OBJECTIVETo analyze rationality of internal fixation with original fixation in the second operation for femoral nonunion.

METHODSA retrospective study was conducted to analyze the clinical data of 19 femoral nonunion patients treated by internal fixation with original fixation in the second operation since January 2009 to July 2014, including 14 males and 5 females with an average age of (43.63 ± 3.95) years old ranging from 18 and 75 years old. The original fixations involved plate fixation in 11 cases and interlocking intramedullary nail in 8 cases (including 3 cases of retrograde interlocking intramedullary nails). There were 13 cases of atrophic nonunion and 6 cases of hypertrophic nonunion in pathological classification. After second operation, the fracture healing time, Harris hip score and range of motion of the knee joint was recorded and compared with preoperative.

RESULTSAfter the second operatioin, all patients were followed up for 6 to 30 months with an average of (18.67 ± 7.59) months. All patients got fracture healing, and the fracture radiological healing time was from 7 to 29 months with an average of (15.78 ± 4.97) months. Harris hip scores were improved from preoperative 62.37 ± 19.48 to postoperative 87.42 ± 8.86. The range of motion of the knee joint was improved from preoperative (52.16 ± 20.10)° to postoperative (96.32 ± 22.10)°.

CONCLUSIONIt has a better clinical healing rate for using original fixation to treat femoral nonunions, and theoretically speaking it was rationality.

Adolescent ; Adult ; Aged ; Female ; Femoral Fractures ; surgery ; Fracture Fixation, Internal ; methods ; Fracture Healing ; Fractures, Ununited ; surgery ; Humans ; Male ; Middle Aged ; Retrospective Studies

Adolescent ; Child ; Child, Preschool ; Female ; Homeodomain Proteins ; genetics ; Humans ; Infant ; Male ; Oncogene Proteins, Fusion ; genetics ; Precursor Cell Lymphoblastic Leukemia-Lymphoma ; genetics

BACKGROUND:It has been proved that Rhizoma Chuanxiong can promote osteoblast proliferation and differentiation.
OBJECTIVE:To further observe the effects of tetramethylpyrazine (Ligustrazine) extracted from Rhizoma Chuanxiong on osteoblast proliferation and type I col agen expression.
METHODS:Mouse osteoblast cel line MC3T3-E1 was cultured in medium containing 1, 5, 10, 15 and 20 mg/L Ligustrazine, respectively. Osteoblast proliferation was detected by cel counting kit-8 assay, and alkaline phosphatase activity and type I col agen level measured using ELISA method.
RESULTS AND CONCLUSION:Different concentrations of Ligustrazine al significantly promoted the osteoblast proliferation and type I col agen level compared with the blank control group (P<0.005). The activity of alkaline phosphatase in al Ligustrazine groups except 15 and 20 mg/L groups was significantly higher than that in the blank control group (P<0.005). These results show that Ligustrazine isolated from Rhizoma Chuanxiong can effectively promote the osteoblast proliferation and type I col agen expression, with the optimum concentration of 10 mg/L.

Sixty-two elderly patients with distal radius fractures after fixation with small splints were enrolled in the study from January to December 2014.Patients were randomly divided into intervention and control groups with 31 cases in each group.Patients in both groups received comprehensive prevention for hand swelling, those in intervention group were given additional external administration of sodium aescinate gel (SAG), 1 g, t.i.d for 7 d.Swelling score and visual analogue scale (VAS) were documented before and 3, 7 d after intervention.At the time of fracture healing, the wrist functions, including motions of flexion-extension, motions of radial-ulnar and motions of pronation-supination were examined.At 3 and 7 d after intervention, the swelling score(1.22 ±0.69 vs.1.65 ±0.75 and 0.64 ±0.42 vs.0.96 ±0.71) and VAS(1.96 ±1.27 vs.2.85 ±1.40 and 1.11 ±0.65 vs.1.86 ±1.09)of intervention group were lower than those of control group (all P<0.05).At the time of fracture healing, the wrist motions of flexion-extension [(83.7 ±8.6) vs.(77.6 ±7.1)%], motions of radial-ulnar [(83.0 ±7.6) vs.(78.2 ±8.7)%] and motions of pronation-supination [(81.0 ±7.0) vs.(76.2 ±7.5)%] of intervention group were higher than those of control group ( P <0.05 ) .The results indicate that SAG can reduce swelling, relief pain and promote the recovery of wrist function in elderly patients with distal radius fractures.

Phospholipase A_2 (PLA_2) inhibitor quinacrine was used to explore protective effect on multiple organ dysfunction (MOD) caused by intestinal ischemia-reperfusion (I/R) in rats. Gut I/R caused the increase of gut PLA_2 activity and induced endotoxemia and bacteriemia. Pretreatment with intravenous quinacrine 10mg?kg~(-1) attenuated bacteria and endotoxin translocation,markedly lowered the levels of thromboxane A_2 and prostacyclin I_2 in blood,and provided protection from the development of vital organs dysfunction. As a result,the survival rate in pretreatment group increased by 25%. The results demonstrate that gut I/R promotes gut barrier failure,then contributes to the development of MOD by allowing bacteria or endotoxin reaching the circulation. PLA_2 and PLA_2-dependent lipid mediators play an important role in the development of gut I/R injury and MOD. Intravenous quinacrine has protection against MOD resulting from gut I/R.

Objective To investigate the therapeutic effect of artificial tiger bone powder on osteoporosis.Methods The postmenopausal women with osteoporosis were randomly divided into treatment group and control group,31 cases in each group.The treatment group orally received artificial tiger bone powder,the control group orally received Caltrate D.At the beginning and 3,6 months after treatment,European health index (EQ-5D),Barthel index (BI) and Faces Pain Scale-Revised (FPS-R) were used to evaluate the curative effect.Results There were no significant differences in EQ-5D,BI and FPS-R between the two groups at the beginning of treatment.At 3,6 months after treatment,EQ-5D of the two groups were (0.83 ± 0.09) points vs.(0.77 ± 0.08) points,(0.89 ± 0.07) points vs.(0.84 ± 0.08) points;BI were (74.61 ± 8.39) points vs.(70.07 ± 8.51) points,(77.24 ± 7.15) points vs.(73.31 ±7.41) points;FPS-R were (3.14 ± 1.06) points vs.(3.79 ± 1.12) points,(2.31 ± 0.92) points vs.(2.98 ±0.87) points,which in the treatment group were better than those in the control group (t =2.774,2.619,2.115,2.125,2.347,2.946,all P ＜ 0.05).Conclusion Artificial tiger bone powder can relieve pain in postmenopausal osteoporosis patients,improve the patients' ability and improve their quality of life.And artificial tiger bone powder can effectively treat postmenopausal osteoporosis.

Objective To evaluate the effect of ulinastatin on Th1/Th2 cell balance in a rat model of stress-induced gastric ulcer (GU).Methods Twenty-four male SPF Sprague-Dawley rats,aged 6-8 weeks,weighing 180-220 g,were randomly divided into 3 groups (n =8 each) using a random number table:control group (group C),stress-induced GU group (group GU) and ulinastatin group (group U).The rats were subjected to water-immersion and restraint stress for 3.5 h to establish GU model in S and U groups.At 10 min before water-immersion,normal saline 0.4 ml and ulinastatin 100 000 U/kg were injected via the tail vein in GU and U groups,respectively.After GU model was established,the abdomen was opened after anesthesia.The whole stomach was exposed,and the gastric mucosal damage was evaluated under microscope,ulcer index (UI) was recorded,and the pathological changes of the gastric mucous membrane were observed.Spleen samples were obtained to detect T-bet,Gata-3,interferon-γ (IFN-γ),and interleukin-4 (IL-4) mRNA expression by RT-PCR.The ratio of T-bet mRNA expression/Gata-3 mRNA expression (T-bet/Gata-3) was calculated.Results Compared with group C,T-bet mRNA expression was significantly down-regulated,Gata-3 mRNA expression was up-regulated,T-bet/Gata-3 ratio was decreased,UI was increased,and no significant changes were found in IFN-γ and IL-4 mRNA expression in GU group,and UI was increased,and no significant changes were found in the other parameters in group U.Compared with group GU,the ratio of T-bet/Gata-3 was significantly increased,and UI was decreased,and no significant changes were found in T-bet,Gata-3,IFN-γ,IL-4 mRNA expression in group U.The gastric mucosal damage was significantly mitigated in GU group as compared with group U.Conclusion The mechanism by which ulinastatin mitigates stress-induced GU may be related to correction of Th1/Th2 cell imbalance in rats.

Arsenic ; urine ; Freeze Drying ; standards ; Humans ; Reference Standards ; Urinalysis ; methods ; standards

Acupuncture Points ; Acupuncture Therapy ; Adult ; Facial Pain ; therapy ; Female ; Headache ; therapy ; Humans ; Male ; Middle Aged ; Toes

Objective To investigate the application of high-frequency ultrasound in pre-operative evaluation of brachial artery elasticity in chronic renal failure patients planning arteriovenous fistula formation.Methods A total of 65 patients with chronic renal failure undergoing radial artery-cephalic vein fistula (chronic renal failure group) and 40 healthy adults (control group) were selected.The elastic modulus (EM) of brachial artery was calculated by ultrasound.All subjects were divided into 5 subgroups according to age (≥50 years),hypertension,diabetes and chronic glomerulonephritis.Patients in subgroup 0 (28 cases),subgroup 1 (22 cases),subgroup 2 (24 cases),subgroup 3 (20 cases),subgroup 4 (11 cases) had 0,1,2,3 and 4 risk factors respectively.Results The levels of systolic blood pressure,pulse pressure,serum creatinine,and the EM of brachial artery in chronic renal failure group were higher than those in control group:(20.65 ± 1.32) kPa vs.(16.38 ± 1.08) kPa,(8.64 ±0.51) kPa vs.(7.12 ±0.35) kPa,(637.3 ± 116.5) μ mol/L vs.(84.7 ±31.1) μmol/L,(132.96 ± 11.78) kPa vs.(102.16 ± 10.10) kPa,and there were significant differences (P ＜ 0.01 or ＜ 0.05).The single factor correlation analysis showed that age in control group,serum creatinine in chronic renal failure group and systolic blood pressure in two groups were significantly positively correlated with the EM of brachial artery(r =0.636,0.548,0.703; P ＜ 0.01).With the increase of risk factors,the EM of brachial artery increased gradually:(96.21 ±9.82),(104.45 ± 10.55),(114.87 ± 11.15),(127.26 ± 12.43),(143.54 ± 12.81) kPa in subgroup 0,subgroup 1,subgroup 2,subgroup 3,subgroup 4,and there were significant differences (F=17.43,P＜ 0.05).The EM of brachial artery increased significantly in subgroup 3 and 4 with multiple risk factors.Conclusions Brachial artery elasticity measured by high-frequency ultrasound can be used as an indicator of vascular function preoperative vascular assessment.Age,systolic blood pressure,pulse pressure and serum creatinine levels are the major risk factors for brachial artery elasticity.The coexistence of multiple risk factors of hypertension,diabetes or chronic nephritis could exacerbate the decrease of brachial artery elasticity.