OBJECTIVETo explore the clinical efficacy of self-made Kirschner wire hook in the treatment of severely displaced proximal humerus fractures in children.

METHODSFrom January 2007 to February 2012,35 children with severely displaced proximal humerus fractures were treated with self-made Kirschner wire hook fixation,including 25 boys and 10 girls with an average age of 13.2 years old ranging from 5 to 17. The duration from injury to operation was 1 to 10 days with an average of 4.5 days. Preoperative diagnoses were confirmed by X-ray films as type III in 26 cases and type IV in 9 according to the Neer-Horwitz classification of the proximal humerus fractures. All fractures were close fracture without nerve or vascular injuries. Anatomical reduction was achieved by open reduction and the fractures were fixed by self-made Kirschner wire hook. Intra-operative and postoperative complications, postoperative radiographic examination, upper extremity length and range of shoulder motion were observed and recorded. Neer score system was used to evaluate shoulder function.

RESULTSAll patients were followed up from 6 to 18 months with an average of 12.1 months. The mean Neer score of the injured side was 94.2 +/- 4.8 (ranged, 84 to 99), 30 patients got an excellent result and 5 good according to the Neer scores. The X-ray showed all the fractures healed without shortening deformity or epiphyseal arrest at early stage. There were no complications related to the implant including loosening or breakage of the self-made Kirschner wire hook. The range of shoulder motion in the injuried side was similar to the normal side, except in abductor lift. All the patients could participate in normal physical activities.

CONCLUSIONThe method of open reduction and fixed with self-made Kirschner wire hook is a safe,effective,convenient treatment for severely displaced proximal humeral fractures in children.

Adolescent ; Bone Wires ; Child ; Child, Preschool ; Female ; Fracture Fixation, Internal ; methods ; Humans ; Humeral Fractures ; physiopathology ; surgery ; Male ; Range of Motion, Articular

Objective To explore the experiences of patients with abnormal extubation of PICC tubes.Methods Fifteen patients with abnormal extubation of PICC tubes participated in the semi-structure interviews.Data were analyzed by Nancy's phenomenological procedure.Results The patients experienced complicated mood which combined negative experience and positive experience,with complainant,helpless,worry,fear for negative experience,relieved,secure for positive experience.Conclusions Patients with abnormal extubation possessed negative experience.Suggestions should be given to nursing staff to communicate with patients before the extubation in order to reduce the dispute of nurses and patients.At the same time,we should summarize the reasons and analyze the factors about the abnormal extubation,and take the targeted intervention measures in the clinical work to decrease the incidence rate of PICC extubation.

OBJECTIVETo investigate the effects of butyl alcohol extract of Baitouweng decoction ( BAEB) on yeast-to-hyphae transition of Candida albicans isolates from vulvovaginal candidiasis (VVC) in alkaline pH.

METHODSerial 2-fold dilution assay was used to determine the minimal inhibitory concentrations (MICs) of Baitouweng decoction extracts against C. albicans isolates from VVC, XTT assay was applied to determine the metabolic activity of C. albicans hypha treated by BAEB for 6 h. The morphological change of C. albicans treated by BAEB was inspected at different pH by inverted microscope, fluorescence microscope, scanning electron microscopy (SEM). Solid agar plate and semi-solid agar were utilized to evaluate colony morphology and invasive growth of C. albicans, respectively. Quantitative Real-time PCR (qRT-PCR) was adopted to observe the expressions of hyphae-specific genes including HWP1, ALS3, CSH1, SUN41 and CaPDE2.

RESULTThe MIC of BAEB against C. albicans is less than that of other extracts; hyphae grow best at pH 8. 0; 512 mg · L(-1) and 1,024 mg · L(-1) BAEB could inhibit formation of hyphae and influence colony morphology. When treated by 512 mg · L(-1) and 1,024 mg · L(-1) BAEB, the colonies became smooth; while by 0 and 256 mg · L(-1) BAEB, the colonies became wrinkled. In semi-solid agar, the length of hyphae decreased steadily as the concentration of BAEB lowered. The expression of HWP1, ALS3, CSHl, SUN41 were downregulated by 5.12, 4.26, 3.2 and 2.74 folds, and CaPDE2 was upregulated by 2.38 fold.

CONCLUSIONBAEB could inhibit yeast-to-hyphae transition of C. albicans isolates from VVC in alkaline pH.

Antifungal Agents ; isolation & purification ; pharmacology ; Candida albicans ; drug effects ; genetics ; growth & development ; Candidiasis, Vulvovaginal ; drug therapy ; microbiology ; Drugs, Chinese Herbal ; isolation & purification ; pharmacology ; Female ; Humans ; Hydrogen-Ion Concentration ; Hyphae ; drug effects ; growth & development

Adult ; Basic Helix-Loop-Helix Transcription Factors ; metabolism ; Cerebral Ventricle Neoplasms ; metabolism ; pathology ; surgery ; Female ; Follow-Up Studies ; Fourth Ventricle ; Ganglioglioma ; metabolism ; pathology ; surgery ; Glial Fibrillary Acidic Protein ; metabolism ; Humans ; Magnetic Resonance Imaging ; Nerve Tissue Proteins ; metabolism ; Oligodendrocyte Transcription Factor 2 ; Rosette Formation ; Synaptophysin ; metabolism ; Young Adult

According to the clinical experience and the active role of electroacupuncture instruments in clinical acupuncture and moxibustion, the potential security hazards of the available electroacupuncture instruments are pointed out. These hazards not only can cause injury to a varying degrees for the patient, but also lead to a poor therapeutic effect. The reasons of the security problems are mainly inaccurate regulation parameters, unreasonable displaying parameters, unscientific output of constant voltage, and unqualified protection measures for the electroacupuncture instrument. The countermeasures improving security and the measures increasing the intelligent level of the electroacupuncture instrument are put forward.
Electroacupuncture ; instrumentation ; methods ; Humans ; Safety ; Safety Management ; methods

Objective To analyze the treatment outcome and related influencing factors of Tibet- an nationality new smear-positive pulmonary tuberculosis patients in Qinghai Province，so as to provide evidence for tuberculosis control and treatment among Tibetan population． Methods Statistical analysis was conducted on 5 564 Tibetan nationality new smear-positive pulmonary tuberculosis cases in Qinghai province who were reported in the China Tuberculosis Information Management System and approved to receive treatment from 2008 to 2017． The main influencing factors were detected by unconditional Logistic regression model analysis，dependent variable was successful treatment or not，independent variables were other factors related to the treatment outcome． Ｒesults The treatment success rate of Tibetan nationality new smear-positive pulmonary tuberculosis cases was 87. 1% ( 4 848 /5 564) ，and the adverse outcome rate was 12. 9% ( 716 /5 564) ． Unconditional Logistic regression model analysis indicated that non-full- course supervision management，living in agricultural and pastoral area，having severe disease，floating population，and age older than 60 years were risk factors of adverse outcome． The odds ratio( OＲ) 95% confidence interval( CI) of the above risk factors were 13. 044( 10. 671-15. 944) ，2. 305( 1. 703-3. 119) ， 2. 090( 1. 346-3. 243) ，1. 967( 1. 443-2. 682) ，and 1. 909( 1. 410-2. 586) ． Clinical consultation，farmers and herdsmen were protective factors． The OＲ( 95% CI) were 0. 451( 0. 375-0. 543) ，and 0. 786( 0. 627- 0. 985) ． Conclusions Treatment success rate of Tibetan nationality new smear positive pulmonary tuberculosis cases was low． Therefore，the directly observed treatment short-course ( DOTS) strategy should be strictly implemented and the full-course supervision management should be strengthened to improve the treatment success rate． More attention should be paid to the elderly，severe，floating，agricultural and pastoral populations among the Tibetan population．

OBJECTIVE Hypoxia is associated with many complicated pathophysiological and biochemical processes that integrated and regulated via the key gene, protein and endogenous metabolite levels. Up to date, the exact molecular mechanism of hypoxia still remains unclear. In this work, we further explore the molecular mechanism of hypoxia and adaption to attenuate the damage in zebrafish model that have potential to resist hypoxic environment. METHODS The hypoxic zebrafish model was established in different concentration of oxygen with 3%,5%,10%,21% in water. The brain tissue was separated and the RNA-seq was used to identify the differentially expressed genes. The related endogenous metabolites profiles were obtained by LC-HDMS, and the multivariate statistics was applied to discover the important metabolites candidates in hypoxic zebrafish. The candidates were searched in HMDB, KEGG and Lipid Maps databases. RESULTS The zebrafish hypoxic model was successfully constructed via the different concentration of oxygen, temperature and hypoxic time. The activities of the related hypoxic metabolic enzymes and factors including HIF-1a, actate dehydrogenase (LDH) and citrate synthase (CS) were evaluated. Significant differences (P<0.05 and fold change >2) in the expression of 422 genes were observed between the normal and 3% hypoxic model. Among them, 201 genes increased depended on the lower concentration of oxygen. 53 metabolites were identified that had significant difference between the hypoxia and control groups (P<0.05, fold change>1.5 and VIP>1.5). The ten key metabolites were increased gradually while six compounds were decreased. The endogenous hypoxic metabolites of phenylalanine, D-glucosamine-6P and several important lipids with the relevant hub genes had similar change in hypoxic model. In addition, the metabolic pathways of phenylalanine, glutamine and glycolipid were influenced in both the levels of genes and metabolites. CONCLUSION The up- regulation of phenylalanine, D- glucosamine- 6P and lipid may have further understanding of protective effect in hypoxia. Our data provided an insight to further reveal the hypoxia and adaptation mechanism.

OBJECTIVETo explore the effects of integrative medicine (IM) rehabilitation protocolon motor function, activity of daily living, and quality of life (QOL) in hemiplegia patients after stroke.

METHODSTotally 120 patients with post-stroke hemiplegia were allocated to four groups using sealed envalope drawing, i.e., the rehabilitation group, the Chinese medical treatment group, the acupuncture group, and the comprehensive rehabilitation group, 30 cases in each group. Based on routine rehabilitative training, patients in the Chinese medical treatment group, the acupuncture group, and the compre-hensive rehabilitation group received standardized treatment based on syndrome typing, Shi's Consciousness-Restoring Resuscitation acupuncture, Chinese herbs + acupuncture comprehensive rehabilitatino protocol, respectively. The treatmet cycle consisted of 4 weeks with 24-week follow-ups. Fugl-Meyer motor assessment (FMA), Modified Barthel Index (MBI), and Stroke-Specific Quality of Life Scale(SS-QQL), and safety assessment were taken as main effect indices before treatment, at week 4 of treatment, at week 12 and 24 of follow-ups, respectively.

RESULTSThere was no statistical difference in FMA score, MBI score, SS-QOL score among the four groups before treatment (P > 0.05). These scores were significantly improved in the four groups at week 4 of treatment, week 12 and 24 of follow-ups, respectively (P < 0.05). Besides, FMA score and SS-QOL score were significantly improved in the comprehensive rehabilitation group at each corresponding time point, as compared with other treatment groups (P < 0.05).

CONCLUSIONSThe comprehensive protocol could significantly improve motor function, activity of daily living in hemiplegia patients after stroke, and further improve their QOL. Its effect was better than other single treatment.

Activities of Daily Living ; Acupuncture Therapy ; Hemiplegia ; rehabilitation ; Humans ; Integrative Medicine ; methods ; Medicine, Chinese Traditional ; Motor Skills ; Quality of Life ; Stroke Rehabilitation ; Treatment Outcome

Objective To compare the clinical efficacy and safety of docetaxel combined with carboplatin (TP) and epirubicin combined with cyclophosphamide sequential docetaxel (EC-T) adjuvant in the treatment of three negative breast cancer in phase III . Methods 62 cases of three negative breast cancer patients in phase III from May 2012 to October 2016 were selected and randomly divided into the control group and the experimental group, with 31 patients in each group. The control group was treated with epirubicin combined with cyclophosphamide and sequential docetaxel, and the experimental group was treated with docetaxel and carboplatin. The clinical indicators were compared and analyzed. Results There was no significant difference in the recent remission rate (77.42%) between the experimental group and the control group (74.19%). Two groups of patients with adverse reactions were restored within one month. There were 10 cases of WBC decrease in the experimental group, with the incidence rate of 32.25%. There were 18 cases of WBC decrease in the control group, the incidence rate was 58.06%, the difference was statistically significant (P<0.05). Conclusion Docetaxel combined with carboplatin and epirubicin adjuvant combined with cyclophosphamide than star sequential docetaxel in the treatment of three patients with negative breast cancer stage III were tolerated, TP occurred leukopenia and alopecia with low probability.

Animals ; Bone Marrow Cells ; cytology ; Cell Differentiation ; drug effects ; Ethanol ; adverse effects ; Hepatocytes ; cytology ; Liver Regeneration ; Mesenchymal Stromal Cells ; cytology ; Rats ; Rats, Sprague-Dawley