Objective To evaluate the surgical management and its results of type C fractures of distal humerus. Methods From January 1997 to November 2002, 30 patients of type C fractures of distal humerus were treated surgically. There were 11 males and 19 females with mean age of 41 years (range 16-67 years). Thirteen fractures occurred in left extremity and 17 in the right. Nine patients suffered open fracture, including Custilo typeⅠfracture in 5, and typeⅡin 4 cases. Twenty-one patients suffered closed fracture. The fracture were caused by falling injury in 21 cases, by traffic accident in 7 cases and by another cause in 2 cases. Associated injuries included: distal fracture of radius in 2 cases, fracture of rib in 1 case, and fracture of surgical neck of humerus in 1 case. According to AO/ASIF classification, type C1 fracture was found in 4 cases, type C2 in 14 cases and type C3 in 12 cases. Of the 30 patients, 21 cases were operated with the approach of extra-articular osteotomy of olecranon, and 9 cases with the approach of liguliform flap of musculus triceps brachii. The fractures were reduced and fixed with dual-plates(DP) in 17 cases, and double tension bands(DTB) in 13 cases. The operation was performed in 0-17 days after injury with mean 7 days. Clinical data were recorded and reviewed retrospectively according to the surgical approach, operating time, amount of bleeding, types of internal fixation, function of the elbow and the complications. Results All the patients were followed up, with the duration from 6 to 62 months(mean, 28.5 months). The function of the elbow was evaluated according to Morrey's scale, the results showed excellent in 23 cases, good in 4 cases, and poor in 3 cases. Conclusion The modified approach of extra-articular osteotomy of olecranon provide sufficient exposure without injury of articular surface, and the osteotomy healed easily with long-term stability. The type C fractures of distal humerus should be fixed with DP or DTB for two column fixation. DTB provide a new sufficient internal fixation with simple technical procedure, shortening operation time, less bleeding and reliable stability with similar results compared with DP fixation.

Objective To analyze the clinical characteris tics and diagnostic outline and to elucidate the effects of different managements of femoral shaft fractures with ipsila teral femoral neck fractures.Methods A retrospective study was carried out in 18patients with ipsilateral femo ral neck and femoral shaft fractures from 1998to 2001,and their managements and final clinical outcomes were reviewed.Results The follow -up ranged from8to 40months with an average of 16mon ths.All the fractures united except one femoral shaft fracture and one femoral neck fracture.Conclusion Retrograde intramedullary nailing with multiple cancellous screws to t reat ipsilateral femoral neck and femora l shaft fractures has been proved an e ffective technique.For the cases overlooked initially,treatment with multiple nailing around the intramedullary n ail is a good choice.[

To study on the phylogenetic characterization of the VP1 genes of coxsackievirus A16 (CVA16) causing hand-food-mouth disease (HFMD) isolated from Anhui province in 2014. A total of 413 throat swab specimens from HFMD patients were collected during January to November, 2014 for the isolation and identification of enteroviruses using real-time RT-PCR assays. The VP1 regions of CVA16 isolates were amplified using RT-PCR and sequenced. And the phylogenetic tree was constructed among the VP1 regions of those isolates, the different genotypes and sub-genotypes of CVA16 strains. A total of 97 enteroviruses were isolated from 413 samples, the positive rate was 23.49% (97/413), including seventeen CVA16, seventy six HEV71 and four other enteroviruses. The results of the phylogenetic tree showed that 17.CVA16 strains isolated from Anhui in 2014 clustered within B1b evolution branch of B1 genotype. The nucleotide and amino acid sequence identities were 95.30%-100% and 98.70%-100% among the isolates, respectively, but within B1b branch of 17 strains formed several small transmission chains. The nucleotide acid of 17 CVA16 isolates in Anhui province were closed to the strains isolated from Yunnan, Hunan, Guangdong, Tibet and Jiangsu, especially from Hunan in 2013 and from Shenzhen of Guangdong in 2014, the identity were 96.40%-99.70%. The CVA16 strains isolated from Anhui in 2014 were all belong to genetic subtype B1b of B1 genotype was dominant, and among those isolates, several small virus transmission chains had formed with co-circulating and evolution.
China ; Enterovirus A, Human ; classification ; genetics ; isolation & purification ; Enterovirus Infections ; virology ; Genotype ; Humans ; Molecular Sequence Data ; Phylogeny ; Viral Proteins ; genetics ; metabolism

Objective To evaluate clinical efficacy of shoulder dislocation combined with reverse Hill-sachs injury treated with Neer modified McLaughlin procedure. Methods Clinical data of seven patients for shoulder dislocation combined with reverse Hill-sachs injury in our hospital from October 2013 to June 2016 were retrospectively analyzed. All of the patients were received Neer modified McLaughlin procedure with defect area of humeral head from 25%to 40%. The clinical outcomes were evaluated with plain radiographs, subjective satisfaction, range of shoulder motion, University of Califonia Los Angeles (UCLA) shoulder scale and constant score, which were recorded at the final follow up. Results The mean follow-up period was (12.3 ± 4.3) months. No recurence of shoulder dislocation was found. At the final follow up, a patient was found a slight osteoarthritis based on radiographs. Two patients were very satisfied with the surgery and five patients were satisfied. The average anterior flexion, abduction and external rotation of shoulder were 145.7° ± 12.7° and 148.6° ± 15.7° and 47.1° ± 5.7° respectively. The average UCLA score and constant score were (26.6 ± 2.8) and (78.6 ± 7.2) respectively. Conclusion The Neer modified McLaughlin procedure shows a remarkable clinical effect for shoulder dislocation combined with reverse Hill-sachs injury. The short and mid-term effects are definite with few complications.

Objective To investigate the effeets of insulin on the apoptosis of vascular endothelial cells cuinduced by burn$eruln in order to explore its possible mechamsm.Method Cultured human ECV304 cells were randomly divided into 33x)ups:control group,the ECV304 cells hured by 15%(V/V)rat normal,qertlm(t=6);bum semm group,the ECV3()4 cells simulated by 15%(V/V)self-made burn semm collected from rats with 30%TBSA full-thickness burns on the,back(n=6);and burn Serum+insulin group.the ECV304 cells cultared by insulin(10-7mol/L)and 15%(V/V) seIf-made rat bum serum(n=6).The transferase mediated nick end labeling(TUNEL) method was employed to measure the apoptosis of endothelial cells at 6 hours after stimulation.Meanwhile.immanohistochemical technique and Western blotting were used to determine the protein expressions of bcl-2 and eNOS.Data are expressed ills mean ±SEM.Statistical comparison was made using oneway analysis of vtriance.Significance was accepted at P<0.05.Results Compswith the control group,bum$erunl induced the apoptusis(18.5±3.1%)and down-regalated bcl·2(O.36±0.12)and p-eNOS(O.55±0.28)protein expressions of HUVECs(P<0.01).Burn 9AJ'unl+insulin significantly decreased the apoptosis(9.6 4-2.8%)and up-regulated bcl-2(0.944-0.25)and p-eNOS(0.89±0.16)protein expressions ofHU-VECs in comparison with the bum serllm group(P<0.01).eNOS showed no significant differences in three groups.Conclusions Insulin could markedly inhibit the apoptosis and up-regalate bcl-2 protein expression of HUVECs induced by bum serum,and its mec,harfism might involve the protein expression ofphosphorylated eNOS.

BACKGROUND: Mesenchymal stem cells (MSCs), with low immunogenicity, can regulate cellular immunity and mitigate graft rejection, which has a good prospect in tissue engineering. However, it is rarely present in bone marrow. OBJECTIVE: To explore an isolation and culture method of the rabbit bone marrow-derived MSCs, to observe the biological characteristics and differentiation potential of bone marrow-derived MSCs.METHODS: MSCs were isolated from rabbit tibia bone marrow by combination of gradient centrifugation and different adherent method, then proliferation in vitro. Morphology was examined by phase contrast microscopy, and the growth curve of cultured MSCs was drawn via MTT results. MSCs were treated with osteogenetic inductor (L-DMEM/F12, 10% fetal bovine serum, 0.1 μmol/L dexamethasone, 200 μmol/L vitamin C, 10 mmol/L β-phosphoglycerol), adipose inductor (L-DMEM/F12, 10% FBS, 1 μmol/L dexamethasone, 200 μmol/L antifani, 0.5 mmol/L IBMX, 10 μg/mL insulin), and chondrocytes inductor (L-DMEM/F12, 10% FBS, 10 μg/L TGF-β1, 0.1 μmol/L dexamethasone, 50 μmol/L vitamin C, 6.25 mg/L insulin) to differentiated into osteoblast, dipocytes and chondrocytes. And the differentiated cells were identified by alkaline phosphatase staining, oil red O staining, and toluidine blue staining, respectively.RESULTS AND CONCLUSION: Bone marrow-derived MSCs can be isolated and cultured by the combination of gradient centrifugation and different adherent method in vitro, which have the better potentiality of proliferation and multi-directional differentiation. Mostly of the primary and passaged cells were spindle-shaped. After osteogenetic induction, cells were positive to alkaline phosphatase staining. Oil red O staining showed that red lipid droplet existed in adipose cells, and toluidine blue staining showed that toluidine blue was positive after chondrocytes induction.

Type 2 diabetes mellitus (T2DM) is a common chronic disease characterized by hyperglycemia. Itchy skin is common in patients with diabetes, and high blood sugar leads to decreased immunity and nerve damage, causing skin problems. 40 patients with T2DM complicated with pruritus diagnosed and treated in our hospital from March 2022 to September 2022 were included to observe the clinical characteristics of the patients.

Objective: To investigate the molecular epidemiological characteristics of Human Calicivirus (HuCV) infection among children less than 5 years in Kunming city, Yunnan province, it might be provide effective evident for prevention and control the diarrhea related with HuCV infection. Methods: Four sentinel hospitals were recruited in the study from Kunming city, Yunnan province, 850 diarrhea cases and 170 non-diarrhea subject were recruited in this study from 2014 to 2015. RT-PCR was performed to screen HuCV infection, and gene sequencing was used to ensure positive infection subtypes and genotypes. Results: The positive rate of HuCV was higher in children with diarrhea than in non-diarrhea children (11.5%, 98/85; 4.7%, 8/170, χ²=7.083, P=0.008), and the positive rate of Norovirus (NoV) GII was higher in non-diarrhea children were (11.1%, 94/85; 4.7%, 8/170, χ²=6.353, P=0.012). There was no significant difference in the positive rate of NoV GI (0.1%, 1/850; 0.0%, 0/170, P=0.833) and Sappovirus (0.4%, 3/850; 0.0%, 0/170, P=0.578) in diarrhea children and non-diarrhea children. GII.P4 (10%, n=102) was the most important genotype of NoV GII detected in diarrhea and non-diarrhea individuals. Despite no significant difference in Norovirus GII infection between different age groups (χ²=0.038, P=0.846) and sex(χ²=0.620, P=0.733), infection rate of NoV GII varied with season (χ²=9.867, P=0.020), having close relationship with diarrhea in autumn (15.6%), primarily caused by GII.4 and GII.12 genotype (χ²=8.881, P=0.031; χ²=7.917, P=0.039). Conclusions NoV GII diarrhea had higher epidemic rate, which was caused by multiple genotypes, GII.P4 was a dominant genotype, and was a major pathogenic agent of diarrhea in infants f in Kunming city.