OBJECTIVETo explore clinical efficacy and key matters for the treatment of femoral intertrochanteric fracture and integrity of lateral trochanteric wall by proximal frmoral nail antirotation (PFNA).

METHODSFrom June 2010 to December 2012,210 femoral intertrochanteric fracture patients treated with PFNA were retrospectively analyzed, including 76 males and 134 females aged from 46 to 96 years old with an average of 71 years old. All fracture were caused by injury and classified to type I (5 cases) type II (16 cases), type III (73 cases) and type IV (116 cases) according to Evans classification. The time of getting out of bed, postoperative complications and displacement of screw blade and fracture healing were observed, Baumgaertner criteria were used to evaluate quality of fracture reduction, Harris criteria were used to evaulate hip joint function.

RESULTSAll incisions were healed at stage I, no complications occurred except incomplete of lateral trochanteric wall patients without reconstruction, other patients could get out of bed with crutches at one week and all patients discharged from hospital at 10 days after operation. One hundred and seventy-eight patients were followed up from 3 to 17 months with an average of 10 months. One case occurred unhealed fracture displacement caused by screw blade cutting, 2 cases occurred screw blade transfomed to proximal and out femoral head, other patients obtained fracture healing at 12 to 16 weeks after operation. According to Baumgaertner criteria, 130 cases obtained good results, 45 cases acceptable, and 3 poor; while 107 cases obtained excellent results, 65 good, 3 good and 3 poor according to Harris score.

CONCLUSIONPFNA with mechanical advantage of intramedullary fixation has advantsges of stable fixation, shorter operation time, minimally invasive. Satisfied clinical effects could obtained by grasping fixation principle, dealing with negative factors in operation. Intraoperative reconstruction for integrity of lateral trochanteric wall could assure stable fixation and earlier get out of bed.

Aged ; Aged, 80 and over ; Bone Nails ; Female ; Femoral Fractures ; surgery ; Fracture Fixation, Intramedullary ; instrumentation ; methods ; Hip Fractures ; surgery ; Humans ; Male ; Middle Aged ; Retrospective Studies

Humans ; Occupational Health ; Workplace ; statistics & numerical data

Objective To explere the curative effects of L-carnitine on neonates with myocardial injury caused by asphyxia.Methods Ninety-one neonates with myocardial injury caused by asphyxia were randomly divided into L-carnitine treatment group(48 cases) and control group(43 cases).The patients in control group were received routine treatment;the patients in treatment group were given L-carnitine 0.1 g/(kg?d) on the basis of routine treatment for 10 days.Symptoms and physical signs were observed pretreatment and during the time of therapy.Before and after the treatment,serum MB isoenzyme of creatine kinase(CK-MB) and aspartate aminotransferase(AST) were mea-sured with immunosuppression and enzyme rate respectively,and serum albumin and prealbumin were detected with the method of bromcresol green chromatometry and immunoturbidimetry,respectively.Results Clinical effective rate of the treatment group(91.67%)was higher than that of control group(74.42%)(P

Animals ; Cerebral Cortex ; metabolism ; Disease Models, Animal ; Male ; Mice ; Mice, Inbred Strains ; Morphine Dependence ; metabolism ; Neurotrophin 3 ; metabolism ; Prosencephalon ; metabolism

BACKGROUND:Fibrin glue is a natural biodegradable scaffold, which can be used for tissue-engineered scaffolds, and is increasingly used as seed cel carrier for tissue engineering repair. OBJECTIVE:To investigate the biocompatibility in vitro of rabbit fascia fibroblasts and fibrin glue. METHODS:Tissue explants adherent method was used to culture fibroblasts from subcutaneous deep fascia tissue of New Zealand white rabbits. The fibroblasts could be passaged with trypsin digestion method. Suspension of passage four fibroblasts was co-cultured with fibrin glue. Morphology and proliferation of fibroblasts on the surface of fibrin glue were dynamical y observed under the inverted phase contrast microscope. At 5 days after co-culture, fibroblasts were identified by immunofluorescence staining under the laser scanning confocal microscope. The fibroblast growth and adhesion were observed under the scanning electron microscope. RESULTS AND CONCLUSION:There was no significant difference in fibroblast morphology between co-culture fibroblasts and pure culture fibroblasts with inverted phase contrast microscope. Scanning electron microscope demonstrated that fibroblasts ful y extended in fibrin glue surface, and showed a good adhesion between the“pseudopodium”and fibrin glue, and secreted matrix material. It is clear that the fibrin glue did not alter the morphologic features of fibroblasts. Laser scanning confocal microscope revealed that fibroblasts were positive for vimentin. These verified that properties of fibroblasts did not change after they were seeded in fibrin glue surface and did not be induced to differentiate. There is a very good biocompatibility between fascia fibroblasts and fibrin glue in vitro.

Objective · To study the regulation of hsa-miRNA124-3p on the proliferation and migration of human lung cancer NCI-H460 cells and its mechanism. Methods · Four pairs of lung cancer and para-carcinoma tissues were harvested in clinical and measured for hsa-miRNA124-3p and Krüppellike factor 4 (KLF4) levels. The theoretical binding site of hsa-miRNA124-3p in 3'-UTR of KLF4 was predicted by bioinformatics, and validated by luciferase report assay. NCI-H460 cells were transfected with pshRNA-Sponge-miRNA124 or pshRNA-KLF4, and 48 hours later, the proliferation of NCI-H460 cells after genetic intervention was assayed by the MTT method, and cell migration ability was observed by streak method. Results · For all four pairs of samples tested, hsa-miRNA124-3p was higher in the cancer tissues than in the adjacent tissue (P<0.01), and KLF4 protein was lower in the cancer tissues than in the adjacent tissue (P<0.01). The bioinformatic analysis showed there is a theoretical binding site (5'-UGCCUUAA-3') of hsa-miRNA124-3p in 3'-UTR of KLF4. Luciferase activity assay showed that hsa-miRNA124-3p could bind to the 3'-UTR region of KLF4 gene and negatively regulate the expression of protein. The proliferation of NC-H460 cells was suppressed by transfection with pshRNA-Sponge-miRNA12472 h after transfection (P<0.05 ). Compared with the control group, the proliferation activity of pshRNA-KLF4 transfection group was further enhanced (P<0.05) There was no significant difference in the proliferation of pshRNA-Sponge-miRNA124 and pshRNA-KLF4 cotransfection group and the control group (P>0.05). The data of cell migration assay showed that the changes of cell migration ability were the same as proliferation activity of the cells in groups 72 h after transfection. Conclusion · Hsa-miRNA124-3p increases the proliferation and migration in NCI-H460 cells via suppressing the expression of KLF4, and reducing the content of miRNA124-3p in NC-H460 cells can inhibit cell proliferation and migration via upregulating KLF4 expression.

OBJECTIVETo analyze the causes of delayed union or nonunion of the ulna after intramedullary nailing in pediatric forearm fractures.

METHODSFrom February 2005 to February 2010,5 patients with forearm fractures who were treated with titanium elastic nailing (TEN) were identified to fulfill the criteria of having developed a delayed union or nonunion of the ulna. The causes of delayed union or nonunion were investigated according to mechanism of injury, fracture location, treatments methods and postoperative management. All patients were male and the age was 3 to 14 years old with an average of 9.4 years. All fractures were located on the mid-third part of forearm. Two cases had a re-fracture. Among them, 3 cases caused by high-energy injury and 2 cases by falling down. Open reduction were performed in 4 cases while the other one was treated with closed reduction. Four patients were immobilized in an above-elbow cast, postoperatively.

RESULTSAll patients were followed up from 7 to 19 months with an average of 11.4 months. There were 4 delayed union and 1 nonunion. Three patients healed after the removal of the nail and avoidance of weight-bearing. Two patients healed by replacing another fixation. No patients had soft-tissue irritation or nail-entry-site infections.. The clinical effect was evaluated according to Daruwalla and Price scores with 3 excellent and 2 good of the results.

CONCLUSIONSUsing titanium elastic nailing for the treatment of pediatric both-bone forearm fractures is a good method. However,strict indication selection should be followed to avoid delayed union or nonunion.

Adolescent ; Child ; Child, Preschool ; Fracture Fixation, Intramedullary ; methods ; Fracture Healing ; Humans ; Male ; Radius Fractures ; physiopathology ; surgery ; Retrospective Studies ; Ulna Fractures ; physiopathology ; surgery

Objective To detect and analyze the mutation of fibroblast growth factor receptor 3(FGFR3) gene among a family with congenital achondroplasia(ACH).Methods Six blood samples of family member in this pedigree were cellected according to the informed consent process for genetic research,and 2 unralted healthy human blood sample were taken as controls.The mutation at nucleotide position 1 138 on FGFR3 gene was detected by using Polymerase chain reaction and single-strand conformation polymorphism(PCR-SSCP)and polyme-rase chain reaction and restriction endonuclease technology(PCR-RFLP) methods.Results Using PCR-SSCP method firstly,only the proband with ACH and his father in this family had the same abnormal band.The amplified products including 1 138 loci on FGFR3 gene further was analyzed by Sfe Ⅰ digestion,3 fragments including 164 bp,109 bp and 55 bp were detected in the proband and his father again,and the other members in the family and 2 controls just showed 164 bp band.It indicated that just 2 patients (proband and his father) showed heterozygous G→A transition mutation at nucleotide position 1 138 on the FGFR3 gene.The amplified products at 1 138 loci was also detected by MspⅠ digestion,just 1 band was observed in all members in this family and 2 controls.It showed that there was no G→C substitution at nucleotide position 1 138.Conclusions The G→A transition mutation at nucleotide position 1 138 in transmembrane domain of FGFR3 gene may be the main cause of achondroplasia in this family.In this pedigree,the proband showed's father a de novo mutation which was transferred to his child again.

·AIM: To report the results of phacotrabeculectomy with 2.8mm scleral tunnel incision.·METHODS: Phacotrabeculectomy was performed through an identical 2.8mm scleral tunnel incision in 52 eyes of 49 patients with cataract and glaucoma. The incision was closed with out suture. Foldable intraocular lens was implanted in all eyes.·RESULTS: The control of intraocular pressure on 36 eyes was desirable. The average postoperative intraocular pressure was (8.24±3.61)mmHg, (13.22±4.12) mmHg, (12.11±4.23)mmHg and (12.59±4.26)mmHg at one week, one month, three months and six months. As compared with 56 eyes in which phacotrabeculectomy was performed with 5.5mm scleral tunnel sutureless incision, there was no statistical difference, between the two, regarding the mean postoperative intraocular pressure at six months (t=1.7536,P=0.08239).The retinal nerve fiber layer thickness was not statistically different between the preoperative and postoperative times in one year in 26 eyes. The uncorrected postoperative visual activity was 0 8 or better in 62% of 52 eyes.·CONCLUSION: The advantages of this operative method are minimal size scleral flap, smaller and sutureless incision, immediate chamber restoration, decrease in postoperative astigmatism, enhanced postoperative visual activity, reduced postoperative inflammatory response and complications.

OBJECTIVETo investigate the diagnostic value of MRI in radial head fracture with forearm interosseous membrane injuries.

METHODSFrom December 2011 to December 2012,26 patients with fractures of capitulum radial in our hospital were collected. There were 15 males and 11 females, ranging in age from 21 to 53 years old,with an average of 37.6 years old. All the patients visited hospital within 72 hours after injuries. X-ray radiography of full ulnar radial length in injured side, CT in injured side (three-dimensional reconstruction if necessary) and MRI (including the elbow and wrist joints) were performed within a week after the injury. The MRI manifestations of the forearm interosseous membrane (with or without damage, the injured location and the injury degree ) and the fractures degree of radial head were observed and compared for the relativity.

RESULTSRadial head fracture from Mason type I to III was associated with the forearm interosseous membrane injury. Radial head fracture degree was positive correlated with forearm interosseous membrane injury degree (P < 0.05).

CONCLUSIONRadial head fracture with suspicious forearm interosseous membrane injury is necessary to take MRI for checking for any interosseous membrane injury and injury degree, then choose the right treatment for radial capitulum fracture, only in this way can be helpful for the functional recovery of elbow and forearm.

Adult ; Female ; Forearm ; pathology ; Humans ; Magnetic Resonance Imaging ; Male ; Membranes ; injuries ; Middle Aged ; Radius Fractures ; diagnosis ; pathology ; Young Adult