Objective To study the role of inflammation in white matter damage of spontaneously hypertensive rats (SHRs) through observing the pathology changes of tissues after white matter damage and detecting the levels of inflammation-related indicators.Methods Eighteen 40-week-old male SHRs were chosen as experimental group,and seven male Wistar-Kyoto (WKY) rats were used as control group.The animal brain tissues were taken for hematoxylin-eosin staining (HE staining) and immunohistochemical staining to observe the pathological changes,and the levels of myelin basic protein (MBP),neurofilament (NF) and glial fibrillary acidic protein (GFAP).Real-time PCR was employed to detect toll-like receptor 4 (TLR-4),monocyte chemotactic protein 1 (MCP-1) and vascular cell adhesion molecule-1 (VCAM-1) expression levels in the white matter tissues.Results The white matter of 40-week-old SHRs was apparently injured.HE staining displayed sponge-like changes in the white matter and immunohistochemical staining showed astrocyte activation,reduced number of axonal and demyelination in the white matter.As compared with those in the WKY rats,TLR-4,MCP-1 and VCAM-1 mRNA expressions in SHR white matter were significantly increased (P＜0.05); and TLR-4,MCP-1 and VCAM-1 expression levels in SHRs were positively related to the degree of white matter damage.Conclusion The white matter damage in 40-week-old SHRs is similar to that of LA;inflammation is involved in the pathophysiological process of white matter damage,being one of induced factors of white matter injury.

OBJECTIVETo compare the stability of sacroiliac screws fixation for the treatment of bilateral vertical sacral fractures to provide reference for clinic application.

METHODSA finite element model of Tile C pelvic ring injury (bilateral type Denis II fracture of sacrum) was produced. The bilateral sacral fractures were fixed with sacroiliac screws in 4 types of models respectively: two bidirectional sacroiliac screws fixation in the S₁ segment, two bidirectional sacroiliac screws fixation in the S₂ segment, one sacroiliac screw fixation in the S₁ segment and one sacroiliac screw fixation in the S₂ segment, two bidirectional sacroiliac screws fixation in S₁ and S₂ segments respectively. By the ABAQUS 6.9.1 software, in the case of standing on both feet, 600 N vertical load was imitated to be imposed to the superior surface of the sacrum and downward translation and backward angle displacement of the middle part of the sacral superior surface and everted angle displacement of the top of iliac bones were extracted for analysis. The stability of sacroiliac screws fixation was compared according to the principle of the better stability the smaller displacement.

RESULTSThe stability of 2 bidirectional sacroiliac screws fixation in S₁ and S₂ segments respectively was markedly superior to that of 2 bidirectional sacroiliac screws fixation in S₁ or S₂ segment and was also markedly superior to that of one sacroiliac screw fixation in S₁ segment and one sacroiliac screw fixation in S₂ segment. The vertical and everted stability (the downward translation: 0.531 mm; the everted angle displacement: 0.156° (left side), 0.163° (right side)) of sacroiliac screws fixation in two bidirectional sacroiliac screws fixation in the S₂ segment was superior to that of two bidirectional sacroiliac screws fixation in the S₁ segment (the downward translation: 0.673 mm; the everted angle displacement: 0.200° (left side), 0.232° (right side)). The rotational stability of two bidirectional sacroiliac screws fixation in the S₁ segment (the backward angle displacement: 0.269°) was superior to that of two bidirectional sacroiliac screws fixation in the S₂ segment (the backward angle displacement: 0.287°). Moreover, the rotational stability of one sacroiliac screw fixation in the S₁ segment and one sacroiliac screw fixation in the S₂ segment was inferior to that of two bidirectional sacroiliac screws fixation in the S₁ segment or two bidirectional sacroiliac screws fixation in the S₂ segment, and the vertical and everted stability of one sacroiliac screw fixation in the S₁ segment and one sacroiliac screw fixation in the S₂ segment was between that of two bidirectional sacroiliac screws fixation in the S₁ segment and two bidirectional sacroiliac screws fixation in the S₂ segment.

CONCLUSIONSTwo bidirectional sacroiliac screws fixation in S₁ and S₂ segments respectively is recommended to be utilized for fixing bilateral sacral fractures of Tile C pelvic ring injury as far as possible. It is suggested to choose sacral segments in which sacroiliac screws fixed according to vertical, rotational and everted stability degree of sacral fractures.

Adult ; Bone Screws ; Computer Simulation ; Female ; Finite Element Analysis ; Fracture Fixation, Internal ; methods ; Fractures, Bone ; surgery ; Humans ; Sacrum ; injuries ; surgery

Objective:To evaluate the treatment of nonunion of lateral humeral condyle complicated with cubitus valgus with primary fixation in situ and secondary supracondylar varus osteotomy.Methods:A retrospective analysis was made of the 8 children who had been treated for nonunion of lateral humeral condyle complicated with cubitus valgus at Department of Pediatric Orthopedics, Honghui Hospital from January 2016 to March 2018. They were 5 boys and 3 girls with 5 left and 3 right sides involved. Their age at injury ranged from 6 to 14 years (average, 10 years) and the duration from injury to operation from 2 to 6 years (average, 4 years). At the primary stage, the fragments were fixated in situ with compressive cannulated screws after cleaning the nonunion ends, followed by iliac autograft. At the secondary stage, the humeral supracondylar varus osteotomy was performed after the nonunion was healed and the elbow range of motion recovered. The therapeutic effects were assessed by comparing the elbow range of motion, carrying angle and Mayo elbow performance score (MEPS) between preoperation and the final follow-up.Results:All the patients were followed up for an average of 44.5 months (range, from 27 to 64 months). The average healing time for obsolete nonunion of lateral humeral condyle was 81.3 days (range, from 55 to 120 days) after the primary operation and that for supracondylar varus osteotomy 51.1 days (range, from 45 to 60 days) after the secondary operation. The elbow range of motion was 129.0°±4.6° before operation and 138.0°±5.4° at the final follow-up, showing a significant difference ( P<0.001). The average carrying angle at the healthy side in 8 children was 5.4° (range, from 3° to 8°). The carrying angle at the affected side was 31.9°±4.7° (range, from 25° to 42°) before operation and 4.0°±2.2°(range, from 1° to 8°) at the final follow-up, showing a significant difference ( P<0.05). Their preoperative MEPS was 57.5 ± 6.5 (4 good cases and 4 poor ones) but 95.9±3.4 (6 excellent cases and 2 good ones) at the final follow-up, showing a significant difference ( P<0.05). Conclusions:Treatment of nonunion of lateral humeral condyle complicated with cubitus valgus can be effectively carried out by cleaning fibrous tissue in the nonunion gap, iliac autograft and fragments fixation in situ with compressive cannulated screws at the primary stage and supracondylar varus osteotomy at the secondary stage. Intraoperative preservation of the blood supply to the nonunited fragments is the key to successful management.

To understand the maintenance and transmission of SFTS virus, the potential vector ticks were collected from sheep, cattle and dogs in the endemic areas of SFTSV in Shandong Province. Among the collected ticks, the dominant species was H. longicornis ticks. Real-time PCR for RNA detection, virus isolation and characterization, genomic sequencing, phylogenetic and antigenic analysis were performed in this investigation. The results showed that the SFTS viral RNA was detected in 2.14% H. longicornis, and a SFTS virus was isolated from one of viral RNA positive ticks collected from sheep. Whole genome analysis of the SFTSV isolates with 11 human-origin SFTS virus revealed a highly pairwise similarity, and the growth curve analysis showed nearly identical in virus yield and the dynamic of virus reproduction compared to human derived viral isolates. Immunofluorescence and neutralization test showed identical serological reaction character of the two different origin viral strains. In this study, the characters of a SFTSV isolate was firstly described, which suggested that the tick species H. longicornis acting important vector role in the transmission of SFTS virus.
Animals ; Animals, Domestic ; parasitology ; Arachnid Vectors ; virology ; Bunyaviridae Infections ; transmission ; virology ; Cattle ; Cell Line ; Dogs ; Humans ; Livestock ; parasitology ; Molecular Sequence Data ; Phlebovirus ; classification ; genetics ; isolation & purification ; Phylogeny ; Sheep ; Ticks ; virology

Objective:To summarize and discuss the concept and clinical manifestations of complex fracture-dislocations of the elbow in children, and compare its injury characteristics, treatment and clinical effect with adults.Methods:From September 2015 to January 2020, 34 patients seen and treated at our institution for complex fracture-dislocations of the elbow were identified, and their medical records and radiographs were reviewed retrospectively. The inclusion criteria were elbow dislocation combined with one or more fractures at the proximal ulna and radius. There were 25 boys and 9 girls, with an average age of 8.3±3.2 years. The left arm was involved in 27 cases, and the right arm was involved in 7 cases. The causes of injury included falling from a scooter in 16 cases, falling from height in 10 cases, cycling in 5 cases and traffic accident in 3 cases. All patients were treated with closed reduction and the application of plaster under local anaesthesia in the emergency room. Then, X-ray, CT and MRI were performed to evaluate the fracture-dislocation and ligament injury. The following treatment plan was comprehensively evaluated according to the size and displacement of the combined fracture block and the stability of the elbow, for example, open reduction with K-wires and tension band or plate fixation for olecranon fracture, open reduction with loop plate fixation for coronal process fracture, closed reduction or open reduction with K-wires or elasticstable intramedullary nail for radial neck fracture.Results:Among the 34 patients, there were 16 cases of transolecranon fracture-dislocation, 1 case of varus posteromedial rotational instability, 4 cases of valgus posterolateral rotatory instability and 13 cases of divergent dislocation of elbow. All patients were followed up for 13(8, 15) months, and the average fracture healing time was 3.5±0.8 weeks, with no failure of internal fixation. In 2 cases of elbow dislocation combined radial neck fracture, one case had ischemic necrosis of the radial head and one case had early closure of epiphyseal plate of the proximal radius. At the last follow-up, all patients had no subluxation, dislocation or instability of the elbow. The therapeutic efficacy was evaluated at the final follow-up by the Mayo elbow performance score (MEPS) as excellent in 25 cases, good in 5 cases, fair in 3 cases, and poor in one case, with excellent and good rate 88%.Conclusion:The complex fracture-dislocations of the elbow is rare in children. We have the opinion that the clinical characteristics are dislocation combined with one or more fractures of the proximal ulna and radius. Compared with adults, its pathological characteristics and the scope of injury are similar, but most of the injuries are mild. The clinical manifestations are mainly transolecranon fracture-dislocation and divergent dislocation of elbow. Good results can be achieved in most cases through open reduction with internal fixation for fractures.