Objective To evaluate the short?term functional outcome of Multiloc Proximal Humeral Nails (PHN) in the treatment of proximal humeral fractures, by retrospectively reviewing the function and complications of our institutional experi?ence. Methods 15 patients were treated operatively for displaced proximal humeral fractures using the Multiloc PHN. Fractures were classified according to Neer's classification. Male 4 cases, female 11 cases, with a mean age 63.7 years (58-73 years), and the mean follow?up was 5.2 months (3-10 months). A number of parameters including patient demographics, mechanism of injury, operative time, time to union and complications were recorded. Functional outcome was evaluated using the rating scale of the American Shoulder and Elbow Surgeons (ASES) and Constant Score, Visual Analogue Scale (VAS) scores. Results 15 patients completed the follow?up more than 3 months, the operation time was 145.3minutes (70-200 min), the blood loss was 189.3ml (50-310 ml). The union rate was 100%(mean time to union: 2.5 months). The ASES score was 83.1 and Constant Score was 81.7 , while the VAS was 1.7. The Constant score 87 (85, 92) and ASES 90 (83.5, 100) were higher for 5 cases without calcar screw than those of the other 10 cases using the calcar screw whose Constant 83 (77, 90), ASES 85 (73, 95). The average Constant score 88 (78, 92) and ASES score 91.5 (75, 100) were higher in 7 cases with 1 screw?in?screw than those with more than 2 screw?in?screw in 8 cases whose Constant 80.5 (74, 88.5), ASES 81.8 (73, 92.5). There were no complications such as hardware failure, protruded screws, infection, nonunion, avascular necrosis of humeral head or impingement syndrome, but 1 patient suffered from elbow stiff?ness (complication rate:6.7%). Conclusion The Multiloc proximal humeral nail is an effective implant for stabilisation of dis?placed proximal humeral fracture with a good short?term functional outcome. Its advantages are short operation time, small inci?sion, less trauma, less blood supply and less complications. The shoulder pain history and or with intraoperative findings of rotator cuff injuries, may have a negative impact on the prognosis.

Objective:To compare two methods for the determination of compound cod-liver oil emulsion. Methods:The content of ciprofloxacin in compound cod-liver oil emulsion was determined by HPLC and UV, respectively. The determination by HPLC was performed on a Thermo C18 column (150 mm ×4.6 mm, 5 μm). The mobile phase was 0.025 mol·L-1phosphate-acetonitrile (87∶13)andpHwasadjustedto3.0±0.1withtriethylamine. Thedetectionwavelengthwas277nmandtheflowratewas1.5ml·min-1. The detection wavelength of UV was 277 nm. Results:The average recovery of HPLC and UV was 100. 44% and 100. 84% with RSD of 1. 01% and 1. 09% (n=9), respectively. The detection results of the two methods were compared by paired sample t-test, and no statistically significant difference was found (P>0. 05). Conclusion:The two methods are specific and accurate, and can be used for the determination of ciprofloxacin hydrochloride in compound cod-liver oil emulsion.

OBJECTIVETo study the molecular action mechanism of active constituents desoxyrhaponticin (DES) and human serum albumin (HSA).

METHODUnder the simulated physiological condition, computer analog technology, fluorescent spectrometry and ultraviolet spectrum were combined to study the binding mechanism between drug and protein.

RESULTMolecular modeling was adopted to establish the binding model between DES and HSA, suggesting that the interaction force maintaining drug and protein is mainly the hydrophobic interaction with a hydrogen-bond interaction. The results from spectroscopy indicated that the interaction between DES and HSA is a dynamic binding process with a high intensity. The value of the binding distance (r) between DES and HSA was low, which demonstrate the occurrence of energy transfer. DES made an impact on HSA' structural domain microcell conformation, which resulted in hydrophobic changes in binding areas. According to the fluorescent phase diagram technical analysis, the changes in the DES-HSA reaction conformational pattern showed a "two-state" model. According to the obtained thermodynamic parameters for the DES-HSA interaction, the interactional force between DES and HSA was mainly a hydrophobic interaction. The fluorescence polarization proved that a non-covalent compound was generated during the interaction between DES and HSA.

CONCLUSIONThe spectrum experiment showed consistent results with the computer analog technology, which could provided certain reference for studies on the interaction between DES and HSA.

Humans ; Models, Molecular ; Protein Binding ; Protein Conformation ; Serum Albumin ; chemistry ; metabolism ; Spectrometry, Fluorescence ; Spectrophotometry, Ultraviolet ; Stilbenes ; metabolism ; Thermodynamics

Objective To study the role of extra-anatomic arterial bypass grafting in the management of aorta-iliac occlusive disease. Methods Forty-one cases of aorta-iliac occlusive disease managed by extra-anatomic arterial bypass grafting were retrospectively analyzed. Clinical features included claudicafion 11, resting pain 12 and ulcer/gangrene 18 patients. Axillofemoral bypass was performed in 15 cases with aortic and bilateral iliac artery occlusion, femorofemoral bypass in 18 cases with unilateral iliac occlusion and femoro-cnntralateral popliteal bypass in 8 cases with iliac and ipsilateral femoral artery occlusion. Results Postoperatively, clinical features were reheved in 40 cases (97.6%). Ankle brachial index increased significandy from 0.41 ± 0.15 to 0.89 ± 0.21 perioperatively (P < 0.05 ).Thirty-five cases were followed up for 1 year to 5 years. The overall graft patency rates in this series were 93%, 86% and 80% in 1, 3 and 5 years, respectively. Conclusion Extra-anatomic arterial bypass has merits as less invasive and rapid postoperative recovery, and this is one of the effective methods for the treatment of aorta-iliac occlusive disease.

Bacillus amyloliquefaciensin can cause infections and the building related ill-health syndrome among newborns, infants and other immunocompromised populations by polluting hospital disinfectants, such as alcohol 75%, moisture housing and food. In this article, we reviewed the prevalence of Bacillus amyloliquefaciens in environment, food and intrahospital infection, the toxicology by describing its toxicity in mammalian cells, the physicoehemical characteristics by analyzing its special structure of bacterial spores. Its pathogenicity through animal model of disease was discussed as well.(J Glin Pediatr,2010,28(2) :190-192)

Objective To study the therapeutic effects of human umbilical cord mesenchymal stem cells (hUCMSCs) on acute liver failure ( ALF) induced by D-galactosamine (D-gal) and lipopolysaccharide (LPS) in rats. Methods The ALF model was obtained through intraperitoneal injection of D-gal(300 mg/kg)and LPS (20μg/kg)in Wister rats. The hUCMSCs were transplanted after intoxication. All rats were divided into four groups, and each group received either hUCMSCs or 0.9% NaCl solution through intraperitoneal or tail-intravenous injection. To evaluate the liver function of each group, the levels of alanine aminotransferase (ALT), total bilirubin (TBil) and serum albumin (Alb) were measured on the day of hUCMSCs transplantation and the following 1, 2, 3, 5 and 7 days. All rats were then sacrificed to examine the liver histology at day 7. Analyses were done by using Fisher's exact test, unpaired t test and Mann-Whitney U test. Results There were no significant differences of survival rates among four groups (Fisher's exact test, both P = 1. 00). The levels of ALT, TBil and Alb in group receiving hUCMSCs intraperitoneally were (804. 9 ± 88. 0) U/L,(17. 4±2. 7) μmol/L and (20. 9±0. 8) g/L, respectively after 2 days of injection, whereas in the corresponding control group, those were (1294. 3± 171. 4) U/L, (32. 3±5. 5) μmol/L and (16. 1±0. 9) g/L, respectively, which indicated that hUCMSCs transplantation significantly improved the liver function (t = 2. 640, P =0.020;t=2.529, P = 0. 025;t= - 3. 833, P = 0. 002). Both of hUCMSCs-transplanted groups showed no significant differences. Liver histological data showed that transplantation of hUSMSCs through either intraperitoneal or tail-intravenous injection alleviated liver damage (U=4. 500, P = 0. 005;U=4. 500, P = 0. 008) and the mitotic index also increased in hUCMSCs-transplanted groups (U=4. 000, P = 0. 005; U=5. 500, P = 0. 013). Conclusions The levels of ALT, TBil and Alb can rapidly normalize in ALF rats after injected with hUCMSCs either intraperitoneally or tail-intravenously. hUCMSCs application raises the mitotic index, enhances hepatocellular regeneration and improves histological status.

Objective To evaluate the clinical outcomes of primary repair of bony and ligamentous components in treatment of Mason-Johnston type Ⅳ radial head fractures.Methods From August 2007 to November 2011,16 cases of Mason-Johnston type Ⅳ radial head fractures were treated by open reduction and screw or plate fixation combined with simultaneous repair of ruptured capsular ligaments with suture anchors.There were 11 men and 5 women with a mean age of 31.6 years (range,18-52 years).Totally,left side was involved in seven cases and right side in nine； dominant side was involved in 13 cases and non-prominent side in three.Time from injury to operation averaged 6.2 days (range,2-11 days).Nine cases of partial articular fractures with 2 or 3 fragments were treated with 1.5 mm or 2.0 mm AO miniscrews and seven cases of complete articular fractures with 2-4 fragments were treated with 2.0 mm AO mini plastic plates and screws after reduction.Active and assisted functional exercise was instructed in the early period after surgery.Visual analogue scale (VAS) and Broberg-Morrey elbow performance were measured for function assessment at the latest follow-up.Results Follow-up averaged 22.6 months (range,12-38 months),which showed primary wound healing without infection.All fractures achieved bony union at an average of 4.8 months (range,3.3-6.2 months).Ten out of the 16 cases,four of partial articular fractures and six of complete articular fractures,had slight but asymptomatic ossification in the medial and lateral collateral ligament attachment.There were two excellent,six good and one fair results in partial articular fracture group,with excellent-good rate of 89％ as well as one excellent,four good and two fair results in complete articular fracture group,with excellent-good rate of 72％.Moreover,the total excellentgood rate reached 81％.Range of motion in extension,flexion and rotation,Broberg-Morrey score and VAS presented statistical differences between partial and complete articular fracture groups (P ＜ 0.05).Conclusion Primary management of bony and ligamentous components to treat Mason-Johnston type Ⅳ radial head fractures brings timely three-dimensional stability of the elbow joint,favors early functional exercise and further decreases incidence of postoperative complications,such as elbow stiffness,pain and heterotopic ossification.

ObjectiveTo analyze the therapeutic effect of open reduction with internal fixation (ORIF) and anatomic reconstruction locking plate in treatment of Neer 3-part and 4-part fracture dislocations of proximal humerus.MethodsThe study involved 30 patients with Neer 3-part and 4-part fracture dislocations treated with anatomic reconstruction locking plate from September 2004 to December 2007.Twenty patients had complete follow-up data.The treatment methods included locking proximal humeral plate (LPHP) in seven patients and proximal humeral internal locking system (PHILOS) in 13.There were 15 males and five females,at age range of 29-84 years (average 52.5 years),including nine patients younger than 65 years and 11 older than 65 years.According to Neer classification,there were 15 patients with 3-part fracture dislocations including 12 anterior and three posterior dislocations and five patients with 4-part fracture dislocations including four anterior and one posterior dislocations. VAS and Constant scoring system were adopted to evaluate the shoulder joint function postoperatively. Results All 20 patients were followed up for 36-71 months ( average 51 months),which showed avascular necrosis of humeral head in six patients (30％),plating loosening in two,screw penetration in six,nonunion in two and infection in two.The mean visual analogue score (VAS) was 2.55 poiuts and the mean Constant score for the shoulder was 80.8.According to the Neer shoulder functional evaluation standard,eight patients were graded as excellent,six as good,three as fair and three as poor,with excellence rate of 70％.ConclusionsAlthough the anatomic reconstruction locking plate and ORIF can cause a high incidence of avascular necrosis of humeral head in the treatment of Neer 3-part and 4-part fracture dislocations of proximal humerus,especially for the patients older than 65 years.However,there is no obvious correlation between necrosis of humeral head and shoulder function.Clinically,the method could be selected on the ba-sis of individual condition of the patients.

OBJECTIVETo investigate the clinical outcomes of cannulated screw combined with buttress plate in treating transarticular shear fractures of the distal humerus.

METHODSFrom July 2008 to December 2011, 17 patients with shear fractures of the distal humerus were treated with cannulated screw combined with buttress plate. Among them, included 10 males and 7 females aged from 20 to 59 years old (mean 36.5). All the fractures were classified into type I (8 cases), type II (1 case), type III (3 cases) and type IV (5 cases) according to Bryan-Morrey and McKee classification. According to AO/ASIF classification, 10 cases were type 13B3.1, 7 cases were type 13B3.3; according to Dubberley classification, 5 cases with type 1A, 2 cases with type 1B, 2 cases with type 2A, 2 cases with type 2B, 4 cases with type 3A, 2 cases with type 3B. There were 12 cases with fresh injuries, 4 cases with old injuries. All fractures were closed injuries. Complications and range of motion of elbow were observed, and clinical efficacy were evaluated by Broberg-Morrey standard.

RESULTSAll patients were followed up with a mean time of 21.3 months (ranged, 18 to 24). All fractures obtained bone healing from 10 to 15 weeks with a mean of 12.5 weeks. No malunion or delayed healing occurred. Two cases occurred ossification in lateral collateral ligament attachment. 2 cases occurred heterotopic ossification in the capitellum in front of capsule joint. The range of elbow extension was (16 +/- 7) degrees, flexion was (115 +/- 9) degrees, the average are of pronation and supination was (65 +/- 5) degrees and (60 +/- 5) degrees respectively. According to Broberg-Morrey standard, there were excellent in 7 cases, good in 8 cases, fair in 2 cases, and average score was 92.44 +/- 4.64.

CONCLUSIONFor transarticular shear fractures of the distal humerus, classification should be performed according to preoperative X-ray and CT, cannulated screw and buttress plate combined and early function rehabilitation could recover elbow function.

Adult ; Bone Plates ; Bone Screws ; Female ; Fracture Fixation, Internal ; methods ; Humans ; Humeral Fractures ; physiopathology ; surgery ; Male ; Middle Aged ; Range of Motion, Articular

OBJECTIVESTo evaluate the clinical application of one-stage repair of hypospadias using pedicled penis and scrotal septal symphysis skin flap.

METHODSOne hundred and forty-nine cases of hypopadias were treated with the skin flap and followed up.

RESULTSAfter the operation, one hundred and twenty-two cases of patients obtained satisfactory outcomes, twenty-seven cases happened urethral leakage and preputial uredema were observed, and three cases suffered from urethral-skin fistula.

CONCLUSIONSThis technique was an optimal choice to penis hypospadias, Penoscrotal hypospadias and light-duty scrotal hypospadias. It was simple and convenient and could prevent infection but manage of drain must be done postoperatively.

Adolescent ; Adult ; Child ; Child, Preschool ; Humans ; Hypospadias ; surgery ; Male ; Penis ; surgery ; Scrotum ; surgery ; Skin Transplantation ; methods ; Surgical Flaps ; Treatment Outcome