OBJECTIVETo summarize the experience of percutaneous fixation of scaphoid fractures with Herbert screws through volar approach, and provide a reliable and efficient treatment method for scaphoid fractures.

METHODSFrom April 2008 to September 2012,15 patients with scaphoid fractures were treated by percutaneous fixation with Herbert cannulated screws through volar approach including 14 males and 1 female with an average age of 35 years ranging from 25 to 45 years old. Among them, 10 cases were on left side and 5 cases were on right side. Durations from injury to operation ranged from 3 to 10 days with an average of 5 days. All these cases were identified as B2 type according to the Herbert classification based on X-ray and CT scan. In order to assess the function of wrist, all patients were calculated according to Krimmer's score postoperatively.

RESULTSThe follow-up period were from 5 to 18 months with an average of 10 months. At 3 months after operation,X-ray was re-checked every month. All the patients achieved bone union with a mean time of 10 weeks (ranged from 7 to 14 weeks) postoperatively. According to Krimmer's score, 14 cases gained 100 scores as perfect and one case got 90 scores as good. The small volar incision of all patients were union at the first period. No operation complications such as infection and nonunion occurred.

CONCLUSIONPercutaneous fixation with Herbert cannulated screws through volar approach is a reliable and efficient treatment method for scaphoid fractures with small invasion, high bone union rate, and fewer complications.

Adult ; Bone Screws ; utilization ; Female ; Fracture Fixation, Internal ; instrumentation ; methods ; Fractures, Bone ; physiopathology ; surgery ; Fractures, Ununited ; surgery ; Humans ; Male ; Middle Aged ; Range of Motion, Articular ; Scaphoid Bone ; injuries ; physiopathology ; surgery ; Treatment Outcome ; Wrist Injuries ; physiopathology ; surgery ; Wrist Joint ; physiopathology ; surgery

Objective To evaluate the factors associated with clinical pregnancy rate of in-vitro fertilization (IVF) in endometriosis related infertility.Methods Total of 326 patients with endometriosis related infertility undergoing IVF between January 2007 and December 2011 were studied in Department of Reproductive Medicine,First Affiliated Hospital,Nanjing Medical University,retrospectively,which were divided into 141 cases in clinical pregnancy group and 185 cases in non-pregnancy group.Those factors including age,body mass index (BMI),basic FSH,antral follicle count (AFC),CA125 and CA199,endometriotic stage and history of surgery,stimulation scheme were analyzed by bivariate analysis and multivariable logistic regression.Results (1) Pregnancy rate:total of 141 pregnant cases and 185 nonpregnant cases treated by IVF were observed,pregnancy rate was 43.2％ (141/326).(2) Basic parameters:there was no statistical difference in age,BMI,basic FSH,AFC,CA125 and CA199 between clinical pregnancy group and non-pregnancy group (P ＞ 0.05).(3) Bivariate analysis:clinical pregnancy rate of 50.0％ (87/174) among patients with infertility year less than five years was significantly higher than 35.5％ (54/152) in patients with more than five years.Pregnancy rate of 56.1％ (46/82) in stage Ⅰ-Ⅱ was significantly higher than 42.5％ (79/186) in stage Ⅲ-Ⅳ.Pregnancy rate of 46.6％(125/268) with history of surgery was significantly higher than 27.6％ (16/58) with no history of surgery (P ＜ 0.05).Pregnancy rate of 48.2％ (79/164) in long-term scheme was higher than 38.3％ (62/162) in short-term scheme,but there was no significant difference (P =0.075).(4) Multivariable logistic regression:clinical pregnancy rate of infertility year with less than 5 years,stage Ⅰ-Ⅱ,history of surgery proved stage Ⅰ-Ⅱ and stage Ⅲ-Ⅳ was significantly higher compared with infertility year more than 5 years,stage Ⅲ-Ⅳ and no history of surgery respectively (adjusted OR and 95％ CI:2.003,1.263-3.175; 1.899,1.110-3.248; 3.769,1.802-7.887,P＜0.05).Conclusion Factors affecting clinical pregnancy rate of IVF in endometriosis related infertility were infertility year,stage and surgery.

AIM:To evaluate the effects of pilocarpine, brinzolamide and the preservatives of them on corneal epithelial cells and the histopathology of rabbit conjunctiva. METHODS: Fifteen New Zealand white rabbits weighing 1.5 kg to 2.5 kg were randomly divided into three groups. One group with three rabbits served as untreated controls. Pilocarpine 1% and brinzolamide 1% each were administered to the right eyes in one treated group, and the preservatives (chlorobutanol 0.01% in pilocarpine, benzalkonium chloride 0.01% in brinzolamide) to the left eyes. Corneal epithelial damage was evaluated by scanning electron microscopy, and conjunctival specimens were examined under light microscopy. RESULTS: Compared with normal controls, brinzolamide and BAC caused corneal epithelium damage and increased number of inflammatory cells in the conjunctiva, while pilocarpine and the preservative chlorobutanol mainly influenced the corneal epithelium. Brinzolamide produced significantly more damage than pilocarpine (P

Background Lowing intraocular pressure (IOP) is the only effective treating method in glaucoma.Making sure the change of optic disc parameters and retinal nerve fiber layer thickness(RNFLT) in primary open-angle glaucoma (POAG) patients after IOP reduced can provide objective evidence for evaluating the effect of lowing-IOP on the function of optic nerve.Objective The present study was to evaluate the change of optic disc parameters and RNFLT in POAG patients after trabeculectomy,and analyze the affecting factors of image parameters.Methods A serial case-observational study was adapted.Forty eyes of 39 patients with POAG underwent trabeculectomy were recruited in the study.IOP was examined and perimetry was performed before operation and 2 weeks,1 month,3 months,6 months and 1 year after surgery.Optical parameters and RNFLT were measured using Heidelberg retina tomography (HRT) and optical coherence tomography (OCT) in above-mentioned time points.The correlations between lowing-IOP range or disease severity and optical disc parameters or mean RNFLT (mRNFLT) were analyzed by Pearson linear correlation.Results Mean IOP of the 40 eyes was (32.77±8.64) mmHg before operation and (12.45 ±3.65) mmHg,(13.05±3.90) mmHg,(13.42± 3.33) mmHg,(14.22± 2.60) mmHg and (14.74±2.46)mmHg 2 weeks,1 month,3 months,6 months and 1 year after operation,with a significant difference among various time points (F=13.73,P =0.00).However,no significant difference was seen in the mean defect of perimetry among the different time points (F=1.02,P=0.41).The cup area (CA),cup/disc area ratio (C/DAR),cup volume (CV),mean cup depth (MCD),cup shape measurement (CSM),horizontal C/D,vertical C/D,rim area (RA),rim/disc area ratio (R/DAR),height variation contour (HVC),rim volume (RV),mRNFLT,RNFL cross sectional area (RNFLA) were gradually improved after operation in comparison with before operation.One year after operation,RV,CSM,mRNFLT,RNFLA were still increased,but vertical C/D was reduced after operation than that of before (P＜0.05).No significant differences were found in the whole mRNFLT and superior quadrant mRNFLT,inferior quadrant mRNFLT,nasal quadrant mRNFLT and temporal quadrant mRNFLT among before and after operation (F=1.63,P=0.16; F=0.51,P=0.77; F=1.44,P=0.20;F=1.02,P=0.32; F=1.31,P=0.30).Positive correlations were found between lowing-IOP range and the improvement of RV,CSM,vertical C/D (r =0.45,P =0.02; r=0.41,P=0.04; r=0.58,P=0.00),and negative correlations were seen between absolute value of MD and the improvement of RV,CSM 1 year after operation (r=-0.43,P=0.03; r=-0.62,P=0.00).Conclusions Reduction of IOP after trabeculectomy results in the reversal of optic disc parameters.The improvement of the optic disc parameters may be a protective factor for progression of glaucomatous optical nerve damage.

Objective To explore the effects of chronic levodopa treatment on characteristics of N-methyl-D-aspartate(NMDA) receptor subunit 1(NR1) on the neurons of striatum in rat models of Parkinsonism related motor complications.Methods Rat models(n=25)of Parkinsonism related motor complications were established and were randomly divided into solvent treatment group(n=5,intraperitoneal injection with vitamin C),levodopa chronic treatment group(n=10,intraperitoneal injection with levodopa for 23 d) and MK-801 treatment group(n=10,intraperitoneal injection with MK-801 on d 23 after intraperitoneal injection with levodopa for 22 d).Another 5 rats were served as controls(sham-operation group,n=5).Locomotion changes of rats in MK-801 treatment group were recorded,and NR1 phosphorylation in the other three groups was detected by Western blotting. Results After chronic treatment with levodopa methylester for 1,8,15 and 22 d,rats in MK-801 treatment group displayed shortened rotational duration and increased peak rotation.Compared with d 22,MK-801 both prolonged rotational duration and reduced peak rotation(P0.05).The expression of NR1,phosphorylated NR1S890,NR1S896 and NR1S897 in striatal membranes in levodopa chronic treatment group was increased compared with that of solvent treatment group(P

In this paper, optimization of the conditions of microwave technique in extraction process of Guizhi Fuling capsule in the condition of a pilot scale was carried out. First of all, through the single factor experiment investigation of various factors, the overall impact tendency and range of each factor were determined. Secondly, L9 (3(4)) orthogonal test optimization was used, and the contents of gallic acid in liquid, paeoniflorin, benzoic acid, cinnamic acid, benzoyl paeoniflorin, amygdalin of the liquid medicine were detected. The extraction rate and comprehensive evaluation were calculated with the extraction effect, as the judgment basis. Theoptimum extraction process of Guizhi Fuling capsule by microwave technology was as follows: the ratio of liquid to solid was 6: 1 added to drinking water, the microwave power was 6 kW, extraction time was 20 min for 3 times. The process of the three batch of amplification through verification, the results are stable, and compared with conventional water extraction has the advantages of energy saving, time saving, high efficiency advantages. The above results show the optimum extracting technology of high efficiency, stable and feasible.
Capsules ; Chromatography, High Pressure Liquid ; Drugs, Chinese Herbal ; isolation & purification ; Microwaves ; Technology, Pharmaceutical ; methods

Background Retinal retinoic acid (RA) plays an important role in the formation of the lensinduced myopia.However,it is not clear how RA transfer the myopic signal to choroid throughout the retinal pigment epithelium (RPE) barrier.Objective The aim of this study was to investigate the effect of all-trans retinoic acid (atRA) on the barrier of RPE in lens-induced myopic eye of guinea pig.Methods Thirty left eyes of 30 21-dayold clean guinea pigs were randomized into normal control group and the model group.The models of out of focus were induced by covering of-6.00 D concave lens on the left eyes for 15 days.Radius of corneal curvature was measured using corneal curvimeter,and diopeter of the guinea pig was examined by mydriatic optometry.The length of ocular axis was detected by A-sonography.The animals were sacrificed and the retinas of the left eyes were isolated for the culture and passage of RPE cells.The third generation of cells were incubated Millcell-PET microporous film,and atRA at the concentration of 1 × 10-6,1 × 10-7,1 × 10-8 and 1 × 10-9 mol/L was added to the micropore respectively for 12 hours,and the micropores with equal-solvent served as negative control group.Methyl thiazolyl tetrazolium (MTT)colorimetric method was used to detect the survival rate of the cells.Subsequently,the transepithelial electrical resistance (TER) of the monolayer cells was determined with CN10-EVOM2 resistance measuring meter.The vesicular transport change of RPE membrane in different groups was evaluated by FM1-43 fluorescence staining.Results The mean diopter was (-2.20±0.95) D in the models,and that in the controls was (+ 1.15 ±0.30) D,with a significant difference between them (t =14.57,P＜ 0.01).The axial length was (8.24 ± 0.09) mm in the models and it was significantly longer than (7.81±0.05) mm in the controls (t=17.20,P＜0.01).RPE cells grew well to form a monolayer in Millcell culture pool after one week.After 24 hours of the atRA treatment,the survival rate of RPE cells reduced gradually with the increase of atRA concentration with the highest rate in the 1 × 10-9 mol/L atRA group (93.3 ％) and followed by the 1 × 10-8 mol/L atRA group (88.2％).More than half of the cells dead in the 1 × 10-6mol/L and 1 × 10-7mol/L atRA groups (53.8％ and 47.1％).Significant differences in the TER value and fluorescence staining intensity of the cells were seen among the various groups (F =43.89,P =0.00 ; F =26.13,P =0.00),with the maximal values in the 1 × 10-8mol/L atRA group.The FM1-43 fluorescence located on the cellular membrane and cytoplasm.Conclusions AtRA can increase the functional state of tight junction and vesicular transport,which regulated the RPE cell barrier in the guinea pig.

Objective To study the different ultrasonic features in patients of polycystic ovary syndrome (PCOS) with or without obesity based on body mass index (BMI), and to investigate whether certain hormonal factors correlate with ovarian morphology and blood flow, and to discuss the role of ultrasound combined with hormone test in the diagnosis of obese PCOS. Methods One hundred and five women with PCOS were recruited. Patients were divided into two groups according to BMI;obese PCOS group (OB-PCOS, n=32, BMI≥25 kg/m2) and non-obese PCOS (NOB-PCOS, n=73, BMI<25 kg/m2). The ultrasonic parameters of follicle number (FN), ovarian volume (Vol), resistance index (RI) of ovarian stromal blood, RI of uterine artery and serum levels of luteinizing hormone (LH), follicle stimulating hormone (FSH), the ratio of luteinizing hormone and follicle-stimulating hormone (LH/FSH), progesterone (P), estradiol (E2), free testosterone (FT), prolactin (PRL), sex hormoe binding globulin (SHBG), fasting plasma glucose (FPG), fasting insulin (FINS), the extent of insulin resistance and hyperandrogenism (HOMA-IR) were measured and compared. The correlation of the ultrasonic parameters and hormonal factors were analyzed. Results The Vol of OB-PCOS group was significantly higher than NOB-PCOS group [(12.25±4.89) ml vs (10.73±2.30) ml, t=2.20, P < 0.05]. FN and uterine artery RI of OB-PCOS group had a rising trend and RI of ovarian interstitial was on a reducing trend compared with NOB-PCOS group. But the differences were not statistically significant. The levels of FINS and HOMA-IR in OB-PCOS group [(14.82±6.45) mU/L and (3.91±3.30)] were significantly higher than those in NOB-PCOS group [(8.04±4.57) mU/L and (1.64±1.20)] (t=4.87, 3.47, respectively, both P < 0.01). And FSH in NOB-PCOS group was significantly higher than OB-PCOS group [(5.95±1.91) U/L vs (4.65±1.88) U/L, t=-2.77, P<0.01]. In POCS patients, FN was significantly associated with LH/FSH (r=0.35, P<0.01), and FT (r=0.38, P<0.01). Vol was significantly associated with LH/FSH, BMI, HOMA-IR and FPG (r=0.27, P<0.05;r=0.25, P<0.05;r=0.40, P<0.01;r=0.32, P<0.01). RI of ovarian stromal blood flow was significantly associated with SHBG (r=0.28, P<0.05). In OB-POCS group, RI of uterine artery was significantly associated with PRL (r=-0.58, P < 0.05). Vol was significantly associated with HOMA-IR (r=0.47, P < 0.05). In NOB-POCS group, FN was significantly associated with LH/FSH (r=0.33, P<0.05), and FT (r=0. 56, P<0.05). Vol was significantly associated with FT (r=0.31, P < 0.05). Conclusion There are some differences in the ultrasound and endocrine parameters between obese and non-obese PCOS patients, and some correlations exist between them.

Objective: To investigate the proper methods of acupuncture and moxibustion for controlling body weight and their objects. Methods: 274 outpatients were allocated to 3observation groups: obesity, overweight and normal, using standard weight as an index. The obesity group was divided, at a ratio of 1: 1: 3, into 3 groups: fixed prescription, local treatment and treatment based on syndrome differentiation. The syndromes were classified into five types in the syndrome differentiation group. Different protocols of acupuncture and moxibustion plus auricular-plaster therapy were drawn up for treatment. Body mass index (BMI), body fat (F%),body circumferences and subcutaneous fat were evaluated in the patients before and after treatments. Results: There was a difference in the controlling effect of acupuncture on body weight among different populations. The curative effect was better in the obesity and overweight groups than in the normal group; the effective rate was 72.2%, 72.5% and 44.0%, respectively.There was also a difference in curative effect among obesity patients with different types of syndromes. The curative effects on retention of damp-heat in the stomach, stagnation of liver qi and dampness retention due to splenic hypofunction were equal but all better than those on deficiency of splenonephric yang and intemal heat due to yin deficiency. There was also a difference in curative effect among different protocols. The curative effects in the syndrome differentiation-based treatment and fixed prescription groups were equal (77.8%) but all better than that in the local treatment group (53.3%). Conclusion: Acupuncture and moxibustion is an effective way to treat obesity and overweight. Treatment based on syndrome differentiation and fixed prescription on the basis of syndrome differentiation are effective methods.

Objective:To investigate the iodine content distribution of drinking water in Jiangsu Province.Methods:In 2017, the iodine content in drinking water of residents in townships (streets, hereinafter referred to as townships) of Jiangsu Province was investigated. Administrative villages (neighborhood committees, hereinafter referred to as administrative villages) of Jiangsu Province were selected as units for the investigation of townships with the median water iodine greater than 10 μg/L. Delimitation criteria: the median iodine content of water < 40 μg/L was iodine deficiency area, 40-100 μg/L was suitable iodine area, and > 100 μg/L was high iodine area.Results:A total of 1 285 townships were surveyed in 101 counties (cities, districts) in 13 cities, and the median water iodine in townships was 7.28 μg/L. Among them, there were 875 townships with median water iodine < 10 μg/L, accounting for 68.09%; 315 townships 10-< 40 μg/L, accounting for 24.51%; 56 townships 40-100 μg/L, accounting for 4.36%; 39 townships > 100 μg/L, accounting for 3.04%. The water iodine survey at the administrative village level was conducted in 5 864 administrative villages in 410 townships in 6 cities. Among them, 769 administrative villages with median water iodine < 10 μg/L, accounting for 13.11%; 3 558 administrative villages 10 - < 40 μg/L, accounting for 60.68%; 613 administrative villages 40 - 100 μg/L, accounting for 10.45%; and 924 administrative villages > 100 μg/L, accounting for 15.76%.Conclusion:According to the water iodine, there are iodine deficiency, suitable iodine and high iodine areas in Jiangsu Province, mainly in iodine deficiency areas.