OBJECTIVETo explore therapeutic effects of Modified pinning combined with external tension band for the treatment of Gartland type III humeral supracondylar fractures in children.

METHODSFrom February 2009 to November 2010, 79 children with Gartland type III humeral supracondylar fractures were treated by modified pinning (pinning cross internal and external condyle assisted with lateral condyle) combined with external tension band (crossing needle end and hooking around) through lateral approach of elbow. There were 47 males and 32 females, with an average age of 8.7 years (ranging from 2.5 to 14 years). The time from injury to operation was 2 h to 8 d. The elbow joint function and Carrying angle were observed before and after treatment. The Flynn criteria were used to evaluate therapeutic effects.

RESULTSSixty-one patients were followed up (18 patients' data were lost) for 6-30 months (mean 13.5 months). According to Flynn criteria, 53 patients got excellent result, 7 good and 1 fair.

CONCLUSIONTreatment of child Gartland type III humeral supracondylar fractures with modified pinning combined with external tension band through lateral approach of elbow is believed to be an ideal method, which has advantages of reliable fixation, rapid recovery and less complications.

Adolescent ; Bone Nails ; Child ; Child, Preschool ; Female ; Fracture Fixation ; instrumentation ; methods ; Humans ; Humeral Fractures ; diagnostic imaging ; surgery ; Male ; Mechanical Phenomena ; Radiography ; Treatment Outcome

Endoscopes ; Humans ; Nasal Cavity ; surgery ; Nasal Septum ; surgery ; Reconstructive Surgical Procedures ; Rhinoplasty ; Surgical Flaps

Objective To investigate the value of urinary calprotectin in differential diagnosis between prerenal and intrinsic pediatric acute renal injury(AKI).Methods A total of 68 cases with AKI were enrolled in this study,and they were divided into prerenal AKI group(25 cases) and intrinsic AKI group(43 cases) according to their tissue perfusion.The general data was collected,and the blood urea nitrogen(BUN),serum creatinie(Scr),BUN/Scr,potassium,fractional excretion of filtrated sodium(FENa),urine osmotic pressure,B-type natriuretic peptide (BNP),urinary calprotectin,neutrophil gelatinase-associated lipocalin (NGAL),kidney injury molecule 1 (Kim-1) were recorded and compared between the 2 groups.Results There were significant differences between prerenal AKI group and intrinsic AKI group in Scr[(439.0 ± 278.0) μmol/L vs.(603.0 ± 286.0) μmol/L,t =2.30,P ＜ 0.05],BUN/Scr (20.58 ±5.62 vs.14.93 ±4.32,t =4.65,P＜0.05),FENa[(1.5 ±0.6)％ vs.(8.1 ±2.6)％,t =12.46,P＜ 0.05],BNP[95.6(54.0,109.4) ng/L vs.512.3(320.1,520.3) ng/L,Z =2.21,P ＜0.05],urinary calprotectin [20.7(4.3,42.4) μg/L vs.402.4(60.1,498.7) μg/L,Z=3.13,P＜0.05] and NGAL[74.9(14.5,365.5) μg/L vs.684.2(56.2,1 502.5) μg/L,Z =2.35,P ＜0.05].Receiver operating characteristic curve analysis showed that urinary calprotectin[area under the curve(AUC) =0.940] and BNP(AUC =0.909) both had higher value in differential diagnosis.When the cut off value of calprotectin was 240.6 μg/L,its specificity was 96.0％ and the sensitivity was 86.0％.When the cut off value of BNP was 120.6 ng/L,its specificity was 92.0％ and the sensitivity was 90.7％.The diagnostic accuracy was low in Scr,but moderate in BUN,Scr,FENa and NGAL.BUN,potassium,urine osmotic pressure and Kim-1 had no diagnostic value.Conclusions Urinary calprotectin may have higher diagnostic value in the differential diagnosis between prerenal and intrinsic pediatric AKT.It can be used in the clinical diagnosis as a reference index.

OBJECTIVE To evaluate the status of the anxiety and depression in the inpatients of the otolaryngology with hospital anxiety and depression scale(HADs). METHODS A cross-sectional study was conducted from October 2014 to September 2016 at the Department of Otolaryngology, Affiliated Hospital of Yan'an University. We recruited 624 Chinese otolaryngology's inpatients to determine the prevalence of anxiety and depression using the HADs. HADs consists of 14 items, depression(seven items) and anxiety(seven times), each with four choices numbered alphabetically. Each of the subscales' scores ranges from 0 to 21, corresponding to total scores of 0 to 42, with higher scores indicating greater distress. Psychological distress was assessed for adult inpatients among the department of otolaryngology by a standardized HADs. In addition, the nasal bone fracture patients were treated as control and compared it to other diseases. Demographic data and clinical information collected from the patients and their hospital records were reviewed. RESULTS 1. Patients with sensorineural hearing loss, secretory otitis media, sudden sensorineural hearing loss, benign paroxysmal positional vertigo, peripheral facial paralysis, chronic sinusitis, polyp of vocal cord, laryngeal paralysis, fungal sinusitis and OSAHS revealed depressive and anxiety symptoms in comparison with the control. 2. Psychological distress of patients with sensorineural hearing loss and laryngeal paralysis were significantly related to education, which the anxiety or depression scores tended to increase with the education(P<0.05). CONCLUSION Depression and anxiety disorders were common in the local population of otolaryngology's inpatients. Recognizing the predictors for psychiatric morbidity could assist clinicians to identify those patients with a predisposition to developing psychiatric complications, and refer them for appropriate treatment. We recommend screening for psychological distress in patients with some otolaryngological diseases using a simple HAD tool to identify those patients who might benefit from a more psychologically based approach to therapy.

Objective To observe the expressions of interferon gamma (IFN-γ) and IFN-γ-inducible protein 10 (IP-10) at different stages of chronic hepatitis B virus (HBV) infection,and to investigate the relationship between IP-10 with hepatic inflammation activity and hepatitis aggravation.Methods Fifteen chronic hepatitis B (CHB) patients,15 asymptomatic HBV carriers (AsC) and 15 chronic severe hepatitis B (CSHB) patients were enrolled in the study from January 2010 to December 2011 in the Third Hospital of Hebei Medical University.The liver samples were collected by percutaneous needle biopsy or from liver transplantation.The IFN-γ and IP-10 mRNA expressions were measured by quantitative real-time polymerase chain reaction (PCR).Localization and hemi-quantitative analysis of IFN-γand IP-10 proteins were performed by immunohistochemistry staining.Concentrations of serum IFN-γ and IP-10 were quantified by enzyme linked immunosorbent assay (ELISA).HBV markers and liver function were also evaluated for each patient.Results Serum IFN-y and IP-10 concentrations increased significantly in CHB [(415.27±145.52) ng/L and (6.98± 1.12) ng/L,respectively] and CSHB [(658.33 ± 213.52) ng/L and (10.78 ± 1.19) ng/L,respectively] patients compared with AsC [(142.09 ± 47.64) ng/L and (2.4 7 ± 0.60) ng/L,respectively] patients,and were highest in CSHB patients (F=43.48,256.98 ;both P＜0.05).Meanwhile,intrahepatic IFN-γ and IP-10 mRNA and protein expressions paralleled with IFN-γ and IP-10 concentrations in the serum,which was highest in CSHB patients,followed by CHB and AsC patients (F＝693.85,210.21,433.05,214.46; all P＜0.05).Furthermore,Spearman linear correlation analysis showed that serum IP-10 level was positively correlated with both hepatic inflammation activity and serum IFN-γ concentration in CHB and CSHB patients (r =0.76 and r 0.77,respectively;both P ＜ 0.05).Conclusions IP-10,one important immunologic marker of regulating anti HBV activation,indicates progression from immune tolerance phase to immune clearance phase.Furthermore,it may affect the degree of inflammation and hepatitis aggravation.

A nest RT-PCR/restriction test has been developed in order to distinguish the lapinised vaccine strain from field isolates of classical swine fever virus. The restriction enzyme cut sites mapping of the major coding sequence of E2 gene lapinised vaccine strain and ShiMen strain of classical swine fever virus have been compared. Ten and sixteen unique restriction markers have been found in the lapinised vaccine strain and ShiMen strain. The restriction enzyme cut sites mapping of the twenty six unique restriction marker in the major coding sequence of E2 gene of 17 classical swine fever field isolates have been analyzed. Only 3 sites (HgaI、Hin8I及Hsp92I) are present in the lapinised vaccine strain sequence. Two pans of nested primers and a criteria of analysis have been designed for HgaI restriction marker site. The tests have been conducted first on the lapinised vaccine strain and ShiMen strain of classical swine fever virus resulting in predicted restrection patterns. Finally, the tests have been applied to 5 field isolates of different gene group analyzed by phylogenetic study. The result showed that only HCLV strain gene can be cut to 2 fragment by Hgal , and ShiMen strain and 5 field isolates cant be cut At the same time the sensitivity and specificity of nest RT-PCR have been tested. The sensitivity is 0. 2MLD. The specific fragment of BDV and BVDV were not obtained by the nest RT-PCR. These results showed that the development of the nest RT-PCR/restriction tests is very important for the control and perish of classical swine fever in china.

Objective To observe the effects of astragaloside Ⅳ on electrocardiogram (ECG) and action potential of ventricular myocytes in guinea pigs. Methods ECG was recorded in vivo and ex vivo by using conventional ECG recording method from anesthetic guinea pigs and Langendoff perfusion model of hearts. Action potentials were recorded from isolated papillary muscles of right ventricles of guinea pigs by using microelectrode techniques. Results RR interval was prolonged by Astragaloside Ⅳ in a dose-dependent manner both in vivo and ex vivo. Astragaloside Ⅳ shortened action potential duration (APD), while had no effects on resting potential, action potential amplitude and maximal rate of depolarization. Conclusion Astragaloside Ⅳ exerts a negative chronotropic effect on heart and shortens APD of cardiac myocytes, which may be involved with calcium channels.

Objective To explore renal transplantation model in non-human primate cynomolgus monkeys.Methods 50 non-human primates' kidneys were transplanted into the lower part of the abdomen with end-to-side anastomosis of renal artery to aorta and renal vein to inferior vena eava,and with end-to-end anastomosis of ureter to bladder.Results In the 50 cases,1 case death as accident of anesthesia;7 cases with postoperative complications,and all with creatinine sudden rise,after ultrasonic examinations showed that 2 cases with renal vein thrombosis,and 5 cases appeared urinary leakage.All animal models were without surgical infections,and with normal serum creatinine,urine output.Conclusion Non-human primate animal kidney transplantation model establishment method is reliable,but should pay attention to the the surgical technique training,complications prevention.The model is valuable for application in the research of immune tolerance,heterogeneous transplant.

Objective To evaluate the safety and efficacy of colour doppler in guiding the percutaneous nephrolithotomy(PCNL) for Staghom calculi.Methods The clinical records of 46 patients with renal calculi who underwent PCNL were retrospectively analyzed.Patients' mean age was 43 years old,and the range of diameter of stone was 3.0 -7.5 cm.Among these cases,29 cases had complete staghorn calculus.One case had isolated kidney stone.And the other 6 patients had open surgery history.Using Colour Doppler guidance,the percutaneous nephrolithotomy for renal calculi was conducted.Results F22 percutaneous channel was successfully established in 55 sides of 46 patients,with the first and the second phase surgeries of 41 and 14 sides respectively.Single-,double- and three-channel PCNL were performed in 38,16,and 1 sides respectively.Abdominal x-ray conducted at 3 -4 days post operation revealed residual stones on 18 sides,with the range of 0.4 -2.0 cm in diameter.Second-phase lithotripsy was conducted on 14 sides of patients.After the first and the second phases of surgery,4 sides having residual stones ranging 0.6 - 1.0 cm,underwent extracorporeal shock wave lithotripsy.Ater the third-phase surgery,the diameters of residual stones were much less than 0.5 cm and patients were treated with medication.The total rate of clearance was 87.0％ (48/55).The duration of surgery was 65 - 160 minutes and 95 minutes on average.One patient having delayed bleeding was cured with selective renal artery embolization.There were no complications such as nephrectomy,deaths,pleural or intestinal damage during the period of study.Patients were followed up for 3 to 18 months.Six of 9 patients with renal insufficiency recovered after surgery.The serum creatinine in the remaining 3 patients ranged 185 -220 μmol/L Conclusion Colour Doppler-guided percutaneous nephrolithotomy for renal calculi is safe and effective.

Objective Exogenous small-diameter vascular grafts have been developed with tissue-engineered small-di-ameter vascular grafts for the reconstructive surgery in the treatment of patients with coronary artery diseases in whom restenosis of the initially transplanted autografts occurred.This study was conducted to develop decellularized umbilical arteries (HUAs) and evaluate their physical and mechanical properties,as well as to assess the usefulness of decellularized HUAs in the coronary artery bypass grafting procedures.Methods After HUAs were harvested,their inner diameters were measured with a sliding caliper and the blasting pressure was measured with a pressure gauge.HUAs were firstly infused with a compound liquid consisted of 0.25％ Trypsin and 0.01％ Ethylene Diamine tetraacetic Acid(EDTA) and then with 1％ Sodium Lauryal Sulfate (SDS).Fragments of the vessels were collected and observed under light microscope and electron microscope.The mechanical characteristics of HUAs were identified with an electronic experiment machine before and after decellularization.Fibroblasts and endothelial progenitor cells growing along the lining of decelluarized human umbilical arteries(dHUAs) could be observed.Results The average inner diameter of HUAs was ( 3.50 ± 0.55 ) mm.Two of thirty HUAs were broken at a pressure of 300 mm Hg.The process for the lining of HUAs to be decellularized with a peristaltic pump took 0.5 hour with 0.25％ Trypsin and 0.01％ EDTA and 3 hours with 1％ SDS.Observations with light microscope and electron microscope demonstrated that all of the original lining cells were decellularized.The ultimate stress of the HUAs did not change significantly after decellularization ( P ＞0.05 ).Attached fibroblasts and endothelial progenitor cells could be seen along the decellular lining of the grafts and the ultimate stress of the HUAs did not change significantly after implantation of the two kinds of cells.Conclusion dHUAs,with good histocompatibility and properties mentioned above,may be used as potential vascular grafts in CABG.