Objective To report our method to determine lateral needle insertion point (intersection point skin marker) in closed reduction and percutaneous Kirschner wire fixation for pediatric supracondylar fracture of humerus.Methods From May 2012 to June 2014,125 children with supracondylar fracture of humerus were treated with closed reduction and percutaneous Kirschner wire fixation.Of them,60 did not use the intersection point method to determine the lateral needle insertion point (group A),including 46 boys and 14 girls,with an average age of 6.3 ±0.6 years.According to Gartland classification,28 cases were type Ⅱ and 32 cases type Ⅲ.In the other 65 children,the intersection point method was used to determine the lateral needle insertion point (group B),including 50 boys and 15 girls,with an average age of 6.4 ± O.9 years.According to Gartland classification,29 cases were type Ⅱ and 36 cases type Ⅲ.The 2 groups were compared in terms of operation time,fluoroscopy times,hospital stay and hospitalization cost.The efficacy was evaluated at the final follow-ups using Flynn criteria.The 2 groups were compatible without significant differences in preoperative general data (P ＞ 0.05).Results All the 125 children obtained successful closed reduction and percutaneous pin fixation,and an average follow-up of 13 months (from 12 to 15 months)as well.There were significant differences between groups A and B in average operation time (23.1 ± 15.3 min versus 17.5 ± 10.3 min) and fluoroscopy times (9.2 ± 1.0 times versus 5.3 ± 1.3 times) (P ＜ 0.05).There was no statistically significant difference between the 2 groups either in Flynn excellent to good rate [(98.3％ (59/60) versus 98.5％ (64/65)] (P ＞ O.05).Needle irritation occurred in 2 cases and Kirschner wire shift in one in group A while tensile blistering occurred in one in group B.Conclusion In closed reduction and percutaneous Kirschner wire fixation for pediatric supracondylar fracture of humerus,the intersection point skin marker is a simple and reliable method to determine the lateral needle insertion point,leading to considerable reduction in radiographic exposure for both patients and doctors.

Objective To study the clinic effects and safety of budesonide suspension combined with tubertaline solution for nebulization therapy on infantile asthma.Methods Seventy-five cases with asthma were divided into 3 groups randomly,double-blinded and controlled,each group having 25 cases.Group A inhaling tubertaline solution(bricanyl),while group B inhaling pulmicort respules combined with bricanyl,group C inhaling budesonide suspension(pulmicort respules)only.Results In group A,16 cases was cure,3 cases was markedly improved,6 cases was failure,the total efficacy rate was 76 percent.In group B,22 cases was cure,2 cases was markedly improved,1 case failed,the total efficacy rate was 96 percent.While in group C,14 cases was cure,4 cases was markedly improved,7 cases failed,the total efficacy rate was 72 percent.The difference of efficacy rate between group A and group B was significant(P0.05).Conclusion Pulmicort respules combined with bricanyl for nebulising inhalation is effective and safety on infantile asthma and its effect is better than inhaling bude-sonide or tubertaline only.

Objective:To assess the discrepancy between preoperative needle biopsy (NB)Gleason score and pathological specimen Gleason score (GS)after radical prostatectomy,and to explore the risk factors of postoperative upgrading of GS.Methods:We retrospectively evaluated 160 patients who suf-fered from biopsy proved prostatic carcinoma and performed radical prostatectomy.Age of the patients was 57 -82 years,with the average age of 71.6;prebiopsy prostate specific antigen (PSA)was 0.31 -40.32 μg/L,with the average PSA of 11.29 μg/L;body mass index (BMI)was 16.41 -32.04 kg/m2 , with the average BMI of 23.63 kg/m2;prostate volume (PV)was 9.52 -148.46 mL,with the average PV of 40.19 mL.All the patients included in the study had complete information for clinical variables, including age,BMI,prebiopsy PSA level,PV,number of biopsy cores obtained,percentage,clinical stage,and biopsy GS.Grading of NB Gleason score was compared with their corresponding radical pros-tatectomy specimens,and the discrepancy between the NB and prostatectomy specimens GS assessed. Upgrading was defined as any increase in the pathological GS over that of the biopsy GS as a total sum of primary and secondary grades or a change in the order of primary and secondary grades towards higher ones.Univariable and multivariable Logistic regression analyses were used to identify predictors of patho-logical grading changes.Results:Of the 160 patients,the specimen GS was upgraded in 49 (30.6%) patients and remained with no change in 82 (51.3%)patients.Univariate and multivariate regression analysis showed that prostate volume and biopsy GS were independent predictors with postoperative upgra-ding of GS.Age,BMI,PSA before needle biopsy,clinical stage and needle number showed no statistical significance (P >0.05).Conclusion:Lower biopsy GS and smaller prostate volume are increased risks for clinically upgrading of GS after radical prostatectomy.This fact should be kept in mind when deciding on therapy decisions for patients with prostate cancer.

OBJECTIVE:To observe the changes of insoluble particles in traditional Chinese drugs injections(TCDI)mixed with infusion fluid and to study the way to solve METHODS:61 kinds of TCDI in therapeutic dosages were mixed in 0 9% sodium chloride solution,then the insoluble particles formed with diameters of 2 5?5 0?10 0 and 25 0?m were counted with Coulter counter,and determined with physical method and microscope The precise filter for liquid medicine were investigated in respect to its flow rate,quantity of flow,adsorbability and scavenging action RESULTS:(1)The number of insoluble particles in 26 kinds of TCDI exceeded the standard in ChP accounting for 42 6% of total samples observed (2)The insoluble particles included glass fragments,active carbon,rubber particles,soft flocks and residue of drugs (3)The flow rate and quantity of flow met the clinical requirement with a scavenging rate of 88 5%,and no adsorbability was found CONCLUSION:Precise infilter for liquid medicine can scavenge the particles in TCDI so as to ensure the safe use of drugs for patients

Objective To investigate the effect of all trans-retinoic acid (ATRA) combining with Interferon α-2a on bladder tumor and the possible mechanisms. Methods Fifty female Wistar rats with bladder tumor were established and separated into 4 groups randomly that are DMSO group (A), IFN-α-2a group(B), ATRA group(C) and ATRA+IFN-α-2a group(D). Then each group was treated by drugs indicated. Finally, the weight of bladder, the stage and grade of tumor, the apoptosis and proliferation index of tumor were determined to estimate the effect of ATRA+IFN-α-2a. Results The body weights in group D are the highest and the bladder weights in group D are the lowest. The stages and grades of tumor in group D were statistically decreased compared with those in the other 3 groups. Accordingly, the apoptosis of cancer cells in group D was enhanced, whereas the proliferation index in group D was decreased significandy. Conclusion The effect of ATRA combined with Interferonα-2a on the bladder tumor is better than that of monotherapy.

OBJECTIVETo compare the efficacy of internal fixation (including PFNA and PFN) versus hip replacement (including FHR or THA) in the treatment of trochanteric fractures in adults.

METHODSReports of studies using randomized controlled trials (RCT) to compare internal fixationg with hip replacement in the management of intertrochanteric fractures were retrieved (up to January 1, 2013) from the Cochrane Library, PUBMED Data, CNKI (China National Knowledge infrastructure), Elsevier, the Chinese Biomedical Database, Wanfang Data, and manually. Methodological quality of the trials was critically assessed, and relevant data were extracted. Statistical software RevMan 5.0 was used for data-analysis.

RESULTSSeven articles were included in the meta-analysis. The results showed that,compared internal fixation with hip replacement,there were statistical significance in the duration of surgery time [WMD = -2.66, 95% CI (-5.25,-0.06), P = 0.05], intra-operative blood loss [WMD = -24.20, 95% CI (-30.38, -18.02), P < 0.000 01], hospital stays time [WMD = -4.72, 95% CI (-5.18, -4.25), P < 0.000 01], bearing load time [WMD = -29.54, 95% CI (-30.77, -28.31), P < 0.000 01], total complications rate [WMD = 0.15, 95% CI (0.11, 0.22), P < 0.000 01], the good rate of Harris scores [WMD = 1.09, 95% CI (0.54,1.32), P < 0.05]. However, there were no statistical significance in the rate of deep venous thrombosis [WMD = 1.09, 95% CI (0.47, 2.55), P > 0.05]. CON- CLUSION: Hip replacement (containing FHR or THA) for the treatment of intertrochanteric fractures is superior to internal fixa- tion in regards to the duration of surgery time, the mean duration of hosipital stays, mean post-operative down time, intra-opera- tive blood loss, the rate of post-operative good Harris scores. But there is not enough evidence to show any difference between hip replacement (containing THA or FHR) and internal fixation in regards to the rate of deep venous thrombosis. However, internal fixation for the treatment of intertrochanteric fractures is superior to hip replacement (containing FHR or THA) in regards to total complications rate.

Arthroplasty, Replacement, Hip ; methods ; Fracture Fixation, Internal ; methods ; Hip Fractures ; surgery ; Humans

Objective The aim of this study was to evaluate the efficacy and safety of the approach of the Nuss procedure for the correction of pectus excavatum in children without thoracoscopy.Methods From Oct 2007 and May 2009,48 patients with pectus excavatum underwent Nuss procedure.Among them 22 were done under the thoracoscopic guidance,and the other 26 in a non-thoracoscopic way,in which,a bilateral extrapleural tunnel to the edge of sternum was created using a blunt dissection via a bilateral thoracic skin incision.Without introducing the thoracoscopy into the thoracic cavity,a steel bar was inserted in the entirely extrapleural tunnel and turned as the standard Nuss procedure.Results All 48 patients recovered uneventfully.There were no postoperative deaths and serious complications.A single alloy steel bar(23-40 cm)was used in all patients.In the non-video-assisted extrapleural group(n=26),no pneumothorax occurred,the operating time(after anesthesia)ranged from 24～38 minutes[mean(25.4±2.6)mins],blood loss was minimal(range,5-10 ml),and the hospital stay was ranged from 3-6 days[mean(4.5±1.1)days].In the thoracoscopic group(n=22),the corresponding figures were 40 to 60 minutes[mean(53.5±3.4)mins)],10 to 15ml,5-8days[mean(7.0±2.2)days],respectively.No recurrent of the funnel chest occurred during the 3-18 months(median 10.4 monthes)of follow-up.The bar displacement occurred in 1 case 2 months after operation,which was replaced with satisfied result.Conclusion The non-thoracoscopic approach of the Nuss procedure is a safe and less traumatic procedure for the correction of pectus excavatum.

There are 250 species of Zanthoxylum (Rutaceae) in the world. This genus distributed in tropical and subtropical regions. Alkaloids are the major and representative ingredients in these plants including quinolines, isoquinolines, and amide alkaloids, with such biological activities as anti-tumor, anti-inflammatory, analgesic, anti-virus, anti-platelet aggregation, anti-bacteria and anti- oxidant. These species have been used for a long time to treat toothache, urinary and venereal diseases, lumbago and rheumatism. This review summarizes the chemical constituents and pharmacological activities from the Z. sppplants, in an effort to the systematic research and application of the alkaloids of this genus.
Alkaloids ; chemistry ; pharmacology ; Animals ; Drugs, Chinese Herbal ; chemistry ; pharmacology ; Humans ; Molecular Structure ; Zanthoxylum ; chemistry

AIMTo investigate the relative bioavailability of pulmonary-delivered insulin lipid suspension (INS-LIP-SP) in normal Wistar rats.

METHODSINS-LIP-SP were prepared by two different methods and then delivered to the rat lung using an intratracheal instillation method. Blood glucose levels and INS concentrations in serum were determined by glucose oxidase method and radioimmunoassay method, respectively. The relative pharmacological bioavailability (f%) and relative bioavailability (F%) of INS-LIP-SP were calculated from the area above the curve (AAC) and the area under the curve (AUC) compared with subcutaneous injection of INS solution.

RESULTSThe mean particle diameter, span of dispersity and entrapment efficiency of INS-LIP-SP prepared by a membrane-formed with sonication method and a reversed phase evaporation method were 1.91 microns, 0.94 and 16.45% and 2.08 microns, 1.28 and 39.51%, respectively. The values of f% and F% of both INS-LIP-SP were up to 37% and 32%, separately, and there was a statistically significant difference between INS-LIP-SP and INS solution. However, there was no significant difference between the two INS-LIP-SP and the physical mixture of INS solution and blank liposomes.

CONCLUSIONThe results showed that INS-LIP-SP could achieve higher bioavailability following pulmonary delivery to rats.

Administration, Inhalation ; Animals ; Biological Availability ; Blood Glucose ; metabolism ; Drug Delivery Systems ; Hypoglycemic Agents ; administration & dosage ; pharmacokinetics ; Injections, Subcutaneous ; Insulin ; administration & dosage ; pharmacokinetics ; Liposomes ; Male ; Particle Size ; Random Allocation ; Rats ; Rats, Wistar ; Suspensions ; Trachea ; metabolism

Objective To study the correlation between the coagulation factor Ⅶ (F Ⅶ) and progressive hemorrhage after brain contusion in mice and provide the experimental evidence for the clinical application of recombinant human FⅦa.Methods Twelve male BALB/c mice were given liposomeencapsulated FⅦsiRNA via tail vein at doses of 1,3,5 and 10 mg/kg with 3 mice per dosage.The other 3 mice received equivalent volume of normal saline as controls.Two days after the injection,mice blood sampling was used to detect FⅦ mRNA expression in liver using real-time PCR,level of plasma FⅦ using ELISA method,and activity of plasma FⅦ using chromogenic substrate assay.The optimal dose at which F Ⅶ expression was inhibited was determined.Thirty BALB/c male mice were assigned to two groups (n =15 per group) according to the random number table:FⅦ-suppressing group,mice were injected with FⅦsiRNA at the optimal dose and control group,mice were injected with same volume of negative control vector.The model of brain contusion was established in both groups.Volume of hemorrhage following brain contusion was measured at 3,24 and 72 h postinjury,and hematoma volume at 24 and 48 h postinjury.Results Liposome-encapsulated siRNA delivery down-regulated FⅦ expression in the mouse liver.Level and activity of plasma FⅦ were also reduced significantly.The optimal siRNA dose was 3 mg/kg.At 3,24 and 72 h postinjury,relative volume of brain hemorrhage in FⅦ-suppressing group was 1.46 ± 0.10,1.82 ± 0.23 and 2.28 ± 0.15 respectively,significantly higher than that in control group (1.00 ± 0.25,1.20 ± 0.31 and 1.20 ± 0.22 respectively) (P ＜ 0.05).At 24 and 48 h postinju-ry,volume of hematoma in FⅦ-suppressing group was (6.7 ± 1.5)mm3 and (9.8 ± 1.0) mm3,significantly higher than that in control group [(5.2 ± 1.2) mm3 and (5.5 ± 1.5) mm3] (P ＜0.01).Conclusions Level of FⅦ in vivo relates closely to the progressive hemorrhage of brain contusion in mice.Administration of FⅦ is effective to reduce the incidence of progressive hemorrhage.