OBJECTIVETo report and assess the efficacy of a coupled exofixator in the treatment of comminuted fracture of the humeral shaft.

METHODSFrom June 1999 to September 2003, 24 patients with comminuted fracture of the humeral shaft were treated in our department, in whom 11 were involved in left humerus fractures and 13 in right humerus fractures. Closed reduction or open reduction with a small incision as well as a coupled exofixator was used to treat these patients.

RESULTSAll cases got anatomical reduction after 6-12 months follow-up. The time for fracture union averaged 5.8 months with a good functional recovery of the shoulder-elbow joints.

CONCLUSIONSThe coupled exofixator is favorable to the treatment of comminuted humeral shaft fractures. It can shorten union time and avoid nonunion occurrence.

Adolescent ; Adult ; External Fixators ; Female ; Fracture Fixation ; methods ; Fractures, Comminuted ; surgery ; Humans ; Humeral Fractures ; surgery ; Male ; Middle Aged ; Treatment Outcome

BACKGROUND: The association of genetic variation in the IRAK-1 gene with sepsis outcome has been proved. However, few studies have addressed the impact of the IRAK-4 gene variants on sepsis risk. This study aimed to determine whether the polymorphisms in the IRAK-4 gene are associated with susceptibility to and prognosis of severe sepsis in the Chinese Han ethnic population.METHODS: In this case-control study, 192 patients with severe sepsis hospitalized in the emergency department of Zhongshan Hospital from February 2006 to December 2009 and 192 healthy volunteers were enrolled. Exclusion criteria included metastatic tumors, autoimmune diseases, AIDS or treatment with immunosuppressive drugs. This study was approved by the ethical committee of Zhongshan Hospital, Fudan University. Sepsis patients were divided into a survival group (n=124) and a non-survival group (n=68) according to the 30-day mortality. Primer 3 software was used to design PCR and sequencing primers. Genomic DNA was extracted from peripheral blood mononuclear cells. Seven tagSNPs in IRAK-4 were selected according to the data of the Chinese Han population in Beijing from the Hapmap project and genotyped by direct sequencing. The chi-square test was used to evaluate the differences in genotype and allele frequencies between the two groups.RESULTS: The distributions of all tagSNPs were consistent with Hardy-Weinberg equilibrium. The allele and genotype frequencies of rs4251545 (G/A) were significantly different between the severe sepsis and healthy control groups (P=0.015, P=0.035, respectively). Carriers of the rs4251545A had a higher risk for severe sepsis compared with carriers of the rs4251545G (OR=1.69, 95％ CI: 1.10-2.58). The allele and genotype frequencies of all SNPs were not significantly different between the survival group and non-survival group.CONCLUSION: These findings indicate that the variants in IRAK-4 are significantly associated with susceptibility to severe sepsis in the Chinese Han ethnic population.

OBJECTIVETo study the effect of Tongluo Xingnao effervescent tablets on learning and memory capacity and expression of Na(+)-K(+)-ATPase in hippocampus of rats with chronic cerebral ischemia-induced learning and memory dysfunction model.

METHODThe 2-VO method was used to establish sd rat model learning and memory dysfunction induced by chronic cerebral ischemia. The 50 rats in the successfully established model were randomly divided into the model control group, the Dihydroergotoxine Mesylate tablets group (0.7 mg x kg(-1), Tongluo Xingnao effervescent tablets high dose (7.56 g x kg(-1)), middle dose (3.78 g x kg(-1)) and low dose (1.59 g x kg(-1)) groups and the sham operation group (n = 10) as the control group. The groups were orally given 10 ml x kg(-1) x d(-1) drugs for consecutively 90 days. On the 86th day, Morris water maze was adopted for them. On the 90th day, a leaning and memory capacity test was held. The brain tissues were fixed with 10% formaldehyde and observed for pathomorphism after routine slide preparation and staining. The expression of hippocampal Na(+)-K(+)-ATPase was detected with immunohistochemistry and image quantitative analysis.

RESULTCompared with the model group, all of Tongluo Xingnao effervescent tablets groups showed significant decrease in the escape latency at the 5th day in the Morris water maze, and notable increase in the frequency of the first quadrant dwell, the frequency passing the escape platform and the frequency entering effective area (p < 0.05). According to the pathomorphological detection, the control group showed a significantly higher pathological score than the sham operation group (p < 0.01), the middle dose group showed a significantly lower pathological score than the model group (p < 0.05). According to the immunohistochemistical detection, the model control group showed a remarkably lower mean OD value of Na(+)-K(+)-ATPase than the sham operation group (p < 0.05), high and middle dose groups showed a significantly higher mean od value than the model control group (p < 0.01).

CONCLUSIONTongluo Xingnao effervescent tablets can improve the learning and memory capacity, reduce pathological changes of hippocampal tissues of rats with chronic cerebral ischemia-induced learning and memory dysfunction model, and promote the expression of Na(+)-K(+)-ATPase in hippocampus.

Animals ; Brain Ischemia ; drug therapy ; enzymology ; genetics ; psychology ; Chronic Disease ; drug therapy ; psychology ; Drugs, Chinese Herbal ; administration & dosage ; Female ; Hippocampus ; drug effects ; enzymology ; Humans ; Learning ; drug effects ; Male ; Memory ; drug effects ; Rats ; Rats, Sprague-Dawley ; Sodium-Potassium-Exchanging ATPase ; genetics ; metabolism ; Tablets ; administration & dosage

ObjectiveBy analyzing the epidemiological characteristics and trends of brucellosis in Hebei province,provide a scientific basis for the formulation of strategies for effective prevention and control of the disease.MethodsUsing the descriptive epidemiological method,data of the “China information system for disease control and prevention” from 2006 to 2010 were statistically analyzed.ResultsThere were 13 632 reported cases from 2006 to 2010 in Hebei province,no death,the annual incidence rates reported were 3.4068/10 million,3.4851/10 million,4.5701/10 million,4.6045/10 million,and 3.5582/10 million,respectively.Eleven counties throughout the province had reported cases.The cases were found intensively in Zhangjiakou,Chengde,Baoding,Handan and Shijiazhuang,which accounting for 90.02％ (12 271/13 632) of the total cases.The disease was found each month throughout the year,and showed a seasonal cycle with peak period in spring and summer.The disease was most commonly found in 25 - 65 age people,which accounting for 84.57％(11 529/13 632).The incidence in male was higher than that of female,and male to female ratio was about 3.56:1.00.Vocational high risk population was farmers,accounting for 91.15％ of the total cases(12 425/13 632).ConclusionsBrucellosis epidemic in Hebei province is relatively serious,and the epidemic range has expand each year,even highly active in some particular areas.To control the outbreak of brucellosis,departments cooperation between health and animal husbandry should be strengthened; management of source of infection should be strengthened; health education and behavior intervention should be carried out thoroughly and deeply for high-risk groups.

[Introduction] To design a workable compensatory scheme of new cooperative medical system (NCMS) in rural China, 'Monte Carlo Simulation Techniques' is developed based on the data of a multistage random sampling survey. The total compensation rate, the decreased percentages of poverty caused by diseases and the deficit ratio of fund a 0.3782, 0.6540 and -0.0794 respectively, when the main strategy of inpatient reimbursement is recognized as 'serious illness'. The deficit ratios of funding appeared to be 0.4840, 0.4091 and -0.3789 when the main strategy of outpatient reimbursement is recognized on minor diseases. Compensation for minor diseases is more important than that of serious diseases. Considering the further impact of minor diseases on peasants, we should incorporate compensation for minor diseases into the compensatory scheme of NCMS.

OBJECTIVETo study the differential expression of four TRAIL receptors on bone marrow mononuclear cells (BMMNC) from multiple myeloma (MM) patients and myeloma cell line KM3 cells, to compare their altered expressions after chemotherapy and to explore the mechanisms by which TRAIL selectively kills tumor cells.

METHODSSemi-quantitative reverse transcriptase-polymerase chain reaction (RT-PCR) and flow cytometry were used to investigate the expression of four TRAIL receptors on BMMNCs in 23 MM patients, KM3 cells and 15 controls, and the changes of their expression pattern after chemotherapy and after incubation of KM3 cells with sub-clinical concentration of doxorubicin.

RESULTSDR4 and DR5 were highly expressed on KM3 cells with no expression of DcR1 and DcR2. Expressions of DR4 and DR5 on BMMNCs from MM patients were higher and expression of DcR1 and DcR2 were lower than that of controls (P < 0.05). The expression of DR5 on MM and KM3 cells was up-regulated after chemotherapy and exposure to doxorubicin (P < 0. 05).

CONCLUSIONSThe expressions of four TRAIL receptors on myeloma cells and normal controls were different, which might account for the selective killing effect of TRAIL on MM cells. Up-regulated DR5 on KM3 cells after incubating with doxorubicin and after chemotherapy suggests the cytotoxic agents might enhance the apoptosis of MM cells.

Antineoplastic Agents ; pharmacology ; Cell Line, Tumor ; Cells, Cultured ; Doxorubicin ; pharmacology ; Female ; Flow Cytometry ; Gene Expression ; drug effects ; Humans ; Leukocytes, Mononuclear ; cytology ; drug effects ; metabolism ; Male ; Middle Aged ; Multiple Myeloma ; drug therapy ; genetics ; pathology ; Receptors, TNF-Related Apoptosis-Inducing Ligand ; biosynthesis ; genetics ; Reverse Transcriptase Polymerase Chain Reaction

BACKGROUNDOuabain, a cardiac glycoside that specifically binds to Na/K-ATPase and inhibits its activity, was applied to gerbils to develop a method for studying auditory neuropathy.

METHODSOuabain was applied to the round window of the cochlea in each gerbil by using a piece of gelfoam with 3 microl or 24 microl (1 mmol/L) ouabain solution. The changes of the threshold of auditory brainstem response, cochlear function round window electrocochleography, as well as the morphological changes of the spiral ganglion cells of the cochlea were observed after application of ouabain for 24 hours or 96 hours.

RESULTSIn ouabain treated gerbils, auditory brainstem response and compound action potential thresholds showed either elevation or no response at all. However, the thresholds of cochlear microphonic and distortion product otoacoustic emissions were not affected. Degeneration and necrosis of some spiral ganglion cells in ears with applications of ouabain (24 hours, 3 microl, 1 mmol/L; 96 hours, 24 microl, 1 mmol/L ouabain). The number of spiral ganglion cells was decreased (24 hours, 3 microl, 1 mmol/L ouabain) or near to a total loss (96 hours, 24 microl, 1 mmol/L ouabain).

CONCLUSIONSThese results indicate a high degree of independence between the spiral ganglion cells and the outer hair cell systems in the cochlear transduction mechanism. The method used in this study would provide a valuable tool for studying auditory neuropathy.

Action Potentials ; drug effects ; Animals ; Cochlea ; drug effects ; physiology ; Evoked Potentials, Auditory, Brain Stem ; drug effects ; Gerbillinae ; Ouabain ; toxicity ; Spiral Ganglion ; drug effects

OBJECTIVETo explore the efficiency of a comprehensive surgical approach of genioglossus advancement and hyoid suspension (GAHM) plus uvulopalatopharyngoplasty (UPPP) for treating severe obstructive sleep apnea hypopnea syndrome (OSAHS) and to evaluate related factors on surgery outcomes.

METHODSEighteen patients with severe OSAHS (apnea hypopnea index, AHI > 40/h) confirmed with polysomnography received genioglossus advancement and hyoid suspension plus uvulopalatopharyngoplasty. The obstruction in both the oropharynx and the hypopharynx were evaluated by preoperative physical examination, fiberoptic pharyngolaryngoscopy, cephalometry, and computed tomography of the upper airway. The follow up was at least 6 months postoperatively. The Wilcoxon signed rank test was used to compare the preoperative and postoperative results by SPSS 11.0 for windows. The Mann-Whitney test was used to analyze the difference between responders and nonresponders.

RESULTSThe follow up time ranges from 6 to 24 months, there were statistically significance in all but body mass index (BMI) between preoperative and postoperative measurements. Mean AHI was reduced from preoperative (x +/- s, 63.8 +/- 16.3)/h to postoperative (23.6 +/- 19.5)/h, lowest mean oxygen saturation increased from 0.72 +/- 0.07 to 0.81 +/- 0.13(x +/- s). According to criterion at home, the 6-month rate of responder is 83%, if AHI <20/h and decreased by at least 50% as success, the rate of success is 67%. The age, posterior airway space (PAS) and percentage of time with oxyhemoglobin saturation below 0.90 (CT90) were (39.1 +/- 7.4) years, (8.3 +/- 0.9) mm, (18.5 +/- 10.9)% in responder, while (52.5 +/- 9.4) years, (6.8 +/- 1.3) mm, (37.7 +/- 23.6) % in nonresponder, and there are statistically significant between responder and nonresponder.

CONCLUSIONSGAHM plus UPPP is effective surgical approach for patients with severe OSAHS who suffer from oropharyngeal and hypopharyngeal obstruction. Age, PAS and CT90 were possible affective factors on surgical outcomes.

Adult ; Aged ; Humans ; Hyoid Bone ; surgery ; Male ; Middle Aged ; Otorhinolaryngologic Surgical Procedures ; methods ; Palate, Soft ; surgery ; Polysomnography ; Sleep Apnea, Obstructive ; surgery ; Treatment Outcome ; Uvula ; surgery

OBJECTIVETo study anatomic and computed tomographic measurements of Chinese mandibular genial tubercles and to evaluate the correlations between them.

METHODSThe axial images were taken by spiral CT in 40 adult human skulls with 1 mm thick section from infraorbital margin to menton. Sagittal plane reconstruction was produced through mandibular central line. Then the height and width of superior genial tubercles, the distance between menton and inferior margin of genial tubercles, the distance between mandibular incisor apex and superior margin of superior genial tubercles, the thickness of mandible were measured respectively. Thereafter anatomic measurements were taken by the same methods as computed tomographic images. The measured value were showed as means +/- standard deviation, then paired-t test and correlation analysis was made by SPSS 10.0.

RESULTSThe genioglossus almost origins from superior genial tubercles, geniohyoideus from inferior genial tubercles. The height of superior genial tubercles which were measured by anatomy and spiral CT were (5.82 +/- 0.71) mm and (6.17 +/- 0.71) mm respectively. The width of superior genial tubercles were (6.98 +/- 1.35) mm and (7.01 +/- 1.13) mm. The distance between menton and inferior margin of superior genial tubercles were (11.08 +/- 2.05) mm and (10.41 +/- 1.55) mm. The distance between mandibular incisor apex and superior margin of superior genial tubercles for male were (15.57 +/- 1.82) mm and (14.34 +/- 2.06)mm, and for female were (9.36 +/- 2.79) mm (8.78 +/- 2.53) mm. The thickness of mandibles at genial tubercles were (11.95 +/- 1.59) mm and (12.19 +/- 1.64) mm. The distance from menton to superior margin of superior genial tubercles were (16.1 +/- 2.30) mm and (15.73 +/- 2.12) mm. The correlations between anatomic measurements and spiral CT measurements of the above mentioned parameters were significant except for height of superior genial tubercles (r = 0.59 - 0.92).

CONCLUSIONThe anatomic and spiral CT measurements of genial tubercles appear to have significant correlations. Preoperative spiral CT measurements of genial tubercles could be help for the design of osteotomy in genioglossus advancement.

Adult ; Chin ; anatomy & histology ; diagnostic imaging ; Female ; Humans ; Male ; Tomography, Spiral Computed

OBJECTIVETo study the incidence of cases with rash and fever illness (RFIs) after measles vaccine (MV) inoculation.

METHODSDuring 1999 to 2002, 150 RFIs cases reported by the special measles surveillance system in Shandong province, China, were investigated and analyzed epidemiologically.

RESULTS7 674 690 ml MV were distributed during 1999 to 2002 and the annual average incidence of RFIs cases after MV inoculation was 0.20/10 000 ml (0.2 ml per dose). There was significant difference of incidences each year (chi(2) = 10.13, P < 0.05). All RFIs cases were sporadically distributed without epidemiological links. Clinical symptoms showed that 88.67% of the 150 RFIs cases having > 38.5 degrees C fever and 75.33% of all cases appeared typical rash after 4 to 11 days (the medium was 8 days) after MV inoculation. The order of rash onset among RFIs cases was consistent with that of regular measles cases caused by wild virus. 68.67% of the RFIs cases had first MV inoculation and 94.71% were 8 to 12 month-olds. IgM sera antibody test from RFIs cases were rubella negative and 45.65% positive for measles.

CONCLUSIONRFIs due to allergic reaction or measles vaccine virus infection might occur after MV inoculation. There seemed to be a correlation between RFIs incidence and the doses of MV. Measles virus genotype analysis needs to be carried out to confirm if the onset of some RFIs cases is aetiologically associated to MV vaccine virus infection.

Exanthema ; etiology ; virology ; Fever ; etiology ; virology ; Humans ; Measles ; prevention & control ; Measles Vaccine ; adverse effects ; Measles virus ; immunology ; Polymerase Chain Reaction ; Vaccination