BACKGROUND: Distal humerus fracture is often comminuted, and is difficult to receive reduction and fixation due to its special anatomical structure. Choosing which surgical approach is still a controversy.OBJECTIVE: To compare and analyze the curative efficacy of the perpendicular double-locking plating system for the internal fixation of type C distal humerus fractures through two kinds of postcubital approaches.METHODS: Thirty-two cases of type C distal humerus fractures were enrolled and divided into groups A (osteotomy of olecranon approach) and B (tricep anconeus flap approach). There was no significant difference in the baseline data between two groups. The operation time, intraoperative blood loss, hospital stay, healing time,postoperative follow-up and complications were recorded and analyzed. The patients were followed up at 2 weeks, 1, 3,6, 12, and 18 months. The healing time and complications were recorded according to radiographs and physical examinations. The Mayo Elbow Performance Score was used to determine the elbow function at 1 year postoperatively.RESULTS AND CONCLUSION: (1) The group A had a longer operation time and more intraoperative blood loss than those in the group B (P < 0.05), but showed a better elbow flexion and extension degrees, and higher Mayo Elbow Performance Score at 1 year postoperatively (P < 0.05). (2) There was no significant difference in the healing time between two groups (P > 0.05). (3) These results suggest that the articular surface of the distal humerus fracture is displayed well through two approaches, and the perpendicular double-locking plating system for the internal fixation of type C distal humerus fractures is rational. Noticeably, the tricep anconeus flap approach dose little damage to the muscle, while the osteotomy of olecranon approach obtains better elbow function and less complications.

OBJECTIVE To investigate the distribution and resistance of pathogens in lower-respiratory tract infection in our area,and help doctors to use antibiotic reasonably.METHODS According to National Guide to Clinical Laboratory Procedures,API identification system or K-B method,the pathogens of 1326 cases sputum specimens were isolated,identified and tested in drug sensitive test.RESULTS A total of 982 strains of pathogens that included 540(20.0%) G-bacilli,196(20.0%) G+ cocci and 246(25.1%) fungi were isolated from 1326 sputum specimens and the detection rate was 74.1%.From them 176 cases which occupied 13.3% were with mixed infection.The drug resistance of G-bacilli to imipenem was the lowest,then was to cefoperazone and amikacin,but the resistance of ampicillin was the highest.From 234 strains of Klebsiella had 89 strains of ESBLs-positive;in 50 strains of Escherichia coli,the strains of ESBLs-positive were 20(40.0%).The resistance rate of Staphylococcus aureus and S.epidermidis to penicillin was 97.5% and 97.2%,respectively,both of them were sensitive to vancomycin,and less sensitive to ciprofloxacin.Fifty seven strains of MRSA were detected from 90 strains of S.aureus(63.3%);and 42 strains of MRSE were detected(56.0%).CONCLUSIONS G-bacilli are the main pathogens in lower respiratory tract infection and the infection caused by fungi is more than that caused by G+ cocci,so we must pay attention also to mixed infection which occupies certain ratio.

0.05). The durations between the start of infusion to the onset of SZ, DYS and ASYS were longer in group C than in group A(P

Objective To explore the diagnostic value of CT for the vegetable stone disease in the stomach,esophagus and small intestine.Methods The clinical data and CT findings of 27 cases confirmed by endoscopy or surgery were analyzed retrospectively. Among 27 cases,6 cases performed contrast-enhanced scan.Results Among 27 cases,18 cases were the gastrolithiasis,6 cases were the intestinal stone disease,1 case was the esophagus stone disease,and 2 cases were the multiple stones of stomach and small intestine.CT missed 7 cases and misdiagnosed 1 case with the rate of missed diagnosis was 25.93%.The lesions were cylindrical or oval shape with mixed density in 27 cases,distinct boundary in 26 cases,sclerotic margin in 22 cases,ethmoid or honeycomb bub-bles in the lesion in 25 cases,no enhancement in 6 cases,and complicated small bowel obstruction in 8 cases on CT images.Conclu-sion The phytobezoars in the stomach,esophagus and small intestine have typical CT findings.Careful analyses can improve its di-agnostic accuracy.

Objective To study surgical techniques and curative effects of laparoscopic vaginoplasty with transferring vascularized ileal flap.Methods Clinical data of 62 cases of laparoscopic vaginoplasty using vascularized ileal flap from March 2004 to March 2006 in this hospital were retrospectively analyzed.There were 16 cases of total laparoscopic surgery and 46 cases of laparoscope assisted surgery.Results The operation was successfully completed in all the 62 cases.The intraoperative blood loss was 30~50 ml(40.0?0.6 ml) and the operating time was 90~313 min(165.0?5.6 min).Intestinal obstruction occurred 1 month after total laparoscopic surgery in 1 case,requiring a re-operation of ileectomy with end-to-end anastomosis.Vaginal stenosis occurred in 3 cases because of incorrect use of the vaginal mold.The remaining 58 cases had satisfactory vaginal dilatation outcomes. Conclusions Laparoscopic vaginoplasty with vascularized ileal flap is micro-invasive and accordant to normal physiological conditions,being an ideal method for vaginoplasty.

It has recently been demonstrated that anti-angiogenesis drugs targeting every possible aspect of tumor angiogenesis effectively inhibit the growth, invasion and metastasis of breast cancer with low sideeffects and drug resistance. These types of anti-angiogenesis drugs have become a hotspot in the field of breast cancer research.

Objective To investigate the effect of heme oxygenase-1 ( HO-1) on brain edema in a rat model of asphyxial cardiac arrest and resuscitation. Methods Forty male SD rats weighing 250-300 g were randomly divided into 4 groups ( n = 10 each) : group I sham operation; group II cardiac arrest (CA); group Ⅰ Hemin (HO-1 inducer) and group IV SnPP (HO-1 inhibitor). Asphyxial cardiac arrest and resuscitation were performed in CA, Hemin and SnPP groups (group Ⅰ ,Ⅲ, Ⅳ) . Hemin and SnPP groups received hemin 15 mg/kg intraperitoneally (IP) at 12 h before CA and SnPP K 30 μmol/kg IP at 1 h before CA respectively. The animals were sacrificed at 1 and 6 h after recovery of spontaneous circulation (ROSC) . The water content of the cortex, hippocampus and brain stem and the expression of HO-1 and aquaporin-4 (AQP4) mRNA in cortex and hippocampus ( by RT-PCR) were determined. Results Water content of cortex and hippocampus was significantly higher at 1 h after ROSC in CA and SnPP groups than in sham operation group and was significantly lower in Hemin group than in CA group. There was no significant difference in water content of brain stem at 1 and 6 h after ROSC among all 4 groups. The expression of AQP4 mRNA was significantly higher in cortex and hippocampus at 1 h after ROSC in CA and SnPP groups than in sham operation group and was significantly lower in Hemin group than in CA group.Conclusion HO-1 can reduce brain water content at early stage after cardiac arrest and resuscitation by regulating the expression of AQP4.

Objective To evaluate the effects of prostaglandin E1 (PGE1 ) infused in the pulmonary artery of the ventilated lung on hemodynamics and pulmonary gas exchange during one-lung ventilation (OLV).Methods Experiments were performed on 12 healthy pigs of both sexes (6 males , 6 females) aged 3 months, weighing 14-17 kg. The animals were anesthetized with intramuscular ketamine 15-20 mg?kg-1 , diazepam 1.5-2.0 mg?kg-1 and atropine. The animals were mechanically ventilated after tracheal intubation (FiO2 = 0.7, VT = 12-15 ml?kg-1, RR=15bpm, I:E=l:2). PaCO2 was maintained at 35-45 mm Hg. Swan-Ganz catheter was positioned in the right pulmonary artery via the left femoral vein. The right femoral artery was cannulated for BP monitoring and blood sampling. Anesthesia was maintained with a mixture of ketamine 100 mg and succinylcholine 100 mg in 2% procaine 100 ml infused i.v. at a rate of 2-3 ml?kg-1?h-1. The animals were placed in right lateral position. The left chest was opened and OLV was established by clamping the left main bronchus. During OLV RR was increased from 15 to 20 bpm but the minute ventilation remained unchanged. The animals were randomly divided into 2 groups of six : group A and B. Group A received PGE1 infusion in the right pulmonary artery with an initial dose of 0.01 ?g?kg-1?min-1 which was gradually increased to 0.02, 0.04, 0.06, 0.08 and 0.1 ?g?kg-1?min-1 . Theinfusion of each dose was maintained for 20 min. In group B normal saline was infused instead of PGE1. MAP, HR, CVP, PCWP, CO, PaO2 PvO2 were recorded at each dose and at 20, 40, 60 min after PGE1 infusion was terminated. Qs/Qt, PVR and SVR were calculated.Results MPAP, PVR, SVR, peak inspiratory pressure (PIP) and Qs / Qt significantly increased while CO, Cdyn and PaO2 significantly decreased (P 0.05) and a significant decrease of MPAP and PVR ( P

Objective: Effects of surfactant replacement were evaluated on graft pulmonary function in rats. Method: Forty adult Wistar rats were anesthetized with an intraperitoneal injection of pentobarbital sodium(30 mg?kg~(-1)), and intubated through tracheolomy. All rats were ventilated with a ventilator. Surfactant of 50 mg was injected into lungs through tracheal. Cold Ringer's solution(0℃-4℃)was infused into the lungs through pulmonary artery, and then they were kept in cold solution. Result: The static lung compliance (SLC)in the both surfactant-replaced S(no airway pressurc)and SP(0.98kPa airway pressure)groups did not markedly decrease after cold storage. However,SLC in the no surfactant-replaced NP (no airway pressure)and P (0.98kPa airway pressure) groups both significantly decreased after cold storage. SLC was higher after lh in the P group than NP group(P

Objective To evaluate effects of pulmonary surfactant (PS) containing ketamine on respiratory failure induced with lung-lavage in rats Methods Twenty Wistar rats were anesthetized with intraperitoneal pentobarbital sodium and were ventilated with the peak inspiratory pressure(PIP) being 1 47 kPa and E:I at 1:1 following intubation through tracheotomy In all rats whole double lung lavage were performed with normal saline (37℃, 40 ml?kg -1 ) 8 10 times after PIP and PEEP were adjusted to 1 96 kPa and 0 49 kPa respectively The rats were randomly divided into A and B groups after PaO 2 decreased to less than 12 kPa In group A (n=10): PS (25mg, 0 5ml) was injected intratracheally to lungs; in group B (n=10): PS (25mg, 0 5ml) containing ketamine 2 5 mg was injected At 120th min after PS injection, PIP and PEEP were gradually adjusted to 1 47 kPa and 0 kpa (ZPEEP), respectively Results PaO 2 in both groups decreased significantly from 59 3 kPa to 10 3 kPa after lung lavage(P0 05 vs pre-lavage) All rats in group B and 4 of 10 rats in group A survived at the end of experiment Conclusions Intratracheal administration with PS containing ketamine not only reverses hypoxemia , but also maintains the respiratory function under low airway pressure without PEEP after respiratory failure induced with lung lavage,