[Objective]To evaluate the two plates internal fixation treating the distal humeral comminuted and complicated fracture.[Method]Twenty-eight patient with comminuted distal humeral fracture were treated with the double-plate internal fixation from April 2004 to April 2007.According to AO/ASIF classification method,all fractures were C types.There were 9 C1 types,15 C2 types,4 C3 types.All cases were taken from the middle of posterior elbow incision.The patients were treated with the open reduction and double plate internal fixation.Fifteen cases were done through the triceps tongue-shaped flap,13 cases were olecranon osteotomy (including one case with olecranon fractures with ipsilateral).Surgical steps included:the articular surface reduction of intra-articular fractures,small temporary Kirschner wire fixation,making the complete fractures into simple comminuted fractures of humerl condylar fractures,then resetting metaphysis.Internal fixation method used the restruction plate according to the size of fracture.The restruction plate was fixed in the back of the distal humeral radial column.One-third of a good-shaped tubular plate was used to fix the inner edge of humeral ulnar column,two 90 ? of each other into the plane separately fixed on the inner lateral humeral column.[Result]All cases were followed up for an average of 17 months(ranged,8-33 months).Fracture healing time ranged 8-16 weeks.Myositis ossificans was found in 1 case,joint space narrowing was found in 4 cases.No non-union and ulnar nerve injury were found.The final good-to-excellent rate was 82.1%.[Conclusion]The distal humeral comminuted fracture has complicated structure.The internal fixation with two plates and screws,and early functional exercise could improve the elbow function.It has satisfactory curative effect in clinic.

Humans ; Infant ; Male ; Menkes Kinky Hair Syndrome

Objective To explore the mechanism of tripterygium wilfordii hook f(TWHF)for Henoch-Schonlein purpura nephritis(HSPN,nephrotic type)in children.Methods All the children with HSPN(nephrotic type)were divided into 3 groups casually.Method of radioactive pairs conjugating analysis was used to determine the numbers of glucocorticoid(GC)receptors(GCRs).Results were statistically analysed respectively.Results GCRs tested in all the patients with HSPN(nephrotic type)before treatment were statistically lower than those in control group of normal children;GCRs in all the patients tested after 1 week treatment with GC were lower than before treatment.Three weeks later,GCRs in patients treated with TWHF increased much higher than them without TWHF.Following up the recurring times of all the patients 3 months to 5 years,they were much more in patients treated without TWHF treatment than in patients treated with it.Conclusions TWHF treatment on HSPN(nephrotic type)is obviously effective.It can not only decrease the dosage of GC,but decrease the recurring times.One of the mechanism may be TWHF can resist the down-regulation GC to GCR,and enhance the effect of GC.

Actins ; metabolism ; Adult ; Aged ; Carcinoma, Squamous Cell ; metabolism ; pathology ; Female ; Humans ; Laryngeal Neoplasms ; metabolism ; pathology ; Lymphatic Metastasis ; pathology ; Lymphatic Vessels ; metabolism ; pathology ; Male ; Middle Aged ; Vascular Endothelial Growth Factor C ; metabolism

BACKGROUND: This study was designed to describe the current tends of emergency tracheal intubation and predict difficult airway intubations in emergency department (ED) at a teaching hospital in Korea. METHODS: All patients who was taken endotracheal incubation in ED during a 1-year period (Mar 1997 through Feb 1998) were included in the study population. Medical records of the patients were retrospectively reviewed. Among them, 56 patients were prospectively evaluated parameters to predict difficult airway intubations. RESULTS: During the study period, a total of 413 patients(1.5%) required endotracheal intubation. Except far 2 cases, all patients intubated orotracheally, and 298(72%) patients were intubated by emergency medicine resident. Pharmacologic adjuncts were used in 200(48%) patients, the neuromuscular blocking agent(NMBA) was used in 16(3.8%) Commonly used drugs were thiopental and vecuronium. The difficult incubation was not associated with presence of denture, length and circumference of neck, and mental status. The visibility of vocal cord on laryngoscopy significantly correlated to the difficult airway. CONCLUSION: At this institution, the majority of ED incubation were performed by emergency physicians and NMBA was not routinely used. The visibility of vocal cord during the direct laryngoscopy could be a predictor of difficult incubation in ED.
Dentures ; Emergencies* ; Emergency Medicine ; Emergency Service, Hospital ; Hospitals, Teaching ; Humans ; Intubation* ; Intubation, Intratracheal ; Korea ; Laryngoscopy ; Medical Records ; Neck ; Neuromuscular Blockade ; Prospective Studies ; Retrospective Studies ; Thiopental ; Vecuronium Bromide ; Vocal Cords

Objective To study the cellular immune function in children with kawasaki disease(KD).Methods T lymphocyte subcytes,levels of serum interleukin 2(IL-2) and soluble interleukin 2 receptor(sIL-2R) were determined by APAAP,ELISA met-hods,and a double-antibody “sandwich” enzyme-linked immunosorbent assay respectively in 60 cases.Results During the acute stage of KD,the percentage of CD4 +,the ratio of CD4 +/CD8 +,levels of IL-2 and sIL-2R increased markedly,while the percentage of CD3 + and CD8 + decreased significantly compared with the controls.These changes were more remarkable in patients subsequently developed coronary artery aneurysms than in those with normal appearing coronary artery.Conclusion Marked activation of cellular immune function and immune regulation disorders develop in acute stage of KD patients.

Objective To investigate the changes of plasma somatostatin(SS) and its correlation with cellular immune function in neonates with hypoxic-ischemic encephalopathy(HIE).Methods Fifty cases of HIE were collected to detect the SS and T lymphocyte subsets,IL-2,sIL-2R as well as IL-6 levels by radioimmunoassay,APAAP and doule antibody sandwith ELISA methods.Results The SS and sIL-2R levels in patients with HIE were significantly higher(P

ObjectiveTo explore the detection significance of insulin-like growth factor-I(IGF-I),IGF-binding protein-3(IGFBP-3) in children with acute lymphoblastic leukemia(ALL).MethodsSerum samples were obtained from 30 ALL children without any medication;serum control samples were obtained from 30 cases of healthy children.There were no significant differences of body weight,age and sex between 2 groups.All children had no case history of liver,kidney,malnutrition and endocrine system disease.IGF-Ⅰ was determined by radioimmunoassay kit.IGFBP-3 was determined by immunoradiometric kit.The data were analyzed with SPSS 11.0 software.ResultsThe level of IGF-Ⅰ in ALL group [(18.95?4.02)?106 g/L] was significantly lower than that in control group [(34.12?7.86)?106 g/L](t =9.412P

0.05).Genotype CT frequency in T2DM group was significantly increased when compared with non-DM control group(P=0.012,OR=2.254).Conclusion Pro198Leu polymorphism of GPX-1 gene increases the risk of type 2 diabetes in Han Chinese of Shanghai,while T allele is not a risk factor of diabetic CHD.

Objective To study the effects of fluoride on minichromosone maintenance(MCM)3 mRNA and the bone formation-related gene:bone sialoprotein(BSP),osteocalcin(OC),osteopontin(OP)mRNA expression on human osteoblast cells.The expression of MCM3 was tested for diagnosis and surveillance value on osteoblast treated with excess fluoride.Methods Human osteoblast cell(Saos-2)was cultured in McCoy5A medium and treated with fluoride(sodium fluoride,NaF).There were eight groups including:0(control),0.625,1.250,2.500,5.000,10.000,20.000,40.000 mg/L groups.Expression of MCM3,BSP,OC,OP mRNA were detected by real-time PCR.Dual-standard curve method was used for analysis.ALPase was determined by measuring the absorbance using a micro titer plate reader. Results Expression of MCM3 mRNA was lower in the 0.625,1.250,2.500,5.000,20.000, 40.000 mg/L groups(0.059 ± 0.003,0.027 ± 0.001,0.272 ± 0.004,0.115 ± 0.002,0.137 ± 0.004,0.754 ±0.002, all P > 0.05) and was higher in10.000 mg/L group(21.300 ± 1.200, P < 0.01 ) than control group( 1.000 ±0.020), especially 10.000 mg/L group was higher than groups treated with fluoride(all P < 0.01 ), the differences among groups were significant(F = 305.842, P < 0.01 ). Expression of BSP mRNA was significantly higher in 0.625,1.250,2.500,5.000,10.000 mg/L groups(71.80 ± 3.60,133.00 ± 7.20,85.50 ± 0.60,80.90 ± 1.20,304.00 ± 21.00)than the control group( 1.00 ± 0.04), especially 10.000 mg/L group was higher than others groups treated with fluoride(all P < 0.01 ), the differences among groups were signifieant(F = 159.531, P < 0.01 ). Expressions of OC mRNA were higher in 0.625,1.250,2.500,5.000 mg/L groups(110.00 ± 12.00,143.00 ± 2.10,90.60 ± 4.10,23.70±1.20) than control group(1.00 ± 0.01, all P < 0.01), and the differences among groups were significant (F = 158.734, P < 0.01 ). Expression of OP mRNA were higher in 0.625,1.250,2.500,5.000,10.000,20.000 mg/L groups(167.00 ± 11.20, 111.00 ± 12.10,72.50 ± 3.50,134.00 ± 14.00,42.30 ± 2.40,45.20 ± 3.30) than the control group(1.00 ± 0.04, all P < 0.05 or < 0.01 ), the differences among groups were significant(F = 60.226, P < 0.01 ).Compared with control group(4.2 ± 1.2), the ALPase activity was increased in all groups treated with fluoride (6.0 ± 0.4,5.8 ± 0.1,5.7 ± 0.4,7.7 ± 1.1,19.2 ± 2.4,8.5 ± 3.0,18.1 ± 4.2), but only 10.000 mg/L and 40.000 mg/L groups were higher than control group and other groups treated with fluoride(all P < 0.01 ), the differences among groups were signifieant(F = 7.806, P < 0.01 ). Conclusions Irregular expression of MCM3 mRNA is not suitable as a diagnostic and monitoring biomarker of osteoblasts exposed to excessive fluoride. Fluoride may affect the osteoblast-related gene expression and to promote osteogenic differentiation.