Objective serous endotoxin(ET) were measured to determine the relationship between serous endotoxin and differ‐ent type of intestinal obstruction in children .Methods 25 inguinal hernia patients and 43 intestinal obstruction patients were classi‐fied into control group(n=25) ,incomplete intestinal obstruction (n=20) and complete intestinal obstruction group without necrosis of intestine (n=23) according to degree of obstruction .Serous endotoxin were measured in different time (the day of admission ,one day after admission or ,preoperation and one day postoperation ) ,and t test is used to determine the difference between them . Results ET in different group was(6 .53 ± 14 .96) ,(4 .40 ± 1 .15) ,(4 .20 ± 1 .20) ,(4 .09 ± 1 .31) ,(3 .70 ± 1 .46)EU/mL ,respec‐tively .There were no difference between each group .Conclusion ET examination suggests there is no difference between different type of intestinal obstruction in children and endotoxemia is not found in intestinal obstruction according to the results .

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 the clinical significance of anticardiolipin antibodies (ACA)in patients with hemorrhagic fever with renal syndrome(HFRS).Methods The serum ACA- IgM and ACA-IgG in 175 cases of renal diseases and 50 healthy cases were detected by enzyme-linked immunosorbent assay(ELISA). The positive rates of ACA were calculated and compared among different groups.Results The positive rates of ACA-IgM and ACA-IgG in control group were both 0 (0/50),while they were 85.2%(46/54)and 24.1%(13/54)respectively in patients with HERS. 25.0%(13/52)and 21.2%(11/52)respectively in patients with lupus nephritis and 13.0%(9/69) and 8.7%(6/69)respectively in patients with nephrotic syndrome.The poshive rate of ACA lgM in patients with HFRS was higher than that in control group,lupus nephritis group and nephritic syn- drome group(P

Objective:To investigate the efficacy and safety of video assisted thoracic surgery and thoracic surgery in the treatment of myasthenia gravis.Methods:60 patients with myasthenia gravis were selected and randomly divided into two groups.The observation group(32 cases) received video assisted thoracic surgery.The control group(28 cases) received thoracic surgery.The efficacy and safety of video assisted thoracic surgery and thoracic surgery in the treatment of myasthenia gravis was evaluated by perioperative indexes,QMG scores before operation,after 3 months,6 months operation and complications during 6 months follow-up.Results:During the perioperative period,there was no statistical significance in the operation time between two groups(P＞0.05).The bleeding volume of observation group was less than that of the control group (P＜0.05).The drainage time,hospitalization and incision length of observation group were shorter than those of the control group (P＜0.05).Before operation,there was no statistical significance in the QMG scores.At 3 months,6 months after operation,the QMG scores were decreased in both groups.The QMG score of observation group was lower than that of the control group (P＜0.05).During 6 months' follow-up,complications were observed in 7 cases of the observation group and 17 cases of the control group,the major complication was pulmonary infection.The incidence of complications in the control group was higher than that of the observation group (P＜0.05).Conclusion:Video assisted thoracic surgery had advantages of smaller surgical incision,faster recovery and higher safety in the treatment of myasthenia gravis.

Objective To observe the clinical curative effect of drug combined with psychological treatment on patients with sleep disorders after stroke.Methods A total of 180 cases of eligible patients with sleep disorders were included and randomly di-vided into control group and treatment group.Control group were treated with conventional vascular drug(estazolam,2 mg,before sleep);treatment group increased anxiolytic and sedative hypnotic drugs(venlafaxine,dexzopiclone)compared to control group.Af-ter 14 days,sleep quality,NIHSS were compared both within the treatment group and between the two groups.Results The Bar-thel index,NIHSS and PSQI of two groups had significant differences,and those index of treatment group before and after treat-ment had significant differences too(P <0.05).Conclusion Combined conventional cerebrovascular drugs with Venlafaxine,dexzo-piclone as well as psychological treatment significantly improved sleep quality of patients with acute stroke.

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 Research on traumatic the related factors of sleep disorder after traumatic brain injury ,in order to pro-vided the rationale for the diagnosis and treatment .Methods The SPIEGEL was used to evaluate the traumatic brain injury patients who were hospitalized .Recording time in sleep disorders in 3 months .Analysis the relations between the sleep disorders and brain injury site by combining with the patients head CT and MRI .Results Seen in 200 cases of patients with sleep disorders of 105 cases (52 .5% );71 cases appeared in patients within 1 week after waking ,accounted for 76 .19% ;The brain stem ,frontal lobe and basal ganglia injury occurred sleep disorders were more likely(66 .7% ,64 .0% ,70% ) .The difference was statistically significant(P<0 .05) .Conclusion Sleep disorder is a common clinical symptom of mild traumatic brain injury .a time to focus on the patients with-in 1 week after waking ,and closely related to brain stem ,frontal lobe and basal ganglia injury .

Objective To explore the abnormal changeof the polysomnography(PSG) in the patientwith traumatifrontal lobe injury .MethodTotally 16 patientwith traumatifrontal lobe injury accompanying sleep disorde(brain traumgroup) and 20 individualof physical examination (control group) were performed the whole nighPSG .ResultCompared with the control group ,the incubative stage of sleep in the brain traumgroup waprolonged ,while the sleep time and slow wave sleep time were shortened .The rapid eye movemen(REM) time and the periodicity of REM had statistical differencebetween the two group,buthe REM incubative stage ,density and intensity of REM had no statistical differencebetween the two goup.Conclusion The changeof PSG in the patientwith traumatifrontal lobe injury are dominated by the extension of the REM time and the shorten-ing of REM periodicity .

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.

Objective To explore the efficacy of thoracoscopic treatment of giant pulmonary bulla with complex conditions. Methods Video-assisted thoracoscopic surgery (VATS) was performed in 32 cases of giant pulmonary bulla with complex conditions in our department from September 2011 to November 2015. According to the dyspnea index of the American medical research council, there were 22 cases with distress index Ⅳ and 10 cases with distress index Ⅴ. Results All the patients underwent thoracoscopic surgery smoothly. The drainage tube was retained for 4-7 d in 17 cases, 8-14 d in 14 cases and 48 d in 1 case. The follow-up after operation was 12-18 months (mean, 16. 0 ± 3. 2 months). The dyspnea index was maintained at gradeⅠin 10 cases and gradeⅡin 22. All the patients were able to take care of themselves in daily life. Conclusion Giant pulmonary bulla with complex conditions can be treated under thoracoscopy with good surgical outcomes.