory score,pulmonary fibrosis degree score,TGF-β1 and PAI-1 expression levels in lung tissue,IL-4 and IL-17 expression levels in alveolar lavage fluid,hydroxyproline (HYP) content in lung tissue in the model group were significantly higher than those in the normal group (P ＜ 0.05).Alveolar inflammatory score,pulmonary fibrosis degree score,TGF-β1,PAI-1,IL-4,IL-17 expression levels and HYP content in the Danggui Buxue Decoction total glycosides group,Hirudo group and combination group were significantly lower than those in the model group (P ＜ 0.05).In the combination group,alveolar inflammatory score,pulmonary fibrosis degree score,TGF-β1,PAI-1,IL-4,IL-17 expression levels and HYP content were significantly lower than those in the Danggui Buxue Decoction total glycosides group and Hirudo group (P ＜ 0.05).CONCLUSION Danggui Buxue Decoction total glycosides combined with Hirudo have good therapeutic effects on pulmonary fibrosis in rats mainly by reducing TGF-β1,PAI-1 expression levels and HYP coment in lung tissue.

Aim To improve the rate of melanoma metastasis animal model and provide a reliable experimental modeling meth-od for the study of melanoma metastasis mechanism. Methods Five immunosuppressants were selected and then their targets were screened by network pharmacology. Intraperitoneal injection of immunosuppressants and intravenous injection of B16F10 cells were performed on C57BL/6 mice, then the mice were observed, and body weight were recorded daily. The contents of TNF-α, IL-6, IL-10, VEGF and MMP-9 in serum were measured with ELISA kit. The mice were dissected, then the metastasis situa-tion and the number of metastatic nodules in the lung and other organs were evaluated. HE-staining was involved to determine the morphology of metastatic tissues. Results The closeness centrality of cyclosporine and dexamethasone ranked the top and the targets were concentrated in lung and liver. No significant difference in body weight were observed after animal madel in-duced. The contents of TNF-α, IL-6 IL-10, VEGF and MMP-9 in the model group increased. The number of metastatic nodules in the lung significantly augmented with some kind of liver metas-tasis. HE-staining in the lung tissues showed that tumor presen-ted invasive growth. Conclusion By intraperitoneal injection of dexamethasone, the success rate of mice melanoma metastasis model can be greatly increased.

OBJECTIVETo report the operative technique and clinical application of the neurocutaneous flap with anterior cutaneous branch of the femoral nerve supplied by the perforator of saphenous artery.

METHODSThe reverse neurocutaneous flap with anterior cutaneous branch of the femoral nerve supplied by the perforator of saphenous artery was used for repairing the defect around knee or at the upper pad of leg. Since Oct. 2005, 16 cases were treated. The flap size ranged from 15 cm x 7 cm to 30 cm x 15 cm. Flap rotation angle ranged from l00 degrees to 180 degrees.

RESULTS13 flaps survived completely. Flap necrosis happened at the 1/7 - 1/5 distal end of the 3 flaps, which healed with dressing or local flap advancement. The patients were followed up for 6 to 24 months with satisfactory functional and cosmetic results. There was no morbidity at the donor site.

CONCLUSIONThe flap has the advantages of both the perforator flap and the neurocutaneous flap. The size of the neurocutaneous flap with the anterior cutaneous branch of the femoral nerve can be enlarged for the large defect at lower extremity.

Adolescent ; Adult ; Arteries ; surgery ; Female ; Femoral Nerve ; surgery ; Humans ; Male ; Middle Aged ; Skin Transplantation ; methods ; Surgical Flaps ; blood supply ; innervation ; Young Adult

Ten compounds were isolated from the barks of Jasminum giraldii by means of various of chromatographic techniques such as silica gel, Sephadex LH-20 and Rp-HPLC. Their structures were identified by spectroscopic data analysis as (+)-medioresinol (1), (+) -syringaresinol (2), syringaresinol-4'-O-beta-D-glucopyranoside (3), oleanic acid (4), 3-methoxy-4-hydroxy-trans-cinnamaldehyde (5), trans-sinapaldehyde (6), syringaldehyde (7), 1-(4-methoxy -phenyl) -ethanol (8), trans-cinnamic acid (9), and 4-(1-methoxyethyl) -phenol (10). Among them, compounds 1-3, 5-8 and 10 were isolated from the J. genus for the first time and compounds 4 and 9 were obtained from J. giraldii for the first time. In the DPPH free radical scavenging assay, compound 1 exhibited significant activity (IC50 55.1 micromol x L(-1)), compared with vitamin C(IC50 59.9 micromol x L(-1)); and compound 2 showed moderate activity (IC50 79.0 micromol x L(-1)), compared with 2, 6-di-tert-butyl4-methylphenol (IC50 236 micromol x L(-1)).
Antioxidants ; chemistry ; isolation & purification ; Drugs, Chinese Herbal ; chemistry ; isolation & purification ; Jasminum ; chemistry ; Magnetic Resonance Spectroscopy ; Molecular Structure ; Spectrometry, Mass, Electrospray Ionization

Ten compounds were isolated from the leaf of Eucommia ulmoides by means of recrystallization and chromatographic techniques such as D-101 macroporous resin, MCI resin, ODS gel, Sephadex LH-20 and Rp-HPLC. Their structures were identified by NMR spectral analyses as kaempferide 3-O-beta-D-glucoside (1), quercetin-3-O-beta-D-glucoside (2), quercetin (3), quercetin-3-O-beta-D-xylosyl-(1-->2)-beta-D-galactoside (4), kaempferol-3-O-alpha-L-rhamnosyl-(1-->6)-beta-D-glucoside (5), (2S,3S)-taxifolin 3-O-beta-D-glucoside (6) ,4-hydroxy cinnamic acid (7), (+)-cycloolivil (8), pinoresinol beta-D-glucoside (9), squalene (10). Among them compounds 1,5-7,10 were isolated from the Eucommia genus for the first time. In the DPPH free radical scavenging assay, compound 2 exhibited significant activity (IC50 13.7 micromol x L(-1)), compared with vitamin C (IC50 59.9 micromol x L(-1)); compounds 1, 3 and 9 showed moderate activity (IC50 161,137, 214 micromol x L(-1)), compared with 2,6-di-tert-butyl-4-methylphenol (IC50 236 micromol x L(-1)); compound 4 and 6 showed weak activity (IC50 264, 299 micromol x L(-1)).
Antioxidants ; chemistry ; Chromatography, High Pressure Liquid ; Drugs, Chinese Herbal ; chemistry ; Eucommiaceae ; chemistry ; Magnetic Resonance Spectroscopy ; Molecular Structure ; Plant Leaves ; chemistry

Objective To summarize the prevalence of diseases and main causes of death in elderly patients aged 80 and over,and to provide epidemiological evidence for preventive care of geriatric diseases.Methods A total of 922 autopsy cases aged from 60 to 106 at our hospital from April 1,1969 to October 31,2013 were analyzed.The disease spectrum and the main causes of death in cases aged 80 and over were compared with those in cases aged from 60 to 79.Results The top fifteen pathological diagnoscs in elderly patients aged 80 and over were chronic pyelonephritis(62.2 ％,290 cases),coronary heart disease(59.2％,276 cases),bronchopneumonia(52.6％,245 cases),prostatic hyperplasia (58.1％,232/399),pleural effusion (47.9％,223 cases),malignant tumor (47.4 ％,221 cases),chronic bronchitis(43.1 ％,201 cases),pulmonary congestion or edema(42.1 ％,196 cases),pericardial effusion (41.8 ％,195 cases),old myocardial infarction (40.1 ％,187 cases),emphysema (36.3％,169 cases),chronic cystitis (22.7％,106 cases),gallstones or cholecystitis (14.2％,66 cases),acute myocardial infarction (13.7％,64 cases),and gastrointestinal bleeding (12.4 ％,58 cases).The leading causes of death were malignant tumor (47.4 ％,221 cases),infectious disease(26.6％,124 cases)with pneumonia as the most prevalent type(24.0％,112 cases),and cardiovascular disease (myocardial infraction and heart failure) (24.7％,115 cases).Conclusions The most prevalent diseases in patients aged 80 and over are chronic pyelonephritis,coronary heart disease,bronchopneumonia,and malignant tumor.The top three causes of death in the aged are malignant tumor,cardiovascular disease.and pneumonia.Enhanced screening and management of the above diseases for inpatients aged 80 and over are recommended.

OBJECTIVETo define the pathological changes of coronary artery and compare the clinical diagnosis and pathological diagnosis differences in elderly patients aged 80 and over.

METHODSA total of 909 autopsy cases aged 60-100 years in our hospital from April 1st 1969 to October 31th 2013 were analyzed. The prevalence and pathological features of coronary artery disease (CAD) in cases aged 80 years and over were compared with those aged 60-79 years old. The misdiagnosis and missed diagnosis rate were calculated.

RESULTSThe prevalence of CAD by autopsy (63.8% (289/453) vs. 39.9% (182/456), P<0.01), old myocardial infarction (OMI) by autopsy (63.0% (182/289) vs. 51.6% (94/182), P<0.05) and chronic myocardial ischemia by autopsy (22.5% (65/289) vs. 7.1% (13/182), P<0.01) were significantly higher while the prevalence of acute myocardial infarction (AMI) by autopsy was significantly lower (22.1% (64/289) vs. 42.9% (78/182), P<0.01) in aged 80 and over group compared to 60-79 years old group. The misdiagnosis rate of CAD was 65.2% (107/164), the missed diagnosis rate of OMI was 62.1% (113/182) and the missed diagnosis rate of AMI was 37.5% (24/64) in the aged 80 and over group.

CONCLUSIONSThe prevalence of CAD and misdiagnosis and missed diagnosis rate are high in dead inpatients aged 80 years and over. OMI is more common but often missed in this group. Thus, the diagnosis and evaluation of CAD should be enhanced in this patient group.

Aged ; Aged, 80 and over ; Autopsy ; Coronary Artery Disease ; pathology ; Diagnostic Errors ; Humans ; Inpatients ; Middle Aged ; Myocardial Infarction ; Myocardial Ischemia ; Prevalence

Phytochemical investigation on the stems of Ilex asprella by using various chromatographic techniques led to the isolation of 13 compounds. By spectroscopic analyses and comparisons the spectral data with those in literatures, these compounds were identified as salicifoneoliganol(1), rel-(7R,8S)-3,3',5-trimethoxy-4',7-epoxy-8,5'-neolignan-4,9,9'-triol 9-β-D-glucopyranoside(2),(+)-cycloolivil(3),(+)-syringaresinol-4'-O-β-D-monoglucoside(4), liriodendrin(5), caffeic acid (6), 3,4-dihydroxy-5-methoxybenzaldehyde(7), benzene-1,2,4-triol(8), 3,4,5-trimethoxyphenyl-1-O-β-D-apiofuranosyl(1″→6')-glucopyranoside(9), aeculetin(10), cryptochlorogenic acid ethyl ester(11), chlorogenic acid ethyl ester(12), and rel-5-(3S,8S-dihydroxy-1R,5S-dimethyl-7-oxa-6-oxobicyclo [3,2,1]oct-8-yl)-3-methyl-2Z,4E-pentadienoic acid(13). Among them, compounds 7, 8, 11, and 13 were isolated from genus Ilex for the first time, and 1-3, 9, 10, and 12 were isolated from this speciesfor the first time. The anti-inflammatory assay results of these compounds showed that compounds 1 and 9 showed moderate inhibitory effect against NO production in RAW 267. 4 cells with IC₅₀ values of 35.7 and 50.6 μmol•L⁻¹, in vitro respectively, whereas compound 10 showed weak inhibition(IC₅₀ value 98.7 μmol•L⁻¹).