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

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

Objective To investigate early and differential diagnosis of Alzheimer disease and vascular dementia (VD)using FDG-PET scan. Methods Clinical data was collected from AD,VD and normal control(NC). 18F-2-fluo-ro-deoxy-D-glucose(18F-FDG)PET scan was conducted to detect the cerebral FDG metabolism. The average standard uptake value (SUV) of cerebral regions was expressed as semiquantitative index relative to ipsilateral cerebellum. Re-sults There were no differences in age and the mean total scores of the mini mental status examination (MMSE) between patients with VD and those with AD.The AD group showed that the SUV was significantly decreased in the right frontal, parietal,temporal lobe,hippocampus,temporo-parietal junction,and bilateral posterior cingulate cortex compared to the VD and in the bilateral posterior cingulate cortex,temporo-parietal junction,frontal and temporal lobe comparing to the NC(P≤0.01). SUV was significantly increased in the right parietal,posterior cingulate cortex and hippocampus whereas was significantly decreased in the left frontal lobe,temporo-parietal junction and thalamus in the VD compared with NC group(P≤0.01). Conclusion AD patients have typical features of 18F-FDG PET which may be helpful for the diagnosis of AD in the early stage.

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

OBJECTIVETo investigate the clinical effect of internal fixation with closed reduction and hollow compression screws for the treatment of femoral neck fracture in young and middle-aged patients.

METHODSFrom June 2013 to December 2016, 33 young and middle-aged patients with femoral neck fractures were treated with hollow compression screws fixation including 17 males and 16 females with an average age of 38.5 years old ranged from 19 to 59 years old; 20 cases were on the left side and 13 cases on the right side;the time from injury to operation ranged from 2 to 5 days with an average of 3 days. According to Garden classification, 1 case were type I, 11 cases were type II, 18 cases were type III, 3 cases were type IV. During regular follow-up after operation, through the hip joint X-ray, the healing situation of bone and osteonecrosis were observed. The Harris score was used to evaluate the hip function of the final follow-up.

RESULTSThe operation time was from 30 to 50 minutes, the blood loss during operation was 20 to 70 ml. All patients were followed up for 8 to 42 months with an average of 24 months. At the final follow-up, the Harris score of hip joint was excellent in 18 cases, good in 10 cases, fair in 2 cases and poor in 3 cases. Among them, the pain scores were 40.61±5.08, function scores were 38.94±6.78, malformation scores were 3.88±0.69, motion range scores were 3.70±0.64 and the total scores were 87.12±11.98. Thirty cases achieved bone healing, the healing time was 4 to 12 months with an average of 7.5 months, 2 patients occurred with nonunion (Garden type IV), 1 patient with femoral head necrosis (Garden type IV). All patients had no postoperative infection, internal fixation loosening, refracture and other complications.

CONCLUSIONSIn treating the young and middle-aged patients with femoral neck fracture, closed reduction and hollow compression screw fixation has advantages of simple, stable fixation, less trauma, high rate of fracture healing, osteonecrosis of the femoral head with low risk and satisfactory clinical effect.

Water eutrophication has become a worldwide environmental problem in recent years, and understanding the mechanisms of water eutrophication will help for prevention and remediation of water eutrophication. In this paper, recent advances in current status and major mechanisms of water eutrophication, assessment and evaluation criteria, and the influencing factors were reviewed. Water eutrophication in lakes, reservoirs, estuaries and rivers is widespread all over the world and the severity is increasing, especially in the developing countries like China. The assessment of water eutrophication has been advanced from simple individual parameters like total phosphorus, total nitrogen, etc., to comprehensive indexes like total nutrient status index. The major influencing factors on water eutrophication include nutrient enrichment, hydrodynamics, environmental factors such as temperature, salinity, carbon dioxide, element balance, etc., and microbial and biodiversity. The occurrence of water eutrophication is actually a complex function of all the possible influencing factors. The mechanisms of algal blooming are not fully understood and need to be further investigated.
Animals ; Environment ; Eukaryota ; growth & development ; isolation & purification ; Eutrophication ; Humans ; Water ; analysis ; Water Microbiology

Objective To observe the blood biochemical and histological changes before and after pancreas freezing, to provide evidence for cryosurgery for pancreatic cancer. Methods Fifteen healthy pigs were divided into deep frozen group (n = 5), shallow frozen group (n = 5), non-frozen group (n = 3) and normal group (n = 2). After anesthesia and Iaparotomy, a probe of the Argon-Helium Surgical System was inserted into the pancreas, 100% and 10% argon output power were used in deep and shallow frozen group, respectively;and the temperature were - 130 ～ - 140℃ and - 110 ～ - 120℃, respectively;which results in an ice-ball with 15 ～ 20 mm in diameter. Then helium gas was inputted to increase the temperature to 10 ～ 20℃ for three minutes;then the whole process was repeated. A probe was inserted into the pancreas in the non-frozen group only and only laparotomy was performed in non-grozen group normal group and normal group. Serum amylase, IL-6, CRP levels before and after the experiment was determined;the pigs were sacrificed at day 7 and the pancreas was harvested for light microscope and electron microscope examination. Results The frozen pancreatic tissue became pitchy necrosis zone, and it could be distinguished from non-frozen tissue;there were obvious tissue necrosis in the center and para-center of frozen area, and the ultra-structure were destroyed and disappeared, mitochondria degranulation and rough endoplasmic reticulum degrannlation were observed. Serum amylase was elevated in 13 (86.7%) pigs and most returned to normal at 6th day. Serum IL-6 was slightly elevated in 5 (33.3%) pigs. There was no significant difference among all the groups in term of serum CRP. All the pigs were alive until the time of sacrifice. Conclusions Cryosurgery has affirmative fatal ablative effects on pancreatic tissue, and it is safe with no serious complications.

mRNA therapy, which involves the use of mRNAs as drugs for disease treatment, is a new kind of gene therapy. It can either treat diseases caused by gene deficiency or repair tissue through the expression of functional proteins, or be applied to immunothera-py through the expression of antigens, antibodies, or receptors, and is thus, of great value for various clinical applications. In tumor im-munotherapy, mRNA that encodes tumor-related antigens, or specific antigens, antibodies, or receptors enters the cytoplasm and is translated into proteins, which then induce specific immune responses, thereby enabling disease prevention and treatment. With the development of immunotherapy and mRNA technologies, mRNA therapy for malignant tumors and infectious diseases has entered the stage of clinical applications. This review briefly introduces the synthesis, purification, and modification of mRNA, with emphasis on mRNA-based tumor immunotherapy, clinical trial results, and key opportunities and challenges in the development of new drugs.

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.

Objective:To study and compare the prognosis of different pathological subtypes of renal cell carcinoma (RCC).Methods:Clinicopathological and prognostic data of 1 346 cases of postoperative renal cell carcinoma during July 2002 to June 2014 in West China Hospital were collected retrospectively.There were 839 males and 507 females, aged (55.1±13.4)years, including 1 120 cases of clear cell RCC, 62 cases of papillary RCC, 79 cases of chromophobe RCC and 85 cases of the other pathological types respectively. ECOG 0 and ≥1 were 911 and 435 cases, with; T 1, T 2, T 3 and T 4 of 1 019, 177, 102 and 48 cases respectively; WHO nuclear grade for well, intermediate, poor differentiation and unknown were 587, 530, 85 and 144 cases separately.Tumor size <5cm, 5-10cm, ≥10cm and unknown were 685, 541, 104 and 16 cases.Combined with necrosis or sacromatoid differentiation were 200/1 146 and 27/1 319 cases separately. Meanwhile, data of 80 439 cases from Surveillance, Epidemiology, and End Results Program (SEER) were also collected.There were 51 371 males and 29 068 females, aged (60.9±12.4) years; , with 66 261, 8 680, 5 022 and 476 cases of White, Black, Asian, American native, or unknown race separately. There were 62 600 of clear cell RCC, 12 170 of papillary RCC, 4 354 of chromophobe RCC and 1 315 of other pathological types, with T 1, T 2, T 3 and T 4 of 55 332, 8 687, 15 516 and 904 cases respectively; WHO nuclear grade for well, intermediate and poor differentiation were 52 323, 22 700 and 5 416 cases separately.Tumor size <5cm, 5-10cm, ≥10cm were 46 741, 25 760 and 7 938 cases respectively. Kaplan-Meier survival analysis were performed on these two group of cases, with different factors between subgroups (gender, age, pathological types, tumor stage, size and nuclear grade) evaluated by log-rank test. To evaluate accuracy of outcome prediction models of SSIGN, Leibovich and UISS score, concordance index of these models were evaluated. Results:In 1 346 cases of our cohort, those with chromophobe RCC were well prognostic, survival were relatively better in clear cell RCC than that of papillary RCC, and worst prognosis were demonstrated in those with other types of RCC (5 year overall survival rate: 97.5%, 87.9%, 79.7% and 68.4% separately). Poor prognosis were seen in those older than 50 years, with poor T stage or nuclear grade, large tumor size and tumors with necrosis or sacromatoid differentiation ( P<0.05). In 80 439 seer cases, the best prognosis was also seen in chromophobe RCC and the worst in other type of RCC separately (5 year overall survival rate: 96.3% and 85.3%). In addition, longer survival was seen in papillary RCC than clear cell RCC (5 year overall survival rate: 92.5% and 88.9%). However, similar results with our cohort were seen in Asian and American native subgroup of SEER cases (95.1%, 88.6%, 86.7%, 80.2% for chromophobe, clear cell, papillary and other types of RCC respectively). Poor prognosis were seen in those older than 50 years, males, Asian/ American Indian, poor T stage or nuclear grade and large tumor size ( P<0.05). Concordance index for SSIGN, Leibovich and UISS models in our cohort were 0.763-0.781, 0.725-0.752 and 0.641-0.660, respectively. The chromophobe RCC subgroup was relative better based on predictive value of prognosis models(c-index of UISS of 0.670-0.781, SSIGN and Leibovich of 0.733-0.903). Conclusions:In Asian RCC population, prognosis of chromophobe RCC is best, clear cell RCC is slightly better than papillary RCC, and the prognosis of other types of RCC is the worst. Concordance index of SSIGN and Leibovich in our cohort were higher than that of UISS, and the use value for predictive model was better in the chromophobe RCC subgroup.