Cardiovascular Diseases ; prevention & control ; Cerebrovascular Disorders ; prevention & control ; Humans ; Medicine, Chinese Traditional ; methods

OBJECTIVETo explore therapeutic effects of Modified pinning combined with external tension band for the treatment of Gartland type III humeral supracondylar fractures in children.

METHODSFrom February 2009 to November 2010, 79 children with Gartland type III humeral supracondylar fractures were treated by modified pinning (pinning cross internal and external condyle assisted with lateral condyle) combined with external tension band (crossing needle end and hooking around) through lateral approach of elbow. There were 47 males and 32 females, with an average age of 8.7 years (ranging from 2.5 to 14 years). The time from injury to operation was 2 h to 8 d. The elbow joint function and Carrying angle were observed before and after treatment. The Flynn criteria were used to evaluate therapeutic effects.

RESULTSSixty-one patients were followed up (18 patients' data were lost) for 6-30 months (mean 13.5 months). According to Flynn criteria, 53 patients got excellent result, 7 good and 1 fair.

CONCLUSIONTreatment of child Gartland type III humeral supracondylar fractures with modified pinning combined with external tension band through lateral approach of elbow is believed to be an ideal method, which has advantages of reliable fixation, rapid recovery and less complications.

Adolescent ; Bone Nails ; Child ; Child, Preschool ; Female ; Fracture Fixation ; instrumentation ; methods ; Humans ; Humeral Fractures ; diagnostic imaging ; surgery ; Male ; Mechanical Phenomena ; Radiography ; Treatment Outcome

Acupuncture Points ; Acupuncture, Ear ; Adult ; Dizziness ; therapy ; Headache ; therapy ; Humans ; Male ; Middle Aged ; Moxibustion ; Rhinitis, Allergic, Seasonal ; therapy

OBJECTIVE: To analyze the case characteristics of poisoning by exhaust gas of the imperfect combustion of natural gas and provide references for forensic identification and prevention of such accidents. METHODS: Twenty-two cases of poisoning by exhaust gas of the imperfect combustion of natural gas in Minhang District during 2004 to 2013 were collected. Some aspects such as general conditions of deaths, incidence time, weather, field investigation, and autopsy were retrospectively analyzed. RESULTS: In the 22 cases, there were 15 males and 16 females. The age range was between 2 and 82 years old. The major occurring time was in January or February (8 cases in each) and the cases almost occurred in small area room (21 cases). There was wide crack next to the exhaust port when the gas water heater was been used in all cases. CONCLUSION There are more prone to occurrence of exhaust gas poisoning of imperfect combustion of natural gas in small area room with a ventilation window near the exhaust port of gas water heated. It shows that the scene of combustion exhaust gas poisoning should be more concerned in the cold season.
Accident Prevention ; Adolescent ; Adult ; Aged ; Aged, 80 and over ; Autopsy ; Carbon Monoxide Poisoning/prevention & control* ; Child ; Child, Preschool ; Death ; Female ; Humans ; Male ; Middle Aged ; Natural Gas/poisoning* ; Retrospective Studies ; Young Adult

Objective To analyse the high-dose dexamethasone suppression test(HDDST)-related differences in the clinical and biochemical features of the patients with Cushing's disease Methods Cases were drawn from 60 consecutive patients with Cushing's disease,who were then divided into two groups according to the response to the HDDST.The clinical and biochemical features between two groups were compared.Results(1) Of the 60 patients with Cushing's disease,23.3%(14/60)of patients(group A)did not yield results of suppression with the HDDST,and the others(group B)did.No difference was found in the age[(33.8?10.4 vs 36.2?11.2)years]and duration of illness[(2.1?1.6 vs 3.9?3.1)years]between two groups.(2)In clinical features,the patients in group A were more likely to have edema of lower limbs(64.3% vs 32.6%),hypokalemia (71.4% vs 28.3%),secondary diabetes(57.1% vs 26.1%)and purple striae(85.7% vs 54.3%,all P

Objective To observe the inhibiting activities of fibronectin (FN) and citrullinated fibronectin (cFN) on disintegrin and metalloproteinase with thrombospondin motifs-4 (ADAMTS-4),and to explore the extracellular regulative mechanisms of ADAMTS-4.Methods FN was incubated with peptidylarginine deaminase type 4 (PADI4).Western blotting analysis was used to verify the citrullination of FN.The binding activity of FN and cFN to ADAMTS-4 were investigated by enzyme-linked immunosorbent assay (ELISA).The proteolytic ability of ADAMTS-4 after binding to FN and cFN were measured with the aggrecanase activity assay kit.One-way ANOVA,LSD-t test and t-test were used for statistical analysis.Results The immunosignal of citrulline was detected in FN after incubated with PADI4,but not in the absence of PADI4.A higher absorbance at 405 nm was detected when the full-length ADAMTS-4 protein was incubated with FN (2.182±0.042) than cFN (0.624±0.033; t=50.522,P＜0.01).Additionally,the recombinant ADAMTS-4 protein with a truncation at the C-terminus displayed low absorbance at 405 nm when the enzyme was incubated with both FN(0.971±0.024) and cFN(0.934±0.012; t=2.388,P＞0.05).Large amounts of ARGxx peptide were detected with full-length ADAMTS-4 in aggrecanase activity assay [(0.908±0.088) nmol/L],but significantly less when in the presence of FN and ADAMTS-4 [(0.573±0.000) nmol/L,P＜0.05].The production of this peptide was more when full-length ADAMTS-4 was incubated with cFN [(0.830±0.020) nmol/L,P＜0.05] than with FN.The reaction containing the truncated ADAMTS-4 without FN or cFN yielded the highest concentration of ARGxx peptide [(36.420±3.673) nmol/L],peptide production was not significantly altered when FN [(41.099±0.101) nmol/L] or eFN [(41.064±0.083) nmol/L] were added to the reaction.Conclusion FN could bind to ADAMTS-4 and inhibit its proteolytic activity.After citrullinated by PADI4,the binding activity of cFN is weakened and less inhibition to ADAMTS-4.

Objective To detect the levels of 25-hydroxyvitamin D3 and analyse the related clinical factors in patients with chronic kidney disease (CKD).Methods Patients with CKD in our department from March 1st to July 1st were enrolled continuously.The level of 25-hydroxyvitamin D3 and intact parathyroid hormone(iPTH) were detected by electrochemiluminescence and immunochemiluminescent respectively.Serum calcium,phosphorus and albumin were measured by automatic biochemical instrument.Results 127 patients were selected and the average age was (60.9?15.3).The mean level of 25-hydroxyvitamin D3 was (12.06?6.41)?g/L.82.6% patients had vitamin D deficiency and 96.9% patients had vitamin D insufficiency.The level of 25-hydroxyvitamin had no statistics difference D3 between stage 1,2 and 3 CKD patients but was much hihger than that of stage 4 and non-haemodialysis stage 5 patients.The level of 25-hydroxyvitamin D3 was not related to serum calcium,phosphorus and iPTH,while positively related to albumin and eGFR and negatively related to serum creatinine and total cholesterol.Conclusion Vitamin D deficiency and insufficiency are frequent in CKD patients and deteriorate with the progress of kidney function impairment.The level of 25-hydroxyvitamin D3 is not related to the traditional CKD-MBD index such as serum calcium,phosphorus and iPTH.

Objective:To validate the clinical value of CT-guided curve-needle percutaneous ethanol injection (CNPEI) for celiac plexus block analgesia. Methods: Thirty-two patients with end-stage cancer, including 13 complicated with extensive retroperitoneal lymph node enlargement and fusion, were enrolled in this study. All patients complained of refractory upper abdominal pain and had received narcotic analgesics and radiotherapy, but the analgesic effect was not good. CT-guided CNPEI was therefore prescribed. Results: The effective rates of CT-guided CNPEI were 100%, 100%, 96.9%, 90.6%, 87.5%, and 84.4% immediately,and at 2 weeks, 4 weeks, 8 weeks, 12 weeks, and 16 weeks after treatment, respectively. All enlarged lymph nodes had obvious necrosis and became shrunk. Conclusion: Combined application of bilateral anterior and posterior diaphragmatic crura block and trans-lymph node block can produce good analgesic effects, and curve-needle puncture make the above technique simpler.

Objective:To validate the therapeutic value of CT-guided percutaneous ethanol injection (PEI) in the treatment of metastatic adrenal tumors. Methods: Thirty-one foci (diameter ranging from 1.5 cm to 7.2 cm) in 25 patients with metastatic adrenal tumors were treated with CT-guided PEI for more than twice. Plain and enhanced CT scans were performed 1-2 months after PEI to observe the size and necrosis of the tumors. Results: Post-PEI enhanced CT scan showed that 18 of the 20 foci with diameters less than 3 cm completely necrotized; 11 foci with diameters between 3 cm and 7.2 cm necrotized partially, and 2 foci completely necrotized after another 2-3 courses of PEI treatment. Conclusion: CT-guided PEI is a simple and minimally invasive means for treatment of metastatic adrenal tumors, and the therapeutic effect is satisfactory.

Objective:To examine the feasibility of using cerebral state index(CSI)for monitoring the sedation depth during target-controlled infusion(TCI)with propofol and remifentanil.Methods:Forty-four consenting ASAⅠorⅡpatients(aged 18-60 years)undergoing elective surgery under general anesthesia were randomly divided into 4 groups(n=11 each)according to the target effect-site concentrations of remifentanil administered by TCI during induction of anesthesia.The target effect-site concentrations of remifentanil of R_0,R_2,R_4,and R_6 groups were 0,2 ng?ml~(-1),4 ng?ml~(-1),and 6 ng?ml~(-1),respectively. Anesthesia was induced by TCI with remifentanil and propofol.CSI and bispectral index(BIS)were used to measure the sedation depth.The initial effect-site propofol concentration(PCe)was 1.5?g?ml~(-1),which was increased by 0.5?g?ml~(-1) every 4 min.The modified OAA/S score(5=alert,1=does not respond to prodding),loss of eyelash reflex(LOR eyelash)and loss of response to electric tetanie stimulation(LOR tetanic)were compared against CSI,BIS and PCe(calculated effect-site propofol concentration).Correlation coefficients were calculated between CSI and other parameters.Results:The 4 groups were comparable with respect to the ages and bodyweights.CSI and BIS values were higher but PCe value were lower at LOR eyelash and LOR tetanic in R_2,R_4,and R_6 than those in the R_0 group(P