Objective To systematically review the existing evidence about the effect of medial and lateral (crossed) entry pins versus only lateral entry pin fixation on the supracondylar fractures of the humerus in children.Methods Eligible studies were identified in Cochrane library,the Cochrane Bone,Joint and Muscle Trauma Group (till March 2011 ),Medline (from 1966 to March 2011 ),EMbase (from 1966 to 2011 ),CBM (from January 1979 to March 2011 ),PubMed,Wanfang Data (from 2000 to March 2011 ) and CNKI and the references of the included studies and several Chinese orthopedic journals were manually searched.Then,the randomized controlled trials (RCTs) and quasi-randomized controlled trials (CCTs) about two entries (crossed and only lateral pinning) for supracondylar fractures of humerus in children were collected.After evaluation of methodology with the enrolled studies,available data was extracted and systematic review was conducted via the method recommended by the Cochrane Collaboration.Results In total,five RCTs involving 311 patients were involved.Compared with the preoperative data,the meta-analysis results showed no significant difference in reduction stability in terms of change in Baumann angle and Carrying angle between the two groups.For the postoperative function outcome including complete reduction,Flynn grade and full return to function,no significant difference was found between the two groups.For the postoperative complications,there was no difference in the infection of pin tract,though lateral entry resulted in a significant lower incidence of the iatrogenic nerve injury compared with the medial and lateral entry.Conclusions With the Kirschner wire fixation for supracondylar fractures of humerus in children,current existing evidences indicate that the lateral entry of pinning has similar results in reduction stability,function outcome and incidence of pin tract infection compared with medial and lateral entry.Nevertheless,lateral entry,as a safe pinning technique,may effectively decrease the risk of iatrogenic nerve injury

Objective To summarize the clinical features of mercury poisoning diagnosed by blood and urine tests for improving the diagnosis and treatment of the disease.Methods Poisoning causes,clinical manifestations,diagnosis,treatment and prognosis were retrospectively reviewed in 92 in-patients with mercury poisoning in our hospital from January 2000 to April 2010.Results Of the 92 patients,37 were male and 55 were female with an average age of 33.1(2-65)years old.The mercury poisoning was caused by occupational exposure and non-occupational exposure,such as iatrogenic exposure,life exposure and wrong intake or suicidal intake of mercury-containing substances,mainly through respiratory tract,digestive tract and skin absorption.The most common clinical symptoms were as the followings:nervous system symptom,such as memory loss in 50 eases(54.3%),fatigue in 34(37.0%),numb limb in 25 (27.2%),dizziness and headache in 22(23.9%),cacesthesia in 20(21.7%),fine tremor(finger tip,tongue tip,eyelids)in 15(16.3%),insomnia and more dreams in 12(13.0%);gastrointestinal symptoms:nausea in 16 (17.4%),abdominal pain in 14(15.2%),stomatitis in 5(5.4%);joint and muscle symptoms:muscle pain in 16(17.4%),joint pain in 5(5.4%);cardiovaseular system:chest tightness,hean palpitations in 6(6.5%);urinary system:edema in 9(9.8%);other system:hidrosis in 20(21.7%).After the treatment with sodium dimercaptopropane sulfonate (DMPS),the symptoms were gradually alleviated.Their gastrointestinal,cardiovascular symptoms were alleviated within 2 weeks;neurological symptoms were alleviated within 3 months;kidney damage showed a slower recovery and could be completely'alleviated within 6 months.Conclusions Because of its diverse clinical symptoms,the mercury poisoning was easy to misdiagnosis and missed diagnosis:therefore the awareness of the disease should be further enhanced.Leaving from the poisoning environment timely and giving appropriate treatment with DMPS will lead to a satisfactory prognosis.

AIM: To establish individualized drug therapy strategy for patients with rejection and hyperglycemia after liver transplantation. METHODS: Clinical pharmacist collaborated with the surgeons and participated in the diagnosis and treatment of rejection and hyperglycemia after liver transplantation. Taking together liver function, therapeutic drug monitoring, drug-drug interactions between tacrolimus and wuzhi capsule, individualized drug therapy was adapted to improve the prognosis. RESULTS: The patient recovered well and survived in good health till now. CONCLUSION: It is highly suggested that clinical pharmacists actively involved in treatment of more severe and difficult-to-treat disease and design the individualized dosing regimens. This will largely contribute in reduced adverse drug reaction, improved safety and effectiveness in drug use as well as the quality of life in the "post-transplantation era".