OBJECTIVETo compare clinical outcomes of swing shoulder and internal fixation in treating proximal humeral fractures.

METHODSFrom June 2007 to June 2012, totally 89 elderly patients with humeral proximal fractures were treated by swing of shoulder or internal fixation, and 81 patients were followed up. In swing shoulder group, there were 38 patients including 13 males and 25 females aged from 62 to 84 with an average of (67.11±6.18) years old; 27 cases were 2-part fractures and 11 cases were 3-part fractures according to Neer classfication. In internal fixation group, there were 43 patients including 16 males and 27 females aged from 60 to 80 with an average of (66.47±5.48) years old; and 29 cases were 2-part fractures and 14 cases were 3-part fractures according to Neer classfication. VAS score and complications were compared between two groups after treatment, and Constant-Murley functional scoring was used to evaluate shoulder function of patients.

RESULTSEighty-one patients were followed up from 13 to 26 months with an average of 18.3 months. There was no significant difference in preoperative VAS score between two groups. After treatment, VAS score in swing shoulder group was (3.11±0.95), and (3.88±1.14) in internal fixation group, and had significant difference between two groups (t=-3.313,P<0.05). There was no significant difference in Constant-Murley scores between swing shoulder group (79.53±3.73) and internal fixation group (77.98±4.11) (t=1.768,P>0.05). Postoperative complications in swing shoulder group was 18.4%(7/38), 39.5%(17/43) in internal fixation group, and had significant differences between two groups (χ2=4.313,P<0.05).

CONCLUSIONSwing shoulder for the treatment of proximal humeral fractures in elderly has advantages of low cost, less complications and good recovery of joint function; while internal fixation has a good therapeutic effect but increased complications.

Aged ; Aged, 80 and over ; Female ; Fracture Fixation, Internal ; adverse effects ; methods ; Humans ; Male ; Manipulation, Orthopedic ; adverse effects ; methods ; Middle Aged ; Shoulder Fractures ; therapy

Adolescent ; Brain Diseases ; diagnostic imaging ; Brain Neoplasms ; diagnostic imaging ; surgery ; Diagnosis, Differential ; Hematoma, Epidural, Cranial ; diagnostic imaging ; Hernia ; diagnostic imaging ; Humans ; Male ; Plasmacytoma ; diagnostic imaging ; surgery ; Tomography, X-Ray Computed

In recent years our research team introduced many foreign patterns to our clinics, kept innovating and exploiting more reasonable modes and methods to cure the cleft patients in the situation of a developing country. Now we concluded the treatment principles, patterns and techniques of the sequential therapy according to the different temporal stages of cleft, from its arising to the evolution, evaluated our therapy results and induced a preliminary guide line of our treating clefts. We sincerely hope this rule could promote the general progress in both clinical treatment and researching.
Cleft Lip ; Cleft Palate ; Humans

OBJECTIVETo investigate the influence of biological behavior of epithelial cells on the hair follicles and sebaceous glands (HFSG) structure in keloids (K).

METHODSThe expression of intercellular adhesion molecule (ICAM)-1, D-related human leucocyte antigen (HLA-DR), and cytokeratin (CK) 14 on epithelial cells and the amount of activity T-lymphocytes were detected in specimens of keloid edge and normal skin with immunohistochemical and histological methods.

RESULTSIn comparison with normal skin specimens, epithelial cells were proliferated in K-HFSG presented structural aberration and disintegrate or abnormally to form solid-epithelial island-like structure, and the density of HSFG with hyperplasia and the ageing scar in keloids was apparently decreased. They strongly expressed ICAM-1, HLA-DR, and CK14 in the epithelial cells, there were many immunologic cells which expressed CD4, CD45RO, and interferon (IFN)-gamma around the K-HFSG. The expressed level of epithelial cells was positively correlated with the density of immunologic cells nearby K-HFSG.

CONCLUSIONIt could be concluded that the reactivity with hyperplasia and immunoinduction of epithelial cells might be associated with the destruction of the some HFSG structure in the keloids.

Adolescent ; Adult ; Cell Proliferation ; Child ; Child, Preschool ; Epithelial Cells ; pathology ; Female ; HLA-DR Antigens ; metabolism ; Hair Follicle ; pathology ; Humans ; Intercellular Adhesion Molecule-1 ; metabolism ; Keloid ; immunology ; pathology ; Keratin-14 ; metabolism ; Male ; Middle Aged ; Sebaceous Glands ; pathology ; Young Adult

Objective: To investigate the microhardness distribution of cancellous bone in the proximal tibia and its clinical significance. Methods: Three fresh tibias were obtained and examined by X-ray and CT to exclude skeletal pathologies, such as osteoporosis, osteoarthritis. According to the Heim's square, the proximal tibias were cut off. Each of the proximal tibias was divided into three parts, the medial condyle, the intercondylar area and the lateral condyle. Each part was divided into three sections, proximal, middle and distal sections. Each of the proximal tibias was divided into 9 regions. Bone specimens with a thickness of 3 mm were taken from each region using a high precision low-speed saw and fixed on flat sheets. The microhardness of the bone tissue was measured using a Vickers microhardness tester after polish. Ten effective micro-indentation tests were conducted in each region. After measurement the diagonal length of the indentations, the microhardness values were calculated via software provided by the hardness tester. Analysis of variance and Tukey method were used to compare the microhardness values of different parts, sections and regions of cancellous bone. The microhardness distribution of the proximal tibia was analyzed. Results: A total of 270 effective indentations were made in the specimens, and the microhardness values were obtained. The average microhardness of the three proximal tibias was 40.98±3.44, 34.92±4.64 and 39.49±3.86 HV, respectively. There was a significant difference among the groups (F=55.87, P=0.000). The microhardness distribution of bone tissue in the three proximal tibias was similar. In the comparison of different parts, the microhardness of medial condyle was greater than that of the lateral condyle, which was larger than that of the intercondylar area. The difference between the parts was statistically significant (F=18.42, 8.236, 10.877; P=0.000, 0.001, 0.000). In the comparison of different sections, the microhardness of the distal section was greater than that of the proximal section, which was larger than that of the middle section. The difference between the sections was statistically significant (F=8.720, 17.140, 6.142; P=0.000, 0.000, 0.003). The microhardness distribution was similar among different regions. The region with the highest microhardness is the medial condyle of the distal section with microhardness of 44.87±3.25 HV (range 39.2-49.7 HV). The lowest microhardness was in the intercondylar area of the middle section with hardness of 29.41±4.53 HV (range 24.8-36.2 HV). Conclusion The microhardness value of cancellous bone near the articular surface at the proximal tibia was smaller, which could disperse the load and protect the fragile of articular cartilage. Furthermore, the microhardness of the transition zone is larger. The microhardness value of the cancellous bone in medial tibia condyle is the greatest, which is related to load-bearing.

Objective To understand the current status and relative factors on knowledge, attitude, practice to contraception among college students in Beijing and to provide evidence for developing aimed contraceptive service and education in colleges. Methods Quantitative surveys were employed, questionnaire was conducted anonymously among 12 450 unmarried college students under informed consent. Results Among 12 129 students, acknowledgement of contraceptive knowledge among females was superior to males in college(P=0.000). Rates on the favor for unmarried sexual practice and 'sexual liberation' were 81.9% and 60.2% for males, comparing to 74.8% and 54.3% for females respectively. The prevalence rates for masturbation were 74.3% for males and 24.9% for females respectively. 18.4% of the male and 10.5% of the female students had ever experienced unmarried sexual intercourse. Among those students who had sexual experiences, 29.4% of the males had made their sex partners pregnant and 23.1% of the female students had experienced unexpected pregnancy. Statistical significance was found between males and females (P=0.000) in terms of attitudes and behaviors. 51.3% of the male and female students took contraceptive measures during the episode of first sexual intercourse. The excuses for not taking any measures would include: sexual intercourse happened incidentally, not interested in using condom, only one sexual experience would not cause pregnancy, etc. Conclusion The prevalence of unmarried sexual intercourse among college students had been rising. Among those who had experienced unmarried sexual intercourse, the rate of taking contraceptive measures was low and the incidence of unexpected pregnancy was high. It is urgent to strengthen the education and service programs on contraception among college students.

Objective To study the micro-hardness distribution of ulna and explore its correlation with surgical procedures of ulnar fractures,internal fixator,total elbow arthroplasty and the epidemiology of ulna fracture.Methods The ulna wasdivided into proximal metaphysis,diaphysis,and distal metaphysis.The proximal metaphysis was divided into the olecranon and the metaphysis olecranon of ulna.Thedistal epiphysis included the head of ulna.The shaft of the ulna was divided equally into nine segments.Each ulna was sawed by a band saw into twelve parts,which were prepared for the micro-indention testing.The micro-indention testing samples precision cuts were conductedwith a Buehler Isomet 11-1280-250 low speed diamond saw.Each micro-indention sample was cut 3mm thickness and fixed on glass sheet with epoxy resin.The samples surface was polished with progressive grades of sandpaper.Micro-indentation was pedormed on each bone sample sudace using a vicker micro-hardness tester,and the hardness value were measured as Hardness value (HV,HV=kgf/mm2).Twenty indentions were randomly selected on each sample,which were equally divided into four quadrants (anterior,medial,posterior and lateral).Hence,a total of 720 micro-indentations were pedormed on the three ulna.Before indention,each sample was controlled under the optical microscope where the bone surface was intact and not damaged.The micro-indentations were performed on each sample with a load of 50 g.The indentation time was set to 12 s.Hardness value (HV/0.05) was computed for each indentation.The lengths of the diagonals were measured under reflected light microscopy,and the Vickers hardness value was calculated.Indentations in which one diagonal was 10％ longer or more than the other were ignored.The indention was repeated.These preliminary data were used to determine the appropriate sample size of micro =indentation to be performed on each bone segment.SPSS 19.0 statistical software was used for statisticalanalysis.The one =way ANOVA analysis was used to compare the difference of bone micro-hardness values in different parts,and P ＜ 0.05 was statistically significant.Results The hardest part of the ulna is the lower ulnaand the value of micro-hardness was 47.77 HV.The least hard part was the head of ulna and the value of micro-hardness was 29.64 HV.The proximal metaphysis hardness value was 34.39 HV.The shaft hardness value was 43.47 HV.Thedistal metaphysis hardness value was 29.64 HV.The hardness was higher in diaphysis than metaphysis in the ulna with statistical significance.There was no statistically significant difference in the hardness of ulna anterior,medial,posterior and lateral quadrant.Conclusion It is demonstrated that the micro-hardnessof ulna shaft is significant higher than other two parts of ulna.The micro-hardness value difference was not significant among the anterior,medial,posterior and lateral quadrant.This study revealed the distribution rule of ulna micro-hardness and provided data support for the total elbow arthroplasty with human physiological characteristics through 3D printing.

Objective: To study the effect and mechanism of Shuanghua aerosol (SHA) in treating infantile upper respiratory tract infection. Methods: In the clinical study, 276 patients were randomly divided into two groups. The treated group was treated with SHA and the control group was treated with Shuanghuanglian aerosol (SHLA, 双黄连气雾剂). In the experimental study, the effects of SHA on anti-inflammation and anti-virus were observed. Results: The clinical total effective rate of SHA was 99.03% and its cure rate 65.38%, while those of the SHLA were 94.11% and 44.12% respectively, significant difference was shown between the two groups (P<0.01). Experimental study showed that SHA could inhibit the xylol induced ear swelling and the egg white induced paw swelling in mice obviously, and inhibit the proliferation of influenza virus in rat's lung. Conclusion: SHA has obvious anti-inflammatory and anti-viral effect, and has good curative effect in treating infantile upper respiratory tract infection.

BACKGROUNDSildenafil is one of the selective phosphodiesterase 5 inhibitors that has been proven by many investigators to suppress growth factor stimulated (e.g. platelet-derived growth factor (PDGF) or epidermal growth factor (EGF)) proliferation and hypertrophy of pulmonary artery smooth muscle cells (PASMCs) via cGMP/cGKIa pathway. Serotonin promotes cell cycle progression leading to cell mitogenesis and plays a key role in the pathogenesis of pulmonary artery hypertension. The role of sildenafil in proliferation of PASMCs induced by serotonin has not been investigated so far. In this study we explored the underlying mechanism of the effect of sildenafil on serotonin induced proliferation of porcine PASMCs.

METHODSPASMCs were cells from primary cultures by the explant method from the pulmonary artery of swine and cells at passage 3 - 5 were used in this study. MTT colorimetric assay and flow cytometry analysis were used to evaluate the cell proliferation and alterations in cell cycle progression respectively. Western blotting analysis was applied to determine the expression of phosphorylated extracellular signal-regulated kinase (ERK), proliferating cell nuclear antigen (PCNA) and mitogen activated protein kinase (MAPK) phosphatase-1 (MKP-1).

RESULTSSerotonin (10 µmol/L) induced the upregulation of phosphorylation of ERK1/ERK2 and PCNA, an increase in the percentage of cells in S phase and subsequent cell proliferation. Pretreatment with 1 µmol/L sildenafil potentiated the phosphorylation of ERK1/ERK2, an increase in the percentage of cells in S phase and cell proliferation, compared with serotonin stimulation alone (P < 0.05). Furthermore, 30-minute pretreatment with 10 µmol/L U0126, specific antagonist for ERK kinase (MEK) prevented the increase in phosphorylation of ERK1/ERK2 and abolished cell cycle progression and the proliferation of PASMCs induced by sildenafil.

CONCLUSIONThis study shows that sildenafil potentiated the proliferative effect of serotonin on PASMCs via phosphorylation of ERK1/ERK2.

Animals ; Blotting, Western ; Cell Proliferation ; drug effects ; Cells, Cultured ; Dual Specificity Phosphatase 1 ; metabolism ; Mitogen-Activated Protein Kinase 1 ; metabolism ; Mitogen-Activated Protein Kinase 3 ; metabolism ; Myocytes, Smooth Muscle ; cytology ; Phosphorylation ; drug effects ; Piperazines ; pharmacology ; Proliferating Cell Nuclear Antigen ; metabolism ; Pulmonary Artery ; cytology ; Purines ; pharmacology ; Serotonin ; pharmacology ; Sildenafil Citrate ; Sulfones ; pharmacology ; Swine

Objective To investigate effects of aging on the fracture mechanical behavior of human dentin with finite element numerical method. Methods The finite element model was established according to the typical compact tension specimen in the experiment. The stable crack growth in human dentin was simulated with the cohesive zone model to compare the crack extensions of the young and aged dentin. Results The growth toughness and plateau toughness of the aged dentin were 0.51 and 1.19 MPa•m1/2, respectively, which were significantly lower than those of the young dentin (7.48, 1.71 MPa•m1/2). However, the initiation toughness of the young and aged dentin showed no significant difference with 0.51 and 0.38 MPa•m1/2, respectively. Conclusions The crack growth resistance of human dentin is decreased significantly with aging. Based on the cohesive zone model, the crack growth behavior of biological hard tissue, whose mechanical properties are related with age (such as the human dentin), can be well predicted by using numerical methods.