OBJECTIVETo evaluate the clinical outcomes and complications of Triple-Endobutton plates in treating Tossy type III acromioclavicular joint dislocation.

METHODSFrom January 2011 to January 2013,45 patients with Tossy type III acromioclavicular joint dislocation were treated with Triple-Endobutton plates. There were 35 males and 10 females with an average age of 30.5 (ranged from 19 to 60) years old. At the final follow-up, VAS, DASH, Constant-Murley criterion were used to evaluate shoulder function.

RESULTSAll patients were followed up from 15 to 36 months. No neurovascular injury, wound infection and stress fractures were found,but 3 patients had a re-dislocation. At the final follow-up,the mean VAS score was decreased from (5.7±1.6) preoperatively to postoperative (0.2±0.1); DASH score was significantly decreased from (19.6±4.3) preoperatively to (0.3±0.1) postoperatively; Constant-Murley score was improved from (34.4±4.3) before operation to (94.8± 3.5) after operation.

CONCLUSIONClinical outcomes of treating Tossy type III acromioclavicular joint dislocation with Triple-Endobutton plates is satisfactory. However, re-dislocation is still the most common complication. Careful perioperative management is an important factor in preventing re-dislocation.

Acromioclavicular Joint ; injuries ; surgery ; Adult ; Bone Plates ; Female ; Follow-Up Studies ; Fracture Fixation, Internal ; instrumentation ; methods ; Humans ; Male ; Middle Aged ; Shoulder Dislocation ; surgery ; Treatment Outcome ; Young Adult

Objective:To study the relationship between serum level matrix metalloproteinase-9 (MMP-9) and atrial fibrillation (AF) and to assess its predictive value of AF recurrence in persistent AF patients after cardio-version.
Methods: Our research included in 4 groups: Control group, n=30 healthy subjects, Paroxysmal AF group, n=30, Persistent AF group, n=60 and Permanent AF group, n=30. Serum levels of MMP-9 were examined and compared among different groups. The patients in Persistent AF group received drug therapy or drug+electric cardio-version;with successful cardio-version, antiarrhythmia medication was used to maintain sinus rhythm and the patients were followed-up for prognosis, MMP-9 levels were further compared between the patients with or without AF recurrence to assess the predictive value of MMP-9 for AF recurrence.
Results: Serum levels of MMP-9 were as follows: Control group (151.43±88.14) ng/ml, Paroxysmal AF group (182.66±96.39) ng/ml, Persistent AF group (278.93±89.22) ng/ml and Permanent AF group (336.82±112.35) ng/ml respectively, which indicated that MMP-9 level in Persistent AF group was higher than Paroxysmal AF group and Control group;MMP-9 in Persistent AF group was higher than the other 3 groups, P<0.01. The patients in Permanent AF group were followed-up for (15.4±4.3) months after cardio-version, retrospective analysis found that the patients with AF recurrence had the higher MMP-9 level than those without AF recurrence (315.63±94.52) ng/ml vs (261.92±87.86) ng/ml, P=0.036. Multivariate regression analysis was conducted on age, gender, AF history, left atrial diameter and MMP-9, the consequence showed that serum MMP-9 level was the independent predictor for AF recurrence in persistent AF patients after cardio-version (P=0.035, OR=1.135, 95%CI 1.018-1.321).
Conclusion: Serum MMP-9 level was elevated in persistent and permanent AF patients;MMP-9 was the independent predictor for AF recurrence in persistent AF patients after cardio-version.

Objective To observe the correlation between non-high density lipoprotein cholesterol levels and coronary artery disease(CAD),extent of angiographic coronary artery lesions and risk factors of CAD.Methods Serum total cholesterol ( TC ),triglyceride ( TG),high density lipoprotein cholesterol ( HDL-C ),low density lipoprotein (LDL-C),Lp(a),apoA-1 and apo B levels were measured in 282 patients with angiographic CAD meanwhile in 129 normal controls without angiographic coronary artery lesions.Non-HDL-C and LDL-C/HDL ratio was calculated.Logistic regression and partial correlation were used to find the correlation of serum non-HDL-C with CAD.Results Non-HDL-C[ (3.40 ± 1.01 ) mmol/L vs (3.08 ±0.65)mmol/L,P ＜0.05],LDL-C[ (2.63 ±0.84) mmo/L vs (2.40 ±0.54) mmol/L,P ＜0.05 ],TC[ (4.48 ± 1.07)mmol/L vs (4.23 ±0.69) mmol/L,P ＜0.05 ],and LDL-C/HDL ratio [ ( 2.52 ± 0.96) vs (2.21 ± 0.74 ),P ＜ 0.05 ] were significantly higher in the CAD group than in the control group.The four indexes also showed an increasing trend in the sequence of single,double and triple vessel lesions.Multivariate Logistic regression analysis found that among lipid factors,only non-HDL-C was independently associated with CAD.The results of partial correlation analysis demonstrated that non-HDL-C was positively correlated to the number of lesions( r =0.250,P ＜0.01 )and gensini score of CAD( r =0.116,P ＜0.05 ).Conclusion Non-HDL-C level is an independent risk factor for CAD and significantly correlated with the severity of CAD.

Iridoid glycosides were the main active ingredient of Rehmannia glutinosa, of which catalpol has the highest content. This work will provide theoretical basis for metabolic study and cultivation of iridoids on the basis of the dynamic accumulation of catalpol and total iridoids in the growth of R. glutinosa. The samples of rehmannia 85-5 were gathered in the same filed from July to October. The contents of catalpol and total iridoid glycosides were measured by HPLC and specteophotometric, respectively. The results showed that youngest leaves had the higher content of catalpol and total iridoid glyosides than that of the other two leaf ages in the same growth stage from July to September, while their content of catalpol and total iridoid glycosides were all decreased as the growth of leaves of R. glutinosa. The content of catalpol didn't differ significantly from July to September, whereas it has significantly increased in October in the three leaf stage. In the same stage, the wider the root diameter is, the higher content of the effective components are. In August and September, the total iridoid glycosides have the fastest accumulation. The content of catalpol was increased as the accumulation of total iridoid glycosides.
Iridoid Glucosides ; metabolism ; Iridoids ; metabolism ; Plant Roots ; metabolism ; Rehmannia ; growth & development ; metabolism ; Seasons ; Water ; metabolism

Objective: To evaluate the feasibility and safety of en bloc transurethral resection with thulium (Tm):-Yag laser in the management of patients with non-muscle-invasive bladder cancer. Methods: The data of 287 consecutive patents pathologically identified of non-muscle-invasive bladder cancer, who underwent transurethral resection from January 2008 to December 2013, were retrospectively analyzed. Of these patients, 209 patients underwent the traditional transurethral resection of bladder cancer (TURBT), and the other 78 patients underwent the en bloc transurethral resection with Tm-Yag laser. The operative time, intraoperative blood loss, days for urethral catheterization, duration of hospitalization after surgery, incidence of postoperative complications, detection rate of muscle layer in postoperative pathologic examination, pathologic grade and stage, and recurrence between the two groups were compared. All the patients were followed-up, and the median follow-up time was 27 months. Results: The operative time in Tm-Yag laser group was significantly longer than that in TURBT group (75.77±52.19 min vs 47.18±35.77 min, P < 0.05), but the intraoperative blood loss, days for urethral catheterization, and the duration of hospitalization after surgery were not significantly different between the two groups (all P > 0.05). The incidence of postoperative complications in Tm-Yag laser group was lower than that in TURBT group (6.4% vs 1 7.7%, P = 0.045). In Tm-Yag laser group, the number of stage Tl tumors and the detection rate of muscle layer in postoperative pathologic examination were both higher than those in TURBT group (P = 0.039; P = 0.001). The total rate of tumor recurrence and progression showed no differences between the two groups (35.9% vs 43.5%, P > 0.05; 11.5% vs 14.8%, P > 0.05). The Kaplan-Meier survival curves of recurrence-free survival and progression-free survival also showed no significant differences (both P > 0.05). Conclusion: The en bloc transurethral resection with Tm-Yag laser is feasible and safe in the management of non-muscle-invasive bladder cancer.

Objective To investigate the role of cyclooxygenase-2(COX-2)and mitochondrial adenosine tuiphosphate sensitive potassium channels (mito-KATP channels) in sufentanil preconditioning-induced delayed cardiopreteetion against myocardial ischemia-reperfnsion (I/R) injury in rats. Methods Seventy-two adult male Wistsr rats weighing 250-300 g were randomly divided into 6 groups ( n =12 each). Group Ⅰ,Ⅱ,Ⅲ were preconditioned with intraperitoneal (IP) normal saline (NS) 1 ml/kg while group Ⅳ,Ⅴ,Ⅵ with IP sufentanil 20 μg/kg at 24 h before myocardial ischemia. Group Ⅱ and Ⅴ were given IP NS-398 ( COX-2 inhibitor) 5 mg/kg at 30 rain before myocardial ischemla while group Ⅲ and Ⅵ were given intravenous 5-HD (mito-KATP channelblocker) 10 mg/kg at 10 min before ischemia or before being killed. Six animals in each group underwent 45 min myocardial ischemia followed by 120 min reperfusion, while the other six animals in each group were killed immediately before ischemia for determination of myocardial COX-2 expression and myocardial PGF2 and PGF1α content. Myocardial ischemia was induced by occlusion of left anterior descending branch (LAD) of coronary artety for 45 rain followed by 120 min reperfusion. MAP and HR were recorded immediately before ischemia (T0), at 15, 30, 45 rain of ischemia (T1-3) and at 30, 60, 90, 120 vain of reperfusion (T4-7). Heart rate-blood pressure product (RPP) was calculated. Arterial blood samples were obtained at T0.3 and T7 for measurement of plasma CK-MB activity. The animals were killed at the end of 120 nan reperfusion. The hearts were removed for determination of myocardial infarct area (IA) and area at risk (AAR). LA/AAR was calculated. Results There was no significant difference in HR, MAP and RPP at all time points among the 6 groups. Preconditioning with sufentanil significantly decreased plasma CK-MB activity at T3 and T7 and IA/AAR in group Ⅳ as compared with group Ⅰ.Myocardial COX-2 expression was up-regulated and PGE2 and PGF1α, contents were elevated by sufentanil preconditioning in group Ⅳ as eomared with control group (Ⅰ). In group Ⅴ and Ⅳ preconditioning with NS-398/5-HD significantly increased plasma CK-MB concentration and IS/AAB as compared with group Ⅳ, indicating involvement of COX-2 and mito-KATP channels in the sufentanil-induced delayed cardioprotection.The myocardial PGE2 and PGF1α contents were significantly reduced in group Ⅴ as compared with group Ⅳ. There was no significant difference in the myocardial COX-2 expression among group Ⅳ, Ⅴ and Ⅵ. Conclusion Both COX-2 and mito-KATP channels are involved in sufentanil preconditioning-induced delayed cardiopmtection.

Adult ; Bone Plates ; Bone Transplantation ; Female ; Fracture Fixation, Internal ; Humans ; Internal Fixators ; Male ; Middle Aged ; Tibia ; injuries ; surgery ; Tibial Fractures ; surgery ; Treatment Outcome ; Young Adult

AIM To establish an HPLC method for the simultaneous content determination of four constituents in Hydnocarpus anthelmintica Pierre.METHODS The analysis of 60％ ethanol extract from H.anthelmintica was carried out on a 35 ℃ thermostatic Diamonsil C18column (4.6 mm ×250 mm,5 μm),with the mobile phase comprising of 80％ acetonitrile-0.1％ phosphoric acid flowing at 1.0 mL/min in a gradient manner,and the detection wavelength was set at 347 nm.RESULTS Luteolin,hydnocarpusol,chrysoeriol and hydnocarpin showed good linear relationships within the ranges of 0.0523 6-1.047 μg (r =0.999 9),0.011 24-0.224 8 μg (r =0.999 9),0.029 46-0.589 2 μg (r =0.999 9) and 0.130 5-2.609 μg (r =0.999 9),whose average recoveries were 102.45％ (RSD=1.9％),98.66％ (RSD=1.8％),97.60％ (RSD=1.6％) and 97.88％ (RSD=1.4％),respectively.CONCLUSION This simple,accurate and sensitive method can be used for the quality control of H.anthelmintica.

OBJECTIVETo investigate curative effects of elastic stable intramedullary nails in the treatment of stable and unstable fractures of femoral shaft in children and to guide its clinical application.

METHODSFrom January 2008 to October 2010,44 children with femoral shaft fractures were treated,including 24 boys and 20 girls,ranging in age from 5 to 12 years, with an average of 7.4 years. Based on the fractures stable or not, the patients were divided into stable fractures group(group S) and unstable fractures group (group U). All the children received the same operation to fix broken femoral with elastic stable intramedullary nails and some children received traction or small splint protection after operation when reduction and fixation were considered unsatisfied or his/her weight beyond 30 kg. During the followed-up, the healing time, irritation of the soft tissue (ache, cyst, t al), malunion (angulation above 5 degree in X-ray), limb shortening or lengthening and excellent and good rate were observed.

RESULTSAll the patients were followed up,and the duration ranged from 5 to 19 months, with an average of 13 months. All the fractures were healed at the latest follow-up. The average healing time was 10.2 weeks (ranges, 8 to 14 weeks). The incidence rate of malunion was 23.8% in group U and the average angulation was 9 degree (6 to 12 degree), which was higher than those of patients in the group S (0%). The average healing time, limb shortening or lengthening, irritation of the soft tissue and the excellent and good rate between two groups had no significance differences, which were (10.6 +/- 1.3) vs. (9.9 +/- 1.2) weeks, 0 vs. 3 cases, 3 vs. 1 case and 2 vs. 4 cases respectively. In the group U, among 5 patients had malunion, 4 patients were not treated with traction or small splint protection,and the incidence was higher than those who were given traction or small splint protection.

CONCLUSIONBoth the stable and unstable femoral shaft fractures in children treated with elastic stable intramedullary nails can receive well short-term curative effects. If given certain postoperative protection like as traction or small splint, the malunion incidence can be reduced.

Bone Nails ; Case-Control Studies ; Child ; Child, Preschool ; Female ; Femoral Fractures ; surgery ; Fracture Fixation, Intramedullary ; instrumentation ; Humans ; Male ; Treatment Outcome

OBJECTIVETo establish a real-time reverse transcription-polymerase chain reaction (RT-PCR) for quantitative detection of E2A-PBX1 fusion gene mRNA in acute lymphoblastic leukemia (ALL) children and to explore its clinical significance in minimal residual disease monitoring and prognosis evaluation.

METHODSReal-time RT-PCR was used to quantitatively detect the mRNA expression of E2A-PBX1 gene in 11 newly diagnosed ALL patients at diagnosis (11 cases), complete remission (11 cases) and periods of relapse (3 cases). Ten children with normal bone marrow cell morphology and without hematopathy or tumor diseases were used as the control group.

RESULTSThe median expression levels of E2A-PBX1 fusion gene in the ALL group at diagnosis and the relapse group were significantly higher than in the control and complete remission groups (P<0.01). Compared with E2A-PBX1 negative patients on day 33 during induction of remission, the recurrence rate increased and disease free survival rate at 3 year decreased significantly in E2A-PBX1 positive patients decreased (P<0.05).

CONCLUSIONSMeasurement of E2A-PBX1 levels by real-time RT-PCR is useful for monitoing minimal residual disease, prediction of relapse and individual treatment. The expression level of E2A-PBX1 gene on day 33 during induction of remission can be used for prognosis evaluation.

Adolescent ; Child ; Child, Preschool ; Female ; Homeodomain Proteins ; genetics ; Humans ; Male ; Neoplasm, Residual ; diagnosis ; Oncogene Proteins, Fusion ; genetics ; Precursor Cell Lymphoblastic Leukemia-Lymphoma ; diagnosis ; genetics ; Prognosis ; Real-Time Polymerase Chain Reaction ; methods