UNLABELLEDABSTRA CT OBJECTIVE To compare the complications and clinical outcome of titanium elastic nail (TEN) versus plate-screw fixation (PF) for the treatment of upper segment fractures of femoral shaft in children.

METHODSFrom May 2006 and August 2012,32 consecutive children with upper segment fractures of femoral shaft were studied prospectively. They were randomly divided into TEN group and PF group. Ninteen patients were treated with titanic elastic nail (TEN) fixation including 11 males and 8 females with an average age of (6.9?2.2) years old ranging from 3 to 11,11 cases of them were type A, 6 cases were type B,2 cases were type C according to AO classification. The other 13 patients were treated with plate-screw fixation (PF) including 9 males and 4 females with an average age of (7.5±2.1) years old ranging from 5 to 12 years, and 3 cases of them were type A,6 cases were type B,2 cases were type C. Operative time, blood loss,incision length,the time of hospitalization,fracture healing time, postoperative complications and function recovery between two groups were compared and evaluated.

RESULTSThe average follow-up period of the patients was 25.3 months (ranging from 15 to 48 months) in TEN group, and 36.2 months (ranging from 13 to 36 months) in the PF group. The operation time, time of hospitalization, the time of implants removed after the initial surgery, fracture healing time in TEN group were respectively (56.7±11.2) min, (6.6±3.9) d, (8.1±2.3) months, (12.6+3.8) weeks; and in PF group were respectively (51.5±8.3) min, (7.8±4.8) d, (7.8±1.6) months, (11.8±2.8) weeks, there was no significant difference between two groups (P>0.05). However, the length of incisions was (4.3±1.7) cm and the intraoperative blood loss was (12.7+3.2) ml in TEN group,which were significantly less than that in PF group respectively (89.2±21.1) ml and (11.6?2.3) cm (P<0.05). There was no statistically difference in postoperative in complication between two groups, but the patients in TEN group had a higher incidence of soft tissue irritation and misalignment. Outcome scores according to Sanders had no significant difference between two groups (P>0.05). In TEN group,the result was excellent in 13 cases, good in 3,fair in 2, and poor in 1, while in PF group excellent in 10, good in 2, fair in 1.

CONCLUSIONThere is no significant difference in therapeutic effects between TEN and PF for children with upper segment fractures of femoral shaft. The internal fixation should be selected according to the associated fracture type, weight, the expected value of the parents, scars, and so on.

Blood Loss, Surgical ; Bone Nails ; Bone Plates ; Bone Screws ; Child ; Child, Preschool ; Female ; Femoral Fractures ; complications ; physiopathology ; surgery ; Fracture Fixation, Intramedullary ; instrumentation ; Fracture Healing ; Hip ; physiopathology ; Humans ; Male ; Operative Time ; Postoperative Complications ; epidemiology ; Prospective Studies ; Treatment Outcome

Animals ; Disease Models, Animal ; Sleep Deprivation ; physiopathology ; psychology

Adolescent ; Adult ; Child ; Child, Preschool ; Female ; Humans ; Hypothalamic Neoplasms ; pathology ; radiotherapy ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Pituitary Neoplasms ; pathology ; radiotherapy

Objective To explore the influence of Helicobacter pylori (Hp) infection in serum lipoprotein associated phospholipase A2 (Lp-PLA2), carotid intima-media thickness and stability of atherosclerotic plaques in atherosclerosis patients.Methods A total of 393 cases of patients with carotid artery arteriosclerosis confirmed by carotid color uhrasonography, who are informed consent, was selected as objects.The14C urea breath test was used to determine the infection situation of selected objects of helicobacter pylori.Meanwhile, enzyme-linked immunosorbent assay (ELISA) was used to determine the level of serum lipoprotein associated phospholipase A2 (Lp-PLA2).Results Serum Lp-PLA2 levels and carotid intimamedia thickness (IMT) of patients with carotid artery atherosclerosis in Hp infection group were higher than that of Hp non-infection group, and with the degree of Hp infection aggravating in the patients of carotid artery atherosclerosis, their serum Lp-PLA2 levels and carotid IMT were also increased accordingly.F test showed that the differences of serum Lp-PLA2 levels and carotid IMT in different degree of carotid artery atherosclerosis group were statistically significant (P ＜0.01).The incidence of unstable plaque of Hp infection group was obviously higher than that of the Hp non-infection group in the carotid atherosclerosis with plaques with statistical significance (chi square value =4.744, P =0.029).Multivariate linear regression analysis showed that the possibility of complication of unstable plaques in Hp infection group of carotid artery atherosclerosis was 1.82 times than that of non-infection group.With serum Lp-PLA2 every increasing 1 μg/L, the possibility of instability plaque increased by 2％.Conclusions Hp infection may promote the occurrence and development of carotid artery atherosclerosis by increasing serum level of Lp-PLA2 and changing the stability of atherosclerotic plaques.

Objective To investigate the infection of Helicobacter pylori infection on the serum concentration of homocysteine (Hcy) and its relationship with coronary heart disease (CHD) .Methods 159 cases of patients with CHD were selected as the re‐search subjects .They were divided into two groups :infection group and non‐infection group ,according to the results of 14 C‐urea breathe test .And they were also divided into three groups :negative group ,mild infection group and severe infestation group ,accord‐ing to the severity of infection .The CHD patients infected Helicobacter pylori were divided into three groups:low risk group ,mod‐erate risk group and high risk group ,according to SYNTAX scores .The serum Hcy concentration was determined by cyclic enzy‐matic method .Results Comparing with non‐infection group ,the serum Hcy concentration significantly increased in infection group (P<0 .01) .With the aggravation of Helicobacter pylori infection ,the serum Hcy concentration increased .There were significant difference among negative group ,mild infection group and severe infestation group (P<0 .01) .In the CHD patients infected Heli‐cobacter pylori ,the serum Hcy concentration also increased with the aggravation of the severity of coronary lesion .And there were significant difference among low risk group ,moderate risk group and high risk group (P<0 .01) .Conclusion Helicobacter pylori plays a role in the incidence and development of CHD through increasing the serum Hcy concentration .

Objective To evaluate the safety of surgical procedures for patients after heart valve prosthesis implantation.Methods Clinical data of 12 cases with heart valve prosthesis implantation undergone other surgical treatment from November 1996 to December 2005 were retrospectively analyzed.All the cases had routine oral warfarin with prothrombin time (PT) of 20.0—28.3 s averaged 23.5 s, international normalized ratio (INR) for prothrombin of 1.79—2.23 averaged 1.95 and heart functional class Ⅰ—Ⅲ.Among them,appendectomy was performed in three cases with acute appendicitis,reposition and repair in one with inguinal hernia,radical gastrectomy in two with gastric carcinoma,left hemicolectomy in one,cholecystectomy in three,left femoral head replacement in one,and bilateral high ligation and ablation of great saphenous vein in one.Elective surgical operation was performed in seven cases,and emergency operation in five.In those with elective surgery,warfarin was stopped 2—3 days before operation,while 5—10 mg vitamin K_1 was injected intramuscularly 6—8 hours before emergency surgery with preoperative median PT of 15.1 and 15.3 s and median INR of 1.24 and 1.30,respectively.In operation,5—10 mg vitamin K_1 were injected intravenously into the patients by drip depending on their bleeding on the surface of wound.ECG,blood pressure,hemoglobin and oxygen saturation were routinely monitored for all the cases intraoperatively and postoperatively.For the cases with heart function above class Ⅱ,fluid infusion was adjusted based on intubated central venous pressure,and for those with general anesthesia,analyses of blood gases and electrolyte were monitored routinely in operation.Results OPeration time averaged 20—160 rain in all the 12 patients,with blood loss 5—280 ml in average and without complications of massive hemorrhage,thrombosis and heart failure.Conclusions Surgical operation was safe for patients with heart valve prosthesis implantation,if preoperative PT and INR were adjusted to about 15 s and 1.30,respectively by cessation of warfarin or application of vitamin K_1,combined with careful manipulation and strengthened perioperative management.

Objective To explore the feasibility of artificial silastic framework(SF)in repair of large area of tracheal wall defects.Methods Twenty healthy adult dogs with tracheal defects for 2.5 cm?6.0 cm-3.0 cm?6.0cm were randomly and equally divided into experimental group(repaired with SF combined with sternohyoid fasciae)and control group(repaired with T-silastie tubule combined with sternohyoid fascial flap).After the operation,the animals were sacrificed at the 4th,8th,16th,24th, and 48th weeks respectively for harvesting the tracheae that were used for tracbeoscopically observing in- flammatory reaction of the repaired defect area and light microscopically observing epithelium healing on the repaired defect area.Results In the experiment group,the repaired trachea was smooth,without proliferation of granulation;and at the 8th week,the repaired defect area was covered with epithelial cells,with good functional recovery of respiration,phonation and deglutition.In the control group,there was obvious proliferation of granulation on the tracheal surface near anterior and posterior ends of T-silas tic tubule.The animals were under asphyxia to die with extraction of T-silastic tubule.Conclusions SF has excellent tracheal skeletal function.In the meantime,SF combined with sternohyoid fasciae is a simple but effective method for repair of large area of tracheal wall defects.

Objective To investigate the daily total fluoride intake in relating to the prevalence of skeletal fluorosis in two villages in Jiangsu Province,in order to provide the scientific evidences for the control and prevention of endemic fluorosis.Methods Adults sampled from a high-fluoride Village,Wamiao,and a low-fluoride Village,Xinhuai,were surveyed in this study according to the fluoride concentration in their household shallow well.The average daily total fluoride intake from difierent sources and the skeletal fluorosis were investigated in each subject.Then the subjects from two villages were allocated into five subgroups(＜2.00,2.00～,3.00～,4.00～,≥5.00 mg/d),the relation fluoride intake and prevalence of osteofluorosis was analyzed.Results The prevalence of skeletal fluorosis in Wamiao Village was 31.06%(41/132),but no skeletal fluorosis case(0/35)was found in Xinhuai Village.According to the daily total fluoride intake,subjects with higher daily total fluoride intake tended to associated with a higher prevalence of skeletal fluorosis in a significant dose-response relationship(regression equation:y=2.624-6.855x+3.424x2:r=0.997).The benchmark dose lower limitation of daily total fluoride intake with 95% confidencewas 2.50 mg/d calculated according to this dose-response relationship,the reference dose(RfD)was 2.50 mg/d.In Wamiao Village a significant difference was also found between daily total fluoride intake in 41 subjects[(5.09±1.20)mg/d]with X-ray detectable skeletal fluorosis and in 91 subjects[(3.08±1.12)mg/d]without X-ray detectable skeletal fluorosis(t=-9.32,P＜0.01).Conclusions These findings indicate that the daily total fluoride intake has a significant dose-response relationship with the prevalence of skeletal fluorosis in an endemic fluorosis area associated with high-fluoride drinking water;and the RfD in this study was lower than that in the national standard of"Chinese hygienic standard for daily total fluoride intake(WS/T 87-1996)"(3.50 mg/d).

Humans ; Medicine, Chinese Traditional ; Osteoporosis ; etiology ; therapy

OBJECTIVETo observe clinical curative effect of Shenxiong Bushen Capsule for the treatment of mild vascular dementia (VaD), and probe the partial mechanism.

METHODSWith a block random, double-blinded and controled clinical research method adopted, seventy patients with VaD were randomly assigned to two groups in a ratio of 5:2, including 50 cases in the trial group and 20 cases in the control group. The patients in the trial group were given the Shenxiong Bushen Capsule (5 tablets, thrice a day), while those in the control group were given Piracetam (5 tablets, twice a day). All patients of the two groups were treated for 2 months, and one third cases were follow-up surveyed for 1 month. The cognitive ability, the activities of daily living, Chinese medicine syndrome of VaD, and the quality of life were measured respectively before and after the treatment.

RESULTSAccording to the Mini-Mental State Examination, the clinical effects of patients showed that there was insignificant difference between the trial group (total effective rate was 74.46% and 80.85%, respectively) and the control group (total effective rate was 68.42% and 78.95%, respectively) on the cognitive ability and the activities of daily living (P > 0.05), while the curative effect of the trial group (total effective rate was 85.11%) was superior to that of the control group (total effective rate was 63.16%) on Chinese medicine syndrome of VaD, and had significant difference between the two groups (P < 0.05). The results measured by WHOQOL-SF36 indicated that the total scores and the scores of each field in both the trial group and the control group after treatment increased more than those of before treatment (P < 0.01, P < 0.05), except physical function (PF) field and role physical (RP) field of the control group (P > 0.05). The scores of the trial group about total body, PF field, RP field and vitality (VT) field increased more than those of the control group (P < 0.05); while no difference was shown between the trial group and control group in the scores of bodily pain field, role emotional field, general health field, social function field and mental health field (P > 0.05).

CONCLUSIONShenxiong Bushen Capsule has a definite curative effect on mild VaD, and it can improve the quality of life of patients. Adopting the SF36 Scale to evalute the quality of life of patients with VaD has significance and avaibility to some extent.

Aged ; Aged, 80 and over ; Capsules ; Dementia, Vascular ; drug therapy ; Double-Blind Method ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Humans ; Male ; Middle Aged ; Phytotherapy ; Quality of Life