OBJECTIVETo analyze the causes of delayed union or nonunion of the ulna after intramedullary nailing in pediatric forearm fractures.

METHODSFrom February 2005 to February 2010,5 patients with forearm fractures who were treated with titanium elastic nailing (TEN) were identified to fulfill the criteria of having developed a delayed union or nonunion of the ulna. The causes of delayed union or nonunion were investigated according to mechanism of injury, fracture location, treatments methods and postoperative management. All patients were male and the age was 3 to 14 years old with an average of 9.4 years. All fractures were located on the mid-third part of forearm. Two cases had a re-fracture. Among them, 3 cases caused by high-energy injury and 2 cases by falling down. Open reduction were performed in 4 cases while the other one was treated with closed reduction. Four patients were immobilized in an above-elbow cast, postoperatively.

RESULTSAll patients were followed up from 7 to 19 months with an average of 11.4 months. There were 4 delayed union and 1 nonunion. Three patients healed after the removal of the nail and avoidance of weight-bearing. Two patients healed by replacing another fixation. No patients had soft-tissue irritation or nail-entry-site infections.. The clinical effect was evaluated according to Daruwalla and Price scores with 3 excellent and 2 good of the results.

CONCLUSIONSUsing titanium elastic nailing for the treatment of pediatric both-bone forearm fractures is a good method. However,strict indication selection should be followed to avoid delayed union or nonunion.

Adolescent ; Child ; Child, Preschool ; Fracture Fixation, Intramedullary ; methods ; Fracture Healing ; Humans ; Male ; Radius Fractures ; physiopathology ; surgery ; Retrospective Studies ; Ulna Fractures ; physiopathology ; surgery

Objective To establish a distraction osteogenesis SD rat model for exploring the effect of total flavonoids from Rhizoma Drynariae on the quality of rat bone formation in the process of distraction osteogenesis from the perspective of tomography.Methods Twenty-four rats were randomly divided into experimental group and control group after successful modeling,and were respectively given intragastric administration with total flavonoids from Rhizoma Drynariae(in dose of 77.125 mg/kg) and saline for 8 weeks.Seven days after operation,the tibias of all the rats were given distraction at the speed of 0.2 mm for 20 days.Eight weeks after the operation,X-ray examination for all the rats was performed,and then the rats were killed for obtaining the tibia samples for Micro-CT scanning.The differences of X-ray Lane-Sandhu scores,the bone mineral density and bone mineral content were compared between the two groups.Results The X-ray Lane-Sandhu scores,the bone mineral density and bone mineral contents showed by Micro-CT scanning in the experimental group were higher than those in the control group,and the differences were statistically significant (P ＜ 0.05).Conclusion The total flavonoids from Rhizoma Drynariae can improve the quality of bone formation in the process of distraction osteogenesis in rats.

Objective To investigate the protective effect of continuous intravenous infusion of Isoproterenol (ISO)on myocardial mitochondria of early septic rats and the corresponding mechanism.Methods Thirty Sprague Dawley (SD)rats were randomly divided into 5 groups (6 cases per group):control group,endotoxin group,ISO small-dose group,ISO medium-dose group and ISO large-dose group.Endotoxin group and ISO intervene group received same management apart from drug intervention:receiving intravenous injection of lipopolysaccharide (LPS)10 mg/kg followed by an continuous intravenous infusion of 9 g/L saline 1 mL/h or ISO 0.06 μg/(kg · min),0.30 μg/(kg · min)and 0.60 μg/(kg · min).Control group received intraperitoneal injection and continuous intravenous infusion with the same amount of 9 g/L saline.The primary endpoint of the study was 24 hours after injection of 9 g/L saline or LPS.Serum creatine kinase (CK) and creatine kinase isoenzyme (CK-MB),oxidative and nitrosative stress levels and swelling of isolated heart mitochondrion were detected.The pathological changes of the myocardium and morphologic changes of the heart mitochondria were observed through light microscope and scanning electron microscope,respectively.Results The levels of CK,CK-MB,nitric oxide (NO) content,inducible nitric oxide synthase (iNOS) activity and malondialdehyde (MDA)content in endotoxin group were increased compared with control group (all P ＜ 0.05),while the superoxide dismutase (SOD) activity decreased [(11.543 ± 1.080) U/mg prot vs (9.892 ±0.815) U/mg prot,P ＜0.05].The morphology of the heart mitochondria significantly changed (such as swelling,disordered arrangement,crest fracture,fusion and cavitations,and so on).ISO intervention significantly decreased the levels of CK,CK-MB and mitochondrial swelling (all P ＜ 0.05) and increased the SOD activity (all P ＜ 0.05).The levels of NO content,iNOS activity and MDA content were significantly decreased in small-dose group [(10.823 ± 2.240) μmol/g prot vs (7.917 ± 2.203) μmol/g prot,(0.045 ± 0.008) U/mg prot vs (0.033 ± 0.003) U/mg prot,(1.663 ± 0.618) mmol/mg prot vs (0.768 ± 0.312) mmol/mg prot,all P ＜ 0.05],while the levels of iNOS activity and MDA content were significantly increased in medium-and large-dose group (all P ＜ 0.05) ; compared with medium-dose group,the degree of mitochondrial swelling in large-dose group increased (1.160 ± 0.186 vs 1.393 ± 0.128,P ＜ 0.05).The pathological changes of the myocardium mitochondria significantly improved.Conclusions The myocardium and myocardial mitochondria of early septic rats were damaged,continuous intravenous infusion of low-dose ISO revealed protective effect on these damages,and the corresponding mechanism may relate to the decrease of the oxidative and nitrosative stress.

Objective:To study the antitumor mechanism of W40,a monomer purified from Wedelia prostrate (Hook.et Arn.) Hemsl.Methods:The effects of W40 on the cell proliferative of GLC-82 cells were detected by MTT assay and colony formation assay.The migratory abilities of GLC-82 cells were observed by wound healing assay.Cell apoptosis was evaluated by Annexin V-FITC/PI staining analysis.The levels of apoptosis-relative proteins and cell proliferation-related proteins,such as Caspase-3,PARP,Stat3 and ERK,were detected by Western blotting.Results:MTF assay showed that W40 had a significant cytotoxic effect on non-small cell lung cancer GLC-82 cells.Colony formation assays showed that W40 significantly inhibited GLC-82 cells proliferation.The migration of GLC-82 cells was inhibited by W40 in a dose-dependent manner.Flow cytometry showed that the apoptotic rate increased gradually in a concentration-dependent manner.W40 down-regulated Stat3 as decreasing p-Stat3 and downstream proteins of Bcl-2 and Mcl-1.At the same time,W40 up-regulated the expression of pro-apoptotic protein Bax,and increased the cleavaged Caspase-9,Caspase-3 and PARP.W40 also down-regulated BRAF / MAPK / ERK signal pathway as decreasing p-BRAF,p-MEK and p-ERK.Conclusions:W40 induced apoptosis by inhibiting BRAF / MAPK / ERK and Stat3 signaling pathways.

Objective To assess the therapeutic effect of bone marrow‐derived mesenchymal stem cells (BMSCs) on osteoporotic fracture healing .Methods Bone marrow of the rat bilateral femur and tibia bone tissue were collected ,and BMSCs were isolated by the whole bone marrow adherence method .Sixty female 11‐week‐old SD rats were ovariectomized (OVX) to induce osteoporosis followed by bilateral fracture generation .Twenty rats were left without giving any further treatment (OVX controls) ,20 received injection of saline (OVX+placebo control) and 20 were given injection of BMSCs (OVX+BMSCs) .X‐ray scan was performed at 3‐day ,4‐week and 8‐week post‐fracture ,respectively .Results Flow cytometry analysis revealed that the isolated BMSCs express sur‐face antigens similar to those reported previously .X‐ray results showed that compared with OVX and OVX+placebo groups ,BM‐SCs treatment markedly accelerated fracture healing of in osteoporotic rats .Conclusion Transplantation of BMSCs can effectively improve the healing of primary osteoporotic fracture .

Objective To investigate the morbidity and related factors for osteoporosis in postmenopausal patients with type 2 diabetes mellitus (T2DM).Methods The bone mineral density (BMD) at lumbar vertebrae(L1-4), left femoral neck, femoral trochanter and total hip were measured by dual energy X-ray absorptiometry (DEXA) in 79 postmenopansal patients with T2DM.The patients were divided into two groups: osteoporosis group and non-osteoporosis group.The correlations between BMD and age, course of disease, menopausal age, menopausal duration and body mass index (BMI) were analyzed by multivariate regression analysis.Results There were significantly statistical differences in age, BMI, interleukin 6 (IL-6), osteocalcin and menopause duration between two groups.Linear correlation analysis showed IL-6 was positively correlated with osteoporosis (r=0.260, P=0.020) and glycosylated hemoglobin (GHbAlc) (r=0.259, P=0.023) Logistic regression analysis showed that the morbidity of osteoporosis had an independent positive correlation with age, but an independent negative correlation with BMI.Conclusions In postmenopausal patients with T2DM, age and low BMI are independent risk factors for osteoporosis.

0.05).The blood loss in harmonic scalpel group was less than that in titanium clamp group or conventional group(P=0.001).CONCLUSION Harmonic scalpel is a new type of surgical instrument and is suitable for endoscopic thyroid surgery.It is worth of recommending that harmonic scalpel can not only increase safety of surgery and reduce blood loss,but also decrease the difficulty of operation and shorten the operation time.

Objective To investigate the clinical significance of compensatory angiogenesis and the angiosome-based revascularization strategy for endovascular procedures in treating infrapopliteal critical limb ischemia in elderly diabetic patients.Methods A retrospective study of 194 patients with diabetic feet (Fontaine Ⅳ) who had undergone endovascular procedures at our hospital from January 2005 to December 2014 was performed.Based on the angiosome concept,all subjects were classified into the direct revascularization group (DR group),the indirect revascularization through collaterals group (IR-tc group) and the indirect revascularization without collaterals group (IR-wc group).After one-year follow-up,the therapeutic effects were analyzed and compared between the three groups.Results During the one-year follow-up,the rate of unhealed ulcers,the re-intervention rate and the rate of major adverse limb events (MALE) were higher in the IR-wc group than in the DR and IR-tc groups (P=0.000 and 0.000,P=0.025 and 0.013,P=0.014 and 0.023,respectively).The IR-wc group presented a lower limb salvage rate as compared with those in the DR and IR-tc groups (P=0.011 and 0.027).Patients with a single recanalized branch had a higher rate of unhealed ulcers than those with multiple recanalized branches in the IR-wc group (93.9％ vs.71.0％,P=0.015).Conclusions The angiosome-based revascularization strategy has shown important value in guiding endovascular procedures for patients with diabetic foot disease and,in particular,the compensatory angiogenesis approach appears to be critical in generating favorable short-term clinical outcomes in the treatment of diabetic foot disease.

Objective To evaluate engraftment status of patients after allogeneic hematopoietic stem cell transplantation(Allo-HSCT) and prompt relapse of disease based on DNA polymorphism analysis technique.Methods Sixty-six cases were detected by DNA polymorphism analysis technique and 25 cases were monitored and analyzed dynamically during this period.Results After Allo-HSCT,48 patients obtained type of donors,but 13 patients did not; 5 patients showed mixed chimerism.Two cases of type of donors converted into mixed chimerism and 4 cases of mixed chimerism converted into type of donors after some time. The others' engraftment status did not change.Conclusion DNA polymorphism analysis technique can detect engraftment status of patients exactly, rapidly, which provides effective evidences of constitution for more clinical therapy projects.

· AIM: To investigate the expression and the possible implication of CD40/CD40L costimulatory molecules in erythema nodosum of patients with Beh(c)et's disease.· METHODS: Sampling was done from erythema nodosum of 5 patients with Beh(c)et's disease and normal skin of 2 healthy individuals. Immunohistochemical staining was performed to examine the expression of CD4, CD8, CD19, CD68, HLA-DR,CD40 and CD40L molecules in the obtained tissues.· RESULTS: Approximately 90% of epidermic cells in erythema nodosum expressed CD40 molecule. In the dermis and subcutaneous tissue, a significantly increased number of CD4+Tcells, CD8+Tcells, CD19+cells, CD68+cells, HLA-DR+cells,CD40L+cells, and CD40+cells were observed in the erythema nodosum as compared with that in normal skin. Double staining showed that CD40L molecules were expressed on 45% of CD4+T cells. CD40 molecules were expressed on 100% CD68+ cells and 59.2% of HLA-DR+cells respectively.· CONCLUSION: A number of CD40/CD40L costimulatory molecules are upreguiated in the erythema nodosum of patients with Behcet's disease.