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 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.

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.

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 study the antipyretic and analgesic effects of Compound tuniuxi sirup.METHODS:Fever was induced by dry yeast in SD rats,then divided the rats into high-dose(33.12g/kg),medium-dose(16.56g/kg),low-dose(8.28g/kg)and control,aspirin group,observed the antipyretic effect;The mice were divided into high-dose(47.84g/kg),medium-dose(23.92g/kg),low-dose(11.96g/kg)and control,aspirin group,then were investigated with hot plate and acetic acid induced body twist.RESULTS:Compound tuniuxi sirup can markedly inhibit the fever in the model anmals 1 hour later,the effect of the high,medium groups are similar to aspirin;and could increase the pain threshold obviously(the low-dose group is obviously in 1.5h～2h(P

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 evaluate the feasibility of CEUS in Crohn discasc (CD) activity.Methods Thirty-nine patients with CD were analyzed.The clinical disease activity index of 18 cases were less than 150 (inactivity),and 21 cases were between 150 and 450 (activity).The thickness of intestinal walls were measured and Limberg classification were determined by power-Doppler results.The CEUS was performed,and the parameters including rise time,peak intensity,mean transit time,time from peak to one half,wash in slope and time to peak were statistical analyzed.Results The thickness of the lesions,peak intensity and wash in slope of activity CD were greater than those of inactivity CD,which had significant difference (all P＜0.05).The Limberg classification of type Ⅰ was 1 case,type Ⅱ was 4 cases,type Ⅲ was 10 cases and type Ⅳ was 6 cases in activity CD.The Limberg classification of type Ⅰ was 10 cases,type Ⅱ was 7 cases and type Ⅲ was 1 case.The Limberg classification were mainly type Ⅲ and type Ⅳ in activity CD,and type Ⅰ and type Ⅱ in inactivity CD,which had significant difference (P＜0.001).Conclusion CEUS can provide quantitative parameters in CD activity and has great clinical value.

Objective To investigate the effect of duodenal-jejunal bypass(DJB) on glucose metabolism and the expression of ileum proglucagon mRNA in Goto-Kakizaki (GK) type 2 diabetic rats.Methods 18 male GK rats and 1 8 male Wistar rats were randomly divided into 4 groups:GK operation group(group A),GK sham operation group(group B),Wistar operation group (group C),Wistar sham operation group (group D).There were 9 rats in each group.The fasting blood glucose and GLP-1 levels were measured before and at the 8th weekafter surgery.Oral glucose tolerance test was measured,and the area under blood glucose concentration curve wascalculated.Ileum tissues were obtained 8 weeks postoperatively and reverse transcriptase polymerase chain reac-tion was used to detect ileum PG mRNA expression after the operation.Results At the 8th week after surgery,the fasting blood glucose of group A decreased from(8.73 ± 1.30) mmol/L to(5.86 ±0.57) mmol/L(P ＜0.05).Area under blood glucose concentration curve decreased from preoperative(60.23 ± 5.14)mmol · h/L to (47.80 ±1.79) mmol· h/L(P ＜ 0.05).Fasting serum GLP-1 in group A increased from (7.69 ± 0.74) pmol/L to (29.00 ±4.85) pmol/L while postprandial GLP-1 increased from(15.74 ± 5.71) pmol/L to (45.78 ± 7.26) pmol/L (P ＜0.05).At the 8th week after surgery,the ileum PG mRNA level in group A was significantly higher than that in group B(P ＜ 0.05).Conclusions DJB can directly improve glucose metabolism in non-obese type 2 diabetic rats,and the operation has no hypoglycemic effect on normal blood glucose.The increased expression of ileum PG mRNA might contribute to the hypoglycemic effect of the surgery.