The study assessed the early functional outcomes with cemented titanium implants of radius in the treatment of comminuted fractures of radial heads. The functional outcomes of arthroplasty with cemented titanium implants of radius in the treatment of radial head fractures (Mason Type III: 6; Mason Type IV: 4) in 10 consecutive patients (mean age, 38 years) were evaluated over a mean time of 23.7 months (18-31 months). The patients were assessed on the basis of physical examination, functional rating (Mayo) and radiographic findings. The parameters evaluated included motion, stability, pain, and grip strength. Five patients were considered to have excellent results, 4 patients had good results and 1 patient had fairly good results. There were no cases of infection, prosthetic failure, heterotopic ossification or dislocation. When medial collateral ligament was injured, radial head became the main stabilizing structure of the elbow. Titanium radial head implant may provide the stability similar to that of native radial head. We believe that titanium radial head implants may be indicated for the Mason Type III and Mason Type IV radial head fractures.
Elbow Joint/surgery ; Fracture Fixation/*methods ; Fractures, Comminuted/*surgery ; Prostheses and Implants ; Radius Fractures/*surgery ; Titanium ; Treatment Outcome

To determine the effect of straight-leg-raising (SLR) movement on epidural fibrosis after laminectomy, 40 adult New Zealand rabbits were selected as laminectomy models in the study. They were divided into 2 groups: a SLR group (group S) and a control group (group C) randomly, with each group having 20 animals. All rabbits were subjected to total laminectomy in the site of S1. Every 5 rabbits in each group selected randomly were killed at the 1st, 2nd, 4th, and 8th week after the surgery. Segments of spines from L7 to S2 were removed en bloc. After gross evaluation, specimens were sliced up. The slices were stained by HE and Masson's trichrome methods respectively for histological examination. Our results showed that formation process of scar in group S was retarded as compared with that of group C at the time of the 2nd-week, but there was no statistical difference between groups in the adhesion degree (P> or =0.05). At the 4th and 8th week, the epidural fibrosis of group S was more serious than that of group C. Since the 2nd-week, the area of scar in group S was larger than that of group C. The number of fibroblasts and inflammatory cells in group S were larger than those of group C at early stage. But in later stage, there was no statistical significance between the two groups. It is concluded that SLR movement after laminectomy may promote the formation of epidural fibrosis and retard the maturity of scar. SLR movement can also aggravate scar adhesion.

ObjectiveTo study chronic inflammatory demyelinating polyneuropathy(CIDP)after allogeneic hematopoietic stem cell transplantation(allo-HSCT)and the clinical manifestation,diagnosis and treatment.MethodsThe clinical manifestation,laboratory examination,treatment and outcome of a patient with chronic myeloid leukemia after allo-HSCT were studied.ResultsAcute and chronic graft-versus-host disease(GVHD) were occurred in the patient followed by chronic multiple nervous system symptoms from +105 day including facioplegia,decreased muscle strength and dysuria.According to clinical manifestation,results of cerebrospinal fluid exam and electroneurophysiology exam,CIDP was diagnosed.The clinical condition was improved after treatment with intravenous immunoglobulin,glucocorticoid, immunosuppressive agents and functional exercises,but the patient died of secondary infection finally.ConclusionCIDP after allo-HSCT is a rare complication of nervous system and difficult to diagnose and treat.Numerous transplant-related causes are probably associated with the development of CIDP.The main causes are GVHD and immune dysfunction.Early accurate diagnosis and rational treatment is of great importance.

Objective: To investigate the findings of coronary artery angiography in coronary artery disease patients with diabetes mellitus. Methods: The angiographic fingings of 153 coronary artery disease patients from 1995 to 1997 were reviewed. Among them, 33 were diabetic,23 were impaired glucose tolerance(IGT) and 97 were nondiabetic patients. Results: The age, sex, hypertension, hypercholesterolemia, smoking and the rate of myocardial infarction were the same among 3 groups. But the 2 vessel and 3 vessel disease were more frequent in diabetic group(66.7% ,30.3%) than in nondiabetic group (26.8%,19 6%). Two vessel disease were more frequent in diabetic group(66.7%) than in IGT group (13.1%). Single vessel disease were less frequent in diabetic group(3.0%) than in IGT group(52.2%)and nondiabetic group(53.6%)( P

Objective To observe the value of procalcitonin (PCT ) in the diagnosis ,treatment and prognosis judgement of stoke-associated pneumonia(SAP) .Methods The serum procalcitonin ,hs-CRP and clinical pulmonary infection scores (CPSI) of two groups were detected :SAP group(including 27 patients of stoke-associated pneumonia) and control group(including 31 healthy ob-jects) .Results The CPSI ,hs-CRP and serum concentration of PCT in SAP group were significantly higher than control group (P<0 .01) ,and decreased significantly when get better after treatment .The serum concentration of PCT in SAP group was significantly higher than control group(P<0 .01) .In SAP group ,the serum concentration of PTC was positively associated with CPSI scorers . Moreover ,the results of ROC analysis showed that the cut-off of serum procalcitonin for the diagnosis of SAP was 0 .9 ng/mL .The sensitivety was 88 .6% and the specifity was 79 .3% ,which was superior to hs-CRP .Conclusion The serum concentration of PCT in SAP patients is higher and it is associated with the prognosis .It might be a better clinical marker for the diagnosis and prognosis of SAP .

This study examined effect of a new intervertebral cervical disc prosthesis in relieving the neurological symptoms and signs, improving the patients' ability to perform daily activities, reducing pain, and maintaining the stability and segmental motion. From December 2003 to October 2004, 12 patients, who had received 14 replacements of cervical artificial discs, were followed-up for 2 to 8 months (with a mean of 5.2 months). Of them 5 had cervical spondylotic myelopathy and 7 had cervical disc herniation. The patients included 7 males and 5 females, with their age ranging from 35 to 62 y and a mean of 50.3 y. Single-level replacements were performed in 10 cases and 2 cases received two-level replacement. Operation time of the single-level surgery averaged 130+/-50 min and the time of two-level surgery was 165+/-53 min on average (from skin incision to skin suturing). Neurological or vascular complications during or after surgery was not observed. Japanese Orthopedic Association scores (JOA scores) increased from 8.6 to 15.8 on average. There was no prothesis subsidence or excursion. Replaced segments were stable and the range of motion was partially restored, being 4.68 degrees (3.6 degrees -6.1 degrees ) in flexion and extension position and 3.51 degrees (2.5 degrees -4.6 degrees ), 3.42 degrees (2.6 degrees -4.3 degrees ) in left and right bending position. No obvious loss of physiological curvature was noted. CT or MRI follow-up showed that excursion was less than 1.5 mm) in 2 of 14 levels and between 1.5 mm and 3 mm) in 1 of 14 levels. No ossification in the replaced levels was observed. It is concluded that satisfactory short-term results were achieved in the 12 cases of artificial disc replacements. Different from anterior cervical discectomy and fusion, the replacement could achieve quick functional recovery and did not lead to the movement limitation of cervical vertebrae. At least a 5-years follow-up was needed to assess the long-term effect of the prosthesis on its neighboring segments.

Objective To evaluate the fludarabine instead of cyclophosphamide in modified busulfancyclophosphamide (mBuCy) regimen as a new myeloablative conditioning regimen for the treatment of acute leukemia patients receiving allogeneic hematopoietic stem cell transplantation (HSCT).Methods The clinic data of 45 acute leukemia patients undergoing allogeneic HSCT were analyzed.Among them,23 patients received mBuCy as conditioning regimen and 22 patients received BuFlu regimen (fludarabine 40 mg·m-2·d-1 for 5 days,instead of cyclophosphamide in mBuCy).Hematopietic engraftment,regimen-related toxicity (RRT),graft-versus-host disease (GVHD),infection condition,non relapse mortality,and overall survival were compared between the two groups.Results All patients achieved hematopoietic reconstitution and complete donor chimerism except for one patient of mBuCy group died of cerebral hemorrhage during conditioning.The incidence of RRT was no significant differences (P ＞ 0.05).In BuFlu group,the incidence of virus infection was higher (P =0.009),and the incidence of Ⅲll-Ⅳ aGVHD were 26.l ％ (6/23) and 4.5 ％ (1/22) (P =0.046) in mBuCy and in BuFlu group respectively.With a median follow up of 41 months,the incidence of non relapse mortality in mBuCy group was 17.4 ％ (4/23) and in BuFlu group was 9.1％ (2/22) (P =0.665).In mBuCy group and in BuFlu group,the relapse rates were 30.3 ％ (7/23) and 40.9 ％ (9/22) (P =0.474),the 5-year overall survival rates were (55.1±11.9) ％ and (61.4±10.8) ％ (P =0.659),and disease-free survival rates were (44.5±12.1) ％ and (22.1±12.3) ％ (P =0.747),respectively.Conclusions Fludarabine instead of cyclophosphamide in mBuCy regimen as a new myeloablative conditioning regimen has well tolerance,lower incidence of sever GVHD,satisfied overall survival,but the risk of infection and replase should be considered.

Objective To evaluate the efficiency of amifostine in protecting against oral and gastrointestinal mucositis in hematologic malignancies patients with high-dose total body irradiation following the hematopoietic stem cell transplantation,and assess the hematologic recovery as well as the potential side effect of amifostine.Methods Thirty-two hematologic malignancies patients underwent hematopoietic stem cell transplantation in our institution from 2012 to 2016 were retrospectively analyzed.All of them were treated with total body irradiation (700-1 200 cGy) and high-dose chemotherapy,in which 14 patients received 400 mg amifostine before radiotherapy.Prior institutional experience in 18 patients treated without amifostine was used as a historical comparison (no-amifostine group).Results Severe oral mucositis occurred in 14.3％ of patients in the amifostine group while 77.2％ in the no-amifostine group (x2 =10.62,P ＜0.05).Total parenteral nutrition was used in 21.4％ of amifostine group and 38.8％ in noamifostine group (P ＞ 0.05).The rates of grade 2 and 3 gastrointestinal mucositis were 35.7％ and 61.5％ in amifostine group,while in no-amifostine group the rates were 33.3％ and 66.7％,respectively (P ＞ 0.05).No significant difference was found in engraftnent times of granulocyte and platelet.No amifostine related side effects were observed.Conclusions The combination of amifostine and total body irradiation conditioning therapy during hematologic stem cell transplantation might reduce the severity of oral mucositis.The utilize of amifostine has no obvious effect on hematopoietic recovery and can be well tolerated.

Objective To evaluate the survival status and efficacy,prognosis and safety of several combined chemotherapies in previously untreated patients with follicular lymphoma (FL).Methods Clinical data of 62 previously untreated FL patients were analyzed retrospectively,in order to analyse survival status and to compare the efficacy and safety of different combined chemotherapies.Results The percent of FL patients achieved complete response (CR) after initial therapy was 80.0 ％ (44/55),while achieved for more than 5 years accounted for 23.6 ％ (13/55).Ten-year overall survival (OS) rate was 77.8 ％.The relapse rate was 34.5 ％,and the OS rate in patients with recurrence was significantly lower than in non-recurrence patients (93.8 ％ vs 61.6 ％,P =0.012).The disease-free survival (DFS) and progression-free survival (PFS)rates in FC/FMD (fludarabine,cyclophosphamide/fludarabine,mitoxantrone,dexamethasone) group comparing with CHOP (cyclophosphamide,epirubicin,vincristine,prednisone)-like group were significantly higher (80.0 ％ vs 21.1％ and 80.0 ％ vs 29.2 ％,P ＜ 0.05),but the differences had no statistical significance when adding rituximab (88.9 ％ vs 72.7 ％ and 90.0 ％ vs 73.5 ％,P ＞ 0.05).The OS,DFS and PFS rates in rituximab group were higher than those in the group without it (96.4 ％,79.2 ％ and 79.2 ％ vs 82.9 ％,39.3 ％ and 44.5 ％,P ＜ 0.05).The DFS and PFS rates in fludarabine group comparing with the group without it were significantly higher (86.2 ％ vs 49.4 ％,87.1％ vs 52.7 ％,P ＜ 0.05),but the differences between OS rates had no statistical significance (92.9 ％ vs 89.1％,P ＞ 0.05).The major adverse effects were hematologic toxicity,infection,nausea/vomiting and abnormal liver function.The hematologic toxicity of chemotherapies including fludarabine was stronger,but well-tolerated.Conclusion With initial combined chemotherapies,the CR rate of FL could receive a higher level.It is considered that chemotherapy might cure a part of FL patients thoroughly.Rituximab could increase the OS time significantly.FC/FMD regimen could increase the PFS time,comparing with CHOP-like regimen,while the difference has no statistical significance when adding rituximab.Systemic chemotherapies are well tolerated.

AIM: To investigate the effects of internal change of serum insulin and plasma glucose levels on serum free fatty acid (FFA) concentrations after glucose loading. METHODS: Serum insulin, plasma glucose and FFA concentrations were measured simultaneously in 234 essential hypertension patients who were undergoing oral glucose tolerance test (OGTT) [ including 20 cases with 2 type diabetes mellitus (DM), 74 impaired glucose tolerance (IGT), 140 normal glucose tolerance (NGT); 98 males, 136 females]. RESULTS: Fasting serum FFA concentration (?mol/L) in DM ((1 048.47)?481.6) was higher than that in IGT (760.1?332.1) (P