[Objective]To evaluate the clinical application and results of the anterolateral acromial approach with minimal incision in the treatment of proximal humerus fracture.[Method]From December 2006 to December 2008,42 patients with proximal humeral fracture were treated by the anterorlateral acromial approach using locking plate.There were 25 males and 17 females.All the fractures were classified with AO/OTA classification.There were 5 A2-fractures,11A3-fractures,7 B1-fractures,12 B2-fractures,3 C1-fractures,4 C2-fractures.Anterolateral acromial approach with minimal incision was applied and the deltoid muscle was seperated to expose the fracture fragments.Under direct vision the direct and indirect reduction of the fractures were performed.The locking plate was inserted distally beneath the deltoid muscle and between the distal plate and the humeral shaft was adjusted through another small skin incision on the lateral upper arm.Locking screws were inserted to the proximal and distal plate.Operation time,incision length,blood loss,reduction,Neer scores at 1 year were analyzed in different time points.[Result]All the cases were completed with minimal incision.There were significant differences(P

Objective To investigate efficacy of citalopram on pathological crying after cerebral infarction.Methods 106 patients with pathological crying after cerebral infarction were randomly divided into two groups,treatment group(54 cases) and control group(52 cases).Control group received conventional treatment of cerebrovascular disease.Treatment group taken citalopraml0-20mg orally one time per day for three months based on conventional treatment.The total response rate,effectual time,and Hasegawa Dementia Scale (HDS) scores were compared between two groups after treatment.Results There were significant differences in total response rates (94.4％ and 38.5％,respectively),effectual time(1.98 ± 1.24 and 78 ± 17.95,respectively) and HDS(8.43 ±2.21 and 6.24 ±2.02,respectively) between treatment group and control group (P ＜ 0.01).Conclusion The study suggests that it is effective to treat pathological crying with citalopram and its effect is quick.Citalopram can not only control patient’s pathological crying,but also improve cognitive function.

By virtue of computational fluid dynamics and the fundamental principles of hemodynamics, this paper gives numerical simulations and analyses of blood flow in the human thoracic aorta. The distributive features of velocity and pressure of the blood flow are obtained with the use of initial parabolic pulsatile blood flow. The numerical results show that, due to the angularity of thoracic aorta and due to the branch arteries, the distributions of velocity and pressure display marked difference, especially for the horizontal velocity, in the thoracic aorta connecting with the second and third branch artery, which indicate the place where thoracic aortic dissection often happens.
Aneurysm, Dissecting ; physiopathology ; Aorta, Thoracic ; physiology ; Aortic Aneurysm, Thoracic ; physiopathology ; Blood Flow Velocity ; physiology ; Blood Viscosity ; Computer Simulation ; Hemodynamics ; Humans ; Models, Cardiovascular ; Pulsatile Flow

Objeetive To evaluate the relationship between aspartate aminotransferase to alanine aminotransferase ratio (AST/ALT ratio) and metabolic syndrome in college students.Methods Anthropometric and metabolic measurements including fasting plasma glucose (FPG),triglyceride (TG),high-density lipoprotein cholesterol (HDL-C),true insulin (TI),(AST and ALT) were assessed in a crosssectional study of 425 college students aged 19 to 24 years old (male 216,female 209) in 2009.The participants were then assigned to the AST/ALT ratio ＜ 1 group or the AST/ALT ratio ≥ 1 group.Metabolic syndrome was defined as Adult Treatment Panel Ⅲ criteria.Results AST/ALT ratio ＜ 1 was found in 146 subjects (34.4％).After adjustment for age and sex,AST/ALT ratio showed a positive correlation with HDLC (r=0.125) and negative correlations with body mass index (BMI,r=-0.281),waist circumtance (WC,r =-0.264),TG (r =-0.134),TI (r =-0.118) and HOMA-insulin resistance (HOMA-IR,r =-0.121) (all P ＜0.05).The prevalence of metabolic syndrome was 2.1％ and was similar in males and females (2.3％ vs.1.9％,P =0.774).Those with AST/ALT ratio ＜ 1 had a significantly higher prevalence of metabolic syndrome (4.8％ vs.0.7％,P =0.016).After adjustment for age,gender and BMI,the prevalence of metabolic syndrome of subjects with AST/ALT ratio ＜ 1 was nearly 7 (95％ CI:1.430 to 34.019,P =0.016) times of those with AST/ALT ratio ≥ 1.Conclusion AST/ALT ratio may be related with metabolic syndrome in college students.

Objective To explore the clinical application and follow-up results of minimally invasive percutaneous plate osteosynthesis (MIPPO) in treating proximal humeral fractures. Methods From December 2006 to September 2008, MIPPO using locking plate was employed to treat 36 patients (23 males and 13 females) with proximal humeral fracture. According to AO classification, there were four patients with type A2 fractures, 10 with type A3 fractures, five with type B1 fractures, 11 with type B2 fractures, three with type C1 fractures and three with type C2 fractures. Longitudinal or transverse incision was made through anterolateral acromial approach to separate the deltoid muscle and expose the fracture fragments. The direct and indirect reduction of the fractures were performed under direct vision. The locking plate was inserted distally beneath the deltoid muscle and a longitudinal incision was made at the lateral end of the plate. Locking screws were inserted to the proximal and distal plates. Postoperative follow-up was done to provide guidance to functional exercise and evaluate the clinical results. Results The operation lasted for (50.1±11.3) minutes, with intra-operative blood loss of(76±18.7) ml and average operative incision of (4.5±0.8) cm. All the patients were followed up for 12-17 months (average 14 months), which showed that the time of bone healing was (10. 1 ±1.2) weeks. Neer scoring standards showed the total excellence rate of 86%. Conclusion MIPPO is an ideal method for treatment of proximal humeral fractures, for it has the advantages such as safety, minor trauma, short bone healing time, alleviation of pain and good X-ray reduction.

Objective To establish a citrate pharmacokinetics model which is applied to evaluate the risk of citrate accumulation in patients with liver dysfunction in the continuous renal replacement treatment (CRRT) with regional citrate anticoagulation (RCA). Methods The source of citrate for extracorporeal anticoagulation, the body clearance and filter elimination of citrate, which were the three major citrate fluxes of systemic citrate level, were combined into a single-pool, first order kinetic equation. The data from a published clinical study of systemic citrate kinetics in the intensive care unit patients with or without liver cirrhosis were adapted and the citrate kinetic equation was applied to predict the risk of systemic citrate accumulation in patients with normal, impaired and absent liver clearance while different RCA-CRRT protocols were carried out. Results The single pool, first order citrate kinetic modeling equation was as follows:Csys=C(0)·e-[(clb+clf)·t/V]+G/CLb+CLf×(1-e-[(clb+clf)·t/V])There was excellent agreement between published citrate measurements and our predictions. Kinetic modeling showed that the plasma citrate concentration of patients with normal citrate body clearance was no more than 1 mmol/L during common RCA-CRRT. The model predicted that when the single pass fractional extraction of citrate on the artificial kidney was above 66％, systemic steady citrate concentration would be among the safe range even in patients of impaired body metabolism of citrate.Conclusions The citrate kinetic model of RCA-CRRT can predict the risk of systemic citrate accumulation and provide the basis for designing the safe RCA-protocols for the patients with impaired body clearance of citrate.

OBJECTIVE: To investigate the mechanism of myopia following intravitreous injection of MK801 (dizocipine maleate) intravitreous injected. METHODS: Three-week-old guinea pigs were divided into six groups: group A (control), group B (3 weeks form-deprivation in right eye), group C ( 3 weeks form-deprivation in right eye + saline), group D (3 weeks form-deprivation in right eye + MK801 1ng), group E (3 weeks form-deprivation in right eye + MK801 10 ng), group F (3 weeks form-deprivation in right eye + MK801 100 ng). The refraction and axial length of the eyes were measured. ncNOS was measured by hybridization in situ, and cyclic GMP (cGMP) concentrations by radioimmunochemistry. The correlation between MK801 concentration and diopter degree, axial length of the eyes, and levels of ncNOS or cyclic GMP were analyzed with linear correlation in the groups C-F. RESULTS: Diopter degree was decreased, axial eye length was shorted and levels of ncNOS and c-GMP were decreased in groups C, D, E and F dependent on the concentration of MK801. The diopter degree had positive correlation with MK801 concentration (r=0.702, P<0.05), while the axial eye length and the levels of ncNOS and cGMP were negatively correlated (r=-0.736, -0.637, -0.725, P<0.05) CONCLUSION MK801 injected into the vitreous humor can restrain myopia by down-regulated the expression of the nitric oxide-cyclic GMP signaling pathway. The effect is concentration dependent.
Animals ; Cyclic GMP ; metabolism ; Dizocilpine Maleate ; administration & dosage ; pharmacology ; Down-Regulation ; Female ; Form Perception ; physiology ; Guinea Pigs ; Injections, Intraocular ; Male ; Myopia ; physiopathology ; Nitric Oxide Synthase Type I ; metabolism ; Sensory Deprivation ; physiology ; Signal Transduction ; drug effects ; Vitreous Body ; drug effects

Objective To evaluate the correlation of prognostic nutritional index(PNI) with overall survival of postoperative patients with thymoma. Methods The clinical and pathological data of 173 postoperative patients with thymoma were analyzed retrospectively. Results R0 resection (P < 0.001), myasthenia gravis (P < 0.001), Masaoka stage (Ⅱ/Ⅰ: P=0.012; Ⅲ & Ⅳ/Ⅰ: P=0.011), WHO type (P < 0.001) and PNI (P=0.016) were independent risk factors for OS of postoperative patients with thymoma. R0 resection (P=0.001) and myasthenia gravis (P=0.039) were independent risk factors for OS of higher PNI group (PNI > 45); and Masaoka stage (Ⅱ/Ⅰ: P=0.012; Ⅲ & Ⅳ/Ⅰ: P=0.048), WHO type (P=0.039), R0 resection (P < 0.001) and myasthenia gravis(P < 0.001) were independent risk factors for OS of lower PNI group (PNI≤45). Patients with myasthenia gravis are prone to have a decreased PNI. Conclusion Complete resection, myasthenia gravis, Masaoka stage, WHO type and PNI are independent prognostic factors for postoperative patients with thymoma. Thymoma patients with myasthenia gravis have lower PNI and OS. PNI should be routinely monitored in thymoma patients with myasthenia gravis.

Objective To investigate the pharmacodynamic effects of Poria triterpenes on tumor suppression in mice with ascites tumors,and to detect and identify the chemical components of Poria triterpenes using HPLC-LTQ-Orbitrap method,and to explore the potential mechanism of action of Poria triterpenes on tumor suppression in mice with ascites tumors based on both of them using non-labeled definitive proteomics techniques.Methods Poria triterpene parts were extracted by solvent method,and the main components were detected and identified by HPLC-LTQ-Orbitrap liquid mass spectrometer;mice were randomly divided into model group,Poria triterpene group and positive control group(mushroom polysaccharide group),after 21 days of continuous administration,to establish After continuous administration for 21 days,the H22 ascites tumor mouse model was established,and the effect of each drug group on the amount of ascites,spleen index,thymus index,liver index,serum TNF-Alpha and IL-2 in H22 ascites tumor mice was observed after one week of continued administration;then H22 cells were extracted from the ascites of mice,and the H22 cells in the model group and Poria triterpene group were detected by non-lable-free quantitative proteomics technique.The differentially expressed proteins(DEPs)were screened out by using GO,KEGG and other analyses.Results The abdominal water volume in the mouse Poria triterpene group was significantly lower than that in the model group(P<0.05);the thymus index in the mouse Poria triterpene group was significantly higher than that in the model group(P<0.05);the serum levels of TNF-Alpha in the mouse Poria triterpene group were significantly different from those in the model group(P<0.01),and the serum levels of IL-2 in the mouse Poria triterpene group were significantly different from those in the model group(P<0.01).Through the analysis of the chemical composition of Poria triterpene parts,a total of 19 triterpenoids were identified,with four main structural types.A total of 188 differentially expressed proteins were identified in the Poria triterpene group compared with the model group,of which 86 differentially expressed proteins were up-regulated and 102 differentially expressed proteins were down-regulated;GO database analysis showed that the differentially expressed proteins in the Poria triterpene group were mainly involved in the regulation of interleukin-1 production The KEGG database analysis showed that the differentially expressed proteins in the Poria triterpene group were involved in signaling pathways closely related to tumor,mainly MAPK,Apoptosis,mTOR,Wnt and p53 pathways,etc.The genes coding for the seven representative differential proteins were validated at the mRNA level by RT-qPCR.Conclusion The pharmacodynamic study found that Poria triterpenes had tumor suppressive effect on H22 ascites tumor mice,then by proteomics found Poria triterpenes group ascites H22 cell protein compared to the model group changed significantly,the study thus showed that Poria triterpenes for mice ascites tumor mechanism of tumor suppressive effect mainly involves apoptosis,inflammatory response and immune process.

Objective:To explore the risk factors related to hospitalization events in out patients on hemodialysis and to evaluate the effect of serum retinol-binding protein (RBP) level on hospitalization events in patients on hemodialysis.Methods:Case-control study. A total of 80 patients on dialysis were recruited, including 47 men (58.8%) and 33 women (41.2%), with an average age of (60.9±11.7) years (range: 32-89 years) and a median dialysis age of 43.6 months. Dialysis-related data were collected, the serum RBP level was detected using the ELISA method. Patients were followed-up until June 30, 2019, to record the events associated with all kinds of hospitalization events. The t-test, Mann-Whitney U test and chi-square test were used to compare the differences between the hospitalized event group and the non-event group. Multivariate logistic regression was used to analyze the related risk factors of hospitalization events. The Kaplan-Meier method, Log-rank test, and Cox proportional hazards regression model were used to analyze survival data. Results:During the 19-month follow-up period, 26/80 patients (32.5%) had 67 events of hospitalization. There was no difference ( P>0.05) in age, sex composition, dialysis age, ratio of diabetes/hypertension, interval dialysis weight gain (IDWG), systolic/diastolic blood pressure before dialysis, kt/v and URR between the groups with or without hospitalization events. The cut-off point of serum RBP was calculated using the patient′s highest Youden index. The patients were divided into the high-RBP group ( n=44) and low-RBP group ( n=36) according to the level of 165.34 mg/L. The incidence of hospitalization events in the high-RBP group was higher than that in the low-RBP group (45.45%>16.67%, P=0.006). Using the multivariate logistic regression model, after adjusting for sex, age, albumin and total cholesterol (CHO), only the serum RBP level was independently correlated with hospitalization events. The high-RBP group had an odds ratio ( OR) of 3.64 (95 %CI, 1.14-11.58; P=0.029) compared with the low-level group in hospitalization events. The Kaplan-Meier survival analysis showed that the incidence of hospitalization events in the high-RBP group was significantly higher than that in the low-RBP group ( P=0.0058). The test results of the multivariable Cox proportional hazards regression model showed that for patients on hemodialysis, an elevated serum RBP level is an independent risk factor for hospitalization events. Conclusion:Elevated serum RBP level is correlated with hospitalization events in patients on hemodialysis. RBP is an independent risk factor for hospitalization events in outpatients on hemodialysis.