[Objective]To investigate etiopathogenisis,modus operandi and rehabilitation in treatment of bone nonunion and residual deformity (cubitus valgus) after humeral lateral condyle fractures in children. [Method]The author retrospective summarized a total of 27 patients diagnosed with humeral lateral condyle fracture follow with bone nonunion and/or cubitus valgus consecutive enrolled in Children’s Hospital of Chongqing Medical University from 2001 to 2006,including 19 cases of male,8 cases of female,16 cases of right humeral lateral condyle fracture and 11 cases of left. The mean age at injured for all the patients (n =27) was 5.6 yr (range 3-10 yr).The mean age at suigical operation for all the patients (n =27) was 9 yr (range 5-14 yr).The average time from injury to operation was 2.8 yr (range 8mon-10 yr).There were three modus operations including direct normal position internal fixation of 7 cases,open reduction following os illium bone graft internal fixation of 11 cases,distant humerus varus wedge shape cut orthopaedic for 9 cases.[Result]Thirteen patients were followed up ranging from 6 month to 2 years,and 14 patients over 2 years. All the patients were achieved union for 8 to 16 weeks after surgery. Elbow deformity had been corrected and function of elbow joint had been recoverd satisfactorily. All of them,excellent rerult were found in 13 cases,good in 11 cases,and poor in 3 cases,the excellent and good rates was 88.9%. None of the cases happened with osteonecrosis,traumatic arthritis and myositis ossificans.[Conclusion]It is common that delay treatment of humeral lateral condyle fractures in children can result in bone nonunion and residual deformity (cubitus valgus) and it is difficult for treatment. Corresponding surgical treatment with different condition and early exercise can improve the appearance and function of elbow joint.

Objective To construct the prokaryotic expression vector of mouse CD25 extracellular domain and to express it in E coli.Methods Total RNA was isolated from splenocytes of Balb/c mice.The CD25 extracellular domain gene was amplified by RT-PCR and cloned into the PET-32a vector.A positive recombinant,PET-32a-CD25e,was identified by enzyme cleaving and sequencing before its expression in E.coli,and transferred into E.coli BL21(DE3) plysS for its expression.After purification with Ni+ resin and renaturation in vitro,a relative molecular mass(Mr) of the interesting protein was detected by SDS-PAGE and Wes-tern blotting.Effect of the purified interesting protein on the proliferation of splenocytes from T cell vaccine-immunized syngeneic mice was detected by MTT assay.Results The cloned CD25 extracellular domain gene was identified to be functional by sequencing and expression.The purified interesting protein could significantly induce the proliferation and IL-4 secretion of splenocytes from T cell vaccine-immunized mice in vitro.Conclusion Mouse CD25 extracellular domain gene can be successfully expressed in prokaryotic cells with biological activity,which lays a foundation for further relative studies.

Objective To analyze the electrophysiological characteristics of Hirayama disease and explore their significance for its diagnosis.MethodsElectrophysiological tests were performed on 18 patients who fulfilled the clinical criteria for Hirayama disease. Sixteen were males and 2 were females. The mean age was 24.9years old ( 19-58 years), and the mean case history was 5.2 years ( 1-40 years). The Hirayama disease was clearly unilateral in 10 patients and bilateral in 3, with 5 cases suspected of being bilateral. Motor neuron conduction velocity (MCV) and sensory neuron conduction velocity (SCV) were measured in the median and ulnar nerves.Electromyograms (EMGs) of the abductor digiti minimi, abductor pollicis brevis, extensor digitorum communis,brachioradialis muscle, biceps brachii and sternocleidomastoid were recorded in all cases. The MCV and SCV of the common peroneal nerve and an EMG of the tibialis anterior muscle were examined in one leg. The MCV and SCV of the ulnar nerve and EMGs of the abductor digiti minimi, extensor digitorum communis and brachioradialis muscles were inspected on the contralateral sides of 8 cases, including the patients suspected of suffering bilateral Hirayama disease. The MCVs of the median and ulnar nerves were examined segmentally by stimulating the nerves distally as well as proximally, and recording the amplitude, duration and area of compound muscle action potentials (CMAP) and changes in wave form, then determining whether there was a nerve conduction block.Results (1) No conduction block was detected in any median nerve or ulnar nerve among the 18 cases. (2) All the SCVs and sensory nerve action potentials of the median and ulnar nerves were normal. ( 3 ) All the MCVs and SCVs of the common peroneal nerve and the EMGs of the anterior tibialis muscles were normal. (4) MCV slowing in the upper limbs accounted for 41.3％ (19/44) of the examined nerves. The rates of MCV decrease were 72.2％ (13/18)in the ulnar nerve on the affected sides, 33.3％ (6/18) in the median nerve on the affected sides and 0％ (0/8)in the ulnar nerve on the contralateral sides. (5) Amplitude reduction in the CMAP in the upper limbs accounted for 81.8％ (36/44) of the examined nerves. The rates of amplitude decrease were 100％ (18/18) in the ulnar nerves of the affected sides, 77.8％(14/18) of median nerves on the affected side and 50％(4/8) of ulnar nerves on the contralateral side. ( 6 ) Upper limb EMGs revealed a rate of neurogenic damage of 47.0％ ( 62/132). The EMGs decreased in 100％ (18/18) of the abductor digiti minimi and abductor pollicis brevis on the affected side, 88.9％ (16/18) of extensor digitorum communis on the affected side, 62.5％ (5/8) of the abductor digiti minimi on the contralateral side, 37.5％ (3/8) of the extensor digitorum communis on the contralateral side,5.6％ ( 1/18 ) of the brachioradialis and biceps brachii muscles on the affected sides. There was no neurogenic damage of the contralateral brachioradialis muscle or the sternocleidomastoid on the affected side.Conclusions The electrophysiological features of Hirayama disease include unilateral or bilateral neurogenic damage in the upper limbs. According to the abnormal EMGs, spinal anterior horn cells on the affected sides were injured at C7-T1. C6and above C6 were rarely involved. The electrophysiological characteristics of Hirayama disease could provide a clear basis for localization and differentiation in Hirayama disease diagnosis.

BACKGROUND:Acute poisoning is frequently encountered at emergency department. This study was to investigate the epidemiology and characteristics of patients with acute poisoning who were treated at the Emergency Center, Fujian Provincial Hospital, China. METHODS:We retrospectively analyzed the gender, age, causes of poisoning, types of poisons, poisoning route, emergency diagnoses, outcomes, and prognoses of these patients. RESULTS:Altogether 2867 patients with acute poisoning were treated from January 2004 to December 2009. The ratio of male to female was 1:1.04, and their average age was 33.8 years. Of the 2867 patients, 76.39％ were between 18 and 40 years old. The incidence of acute poisoning was as high as 11.33％ in January each year. The incidence of poisoning was in a descending order:alcohol poisoning (54.55％), medication poisoning (25.95％), pesticide poisoning (5.65％), and drug poisoning (4.88％). Most (56.44％) of the patients with drug poisoning were under 25 years and their mean age was significantly lower than that of patients with medication poisoning or alcohol poisoning (P < 0.01). Approximately 69.54％ of the patients were followed up after emergency treatment, 30.39％ were hospitalized, and four patients died. CONCLUSIONS:Acute poisoning is largely alcohol poisoning and medication poisoning in a city. The emergency green channel "pre-hospital emergency care-emergency department-hospital treatment"can significantly improve the survival rate of patients with acute poisoning.

BACKGROUND: Good neurological outcome after cardiac arrest (CA) is hard to achieve for clinicians. Experimental and clinical evidence suggests that therapeutic mild hypothermia is beneficial. This study aimed to assess the effectiveness and safety of therapeutic mild hypothermia in patients successfully resuscitated from CA using a meta-analysis. METHODS: We searched the MEDLINE (1966 to April 2012), OVID (1980 to April 2012), EMBASE (1980 to April 2012), Chinese bio-medical literature & retrieval system (CBM) (1978 to April 2012), Chinese medical current contents (CMCC) (1995 to April 2012), and Chinese medical academic conference (CMAC) (1994 to April 2012). Studies were included if 1) the study design was a randomized controlled trial (RCT); 2) the study population included patients successfully resuscitated from CA, and received either standard post-resuscitation care with normothermia or mild hypothermia;3) the study provided data on good neurologic outcome and survival to hospital discharge. Relative risk (RR) and 95% confidence interval (CI) were used to pool the effect. RESULTS: The study included four RCTs with a total of 417 patients successfully resuscitated from CA. Compared to standard post-resuscitation care with normothermia, patients in the hypothermia group were more likely to have good neurologic outcome (RR=1.43, 95% CI 1.14–1.80, P=0.002) and were more likely to survive to hospital discharge (RR=1.32, 95% CI 1.08–1.63, P=0.008). There was no significant difference in adverse events between the normothermia and hypothermia groups (P>0.05), nor heterogeneity and publication bias. CONCLUSION: Therapeutic mild hypothermia improves neurologic outcome and survival in patients successfully resuscitated from CA.

Objective To explore the relationship between social participation and needs for rehabilitation of the disabled in Guangdong Province and to make a proposal for developing the rehabilitation strategies. Meth-ods The data of the Second National Sample Survey of Disabled Persons in Guangdong Province was used in this study. Ranked data analysis was made with the sub-items of the social participation assessment and the main needs of the disabled individuals. Results Significantly statistical differences were revealed with regard to the constitu-ent ratio of needs for rehabilitation services among people with different degrees of difficulties in social participation caused by hearing and visual impairments as well as physical and mental disabilities. No significant difference was found in terms of the constituent ratio of rehabilitation needs among those with difficulties in speech and those with psychiatric diseases. The major rehabilitation needs focused on medical service, assistive apparatus support and functional trainings. Conclusions The rehabilitation needs were different among different categories of disabled persons. Rehabilitation services should be provided accordingly.

OBJECTIVETo explore methods and clinical effects of composite external fixtor in treating adult patients with unstable middle 1/3 of clavicular fractures.

METHODSFrom March 2008 to March 2011,36 patients with unstable middle 1/3 of clavicular fractures were treated with composite external fixtor. There were 24 males and 12 females, aged from 18 to 55 years old with an average of 43 years old. Twenty cases on the left side and 16 cases on the right side. Time from injury to operation was 2 to 6 days (averaged 3.5 days). According to Robinson classification, there were 7 cases with type 2A2, 18 cases with type 2B1, and 11 cases with type 2B2. No vessels and nerve damage occurred before opreation. The clinical effects were evaluated according to Neer scoring.

RESULTSAll cases were followed up from 6 to 12 months with an average of 8 months. The mean Neer score was 88.3 +/- 6.2, which included pain 31.6 +/- 3.2, functional score 25.7 +/- 2.2, range of motion score 21.1 +/- 1.7, and anatomy score 8.8 +/- 0.8. There were 22 cases in excellent, good in 13, fair in 1. Two cases occurred pin tract infection.

CONCLUSIONComposite external fixtor is an optional method in treating unstable middle 1/3 of clavicular fracture, and can obtain a good clinical effects.

Adolescent ; Adult ; Bone Nails ; Clavicle ; injuries ; surgery ; External Fixators ; Female ; Fracture Fixation ; Fractures, Bone ; surgery ; Humans ; Male ; Middle Aged ; Young Adult

Adolescent ; Bile Reflux ; etiology ; Child ; Child, Preschool ; Female ; Gastritis ; etiology ; Gastroscopy ; Helicobacter Infections ; complications ; diagnosis ; Helicobacter pylori ; Humans ; Male

Objective To explore the clinical characteristics and treatment of Caroli′s disease in children.Methods The clinical data,laboratory examination and radiological feature of 8 children with Caroli′s disease between Feb.1998 and Dec.2007 were analyzed retrospectively.All children underwent CT and abdominal ultrasonogram.Results Five cases of the 8 children were male and 3 cases were female.The mean age was 6.3 years old.The cases′ history were from 5 days to 4 months.The clinical symptoms showed that 3 cases had hematemesis,5 cases had hepatosplenomegaly,and 1 case had fever and turbid urine.Of the total 8 cases,5 cases were hepatic fibrosis and liver cirrhosis and hepatosplenomegaly,3 cases were portal hypertension,and 1 case had cholangitis.The other 3 cases were simple types.One case had infantile polycystic kidney disease.Laboratory analysis revealed 2 cases had dysfunction of liver and 1 dysfunction of renal.The imaging characteristics showed multiplied irregular dilatation of the intrahepatic bile ducts in enlarged liver,with central dot sign on CT scan.One case presented enlarged gastroesophageal vein.The 8 cases undertook conservative treatment,with no surgery.Conclusions The symptoms of Caroli′s disease are highly variable.Caroli′s disease should be focused especially on children with abdominal pain and hepatomegaly.CT is important for diagnosis of Caroli′s disease at earlier stage.The disease can be conservatively treated,and(or) surgically operated.

Objective To explore the effect of protoporphyrin Ⅸ zinc(Znpp) on hyperoxic lung injury in preterm rats.Methods Three-day-old preterm SD rats were randomly assigned to room air control group(group Ⅰ)hyperoxia control group(oxygen≥900 mL/L)(group Ⅱ),room air plus Znpp group(group Ⅲ),hyperoxia plus Znpp group(group Ⅳ).Group Ⅲ and group Ⅳ were injected intraperitoneally with ZnPP 45 ?mol/kg each day.After the third day and the 7th day of exposure,the activity of heme oxygenase-1(HO-1) and the percent of carboxyhemoglobin(HbCO) in the lungs,the lung wet weight /dry weight ratio(W/D),tumor necrosis factor-?(TNF-?),total protein and malondialdehyde(MDA) in bronchoalveolar lavage fluid were determined and lung histophathological changes were examined in all groups.Results On the third day,compared with group Ⅰ the activity of HO-1 and the percent of HbCO in the lungs,W/D,TNF-?,total protein and MDA,all greatly rised in group Ⅱ(Pa