OBJECTIVETo evaluate the clinical outcomes and complications of Triple-Endobutton plates in treating Tossy type III acromioclavicular joint dislocation.

METHODSFrom January 2011 to January 2013,45 patients with Tossy type III acromioclavicular joint dislocation were treated with Triple-Endobutton plates. There were 35 males and 10 females with an average age of 30.5 (ranged from 19 to 60) years old. At the final follow-up, VAS, DASH, Constant-Murley criterion were used to evaluate shoulder function.

RESULTSAll patients were followed up from 15 to 36 months. No neurovascular injury, wound infection and stress fractures were found,but 3 patients had a re-dislocation. At the final follow-up,the mean VAS score was decreased from (5.7±1.6) preoperatively to postoperative (0.2±0.1); DASH score was significantly decreased from (19.6±4.3) preoperatively to (0.3±0.1) postoperatively; Constant-Murley score was improved from (34.4±4.3) before operation to (94.8± 3.5) after operation.

CONCLUSIONClinical outcomes of treating Tossy type III acromioclavicular joint dislocation with Triple-Endobutton plates is satisfactory. However, re-dislocation is still the most common complication. Careful perioperative management is an important factor in preventing re-dislocation.

Acromioclavicular Joint ; injuries ; surgery ; Adult ; Bone Plates ; Female ; Follow-Up Studies ; Fracture Fixation, Internal ; instrumentation ; methods ; Humans ; Male ; Middle Aged ; Shoulder Dislocation ; surgery ; Treatment Outcome ; Young Adult

Acupuncture Points ; Acupuncture Therapy ; Diarrhea, Infantile ; therapy ; Female ; Humans ; Infant ; Male ; Scalp

The leading bioregional pesticide,Bacillus thuringiensis,is accepted by the public and widely used biopesticide in the world.B. thuringiensis chitinase may contribute to the biocontrol of phytopathogenic fungi and enhance insecticidal activity.It helps to take full advan- tage of Bt and upgrade the efficiency.This paper reviews the progresses of B.thuringiensis chitinase.

AIM: To discuss the effects of preoperative vitreous cavity injection of ranibizumab on 25G minimally invasive vitreoretinal surgery (VRS) in patients with proliferative diabetic retinopathy(PDR).METHODS: From February 2013 to December 2015,74 patients with PDR received VRS (82 eyes) were retrospectively analyzed.Patients were divided into VRS + IVR group and VRS group according to preoperative VRS treatment.VRS+IVR group: preoperative injection of ranibizumab (10mg / mL) at 3-5d before operation;VRS group: VRS only.We recorded VRS operation time,filling situation,iatrogenic retinal hole and so on.RESULTS: The operation time and coagulation times of VRS+IVR group were significantly lower than VRS group.The two groups in operation time and coagulation times were statistically significant (all P<0.05).In the VRS+IVR group,the number of cases of iatrogenic retinal hole and the use of silicone oil were lower than those of VRS group,the difference between the two groups was statistically significant (P<0.05).While the use number of C3F8 and perfusion fluid were not statistically significant (P>0.05).In VRS-IVR group within 3mo after operation,4 eyes appeared to vitreous body hematocele,VRS group was 13 eyes,the difference was statistically significant (x2=4.966,P<0.05).CONCLUSION: PDR patients with 25G minimally invasive VRS with preoperative therapy can reduce postoperative ocular bleeding,rate of retinal injury and silicone oil filling,shorten the operation time,the incidence rate and improve the success rate of surgery and reduce eye bleeding,postoperative complications such as adhesion.

Air Pollutants ; toxicity ; Air Pollution, Indoor ; adverse effects ; Animals ; DNA Damage ; drug effects ; Female ; Interior Design and Furnishings ; Male ; Mice ; Mutagenicity Tests

Objective To study the effectiveness and safety of combined laparoscopy and gonadotropin-releasing hormone agonist (GnRH-a) in the treatment of endometriosis (EM).Methods From January to December 2010,198 patients with EM undergoing treatment in Department of Obstetrics and Gynecology,Beijing Anzhen Hospital were randomly divided into three groups,which include 52 cases treated by only laparoscopy in laparoscopy group; 76 cases treated by laparoscopy combined with domestic Leuprolide acetate with dose of 3.75 mg every 28 days in Leuprolide acetate group; 70 cases treated by laparoscopy combined with imported Goserelin acetate with dose of 3.6 mg every 28 days in Goserelin acetate group.The efficacy,pregnancy rate and adverse reactions were compared among the three groups.Results Thirteen cases lost following up,including 3 cases in laparoscopy group,6 cases in Leuprolide acetate group and 4 cases in Goserelin acetate group.(1) Effective rates:effective rates were 47 ％ (23/49)in laparoscopy group,77％ (54/70)in Leuprolide acetate group and 74％ (49/66)in Goserelin acetate group.Compared with laparoscopy group,the effective rate of Leuprolide acetate group and Goserelin acetate group was significantly elevated (P ＜ 0.05).There was no statistically significant difference between Leuprolide acetate group and Goserelin acetate group (P ＞ 0.05).(2) Recurrence rate:recurrence rate were 33％ (16/49) in laparoscopy group,13％ (9/70)in Leuprolide acetate group and 12％ (8/66)in Goserelin acetate group.Compared with laparoscopy group,the recurrence rate of Leuprolide acetate group and Goserelin acetate group was significantly declined (P ＜ 0.05).There was no statistically significant difference between Leuprolide acetate group and Goserelin acetate group (P ＞ 0.05).(3) Pregnancy rate:the number of patients require fertility were 28 cases in laparoscopy group,39 cases in Leuprolide acetate group and 35 cases in Goserelin acetate group.After 2 years follow up,pregnancy rate of 62％ (24/39) in Leuprolide acetate group and 60％ (21/35)in Goserelin acetate group were high than 39％ (11/28)in laparoscopy group significantly,which did not reached significant difference (P ＞ 0.05).(4) Adverse drug reaction:rates of a adverse reactions were 21％ (15/70) in Leuprolide acetate group and 20％ (13/66) in Goserelin acetate group,including irregular vaginal bleeding associated with low estrogen level.There was no significant difference in adverse reactions (P ＞ 0.05).Conclusions Compared with laparoscopy alone,laparoscopy combined with GnRH-a is more effective in treatment of,which exhibit lower recurrence rate,higher pregnancy rate and fewer adverse reactions.Domestic Leuprolide acetate have similar safety and efficacy compared with imported GnRH-a.

BACKGROUND:Ultrasound therapy can relieve pain and improve the movement function in patients with knee osteoarthritis, but there lacks of consistency in the literatures of ultrasound therapy.
OBJECTIVE:To further identify the effectiveness of ultrasound therapy in the treatment of knee osteoarthritis.
METHODS:Twenty-four rabbits were randomly divided into three groups:normal group, model group and ultrasound group. The rabbit in the normal group received no intervention;rabbits in the model group received anterior cruciate ligament transaction to establish the knee osteoarthritis model without any treatment;the rabbit in the ultrasound group received ultrasound therapy after modeling for 10 minutes once time, once per day, 0.3 W/cm2 , 1 MHz and treated for 10 times. Hematoxylin-eosin staining was conducted for histological observation of rabbit articular cartilage;western blot and reverse transcription PCR assessment were used to assess the expressions of caspases-3 and caspases-8 in rabbit articular cartilage, while Terminal deoxynucleotidyl transferase dUTP nick end labeling was used to assess the ratio of chondrocytes apoptosis of rabbit knee articular cartilage.
RESULTS AND CONCLUSION:The normal rabbit cartilage tissues and chondrocytes were neatly arranged in column;the middle cartilage layer of the model was thin;the chondrocytes were arranged disorderly and became less. After ultrasound therapy, the chondrocytes were rearranged neatly, and the number was increased. Compared with the normal group, the Mankin scores in the model group and ultrasound group were higher;the apoptotic rate of chondrocytes was higher in the model group and ultrasound group than in the normal group, and was also higher in the model group than in the ultrasound group. Compared with the normal group, the expressions of caspases-3 and caspases-8 were higher in the model group and the ultrasound group, while decreased after ultrasound therapy. The results indicate that ultrasound can improve the structure of cartilage tissues, decrease the expressions of caspases-3 and caspases-8 and reduce the apoptosis rate of chondrocytes. It is effective for the treatment of knee osteoarthritis with ultrasound therapy.

Objective To understand the status and drug resistant patterns of strains of extended spectrum ?-lactamase(ESBLs) in children with lower respiratory tract infection,and to give clinical suggestions for rational treatment.Methods Escherichia coli and klebsiella pneumoniae were isolated from the 2 969 nasopharyngeal secretions which collected from lower respiratory tract of children in our hospital from Jan.2006 to Dec. 2007.Dual-sheets and sheets-diffusing method (K-B method) were used to determine the ESBLs and antibiotic susceptibility was tested by K-B method which included 18 kinds of antibiotics,the results were marked by resistant,intermedial and sensitive.Chi-square test was used to analyze the data.Results Total 135 strains were detected,73 strains were escherichia coli,of which 54 strains(74.0%)produced ESBLs,62 strains were klebsiella pneumoniae,of which 33 strains(53.2%)produced ESBLs.The 2 bacterias were found more in children with 1-6 months old than those in other age groups,the ratio of which were 50 strains and 41 strains,respectively (Pa0.05).The resistant rate of ESBLs-producing strains to penicillins,cephalosporins,quinolones,aminoglycosides and sulfamido was higher than that of non ESBLs-producing strains respectively.And the resistant rates to beta-lactam antibiotics of ESBLs strains were located on a high level.Whether producing ESBLs or not,the 2 bacterias were still sensitive to amikacin,cefoxitin,cefoperazone/sulbactam and imipenem.Conclusions The prevalences of ESBLs-producing escherichia and klebsiella pneumonia were high.There was a multi-drug resistance to the varied antibiotics.It is very important to make sputum culture and use sensitive antibiotics in treatment according to drug sensitivity test to control the occurrence and conveying of the ESBLs.

Objective To investigate the effect of angiotenisn ⅡI (Ang Ⅱ) on RIN-m β-cell,and to explore the mechanism of β-cell function impairment caused by Ang Ⅱ.Methods RIN-m cells were cultured with various concentrations of AngⅡ (0.1,1,10,100 nmol/L).After incubation for 24 hours,the basal(3.3 mmol/L) and glucose-stimulated(16.7 mmol/L) insulin secretion(GSIS)were detected by radioimmunoassay,mRNA and protein expressions of uncoupling protein 2(UCP2)were determined by RT-PCR and Western blot,respectively.The intracellular ATP content was measured by luciferase bioluminescence.The mitochondrial membrane potential and cellular Ca~(2+) concentration were detected by flow cytometry.Results (1) Various concentrations of Ang Ⅱ had no significant influence on the basal insulin secrection of RIN-m cell(F=0.644,P = 0.634).Except for 0.1 nmol/L AngⅡ,the other concentrations of Ang Ⅱ markedly reduced GSIS of RIN-m cells(F= 118.528,P = 0.000).(2) Compared with the control group,Ang Ⅱ significantly increased mRNA and protein expression of UCP2(F= 1 370,P = 0.000;F=675.175,P = 0.000).(3)Except for 0.1 nmol/L Ang Ⅱ,the other concentrations of Ang Ⅱ significantly decreased the mitochondrial membrane potential,cellular ATP content,and cellular Ca2+ concentration of RIN-m cell(F=4.035,P=0.008;F=3.353,P = 0.013;F=5.867,P = 0.001).Conclusion Ang Ⅱ impairs GSIS of p-cell,the mechanism of impairment may be interpreted that Ang Ⅱ can increase the expression of UCP2,furthermore,it can reduce mitochondrial membrane potential,decrease the content of cellular ATP and the concentration of cellular Ca~(2+),can finally impair the function of β-cell.

Objective To observe the lung protective effect of Tongfu Xiefei method (TFXF) in rats with sepsis, and to discuss its possible mechanism.Methods Forty-two Sprague-Dawley (SD) rats were randomly divided into blank control group (n = 6), model group (n = 18) and TFXF group (n = 18). Sepsis model was reproduced by cecal ligation and puncture (CLP) in rats of model group and TFXF group. After the reproduction of sepsis model, rats in TFXF group received Tongfu Xiefei granules 0.01 mL/g by gavge, while those in model group were given equal dose of normal saline by the same way. The rats in blank control group received no treatment. At 3, 6, 12 hours after CLP, abdominal aorta blood was collected for blood gas analysis and inferior vena cava blood was collected for determination of the concentrations of tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6). Bronchoalveolar lavage fluid (BALF) was collected for measurement of concentrations of total protein (TP), total phospholipid (TPL), and desaturated phosphatidyl choline (DSPC). The ratio of wet/dry lung weight ratio (W/D) was measured, and malondialdehyde (MDA) and myeloperoxidase (MPO) in lung tissues were determined. The pathologic changes in their lungs were observed with light microscopy.Results Compared with those in blank control group, the levels of pH value, arterial oxygen partial pressure (PaO2), HCO3-, base excess (BE) were lowered, and partial pressure of carbon dioxide of arterial blood (PaCO2) was increased in model group. The serum concentrations of TNF-α and IL-6 were gradually increased after the reproduction of sepsis model. Compared with those in blank control group, the levels of TP, TPL, and DSPC/TPL in model group were decreased, while the levels of W/D, MDA and MPO were increased. Compared with those in model group, pH value was elevated in TFXF group at 3 hours (7.27±0.04 vs. 7.18±0.07,P < 0.05). PaO2 (mmHg, 1 mmHg = 0.133 kPa) was improved at 3, 6, 12 hours (3 hours: 128.00±16.05 vs. 106.78±10.73, 6 hours: 98.46±15.97 vs. 72.80±16.33, 12 hours: 90.70±9.31 vs. 74.28±12.19, allP < 0.05). The serum concentrations of TNF-α (ng/L) in TFXF group were significantly lower than those in model group at 12 hours (508.20±94.08 vs. 756.60±138.77,P < 0.05), and the serum concentrations of IL-6 (ng/L) in TFXF group were significantly lower than those in model group at 6 hours and 12 hours (6 hours: 687.80±35.00 vs. 849.40±148.28, 12 hours: 728.80±214.41 vs. 917.00±245.96, bothP < 0.05). Compared with those of model group, the levels of TP (g/L) in BALF in TFXF group were significantly decreased at 12 hours (1.01±0.23 vs. 1.60±0.47,P < 0.05), and the levels of TPL (mg/L) in TFXF group were significantly increased at 12 hours (86.40±11.33 vs. 62.40±16.33,P < 0.05). The levels of DSPC/TPL in TFXF group were significantly higher than those in model group at 6 hours and 12 hours (6 hours: 0.58±0.13 vs. 0.38±0.10, 12 hours: 0.45±0.13 vs. 0.24±0.07, bothP < 0.05). The levels of W/D in TFXF group were significantly higher than those in model group at 3 hours (3.84±0.25 vs. 2.99±0.50,P < 0.01), but lower than those in model group at 12 hours (3.21±0.53 vs. 4.89±1.14,P < 0.05). The levels of MDA (nmol/mg) in TFXF group were significantly lower than those in model group at 6 hours and 12 hours (6 hours: 4.04±2.58 vs. 8.89±2.61, 12 hours: 11.31±3.60 vs. 20.60±8.10, bothP < 0.05), while the levels of MPO (U/g) in TFXF group were lower than those in model group at 12 hours (4.79±0.66 vs. 7.22±1.76,P < 0.05). Compared with model group, the lungs in TFXF group showed less morphological changes under light microscopy, such as pulmonary edema, congestion, effusion and fibrosis.Conclusions The method of Tongfu Xiefei may improve hypoxemia and metabolic acidosis, alleviate lung edema and ameliorate pulmonary pathological changes in rat sepsis model. Tongfu Xiefei method shows a protective effect in sepsis by the way of reducing peroxidative damage, inhibiting the release of proinflammatory factors and abating degradation of lung surfactant.