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 evaluate retrospectively the difference and complementary of contrastenhanced ultrasound (CEUS) and contrast-enhanced magnetic resonance (CEMR) in early diagnosis and differential diagnosis of small hepatocellular carcinoma (SHCC)(≤2.0 cm) in patients with liver cirrhosis.Methods Forty-five patients with space-occupying lesions in cirrhotic livers were included, who were referred to CEUS and CEMR before operations. Numbers as well as diagnosis results were recorded respectively,and all cases were confirmed by pathological examination. Results Seventy-five lesions were found after CEUS and CEMR,with 69 and 58 respectively. Forty-one lesions were diagnosed pathologically as SHCC by surgery or needle biopsy. Overlapping exited in enhanced mode between CEUS and CEMR.Most SHCC displayed as mode Ⅰ "fast-in and fast-out" and mode Ⅱ "fast-in and slow-out" in both examination,which can be considered as a reliable criterion. The diagnostic accuracy of CEUS and CEMR was 77. 3% (58/75) and 62. 7% (44/75) respectively (0. 50＜ P ＜0. 75). Differences of the diagnostic accuracy of SHCC with atypical enhanced mode between CEMR and CEUS were statistically significant.Conclusions There is no significant difference of diagnostic accuracy of SHCC between CEMR and CEUS.Both of these two examing procedure have its own advantages for atypical lesions, which accounts for its diagnostic difference of small SHCC and benign lesions.

Aim To explore the role of PI3 K/Akt/Sirt1 pathway in cardioprotection of hydrogen sulfide ( H2 S ) postconditioning against ischemia/reperfusion ( I/R) injury. Methods Langendorff perfusion appa-ratus was used to build an isolated rat myocardial I/R model. Isolated rat hearts were subjected to 30 min global ischemia followed by 60 min reperfusion after 20 min of equilibrium. 60 male SD rats were randomly di-vided into 5 groups(n=12):control group(Control), ischemia/reperfusion group( I/R) , H2 S postcondition-ing group( H2 S) , inhibitor LY294002 group( LY) and H2 S with inhibitor group( H2 S+LY) . The left ventric-ular diastolic pressure ( LVEDP ) , the left ventricular developed pressure(LVDP), the maximum rate of in-crease or decrease of left ventricular pressure ( ± dp/dtmax ) were registered at the end of 20 min equilibri-um, 30 and 60 min of reperfusion separately. Triphe-nyl tetrazolium chloride( TTC) staining was used to de-termine the myocardial infarct size. The levels of Sirt1 and PGC-1 mRNA were tested using real-time PCR. The expressions of Sirt1 and PGC-1αwere detected with Western blot analysis. Immunohistochemical method was used to determine the location of Sirt1 . Results There were no differences in equilibrium hemodynamics observed between the experimental groups(P>0. 05). At the end of reperfusion, compared with I/R group, H2 S group had obviously ameliorated functional recov-ery and significantly decreased the myocardial infarct size(26. 9 ± 4. 9)% vs(48. 9 ± 5. 6)%(P <0. 05). Meanwhile, the expression of Sirt1 and PGC-1α in-creased significantly. However,LY294002 reversed the cardioprotective effects provided by hydrogen sulfide postconditioning and reduced the level of Sirt1 and PGC-1α, the percentage of Sirt1-positive nuclei. Con-clusion PI3 K/Akt/Sirt1 signaling pathway mediates the hydrogen sulfide postconditioning-induced protec-tion against I/R injury.

BACKGROUND: The treatment of degenerative knee osteoarthritis is mainly to relieve pain, restore knee function, improve quality of life, delay knee replacement, and reduce the number of revisions. Knee replacement is currently the most common treatment for this disease, but it costs much, has great trauma and high risk, often results in prosthesis loosening and peripheral infection, and has many adverse reactions. OBJECTIVE: We hypothesize that knee-preserving arthroscopic debridement for treatment of knee degenerative osteoarthritis in the elderly patients costs less, is effective, safe, and reliable. METHODS: A total of 212 elderly patients (knees) with degenerative knee osteoarthritis who receive treatment in the Second Hospital of Chaoyang (Liaoning Province, China) will be included in this study. These patients will be assigned to two groups according to patient's conditions and wishes (n = 106/group). In the control group, intra-articular injection of sodium hyaluronate will be performed, followed by oral administration of non-steroidal anti-inflammatory drugs, conventional physiotherapy, and quadriceps functional exercise. In the arthroscopic debridement group, arthroscopic debridement will be performed followed by oral administration of non-steroidal anti-inflammatory drugs, conventional physiotherapy, and quadriceps functional exercise. All patients will be followed up for 1 week, 1 month, 3 months, 6 months, 1 year, and 2 years. RESULTS AND CONCLUSION: The primary outcome measure is the percentage of the number of patients with Hospital for Special Surgery (HSS) knee score ≥ 85 points at 2 years after surgery, which will be used to evaluate knee function recovery. The secondary outcome measures are the percentage of the number of patients with HSS knee score ≥ 85 points before surgery, 1 week, 1 month, 3 months, 6 months, and 1 year after surgery; HSS score, Visual Analogue Scale (VAS) score, The Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), knee range of motion, hospitalization costs, and knee X-ray morphology before surgery, 1 week, 1 month, 3 months, 6 months, 1 year, and 2 years after surgery, medical costs after 2 years of treatment, incidence of adverse reactions at 1 week, 1 month, 3 months, 6 months, 1 year and 2 years after surgery. Findings from this study will reveal whether arthroscopic debridement for the treatment of degenerative knee osteoarthritis in the elderly patients has advantages of less adverse reactions, low treatment costs, and can effectively restore knee function. This trial has been approved by the Second Hospital of Chaoyang, Liaoning Province, China (approval number:2017-08-01).All protocols will be in accordance with Declaration of Helsinki,formulated by the World Medical Association.Written informed consent will be provided by participants. This trial was designed in June 2017. The recruitment of subjects and data collection will begin in June 2018. The recruitment of subjects will be finished in December 2018. Outcome measures will be analyzed in June 2021. This trial will be completed in August 2021. The results of the trial will be reported in a scientific conference or disseminated in a peer-reviewed journal. This trial had been registered in the Chinese Clinical Trial Registry (registration number: ChiCTR1800015208). The version of this study protocol is (1.0).

AIM:To investigate the effects of 1.8mm coaxial micro incision phacoemulsification on corneal endothelial injury and postoperative visual acuity.METHODS: Totally 145 eyes in 120 patients underwent phacoemulsification from July 2013 to July 2015 were randomly divided into observation group 60 cases (73 eyes) and control group 60 cases (72 eyes).The observation group 60 cases were given 1.8mm coaxial micro incision cataract phacoemulsification operation,while the control group were given traditional 3.2mm coaxial micro incision cataract surgery.The uncorrected visual acuity (UCVA),best corrected visual acuity (BCVA),corneal thickness of incision area,incision width,incision length,macular retinal thickness,surgically induced astigmatism,corneal endothelial cell counts and complications of the two groups were compared.RESULTS: The UCVA and BCVA on 1wk after surgery of the observation group were significantly higher than the control group (t=3.604,7.109;P<0.05);the width of incision on 1wk and 1mo after surgery of the observation group were significantly less than the control group (t=205.3,225.2;P<0.05).The length of incision in observation group was significantly greater than the control group (t=3.926,5.009;P<0.05).Macular retinal thickness 1wk after surgery of the observation group was significantly less than the control group (t=2.817,P<0.05).The surgically induced astigmatism was significantly less than the control group (t=19.43,22.16;P<0.01);the difference of corneal edema between the two groups was not significant (8.22% vs 11.11%) (x2=0.348,P>0.05).CONCLUSION: The 1.8mm micro incision phacoemulsification is helpful to improve the visual acuity of patients with cataract phacoemulsification,which may be related to the reduction of corneal cell injury,enhancement of corneal closure and decrease post-operation corneal original astigmatism.

Objective To find out the situation of household consumption of iodized salt in Hebei province so as to provide scientific basis for prevention and control of iodine deficiency disorders(IDD). Methods According to the "national iodine deficiency disorders surveillance program (Trial)", the county (city, district) was taken as a unit, township (town) and administrative villages were selected in accordance with the principle of systematic sampling, then households were chosen by random sampling to collect their edible salt in Hebei province from 2007 to 2009. Salt iodine content was detected by direct titration method. Results A total of 48 675, 48 448 and 48 756 salt samples were collected from 2007 to 2009, respectively. The consumption rate of qualified iodized salt from 2007 to 2009 was 91.16%, 91.96% and 96.17%, respectively. There were 24.6%(41/167)and 18.0%(30/167)counties with consumption rate of qualified iodized salt under 90% in 2007 and 2008, respectively. The percentage of counties with consumption rate of qualified iodized salt above 90% was 100.0%(167/167) in 2009. In general there was a significant differences in frequency distribution of consumption rates of qualified iodized salt among the three years(H = 10.778, P ＜ 0.01 ), and the difference was found significant between 2007 and 2009 as well as between 2008 and 2009(all P ＜ 0.05), but was not significant between 2007 and 2008(P ＞ 0.05). Conclusions The consumption rate of qualified iodized salt at household level increases annually from 2007 to 2009. By 2009,the consumption rate of qualified iodized salt in each county is more than 90%, which has reached the national standard stipulated in "the evaluation programs for fulfilling the goal of eliminating IDD at county level".

OBJECTIVETo investigate the chemical constituents of the rhizome of Ervatamia hainanensis.

METHODThe solvent extraction and silica column chromatography were used to separate the chemical constituents, and their structures were identified by physico chemical properties and spectra analysis.

RESULTTwelve compounds were isolated and their structures were identified as voacangine (1), ibogaine (2), ibogamine (3), coronaridine (4), 19-heyneanine (5), 19-epi-heyneanine (6), 3-hydroxyl coronaridine (7), coronaridine hydroxyindolenine (8), 3-(2-oxopropyl) coronaridine (9), vobasine (10), alpha-amyrin (11), alpha-amyrin acetate (12).

CONCLUSIONCompounds 1, 2, 6, 11 and 12 were first found from this plant.

Apocynaceae ; chemistry ; Chromatography, Gel ; Ibogaine ; analogs & derivatives ; chemistry ; isolation & purification ; Oleanolic Acid ; analogs & derivatives ; chemistry ; isolation & purification ; Plants, Medicinal ; chemistry ; Rhizome ; chemistry

OBJECTIVETo investigate an safe and effective new technology (treatment) to repair maxillofacial region penetrating defect.

METHODSThe lower trapezius musculocutaneous flap is parallel just like as two leaves which is connected to each other, and was folded to provide the liner of oral cavity and external cover.

RESULTSTotally twelve folding lower trapezius musculocutaneous pedicle flap survived. Postoperative follow-up for 1 approximately 3 years, the patients restored the function as well as the shape of maxillofacial region.

CONCLUSIONSThe lower trapezius musculocutaneous pedicle flap is a suitable material for maxillofacial region reconstruction, further more, the successful rate is perfect.

Female ; Humans ; Male ; Mouth Neoplasms ; surgery ; Muscle, Skeletal ; transplantation ; Oral Surgical Procedures ; methods ; Reconstructive Surgical Procedures ; methods ; Skin Transplantation ; methods ; Surgical Flaps ; Treatment Outcome

OBJECTIVETo assess the necessity of detecting the gene of cystic fibrosis transmembrane conductance regulator factor (CFTR) in Chinese men with congenital bilateral absence of the vas deferens (CBAVD).

METHODSWe detected the mutation of all the 27 exons of the CFTR gene in 9 patients with CBAVD by DNA sequencing, and compared the results using NCBI and Cystic Fibrosis Mutation Database.

RESULTSFour novel missense mutations/variants were found in the CFTR gene of the CBAVD patients, which were submitted and accepted in the Cystic Fibrosis Mutation Database.

CONCLUSIONThere are mutations or variants in the CFTR gene in Chinese men with CBAVD, and the mutational distribution is different from that in Westerners.

Alleles ; Asian Continental Ancestry Group ; genetics ; Base Sequence ; Cystic Fibrosis Transmembrane Conductance Regulator ; genetics ; Exons ; Genotype ; Humans ; Male ; Male Urogenital Diseases ; genetics ; Mutation ; Vas Deferens ; abnormalities

OBJECTIVETo summarize the experience in the treatment of erectile dysfunction (ED) with no successful intercourse at the baseline with tadalafil.

METHODSWe retrospectively analyzed 21 cases of ED with no successful intercourse at the baseline treated with tadalafil on alternate days combined with sex guidance.

RESULTSAfter 4 weeks of tadalafil treatment, 19 of the patients achieved successful sexual intercourse, and the IIEF-5 score was remarkably improved as compared with pre-medication (3.24 +/- 1.55 vs 18.95 +/- 3.02, P<0.0001). Mild adverse reactions were observed in 6 cases, including 2 cases of mild headache and 4 cases of facial blush.

CONCLUSIONTadalafil on alternate days combined with sex guidance can significantly improve ED with no successful intercourse at the baseline.

Adult ; Carbolines ; administration & dosage ; therapeutic use ; Coitus ; Erectile Dysfunction ; drug therapy ; physiopathology ; Humans ; Male ; Retrospective Studies ; Tadalafil ; Treatment Outcome ; Young Adult