Objective To design a new type of external fixator for bone fracture and verify its rationality and feasibility. Methods The frame and screw of stainless steel achieved fracture fixation in vitro with a threaded locking structure.At the same time the increasing thickness of body frame, the inclined nail holes and the raised bottoms were designed to greatly enhance the strength and overall stability of body frame.FEM (finite element method),measuring the relative displacement and stress distribution after axial load,was used to verify the rationality of the design.An animal experiment with sheep was used to verify the feasibility of fracture treatment. Results Simulated result of FEM indicated that the biggest relative displacement between the separated bones was 0.04 mm,which was much less than the minimum value 1 mm required for fracture healing.The maximum stresses applied on the frame of the fixator,fixator screw,and bone were 35,26,and 6 MPa, respectively, which was much less than the allowable stress. In the animal experiment, fracture site was fixed firmly after operation and was well cured 3 months later.Conclusion The design of this new device is feasible and it can be used as a new method of fracture treatment.

PURPOSETo investigate the effects of salvianolic acid B (SAB) on tumor necrosis factor a (TNF-α) induced alterations of cerebral microcirculation with a bone-abrading model.

METHODSThe influences of craniotomy model and bone-abrading model on cerebral microcirculation were compared. The bone-abrading method was used to detect the effects of intracerebroventricular application of 40 μg/kg·bw TNF-α on cerebral venular leakage of fluorescein isothiocyanate (FITC)- albulmin and the rolling and adhesion of leukocytes on venules with fluorescence tracer rhodamine 6G. The therapeutical effects of SAB on TNF-α induced microcirculatory alteration were observed, with continuous intravenous injection of 5 mg/kg·h SAB starting at 20 min before or 20 min after TNF-α administration, respectively. The expressions of CD11b/CD18 and CD62L in leukocytes were measured with flow cytometry. Immunohistochemical staining was also used to detect E-selectin and ICAM-1 expression in endothelial cells.

RESULTSCompared with craniotomy method, the bone-abrading method preserved a higher erythrocyte velocity in cerebral venules and more opening capillaries. TNF-α intervention only caused responses of vascular hyperpermeability and leukocyte rolling on venular walls, without leukocyte adhesion and other hemodynamic changes. Pre- or post-SAB treatment attenuated those responses and suppressed the enhanced expressions of CD11b/CD18 and CD62L in leukocytes and E-selectin and ICAM-1 in endothelial cells induced by TNF-α.

CONCLUSIONSThe pre- and post-applications of SAB during TNF-α stimulation could suppress adhesive molecular expression and subsequently attenuate the increase of cerebral vascular permeability and leukocyte rolling.

Animals ; Benzofurans ; pharmacology ; Blood Flow Velocity ; Cerebrovascular Circulation ; drug effects ; Craniotomy ; Disease Models, Animal ; E-Selectin ; metabolism ; Intercellular Adhesion Molecule-1 ; metabolism ; Mice ; Mice, Inbred C57BL ; Microcirculation ; drug effects ; Random Allocation ; Reference Values ; Tumor Necrosis Factor-alpha ; administration & dosage

OBJECTIVETo analyze epidemiological characteristics of burn inpatients in Hainan province over 8 years.

METHODSSix thousand and ninety-nine burn patients admitted to 6 hospitals of Hainan province from January 2002 to December 2009 were enrolled in the study. The clinical data of these patients were analyzed retrospectively, including age, gender, injury cause, wound position, burn area, ailment prior to admission, admission time, medical insurance, length of hospital stay, and mortality rate, relationship among inpatient distribution, admission time, and ambient temperature at the time of admission. Data were processed with SPSS 13.0 software.

RESULTSThere were more burn male patients than female, with ratio of 2.1: 1.0. Most patients were younger than 13 years (57.2%, 3488/6099). The most common burn area was smaller than or equal to 10% TBSA (67.4%, 4108/6099), and the fewest patients had burn areas of over 50% TBSA (2.0%, 121/6099). The main causative agents were hot liquid and flame, accounting for 71.5% (4358/6099), 17.9% (1092/6099), respectively. Most patients had injuries of more than two body areas (60.7%, 3705/6099), and lower extremity injury (17.1%, 1042/6099) was predominant in wound of single body area. Among 703 cases who had other ailments prior to admission (11.5%), the highest rate of prior ailments was found in patients older than 60 years (18.5%, 48/260), it was lowest in children younger than 1 year (8.0%, 32/398). The length of hospital stay was 1 to 375 day, and the admission time was 10 minutes to 90 days after burn. Total mortality rate was 0.4% (26 cases). The number of inpatients aged from 19 to 59 was obviously higher in months with high ambient temperature (from June to August), and for inpatients younger than 13 years the incidence of burn injury showed no obvious seasonal change. The inpatients who had medical insurance accounted for 10.9% (66/603) to 19.5% (121/619) from 2002 to 2005, which increased to 46.0% (372/808) in 2007 and 79.1% (869/1098) in 2009.

CONCLUSIONSFor burn inpatients in Hainan province, the main injury cause of burn injury is hot liquid, the number of burn adults aged from 19 to 59 seems to increase in months with high ambient temperature, while the incidence of burn in children showed no obvious seasonal change. The number of inpatients and those with medical insurance showed a tendency of increase from 2005 to 2009 in Hainan province.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Burns ; epidemiology ; Child ; Child, Preschool ; China ; epidemiology ; Female ; Humans ; Incidence ; Infant ; Inpatients ; Male ; Middle Aged ; Retrospective Studies ; Young Adult

Objective: To investigate the clinical efficacy of liver transplantation in the treatment of acute liver in children with NBAS gene deficiency disease and their outcome. Methods: This retrospective study enrolled children with NBAS gene deficiency who were admitted to the Children's Hospital of Fudan University for liver transplantation from January 2013 to June 2022. The clinical data were collected and analyzed. Medical literature published before June 2022 was searched with the keywords of "NBAS" "neuroblastoma amplified sequence recurrent" "acute liver failure" "SOPH syndrome" "short stature with optic nerve atrophy" "Pelger-Huët anomaly" in PubMed, China National Knowledge Infrastructure and Wanfang database. Results: Liver transplantation was performed in 3 patients (2 males and 1 female) with NBAS deficiency. All patients presented with fever-triggered recurrent acute liver failure. The genetic detection found compound heterozygous NBAS gene pathogenic variants in them. The total episodes of acute liver failure before liver transplantation were 11, 2, and 4 respectively, and the age at liver transplantation was 3.5, 2.3, and 2.0 years respectively. During liver transplantation, patient 1 was in the convalescent phase of acute liver failure, patient 2 was in the acute phase, presenting with hepatic encephalopathy (grade V) and respiratory failure, and patient 3 was considered to be in the acute phase. After liver transplantation, patient 1 recovered normal liver function within 1 month and had no liver transplantation-related complications. Patient 2 had secondary epilepsy, intellectual disability, movement disorder, and transiently elevated transaminases. Patient 3 died of severe infection within 1 month. There was no literature in Chinese, 6 in English, 8 NBAS-deficient patients who were treated with liver transplantation. Total 11 patients presented with fever-triggered recurrent acute liver failure. Their age at liver transplantation ranged from 0.9 to 5.0 years. Postoperative complications occurred in 3 patients. Until the last visit, they were followed up for 0.7 to 14.0 years. Total 2 patients died and the 9 surviving patients did not develop acute liver failure. Conclusions: Liver transplantation is effective for the treatment of acute liver failure associated with NBAS gene disease. However, postoperative complications of liver transplantation may occur. The timing of liver transplantation still needs further research.
Child ; Male ; Humans ; Female ; Infant ; Child, Preschool ; Retrospective Studies ; Neoplasm Proteins/genetics* ; Optic Atrophy/genetics* ; Pelger-Huet Anomaly/genetics* ; Liver Failure, Acute/complications*