OBJECTIVETo investigate the clinical outcomes of cannulated screw combined with buttress plate in treating transarticular shear fractures of the distal humerus.

METHODSFrom July 2008 to December 2011, 17 patients with shear fractures of the distal humerus were treated with cannulated screw combined with buttress plate. Among them, included 10 males and 7 females aged from 20 to 59 years old (mean 36.5). All the fractures were classified into type I (8 cases), type II (1 case), type III (3 cases) and type IV (5 cases) according to Bryan-Morrey and McKee classification. According to AO/ASIF classification, 10 cases were type 13B3.1, 7 cases were type 13B3.3; according to Dubberley classification, 5 cases with type 1A, 2 cases with type 1B, 2 cases with type 2A, 2 cases with type 2B, 4 cases with type 3A, 2 cases with type 3B. There were 12 cases with fresh injuries, 4 cases with old injuries. All fractures were closed injuries. Complications and range of motion of elbow were observed, and clinical efficacy were evaluated by Broberg-Morrey standard.

RESULTSAll patients were followed up with a mean time of 21.3 months (ranged, 18 to 24). All fractures obtained bone healing from 10 to 15 weeks with a mean of 12.5 weeks. No malunion or delayed healing occurred. Two cases occurred ossification in lateral collateral ligament attachment. 2 cases occurred heterotopic ossification in the capitellum in front of capsule joint. The range of elbow extension was (16 +/- 7) degrees, flexion was (115 +/- 9) degrees, the average are of pronation and supination was (65 +/- 5) degrees and (60 +/- 5) degrees respectively. According to Broberg-Morrey standard, there were excellent in 7 cases, good in 8 cases, fair in 2 cases, and average score was 92.44 +/- 4.64.

CONCLUSIONFor transarticular shear fractures of the distal humerus, classification should be performed according to preoperative X-ray and CT, cannulated screw and buttress plate combined and early function rehabilitation could recover elbow function.

Adult ; Bone Plates ; Bone Screws ; Female ; Fracture Fixation, Internal ; methods ; Humans ; Humeral Fractures ; physiopathology ; surgery ; Male ; Middle Aged ; Range of Motion, Articular

OBJECTIVETo investigate the therapeutic efficacy of bone-setting manipulative reduction and small splint fixation combined with micro-movement theory exercise for treatment of humeral shaft fractures.

METHODSFrom March 2011 to February 2014, 64 cases of humeral shaft fractures were treated by bone-setting manipulative reduction and small splint fixation including 28 males and 36 females with an average age of 38.1 years old ranging from 22 to 67 years old. According to the classification of AO/OTA, there were 10 cases of type A1, 12 cases of type A2,11 cases of type A3,10 cases of type B1,12 cases of type B2, 7 cases of type B3, 2 cases of type C1, 1 case of type C2, 1 case of type C3. After close reduction early functional exercise performed according to micro-movement theory. All patients had no other parts of the fractures, neurovascular injury, and serious medical problems. Patients were followed up for fracture healing, shoulder and elbow joint function recovery, and curative effect.

RESULTSAll patients were followed up from 10 to 12 months with an average of 10.3 months. Of them, 2 cases had a small amount of callus growth at 3 months after close reduction, so instead of operation; 2 cases appeared radial nerve symptoms after close reduction ,so instead of operation. Other patients were osseous healing, the time was 8 to 12 weeks with an average of 10.2 weeks. After osseous healing, according to Constant-Murley score system ,the average score was (93.5 ± 3.2) points, the result was excellent in 29 cases, good in 29 cases, fair in 6 cases, excellent and good rate was 90.3%; according to the Mayo score system, the average score was (93.7 ± 4.2) points, the result was excellent in 35 cases, good in 23 cases, fair in 6 cases, excellent and good rate was 91.9%.

CONCLUSIONBone-setting manipulative reduction and small splint fixation combined with micromovement theory exercise for treatment of humeral shaft fractures has advantage of positive effect, easy and inexpensive method, the treatment has relevant scientific basis and practical value, it can effectively reduce complications, promote patients early recovery.

Adult ; Aged ; Exercise Therapy ; Female ; Fracture Healing ; Humans ; Humeral Fractures ; physiopathology ; therapy ; Male ; Manipulation, Orthopedic ; methods ; Middle Aged ; Movement ; Splints

Objective To explore the clinical features and the combined treatment modality of Hurthle cell thyroid tumor(HCT). Methods Twenty-eight cases of HCT treated between 2001 and 2009were analyzed retrospectively. Results The age of the patients ranged from 18 to 72 years (with a median of 46.5 years); 22 females and 6 males. The main symptoms were thyroid solitary node or mass(22 cases)and multiple nodule(6 cases), 2 cases with cervical lymph node metastasis. All of the patients underwent surgery, 11 cases with thyroid lobectomy, 11 cases with thyroid lobectomy plus isthmusectomy, 4 cases with subtotal thyroidectomy, and 2 cases with thyroid lobectomy plus isthmusectomy and combined with modified radical cervical lymph node dissection. Postoperative pathological examination showed that 22 cases were Hurthle cell adenomas and 6 cases were Hurthle cell carcinomas, 1 of them with cervical lymph nodemetastasis. Twenty-one patients with Hurthle cell adenomas were followed up for 6 months to 7.5 years (with a median of 45 months) and 6 patients with Hurthle cell carcinomas for 3 to 8 years (with a median of 54 months), with no recurrence and death case. Conclusions HCT is a potential malignant neoplasm.There are some difficulties in the diagnosis of HCT by frozen section. Surgery is an effective treatment for HCT. L-Thyroxine can be used to inhibit TSH excretion.

The main species and research status were introduced for the haemostatic dressing of the prehospital first aid in foreign countries and China.The advantages and disadvantages,problems and futural development were analyzed for kinds of haemostatic dressing.It's pointed out that the haemostatic dressing tended to be multi-functional and complicated in the future.Dressing and haemostatic system had to be designed based on traumatic conditions in case multi function could not be realized.

OBJECTIVE: To investigate the numbers, sizes and types distribution of diatoms in drowned and postmortem immersed rabbits' lungs. METHODS: Sixty-two rabbits were randomly divided into drowning group (n = 30), postmortem immersion group (n = 30) and land death group (n=2), and the diatoms in each lung lobe were analyzed quantitatively and qualitatively by microwave digestion and scanning electron microscopy. RESULTS: In the drowning group, the diatoms were detected in each lung lobe with Cyclotella and Melosira in the majority. In the postmortem immersion group, Cyclotella was in the majority. And the diatoms weren't detected in some lung lobes in postmortem immersion. There were significant differences in the detection rates of upper lobe of left lung, middle lobe and cardiac lobe of right lung in two groups (P < 0.05). CONCLUSION Based on the microwave digestion and scanning electron microscopy, the numbers, sizes and types distribution of diatoms in drowned and postmortem immersed rabbits' lungs can be analyzed and used as references for testing theory.
Animals ; Autopsy ; Diatoms/isolation & purification* ; Drowning ; Lung/microbiology* ; Microscopy, Electron, Scanning ; Microwaves ; Rabbits

Objective:To investigate the therapeutic efficacy of bone setting manipulative reduction and small splint fixa-tion combined with micro movement theory exercise for treatment of humeral shaft fractures. Methods:From March 2011 to February 2014,64 cases of humeral shaft fractures were treated by bone setting manipulative reduction and small splint fixation including 28 males and 36 females with an average age of 38.1 years old ranging from 22 to 67 years old. According to the clas-sification of AO/OTA,there were 10 cases of type A1,12 cases of type A2,11 cases of type A3,10 cases of type B1,12 cases of type B2,7 cases of type B3,2 cases of type C1,1 case of type C2,1 case of type C3. After close reduction early functional exercise performed according to micro movement theory. All patients had no other parts of the fractures, neurovascular injury, and serious medical problems. Patients were followed up for fracture healing ,shoulder and elbow joint function recovery ,and curative effect. Results:All patients were followed up from 10 to 12 months with an average of 10.3 months. Of them ,2 cases had a small amount of callus growth at 3 months after close reduction ,so instead of operation;2 cases appeared radial nerve symptoms after close reduction,so instead of operation. Other patients were osseous healing,the time was 8 to 12 weeks with an average of 10.2 weeks. After osseous healing,according to Constant-Murley score system,the average score was (93.5±3.2) points,the result was excellent in 29 cases,good in 29 cases,fair in 6 cases,excellent and good rate was 90.3%;according to the Mayo score system,the average score was (93.7±4.2) points,the result was excellent in 35 cases,good in 23 cases,fair in 6 cases,excellent and good rate was 91.9%. Conclusion:Bone setting manipulative reduction and small splint fixation combined with micromovement theory exercise for treatment of humeral shaft fractures has advantage of positive effect ,easy and inexpen-sive method,the treatment has relevant scientific basis and practical value,it can effectively reduce complications,promote pa-tients early recovery.

OBJECTIVETo investigate the association of single nucleotide polymorphisms (SNPs) of 1772 (C-->T) and 1790 (G-->A) in exon 12 of hypoxia-inducible factor 1, alpha subunit gene (HIF1A) with hypoxia adaptation in high altitude in Sherpas.

METHODSThe blood samples were chosen from 148 Sherpas in Tibet high altitude and 90 Han nationality healthy people in Guangdong province, and from which genomic DNA was extracted. The single nucleotide polymorphisms of 1772(C-->T) and 1790(G-->A) in exon 12 of HIF1A gene were examined by restriction fragment length polymorphism-polymerase chain reaction (RFLP-PCR).

RESULTSThe genotype frequency of HIF1A gene 1790 (G-->A) in Sherpas and Han nationality was 57.43% versus 75.56% in GG genotype, 37.84% versus 21.11% in GA genotype and 4.73% versus 3.33% in AA genotype. GG genotype frequency in Sherpas was lower than that in Han nationality (P<0.01), while GA genotype frequency in Sherpas was higher than that in Han nationality (P<0.01). No significant difference in CC, CT and TT genotype frequency of 1772(C-->T) was shown between two groups respectively. The total frequency of CC + GA, CT + AA, TT + GA and TT + AA in Sherpas was higher than that in Han nationality.

CONCLUSIONPolymorphisms of HIF1A gene 1790 (G-->A) are associated with hypoxia adaptation in high altitude in Sherpas. GA and AA genotype may be benefit to hypoxia adaptation, and it is worthy of deep-going investigation.

Adaptation, Physiological ; genetics ; physiology ; Altitude ; Gene Frequency ; Genotype ; Humans ; Hypoxia ; physiopathology ; Hypoxia-Inducible Factor 1 ; genetics ; Linkage Disequilibrium ; Polymerase Chain Reaction ; Polymorphism, Restriction Fragment Length ; Polymorphism, Single Nucleotide ; genetics ; Tibet

OBJECTIVETo study the effect of the degree of muscle relaxation on motor-evoked potential elicited by transcranial electrical stimulation in patients undergoing spine surgery.

METHODSSixty ASA I or II patients undergoing spine surgery were randomly divided into 5 groups (n=12). After an initial intubation, continuous cisatracurium infusion was administered with continuous monitoring of T1. The infusion dose was adjusted according muscle relaxation monitoring, and different muscle relaxation degrees were maintained in the 5 groups. The band and latency of D1 in motor-evoked potential was observed with also subjective assessment of the muscle relaxation.

RESULTSSignificant differences in the band and latency were noted in groups I and II compared with the reference values, but not in groups III, IV and V. Subjective assessment revealed significant differences between groups IV and V and groups I and III in terms of the number of cases with poor muscle relaxation.

CONCLUSIONT1 value between 10% and 15% is sufficient for MEP monitoring and allows the maintenance of good muscle relaxation during spine surgery.

Atracurium ; therapeutic use ; Electric Stimulation ; Evoked Potentials, Motor ; Humans ; Monitoring, Intraoperative ; Muscle Relaxation ; Neuromuscular Nondepolarizing Agents ; therapeutic use ; Orthopedic Procedures ; methods ; Spine ; surgery

OBJECTIVETo investigate the clinical results of arthroscopic surgery for the treatment of stiff elbow.

METHODSFrom October 2010 to December 2012, 27 patients with stiff elbow were treated with arthroscopic debridement and joint capsular releasing. There were 18 males and 9 females, ranging in age from 24 to 54 years old, with an average of 35.7 years old. Analgesia and rehabilitation were necessary after operation. Mayo criteria system was used to evaluate therapeutic effects.

RESULTSAll the patients were followed up, and the duration ranged from 12 to 18 months, with a mean of 13.5 months. The mean maximum flexion angle of patients improved from preoperative (61.5 ± 30.1) degrees to postoperative (102.5 ± 20.1) degrees; and the mean maximum extension angle improved from preoperative (34.8 ± 12.1) degrees to postoperative (16.3 ± 16.1) degrees; the average total range of motion improved from preoperative (34.2 ± 21.0) degrees to postoperative (84.9 ± 9.2) degrees. According to the Mayo criteria system, the average score increased from preoperative 60.5 ± 13.4 to postoperative 88.7 ± 6.3; ten patients got an excellent result, 13 good and 4 fair.

CONCLUSIONArthroscopic surgery to treat elbow stiffness has such advantages as minimal invasion, less blood loss, fast recovery, and clear visualization, which is effective to improve elbow joint functions with less complications.

Adult ; Arthroscopy ; methods ; Elbow Joint ; physiopathology ; surgery ; Female ; Humans ; Joint Diseases ; physiopathology ; surgery ; Male ; Middle Aged ; Treatment Outcome ; Young Adult

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.