Objective To evaluate the operative treatment of nonunion of humeral shaft fracture with in- ternal plate fixation and autogenous cancellous hone graft.Methods Forty-one cases of nonunion of humeral shaft fracture operatively treated from February 2002 to December 2004 were analyzed retrospectively.There were 32 males and nine females.Their average age was 37.5 years(range,17 to 67 years).Sixteen nonunions were defined as hypertrophic and 25 as atrophic.We followed all the patients and obtained their complete medical information. Results Our average follow-up was 22.6 months(range,8 to 42 months).Forty fractures(97.6%)were united within an average of 5.8 months(range,3 to 12 months).Complications included iatrogenic radial nerve injury in three patients,wound infection in one patient and fracture nonunion in one patient.At the final follow-up,shou]der and elbow functions were found to be satisfactory.Conclusion Open reduction and plate internal fixation sup- plemented with autogenous cancellous bone graft is an effective treatment for nonunion of humeral shaft fracture.

BACKGROUND: It has been proved in clinical practice and basic research that acupuncture and moxibustion at Mingmen acupoint is an effective treatment for primary osteoporosis. As a new therapeutic method, heat-sensitive moxibustion has achieved good results in clinical practice, but the research on its mechanism is still in the blank stage. OBJECTIVE: To study the therapeutic mechanism of heat-sensitive moxibustion from the perspective of connective tissue and nervous system, and to explore the optimal therapeutic time of heat-sensitive moxibustion in a certain time range. METHODS: Female Sprague-Dawley rats of SPF grade were randomly divided into five groups: normal group, model group, 4-, 7-, and 14-day heat-sensitive moxibustion groups. Osteoporosis models were prepared by ovariectomy and treated with heat-sensitive moxibustion at different times. After treatment, the superficial subcutaneous fascia 0.5-1.5 cm around the Mingmen acupoint and the spinal cord were stained with fluorescence and hematoxylin-eosin staining. The concentrations of phosphorus ion, calcium ions and alkaline phosphatase in rat serum were detected before and after 14 days of heat-sensitive sensitive moxibustion. RESULTS AND CONCLUSION: (1) Morphological changes of intrafascial fibers by fluorescence staining: In the normal and model groups, collagen fibers were interlaced and arranged in a network. In the 4-day heat-sensitive moxibustion group, the arrangement of collagen fibers showed no changes. After 14 days of intervention the collagen fibers were stretched and pulled significantly under the effect of heat-sensitive moxibustion, and showed a centripetal arrangement toward the Mingmen acupoint. (2) Hematoxylin-eosin staining results of the spinal cord: After 4 days of heat-sensitive moxibustion, the rat spinal cord had no obvious change compared with the model group. After 7 days of heat-sensitive moxibustion, anterior cornual neurons increased in number and size, and the number of glial cells in the spinal dorsal horn increased. After 14 days of heat-sensitive moxibustion, anterior horn neurons increased significantly in number and in size, with large and round nuclei, obvious nucleoli, and enlarged and regularly arranged nerve fibers; glial cells in the posterior horn increased significantly in number and arranged densely. (3) Serum concentration determination: After 14 days of heat-sensitive moxibustion, the concentrations of phosphorus ions and alkaline phosphatase in rat serum increased significantly (P < 0.01), and the concentration of calcium ions decreased significantly (P < 0.05). These findings indicate that heat-sensitive moxibustion can ameliorate the symptoms of osteoporosis through the morphological changes of connective tissue and nerve-body fluid regulation. Heat-sensitive moxibustion for 14 days can achieve ideal results.

Objective To observe the effect of lnng-term in vitro culture on the biological properties of adipose-derived stem cells(ADSCs)as seeding cells of tissue engineering.Methods The surface makers and apoptosis of primary and passaged human ADSCs were identified by flow cytometric analysis.Osteogenic differentiation of ADSCs at different passages were identified by alkaline phosphatase(ALP),Von Kossa staining and RT-PCR respectively.Results The surface marker expression of mesenchymal stem cells on ADSCs was high and did not change with passages of the cells.The early apoptosis rate of the cells was 1% to 2%,and increased insignificantly from passage one to passage nine.The osteogenic potential of ADSCs confirmed by ALP,Von Kossa staining and RT-PCR was maintained to as late as passage eight.Conclusion Since the biological properties of ADSCs are stable,they can be served as optimal seeding cells for tissue engineering and regenerative research.

Objective To explore the influence of sodium selenite(Na2SeO3) and sodium phosphate(Na3PO4)given alone or combined on inhibition of liver cell proliferation of mouse exposed to sodium arsenite(NaAsO2) in vitro.Methods Primary mouse liver cell were treated with 8.0 μmol/L NaAsO2.Based on the two-factor and three-level (3 × 3) factorial design,the cells were randomly assigned into nine groups and cultured with different dosage of Na2SeO3(0.0,5.0,10.0 μmol/L) and Na3PO4(0.0,7.5,15.0 μmol/L),respectively.Liver cell activity was examined with thiazole blue reduction method (MTT) and the protective effect of Na2SeO3 and Na3PO4 on cell proliferation inhibition was tested.Results Different dose of Na2SeO3 had different protective effect on proliferation inhibition of mouse liver cell exposed to NaAsO2(F =35.743,P ＜ 0.05),so did Na3PO4(F =35.182,P ＜ 0.05).Meanwhile there was an interaction between Na2SeO3 and Na3PO4(F =13.702,P ＜ 0.05).The most significant intervention effect was observed in the group given low dose of Na2SeO3 (5.0 μmol/L) plus high dose of Na3PO4(15.0 μmol/L).Through pairwise comparison we found that there was no significant difference between the high and the low dose of Na3PO4 exposure groups of the protective effect on inhibiting of cell proliferation when the dosage of Na2SeO3 was fixed at certain levels(0.575 ± 0.070 vs 0.570 ± 0.017,0.789 ± 0.047 vs 0.797± 0.026,0.648 ± 0.027 vs 0.674 ±0.034,all P ＞ 0.05).However,when the dose of Na3PO4 was fixed,there was a significant difference between the high and the low dose of Na2SeO3 exposure groups(0.629 ± 0.026 vs 0.755 ± 0.063,0.789 ± 0.047 vs 0.648 ± 0.027,0.797 ± 0.026 vs 0.674 ± 0.034,all P ＜ 0.05).Conclusion A certain dose of Na2SeO3 and Na3PO4 has independent and combined antagonistic action to inhibition of mouse liver cell proliferation induced by NaAsO2 in vitro.

Background Mechanism of dry eye disease has not been established clearly.Some increasing evidences showed that inflammation plays an important role in pathogenesis and development of dry eye disease.However,the association of interleukin-6 (IL-6) with dry eye has not been clarified.Objective This study was to assess the correlation of IL-6 levels in tear and serum of patient with dry eye disease and clinical symptom.Methods Twenty patients with Sj（o）gren syndrome (SS) and 20 cases with non-Sj（o）gren syndrome (NSS) were enrolled from Second Affiliated Hospital of Nanjing Medical University,and 20 healthy volunteers were recruited as the normal controls.Symptom questionnaires were self-answered and multiple dry eye-related clinical tests were performed,including tear film breakup time (BUT),Schirmer Ⅰ test (S Ⅰ t) and corneal fluorescence staining.IL-6 concentrations in serum and tear were detected by enzyme-linked immunosorbent assay (ELASA).The correlation between IL-6 level and tear film and ocular surface parameters was analyzed by Spearman rank correlation.Written informed consent was obtained from each subject initial of this trial.Results The scores of symptom questionnaires were 18.50 (11.75,23.00),23.00 (19.00,32.00) and 2.00 (0.25,4.00) in the SS group,NSS group and the normal control group,and significantly increasing values were seen in the SS group and NSS group compared with the normal control group (P=0.00,0.00).BUT values in the SS group and NSS group were 2.50 (2.00,3.88) seconds and 3.50 (2.13,4.00) seconds and were lower than 15.00 (13.13,17.00) seconds in the normal control group (P=0.00,0.00).S Ⅰ t values in the SS group,NSS group and the normal control group were 2.00 (1.50,2.88),4.00 (3.00,5.75) and 19.00 (18.00,25.00)mm,showing significant differences between the SS group and the normal control group (P =0.00),the SS group and the NSS group (P =0.00) or the NSS group and the normal control group (P=0.00).The marked elevation of keratoepithelioplasty score was seen between the SS group and the normal control group (5.75 (4.00,7.75) vs.0.00 (0.00,0.75) (P =0.00) or the NSS group and the normal control group (4.50(3.63,6.00) vs.0.00(0.00,0.75)) (P=0.00).Concentrations of IL-6 in serum and tear in the SS group,NSS group were (131.47±21.04) μg/L and (77.81 ± 15.68) μg/L and were significantly higher than (31.62±8.57) μg/L of the normal control group,and those in the tear were (33.44±8.01) μg/L,(18.78 ±5.73) μg/L and (8.77 ± 3.43)μg/L,respectively in the three groups,with a significant reduce in the normal control group (all P=0.00).tL-6 levels in serum and tear were positively correlated with the score of symptom questionnaires or keratoepithelioplasty and negatively correlated with BUT and S Ⅰ t (all P =0.00).Conclusions IL-6 levels in the tear and serum of the dry eye patient are associated with the severity of the disease.IL-6 levels in serum and tear may be objective,sensitive and reliable indicators of dry eye.

In previous case report entitled "Multidetector CT findings of a congenital coronary sinus anomaly: a report of two cases" by Chou et al. (Korean J Radiol 2008;9:S1-S6), there were mistakes. "The Figure 1A and 1B are the MDCT findings of normal coronary sinus of a normal individual." "The Figure 1C to 1E are the MDCT findings of congenital coronary sinus anomaly in 60-year-old woman with Ebstein's anomaly." "The Figure 2J and 2K are illustration of atresia of the right atrial ostium of the coronary sinus with/without PLSVC"

Objective To investigate the advantage of detaining peripherally inserted central catheter through the veins of lower extremity in neonatal intensive care unit.Methods 165 cases of infants were randomized into veins of lower extremity group (first saphenous veins,then popliteal vein) and veins of upper extremity group (first basilic vein,then median cubital vein,cephalic veins) from January to December 2012.We observed the success rate of detaining,catheter tip location,and complications such as phlebitis in the two groups.Results The success rate of detaining of lower extremity group was higher than that of upper extremity group,and ectopic rate of lower extremity group was lower than that of upper extremity group.There was no significant difference in complications such as phlebitis between two groups.Conclusions Peripherally inserted central catheter through the veins of lower extremity has more advantage over through the veins of upper extremity group.

Objective To measure middle cerebral artery (MCA) hemodynamic parameters of chronic cerebral ischemia in middle aged and elderly people with phase contrast magnetic resonance imaging (PCMRI),and to explore cerebral blood flow dynamic pattern in different degrees of chronic cerebral ischemia patients.Methods Middle aged and elderly people underwent conventional MRI scan,and were divided into 12 cases of the normal group,16 cases of mild cerebral ischemia group and 13 cases of obvious cerebral ischemia group.All groups underwent bilateral MCA PCMRI.Bilateral MCA hemodynamic parameters and phase-velocity curve in a heartbeat cycle were obtained by QFLOW analysis software on the workstation for post-processing.Bilateral MCA vascular area,peak velocity (PV),mean velocity (MV) and mean flow (MF) were recorded.The differences of bilateral MCA hemodynamic parameters among the three groups were compared by SPSS17.0 software.Results Bilateral MCA vascular area,MV,MF and right MCA PV among three groups were statistically significant by one-Way ANOVA (P＜0.05).Compared with normal group,systolic peak of bilateral MCA phase-velocity curve was low,dull,widen,and the connection between the diastolic peak and systolic peak became flattened in chronic cerebral ischemia patients.Conclusion PCMRI can reflect the differences of the cerebral blood flow dynamic change pattern between different degrees of chronic cerebral ischemia.

Objective:To explore the effect of sarpogrelate on platelet function in patients at the bridging stage before coronary artery bypass grafting (CABG).
Methods: A total of 40 consecutive patients with peripheral artery stent and scheduled for CABG in our hospital from 2011-05 to 2013-04 were enrolled in this study. The patients were randomly divided into 2 groups, Low molecular weight heparin (LMWH) alone group, n=19 and Sarpogrelate+LMWH group, n=21. The medications started at 5-7 days before CABG and stopped at 24 h before CABG. The platelet inhibition rates (platelet aggregation induced by collagen+ serotonin) were examined and compared between 2 groups at the baseline (before randomization), 24h and 1h before CABG respectively.
Results: The platelet inhibition rates were similar between 2 groups at the baseline (87.33 ± 6.82) % vs (86.11 ± 6.87) %, P=0.577 and 1h before CABG (62.60 ± 12.39) % vs (56.19 ± 14.99) %, P=0.148. At 24h before CABG, the platelet inhibition rate in Sarpogrelate+LMWH group was higher than that in LMWH alone group (83.87 ± 8.99)%vs (63.13 ± 10.88)%, P<0.001. Compared with the baseline, the falling range of platelet inhibition was lower in Sarpogrelate+ LMWH group at 24h before CABG, (3.46 ± 6.18) % vs (22.98 ± 9.43) %, P<0.001 and the falling range was similar between 2 groups at 1h before CABG (24.73 ± 14.19)%vs (29.92 ± 14.28)%, P=0.257.
Conclusion: Sarpogrelate + LMWH may result better platelet inhibition rate with quicker recovery of platelet function upon the medication stopping, which might be a feasible management in patients at the bridging stage before CABG.

Objective To explore the clinical significance of sCD14-ST in diagnosing children sepsis and monitoring the treatment effects. Methods Case-control study. Patients were recruited by Longyan First Hospital from August 2013 to March 2015.The sCD14-ST, WBC, CRP, PCT and APACHE-Ⅱlevels were measured in 237 septic children ( infectious SIRS, including 120 bacterial and 117 nonbacterial SIRS) , 89 non-infectious SIRS and 156 healthy children.The changes and the correlation of the five indicators in septic children before and after treatment was compared.The diagnosis value of sCD14-ST in sepsis by the receiver operationg characteristic curves ( ROC) was analyzed.Results The sCD14-ST level in septic children [643.47(596.47 -690.46) ng/L] was higher than that in non-infectious SIRS [246.94(234.85-259.03)ng/L]and healthy control [151.00(142.79-159.22)ng/L](χ2 =121.850, 325.663, P<0.01).The whole blood level of sCD14-ST in bacterial sepsis [606.17(542.71-669.63) ng/L]and non-bacterial sepsis [679.83(610.37-747.29)ng/L]were no significance (χ2 =0.854, P=0.335), while compared with the control group, they had significant differences (χ2 =326.228, P<0.01) .Totally 80 blood culture samples were positive in 117 bacterial septic children, and the sCD14-ST level was not significant between Gram positive bacteria infection and [641.07 (553.82 -728.31) ng/L] Gram negative bacteria infection[750.00(597.10 -902.89) ng/L] (χ2 =1.12,P=0.29), but the sCD14-ST level in blood culture positive children was significantly higher than healthy controls ( chi-square =117. 46, 155.846, P<0.01).sCD14-ST, WBC, CRP, PCT, APACHE-Ⅱscore before and after treatment were all significantly decreased ( χ2 =44.569, 113.337, 63.986, 100.055, 51.015, P<0.01).The sCD14-ST was significantly positively related withCRP and APACHE-Ⅱ score before treatment, but there were no correlation with WBC and PCT.The ROC-AUC of sCD14-ST in septic children was 0.901.Compared with the ROC-AUCs of WBC ( 0.875 ) and CRP ( 0.836 ) , there were statistically significant different ( P<0.01).The sensitivity and specificity of sCD14-ST were 85%, 90%, respectively.Conclusions The study suggested that sCD14-ST superior value to the diagnosis of sepsis in children than other parameters.It should be applied as a valuable biomarker for early diagnosis and the evaluation of severity of sepsis.