ObjectiveTo investigate the clinical effects of minimally invasive incision in anterior traverse approach for Gartland type Ⅲ humeral supracondylar fractures in children.Methods Forty-two patients with Gartland type Ⅲ displaced supracondylar fractures of the humerus were treated through anterior traverse approach between January 2008 and April 2011.The fractures were fixed using two Kirschner wires from the medial and lateral epicondyles placed crossing each other.There were 31 males and 11 females,at age of 2.6-12 years (average 5.7 years).Three patients were with open fractures.Seven patients were combined with other fractures,four with radial nerve injury and one with median nerve injury,with time from injury to hospitalization for a range of 1 hour to 3 days.Of all the patients,30 patients were with fractures on the right side and 12 with fractures on the left side.All fractures were treated by minimally invasive incision in anterior traverse approach,when the neurovascular and muscular probing and repair were performed. Results Forty patients were followed up for 3-32 months ( average 13 months),which showed incision healing at one stage,with fracture healing time for 3-4 weeks (average 3.6 weeks).No cubitus varus or incision scar were found after operation.According to Flynn' s criteria,the effect of treatment three months after operation were excellent in 32 patients,good in four and fair in four,with excellence rate of 90％.ConclusionsThe minimally invasive incision of anterior traverse approach is characterized by minor trauma,small incision,nil scar and convenient neurovascular and muscular exploration and hence is a safe and reliable treatment for open reduction of Gartland type Ⅲ humeral supracondylar fractures in children.

Objective To investigate the effect of intramedullary stabilization of lower limb fractures with titanium elastic nails (TENs) in children.Methods From June 2004 to October 2010,278 children were stabilized with TENs in our hospital,including 181 boys and 97 girlsat average age of 7.6 years (range,3.0-14 years).There were 162 patients with femoral fractures,of which 35 underwent open reduction and the rest closed reduction.There were 116 patients with tibial fractures,which was treated with closed reduction.Postoperative fixation lasted for 3-4 weeks.The mean hospital stay was seven days.Of all the patients,272 patients received the removal of the TENs six months after operation and 242 received more than one year of follow-up to have a further observation on the limb length,hip and knee mobility and gait condition in children.Results All the patients were followed up for 6-66 months (mean,33 months).All fractures were healed in good alignment without severe complications.There were no intraoperative complications like infections,delayed union,nonunion,TEN broken and femoral or tibial epiphysis injuries.Ten patients suffered from swell and skin irritation in the nail' s position 3-4 months after operation,and the nails were removed in advance.Nineteen patients showed unequal lengths ( within 1 cm) of the lower limbs,with normal function of the lower limb joint but with no obvious limp.According to the Flynn evaluation standard,the excellent and good rate was 100％.Conclusions Characterized by good stability,rapid healing,small incision,anatomic reduction,unimpaired periosteum,short hospital stay and few complications,intramedullary stabilization with titanium elastic nails can achieve effective fixation in the treatment of lower limb fractures in children.

Objective To explore the changes of SOX9 and WT1 expressions in rat Sertoli cells irradiated by EMP ( electromagnetic pulse),S-HPM ( S-band high power microwave) and X-HPM ( Xband high power microwave).Methods Primary Sertoli cells were isolated from 3-week-old Wistar rats and its purity was immunocytochemistrically indentified with WT1.After exposure to 6 × 104 V/m EMP,100 mW/cm2 S-HPM and X-HPM for 4 min respectively,SOX9 and WT1 expressions in Sertoli cells were determined with real-time PCR and Western blot,respectively.Results SOX9 mRNA expression was decreased at 6 and 12 h post-irradiation of three different bands of electromagnetic microwave ( F =15.20and 4.84,P ＜ 0.05 ).SOX9 protein expression was also decreased at 6 and 24 h after irradiation ( F =8.46 and 7.47,P＜0.05).WT1 mRNA expression was decreased at6 and 12 h (F=13.46 and 5.08,P ＜ 0.05 ),but its protein expression was decreased only at 24 h post-irradiation ( F =10.26,P ＜ 0.05 ).Conclusions Three bands of electromagnetic radiation reduce the expressions of SOX9 and WT1 in rat Sertoli cells,which may provide molecular foundation for genital system hazards induced by microwave radiation.

Objective To investigate the basic situation of radiodiagnosis and radiotherapy institutions and the frequency of medical exposure in Fangshan District, Beijing, China. Methods A general survey using the questionnaire was conducted online to obtain the basic situation of the radiodiagnosis and radiotherapy institutions, the number of people in each type of radiodiagnosis and radiotherapy project, and the number of the usually resident population in the whole district in 2019, thus obtaining the frequency of medical exposure in each type of radiodiagnosis and radiotherapy project. Results There were 60 radiodiagnosis and radiotherapy institutions, 565 radiology staff, and 199 sets of radiodiagnosis and radiotherapy equipment in the whole district in 2019. The frequency of medical exposure was 521.29 per 1000 people, among which conventional medical diagnostic X-ray workers accounted for 301.79 per 1000 people (57.89%) and computed tomography workers accounted for 207.56 per 1000 people (39.82%). The number of tertiary hospitals accounted for 6.67% of the radiodiagnosis and radiotherapy institutions, and the number of people exposed tomedical radiation in tertiary hospitals accounted for 52.25% of the total. The number of secondary hospitals accounted for 5.00% of the radiodiagnosis and radiotherapy institutions, and the number of people exposed to medical radiation in secondary hospitals accounted for 27.83% of the total. Conclusion The distribution of medical exposure in Fangshan District is uneven. The radiodiagnosis and radiotherapy technology used is relatively single. Relevant departments should strengthen macroscopic readjustment and control, and formulate reasonable policies, so as to rationally allocate and effectively utilize medical and health resources.

Inflammation is closely associated with the development of cancer. Tumor-associated macrophages (TAM) actively participate in tumor-related inflammation and promote tumor growth and metastasis, while under certain conditions, TAM also show cytotoxicity and tumor killing activity and thus inhibit the progression of cancer. Crosstalk between TAM and neighboring cells is closely associated with the progression of hepatocellular carcinoma (HCC) and drug resistance during treatment. This article summarizes the role of macrophages in HCC and the crosstalk between macrophages and other cells, so as to provide new strategies for the clinical diagnosis and treatment of HCC.

Liver failure is a common end-stage liver disease syndrome in clinical practice characterized by massive necrosis of hepatocytes leading to rapid liver failure, and it is currently believed that excessive inflammation and immune response are the core mechanisms of this disease. Endogenous lipid mediators are involved in the regulation of a variety of inflammatory processes, including initiation, maintenance, and regression, and eicosanoids and pro-decomposition lipid mediators, as well as their complex metabolic pathways and transduction signals, play a key role in the regulation of these processes. This article reviews the key role of endogenous lipid mediators in the pathophysiological mechanism of inflammation and immune dysfunction in liver failure and the potential significance and new therapeutic opportunities of lipid immune pathway in liver failure, in order to provide new ideas for the clinical diagnosis and treatment of liver failure.

Glycolysis plays an important role in the development and progression of liver diseases and shows varying degrees of enhancement in different liver diseases, and it is closely associated with mitochondrial dysfunction (oxidative phosphorylation deficiency and reactive oxygen species production), which helps to fill energy production deficiency caused by impaired oxidative phosphorylation. Therefore, it might be possible to search for potential new therapies for liver diseases through targeted regulation of the key factors in aerobic glycolysis, such as hexokinase 2, pyruvate kinase M2, and other regulatory pathways. From the perspective of the association between glycolysis and liver diseases, this article elaborates on the therapeutic significance and potential value of glycolysis in liver diseases, in order to provide new ideas for the diagnosis and treatment of liver diseases.

ObjectiveTo investigate the role and possible mechanism of action of rhubarb decoction （RD） retention enema in improving inflammatory damage of brain tissue in a rat model of mild hepatic encephalopathy （MHE）. MethodsA total of 60 male Sprague-Dawley rats were divided into blank group （CON group with 6 rats） and chronic liver cirrhosis modeling group with 54 rats using the complete randomization method. After 12 weeks， 40 rats with successful modeling which were confirmed to meet the requirements for MHE model by the Morris water maze test were randomly divided into model group （MOD group）， lactulose group （LT group）， low-dose RD group （RD1 group）， middle-dose RD group （RD2 group）， and high-dose RD group （RD3 group）， with 8 rats in each group. The rats in the CON group and the MOD group were given retention enema with 2 mL of normal saline once a day； the rats in the LT group were given retention enema with 2 mL of lactulose at a dose of 22.5% once a day； the rats in the RD1， RD2， and RD3 groups were given retention enema with 2 mL RD at a dose of 2.5， 5.0， and 7.5 g/kg， respectively， once a day. After 10 days of treatment， the Morris water maze test was performed to analyze the spatial learning and memory abilities of rats. The rats were analyzed from the following aspects： behavioral status； the serum levels of alanine aminotransferase （ALT）， aspartate aminotransferase （AST）， interleukin-1β （IL-1β）， interleukin-6 （IL-6）， and tumor necrosis factor-α （TNF-α） and the level of blood ammonia； pathological changes of liver tissue and brain tissue； the mRNA and protein expression levels of phosphatidylinositol 3-kinase （PI3K）， protein kinase B （AKT）， and mammalian target of rapamycin （mTOR） in brain tissue. A one-way analysis of variance was used for comparison of continuous data between multiple groups， and the least significant difference t-test was used for further comparison between two groups. ResultsCompared with the MOD group， the RD1， RD2， and RD3 groups had a significantly shorter escape latency （all P<0.01）， significant reductions in the levels of ALT， AST， IL-1β， IL-6， TNF-α， and blood ammonia （all P<0.05）， significant alleviation of the degeneration， necrosis， and inflammation of hepatocytes and brain cells， and significant reductions in the mRNA and protein expression levels of PI3K， AKT， and mTOR in brain tissue （all P<0.05）， and the RD3 group had a better treatment outcome than the RD1 and RD2 groups. ConclusionRetention enema with RD can improve cognitive function and inflammatory damage of brain tissue in MHE rats， possibly by regulating the PI3K/AKT/mTOR signaling pathway.