OBJECTIVETo study the clinical effect of the Gartland III humerus supracondylar fractures in children by manipulative reduction and Kirschner wire percataneous internal fixation.

METHODSFrom July 2010 and July 2013, 60 patients with Gartland III humerus supracondylar fracture were selected and divided into treatment group and control group. In the treatment group 32 patients were treated with traditional bone setting tetradeca-manipulative reduction and percataneous Kirschner wire internal fixation,included 18 males and 14 females with an average age of (7.8 +/- 2.7) years old ranging from 5 to 11; in the control group 28 patients were treated with open reduction and Kirschner wire internal fixation,included 16 males and 12 females with an average age of (7.2 +/- 3.0) years old ranging from 4 to 12. The motion range of the elbow joint,the time of fracture clinical healing, and the effect after 6 months of Flynm clinical functional assessment standards were observed and compared.

RESULTSThe average fracture healing time of the control group (5.01 +/- 0.43) weeks was longer than that of the treatment group (4.29 +/- 0.29) weeks (t = 7.49, P = 0.00). At 6 months after treatment,the elbow motion range of the treatment group (146.02 +/- 2.28) was more than that of the control group (140.76 +/- 4.42) (t = -5.67, P = 0.00). At 6 months after treatment, according to Flynn evaluation, in the control group,there were 7 cases as excellent, 16 as good, 4 fair, 1 poor; in the treatment group, excellent in 21, good in 9, fair in 2 (U = 3.09, P = 0.002).

CONCLUSIONManipulative reduction and Kirschner wire percataneous internal fixation for treatment of children's Gartland III humerus condyle fractures can shorten fracture clinical healing time and the clinical curative effect is better.

Bone Wires ; Case-Control Studies ; Child ; Child, Preschool ; Combined Modality Therapy ; Female ; Fracture Fixation, Internal ; methods ; Fracture Healing ; Humans ; Humeral Fractures ; physiopathology ; therapy ; Male ; Manipulation, Orthopedic ; methods

BACKGROUND:Single-row and double-row suture method are commonly used in the rotator cuff repair. Previous studies have shown that, double-row suture is not better than single-row suture in clinics.
OBJECTIVE:To compare clinical outcomes of single-row suture and double-row suture for rotator cuff repair, and evaluate the difference of therapeutic efficacy between two methods.
METHODS:A computer-based search was performed in the Medline (from January 2003 to February 2014), EMBASE (from January 2003 to February 2014) and Cochrane library (February 2014). According to the inclusion and exclusion criteria, al the randomized control ed studies addressing the outcome of single-row repair and double-row repair techniques were included in this meta-analysis. The methodological quality of each study was judged and a meta-analysis was conducted using Revman5.0. The preoperative and postoperative differences between the Constant score, American Shoulder and Elbow Surgeons (ASES) score, University of California, Los Angeles (UCLA) score, the re-rupture rate and the muscle strength were compared. The forest chart was used to compare the data between two groups, and the funnel plot was finished to detect the publication bias.
RESULTS AND CONCLUSION:A total of 10 randomized control ed trials (Levels I, II) were included. Meta-analysis showed that, there was no statistical y significant difference in the Constant, ASES and UCLA scores in the double-row group and the single-row group before and after treatment. In the postoperative fol ow-up, double-row group had a lower re-rupture rate and a higher abductor muscle strength than single-row group. When the rotator cuff tear was less than 3 cm, double-row group had no significant difference with the single-row suture group. While in the over 3-cm tear group, double-row group showed better results than the single-row suture group on the Constant scpre, ASES score and UCLA score. Double-row suture has a low re-rupture rate than single-row suture in rotator cuff injury, and could achieve better abduction muscle strength. There is no significant difference in the functional score between double-row suture and single-row suture in the rotator cuff tear of less than 3 cm, while in the over 3-cm tear, double-row suture could achieve better functional score.

10.3969/j.issn.2095-4344.2013.26.002

BACKGROUND:Kienb?ck disease lacks of suitable animal models, which are similar to the pathological process of avascular necrosis of human lunate bone.
OBJECTIVE:To establish a new animal model of Kienb?ck disease using medical TH adhesive embolism and to explore the rationality of model establishment.
METHODS:A total of 30 healthy adult New Zealand rabbits, male or female, were selected. Using self-control method, the rabbits were randomly assigned to experimental sides and control sides. By dril ing in the center of the lunate bone, 0.2 mL of medical TH glue was injected three times. An equal volume of physiological saline was injected into the center of the lunate bone on the control side. X-ray examination, general observation, Micro-CT measurement of bone, and tissue pathology detection were conducted at 4, 8 and 12 weeks.
RESULTS AND CONCLUSION:Gross specimen, X-ray and histological results showed that ischemic necrosis of the lunate bone on the experimental side was visible at 8 weeks after model induction. The ischemic necrosis of the lunate bone became more typical at 12 weeks. Among the Micro-CT microscopic parameters of trabecular bone, trabecular bone density parameters bone volume fraction and the number of trabecular bone were significantly lower on the experimental side than those on the control side (P<0.05). Spatial parameters of trabecular bone significantly increased. Trabecular separation and structure model index on the experimental side were significantly greater than those on the control side. Results suggested that ischemic necrosis of the lunate bone appeared on the experimental side at 8 weeks after injection of medical TH glue. Rabbit models of ischemic necrosis of the lunate bone can be established at 12 weeks. Thus, alterations, which were similar to ischemic necrosis of human lunate bone, appeared, such as blood transportation damage in the lunate bone, trabecular bone fracture, and empty lacuna, when surrounding tissues were not obviously injured.

BackgroundOur previous study showed that erythropoietin (EPO) protects the photoreceptor from apoptosis in retinal detachment(RD) rat,but its signal transduction pathway remains unknown.Objective The present study was to investigate the effects of EPO on signal transduction pathway in RD.MethodsTwentyfour albino clean Sprague-Dawley(SD) rats were randomly divided into 4 groups.5 μl PBS was injected into vitreous cavity of rats in RD+PBS group,and 400 ng EPO(5 μl) was used at the same way in RD+EPO group.Three days later,the rats were sacrificed and the retina was isolated in each group.The expression levels of Janus kinase 2 (JAK2),p-JAK2,Akt,p-Akt,extracellular regulated protein kinase-1/2 ( ERK-1/2 ),p-ERK-1/2,signal transducer and activator of transcription 5 ( STAT5 ),p-STAT5,nuclear factor-kB (NF-sB) and p-NF-kB were detected by Western blot assay.The administration of experimental animals followed the Standard of ARVO.ResultsThree days after RD,the expression levels of JAK2,Akt and ERK-1,ERK-2 in retinas among normal group,RD,RD+PBS,RD+EPO groups were statistically insignificant different ( F =0.298,P =0.826 ; F =0.681,P =0.588 ; F =0.978,P=0.450;F=1.115,P=0.399 ),but the levels of p-JAK2,p-Akt,p-Erk-1 and p-Erk-2 among these 4 groups were significant difference ( F=24.435,P =0.000; F=48.163,P =0.000;F =19.092,P =0.001; F =14.393,P=0.001 ),and those in RD+EPO group was significantly higher than that in RD and RD+PBS groups( P＜0.05 ).The expression levels of STAT5 and NF-kB among the 4 groups were no significantly differences (F =1.136,P=0.391 ;F=0.696,P=0.580),but after the phosphorylation of STAT5 and NF-kB,the differences was significant ( F =14.189,P =0.001 ; F =40.103,P =0.000 ).Those in RD,RD + PBS,RD + EPO groups did not increase either (P＞0.05).Although the levels of p-STAT5 and p-NF-kB in RD,RD+PBS,RD+EPO groups were significantly higher than those in normal control group( P＜0.05 ),the level of p-STAT5 in RD+EPO group was not significantly higher than that in RD and RD + PBS groups (P ＞ 0.05 ). Conclusions PI3K/Akt and MAPK/ERK-1/2 signal transduction pathways might participate in the protecting process of EPO to photoreceptor in RD rats.

Objective To study the change of vascular endothelial growth factor(VEGF) in myocardial tissue and serum of myocardial ischemia in rats.Methods Twenty SD rats were randomly divided into normal control group and test group. Test group was ligated coronary artery,and the control group was pulled on line but not ligated,then observed the change of VEGF.The histological and immunohistochemical method were used for observing the change of VEGF serum in myocardial ischemia in rats' heart.VEGF levels were measured by image analysis.Results Compared with control group,the expression of VEGF in the myocardial ischemia group was increased obviously(P

Objective To investigate the anatomical distribution and change of distal deep venous thrombosis in patients with hip fracture,to provide evidence for prevention and treatment of deep vein thrombosis in patients with hip fracture and lower limb deep vein ultrasound examinatio.Methods The clinical data of 383 patients with hip fractures who were admitted in Department of Orthopaedics Trauma,Xi'an Jiaotong University Medical College Red Cross Hospital from July 2014 to April 2018 were analyzed retrospectively.There were 122 males and 261 females,the age range was 17 to 94 years,the median was 78 years,and the interquartile range was 12 years.There were 154 cases of femoral neck fracture,208 cases of femoral intertrochanteric fracture,and 21 cases of femoral subtrochanteric fracture.Deep venous thrombosis was assessed by ultrasonography before and 3-5 days after operation,and the anatomical location and changes of deep vein thrombosis were analyzed.The skewed distribution data were represented by the median and interquartile range.The proportion of the number of deep venous thrombosis case in the anatomical position of the lower extremities was expressed as a percentage.Results Of the 383 patients with hip fracture who had distal deep venous thrombosis before surgery,isolated distal deep vein thrombosis (IDDVT) accounted for 89.30％ (342/383),and multivessel thrombosis accounted for 10.70％ (41/383).In IDDVT,intermuscular venous thrombosis was the most common,and no anterior venous thrombosis occurred.In multivessel thrombosis,two or three of the intermuscular vein,the posterior tibial vein,and the iliac vein were more common.Twenty-eight (7.31％) patients had distal thrombus extension to the proximal end (including 21 cases involving the iliac vein and 7 cases involving the superficial femoral vein),IDDVT accounted for 61.88％ (237/383).The involvement of multiple venous thrombosis accounted for 16.19％ (62/383),62.40％ (239/383) of the distal thrombus position did not change,and 14.62％ (56/383) of the distal thrombus disappeared.Conclusions For patients with hip fracture,the intermuscular vein is the most common site of distal deep venous thrombosis,ultrasound examination of anterior tibial vein is not necessary.Under anticoagulatio(n),7.31％ of distal deep venous thrombosis may extend to the proximal and 14.62％ of distal deep venous thrombosis disappear.For patients with hip fracture complicated with distal deep venous thrombosis in hospital,patients without contraindication of anticoagulation should be treated with anticoagulation at an early stage to prevent the proximal progression or fall off of thrombosis and reduce the risk of distal deep venous thrombosis.

OBJECTIVETo probe into the mechanisms of thread implantation at Zusanli(ST 36) and Chinese herbs in treatment of chronic renal failure(CRF).

METHODSCRF rat model was made by Platt subtotal nephrectomy. They were divided into 5 groups, sham operation group, model group, Chinese herbs group, thread implantation group and thread implantation plus Chinese herbs group. After treatment of 8 weeks, serum parathyroid hormone (PHT), transforming growth factor beta1 (TGF-beta1) expression in residual renal cells, malondialdehyde(MDA) content in the residual renal tissue, serum urea nitrogen(BUN) and creatinine(Scr), protein in urine and pathological changes were investigated.

RESULTSThe above indexes after treatment by thread implantation at acupoint, Chinese herbs, and acupoint thread implantation plus Chinese herbs showed begin reversion, especially, the most obviously improvement in the acupoint thread implantation plus Chinese herbs treatment group.

CONCLUSIONThe mechanism of acupoint thread implantation and Chinese herbs in improvement of CRF is related with decrease of PTH, inhibition of TGF-beta1 expression, decrease of MDA content and resisting lesion of renal fibrosis.

Acupuncture Points ; Animals ; Drugs, Chinese Herbal ; pharmacology ; Kidney Failure, Chronic ; blood ; therapy ; Male ; Parathyroid Hormone ; blood ; Rats ; Rats, Wistar ; Transforming Growth Factor beta ; blood ; Transforming Growth Factor beta1

Objective:To explore the risk factors,preventive measures and therapeutic methods for bronchopleural fistula (BPF) after lung resections.Methods:A restrospective analysis for 11 patients with BPF after pneumonectomy from April 2012 to June 2016 in Department of Thoracic Surgery,Xiangya Hospital,Central South University was performed.Their clinical characteristics,treatment and prognosis were analyzed,and the risk factors and effective therapeutic strategies were summarized.Results:Among the 11 patients with BPF,10 cases were cured finally,and 1 case with conservative treatment was dead.The total mortality rate was 9.09％.The 10 patients treated with positive measures were all cured,including 5 cases with pulmonary lobectomy and pneumonectomy,4 cases with amplatzer and covered stent,and 1 case with fibrin glue.One case with conservative treatment was dead because of respiratory failure.Conclusion:It is important to intervene BPF as early as possible.Fibrin glue via bronchoscope for tiny BPF after lung resection is preferred to be considered.We recommend to take early positive operation (pulmonary lobectomy and pneumonectomy) after pulmonary resection if the BPF cannot be cured via bronchoscope whereas the patients' condition is allowed.The amplatzer or covered stent should be considered first for the patient with BPF after pneumonectomy.

Objective To investigate the relationship between the incidence of deep vein thrombosis (DVT) during hospitalization and the energy of injury in tibial plateau fractures (TPFs).Methods 140 patients were enrolled in the study between September,2014,and October,2017 in Honghui Hospital,Xi'an Jiaotong University.According to the Schatzker classification,the low-energy group (Schatzker Ⅰ-Ⅲ) X-ray showed a simple or lateral fracture or compression fracture of the lateral plateau (n =63);the high-energy group (Schatzker Ⅳ-Ⅵ) X-ray showed the medial tibia or double of the tibial plateau (n =77).Duplex Ultrasonography was performed in lower extremities before and after surgical intervention for DVT evaluation and record the incidence of DVT,the days during hospitalization,the blood loss during surgery and the level of D-Dimer.All patients received mechanical and chemical thromboprophylaxis.The patient was followed up for one month after surgery,and the lower extremity ultrasound was reviewed and recorded.The measurement data were expressed as ((x) ± s),and the categorical variables were expressed in composition ratio.The measurement data were all in accordance with the normal distribution and the variance was uniform.The t-test was used,and the Chi-square test was used for comparison between groups.Results The incidence of thrombosis of tibial plateau fracture in TPFs was 36.43％ and 46.43％ pre-operation and post-operation respectively.The thrombosis incidence was 31.75 ％ (20/63) in the low-energy group and 40.26％ (31/77) in the high-energy group pre-operation.The thrombosis incidence was 44.44％ (28/63) in the low-energy group and 48.05％ (37/77) in the high-energy group post-operation.Statistical analysis showed no significant difference between the two groups pre-operation (P =0.298) and post-operation(P =0.785).The days during hospitalization [(11.94 ± 4.18) d,(9.56 ± 2.54) d],the blood loss during surgery [(208.96 ±224.43) ml,(129.68 ± 142.14) ml] and the level of D-Dimer [(2.39 ± 3.38) mg/L,(1.21 ± 2.32) mg/L] at pre-operation showed differences in the high energy group and the low energy group,respectively.Conclusions The incidence of DVT in TPFs is high during the hospital,but most of DVT is concentrated in the distal to the knee.Although the incidence of high energy injury and low energy injury DVT is not significantly different in TPFs,we should also be alert to the occurrence of DVT.