OBJECTIVETo compare the therapeutic effects between close reduction and plaster slab fixation combined with plaster external traction and operation for the treatment of pediatric closed Gartland type III supracondylar humerus fractures without neurovascular injury complications.

METHODSFrom June 2009 to June 2012, 151 children with closed Gartland III supracondylar humerus fractures were retrospectively studied and divided into two groups, including 87 boys and 64 girls, ranging in age from 1 to 12 years old with an average of 5.3 years old. Among them, 76 children (conservative group) were treated with close reduction and plaster slab fixation combined with plaster external traction; 75 children (operation group) underwent surgical operation. The time of elbow joint function exercise, the healing time of fracture, the function recovery of elbow joint and carrying angle was recorded and analyzed. The therapeutic effects were evaluated by the Flynn criteria system.

RESULTSAll patients were followed up from 6 to 36 months (18.3 months on average). The average time of fracture healing and elbow joint functional exercise of the conservative group was shorter than those of operation group (P < 0.001). Motion range of the elbows and carrying angle of two groups were no statistical difference (P > 0.05). According to Flynn criteria system, in conservative group, the result was excellent in 31 cases, good in 35, fair in 7, and poor in 3; in operation group, 27 in excellent, 30 in good, 17 in fair and 1 in poor; there was no significant difference between two groups in therapeutic effects (P > 0.05).

CONCLUSIONClose reduction and plaster slab fixation combined with plaster external traction in treatment of pediatric closed Gartland type III supracondylar humerus fractures without neurovascular injury complications,which has similar effect to surgical treatment, and the time of fracture healing and elbow joint function exercise are significantly shorter.

Case-Control Studies ; Casts, Surgical ; Child ; Child, Preschool ; External Fixators ; Female ; Fracture Healing ; Humans ; Humeral Fractures ; surgery ; Infant ; Male ; Traction ; methods

10.3969/j.issn.2095-4344.2013.25.007

BackgroundThe study of myopia development is always the hotspot worldwide. Recently,scientist found that some growth factor secreted by retinal nerve epithelium cells and retinal pigment epithelium(RPE)cells are associated with the development of myopia. Whenever, the absorption of RPE cells to different wave-length lights is different. ObjectiveThis study was to investigate the effects of different wave-lengths lights on the proliferation of human RPE cells, and explore the influence of different wave-lengths lights on RPE cells secreting hepatocyte growth factor(HGF) ,basic fibroblast growth factor(bFGF) and transforming growth factor-β(TGF-β).Methods The fourth to fifth passages of human embryonic RPE cells were exposed to blue light( λ =480 nm),red light( λ =775 nm) and white light. The cells of control group were harvested in normal condition. The proliferation and growth of RPE cells were assayed by MTT,and the ultrastructure of cells was examined under the transmission electron microscopy at 48 hours after light exposure of RPE cells. Enzyme linked immunosorbent assay(ELISA) was adopted to determine the concentrations of HGF,bFGF and TGF-β in the culture medium in 12,24,48,72 hours. The expression of HGF mRNA in RPE cells was detected by RT-PCR. This study was approved by Ethic committee of Fudan University. ResultsThe A490 values of the cells exposed to blue light,red light,white light and white light were 0. 0218±0. 0014 ;0. 0353±0. 0025 ;0. 0371 ±0. 0024 and 0. 0445 +0. 0046 respectively with the significant difference among 4 groups ( F =12. 579, P＜0.05 ), and A490 value in blue light group, red light group were significantly lower than that of the control group ( t =2.043 ; t =2.024, P＜0.05 ). ELISA showed that the concentrations of HGF and TGF-β in culture medium were evidently elevated as the prolongation of light exposure in various light exposure groups in 72 hours(HGF) and 48 hours(TGF-β) compared with 12 hours with a predominating rise in the control group. The statistically significant differences were found in the concentrations of HGF and TGF-β between control group and blue light group or red light group in the( all P＜0. 05 ). The bFGF level was decreased with the time increase of various light exposure with the significant differences in 72 hours compared with 12 hours( P＜0.05 ). RT-PCR revealed the considerable difference about expression of HGF mRNA in RPE cells among these four groups( P＜0. 05 ), and the lest expression in HGF mRNA was in the blue light group compared with control group( t =3. 972,P＜0.05 ). Thinning of the chromatin, decreasing of organelle and loss of cellular membrane were seen in the blue light group, but no obvious change of ultrastructure of human embryo RPE cells was found in the ret and white light groups. ConclusionsThe irradiation of different wave-length light can effect the growth and proliferation and secretion of HGF,bFGF and TGFβ in human RPE cells in vitro,implying myopia formation is associated to exposure of different wave-length light.

Objective To study the changes of serum markers of hepatic fibrosis in patients with fatty liver,and to provide clinical diagnosis and treatment for patients with fatty liver.Methods Three hundred and sixty-one patients with fatty liver were divided into light,medium and heavy three degrees according to the intrahepatic echo and structure.Serum markers of hepatic fibrosis-hyaluronic acid (HA),laminin (LN),procollagen Ⅲ (PC Ⅲ) and type Ⅳ collagen (C-Ⅳ) were examined by enzyme linked immunosorbent assay (ELISA),and the ordinal logistic regression model was used to analyze,regarding the grade of fatty liver as dependent variable.Results The levels of serum fibrosis markers HA,LN,PC Ⅲ and C-Ⅳ in patients with mild,moderate and severe fatty liver were (94.53 ± 16.21),(101.38 ± 20.42),(127.34 ± 26.54) μg/L,(107.25±22.63),(117.38±24.84),(136.62±32.27) μg/L,(110.27±23.15),(121.55±27.36),(138.62± 30.62) μg/L,(72.61 ± 15.46),(82.06 ± 18.28),(92.96 ± 21.35) μg/L respectively,there was significant difference in serum fibrosis markers among mild,moderate and severe fatty liver patients (F =675.719,398.771,303.960,840.570;P＜0.05),while the markers of patients with severe fatty liver were higher than normal.The ordinal logistic regression model showed that the serum fibrosis indexes of HA,LN,PC Ⅲ and C-Ⅳ had significant effects on the grading of fatty liver(P＜0.05),whose odds ratio were 1.322,1.229,1.899,3.935,that was the higher the HA,LN,PC Ⅲ,C-Ⅳ,the more severe fatty liver.Conclusion There were liver fibrosis trend in patients with severe fatty liver.Detection of serum markers of hepatic fibrosis can be used as an important basis for monitoring and diagnosis of fatty liver disease.

Objective To analyze the prevalence characteristics of fatty liver in young and middle-aged people,and to explore the risk factors of the disease,so as to provide clinical evidence for the prevention and treatment of fatty liver.Methods In 756 young and middle-aged healthy subjects with age≤50 years old,there were 197 fatty liver cases were diagnosed by ultrasonic test during 2015 year.The prevalence of different characteristics in young and middle-aged fatty liver was analyzed,the difference of blood biochemical index between fatty liver and non fatty liver group was compared,and risk factors of fatty liver was explored by binary logistic regression model.Results The total prevalence rate of fatty liver in young and middle-aged people was 26.1%(197/756),among which 33.1% (119/359) were male and 19.6%(78/397) were female,the prevalence rate of male was significantly higher than that of female(χ2=17.833,P<0.05).The prevalence rate of fatty liver increased with age(χ2=33.296,P<0.05),which in 40-50 years old was 37.1%(111/299) and significantly higher than that in 20 years-(15.0%)(24/160) and 30 years-(20.9%)(62/297).Logistic regression analysis on influencing factors of fatty liver prevalence showed that age,sex,body mass index(BMI),drinking,diabetes and fasting blood glucose(FPG),triglyceride(TG),total cholesterol(TC) were closely related to fatty liver(P<0.05),overweight,obesity,drinking,diabetes increased the risk of fatty liver disease.Biochemical indicators(FPG,TG,TC) in fatty liver group were higher than those in non fatty liver group((7.09±1.47) mmol/L vs.(5.14±1.71) mmol/L,(5.98±1.23) mmol/L vs.(4.95±1.42) mmol/L,(2.03±0.45) mmol/L vs.(1.23±0.67) mmol/L,t=271.905,98.866,278.255;P<0.05).Conclusion The prevalence rate of fatty liver in young and middle-aged people is high,and controlling body weight,give up drinking,active treating diabetes,reducing blood glucose and blood lipids can effectively decrease the prevalence of fatty liver in young and middle-aged people.

Objective: To observe the difference of the effect of low-frequency electroacupuncture (EA) on blood lipids between male and female patients with simple obesity due to damp induced by spleen deficiency. Methods: Eighty patients with simple obesity were recruited, including 37 males and 43 females, to receive low-frequency EA by selecting Yinlingquan (SP 10), Sanyinjiao (SP 6), Zusanli (ST 36), Fenglong (ST 40), Quchi (LI 11), Tianshu (ST 25), Zhongwan (CV 12), Shuifen (CV 9), Qihai (CV 6) and Guanyuan (CV 4), with needles retained for 30 min. The treatment was given once a day, 10 sessions as a treatment course, for 2 courses in total. The contents of body fat percentage (F%), total cholesterol (TC), triglyceride (TG), high-density lipoprotein (HDL), low-density lipoprotein (LDL), blood glucose (Glu) and adiponectin (ADPN) in serum were observed to see the changes, and the two groups were compared and analyzed. Results: After the treatment, F%, and serum contents of TC, TG, LDL, Glu and ADPN dropped significantly in the two groups (P<0.05 or P<0.01) and the serum content of HDL increased significantly in male group (P<0.05). The decrease of F% in female group was more significant than that in male group (P<0.01); the decrease of ADPN in male group was more significant than that in female group (P<0.05). Conclusion: EA can regulate the disordered blood lipids in male and female patients with simple obesity, with certain differences between genders. The decrease of subcutaneous fat content is more significant in females than that in males, while the decrease of ADPN is more significant in males.

Objective To verify the feasibility and accuracy in the measurement of tricuspid valve annulus diameter(TVD) in the right ventricular outflow tract view.Methods Seventy five patients under the valve replacement surgery for the left heart valve lesions were divided into mild,moderate and severe group according to the severity of the regurgitation.The TVD was get on the apical four-chamber heart viewpreoperatively by transthoracic echocardiography(TTE),noted as TTE-TVD,meanwhile it was also get by the transesophageal echocardiography on the four-chamber view (TEE-TVD),right ventricular inflow (RVIT-TVD) and outflow tract view(RVOT-TVD).The changes of tricuspid regurgitation severtity was observed preoperatively.And the morphology of tricuspid annulus were observed using both real-time three dimensional transesophageal echocardiography (RT-3D TEE) and the quantitative software.Results Comparison in the groups:no statistically significant difference (P ＞0.05) was found between TTE-TVD,TEE-TVD and RVIT-TVD;while the RVOT-TVD was significant greater than that in the same group from other views (P ＜ 0.05).Comparison between the groups:no significant difference was found between mild and moderate regurgitation group on the same view.There was a significant difference of the TVD between the severe regurgitation group and the former two groups on each view(P ＜0.05).The severity of tricuspid regurgitation in intraoperative anesthesia was reduced.The saddle tricuspid ring evolved into the narrow planar structure on the RT-3D TEE.For the expansion of the annulus,it departure from the tricuspid septal leaflet.Conclusions TVD measured on the right ventricular outflow tract view reflect the maximum expansion of the tricuspid valve annulus diameter,and can effectively guide the decision-making choices of the surgeon.

To investigate the application of a recently developed metallic oxide semiconductor field effect transistor(MOSFET)detector for use in vivo desimetry.Methods The MOSFET detector was calibrated for X-ray beams of 8 MV and 15 MV,as well as electron beams with energy of 6,8,12 and 18 MeV.The dose linearity of the MOSFET detector was investigated for the doses ranging from 0 up to 50 Gy using 8 MV X-ray beams.Angular effect was evaluated as well in a cylindrical PMMA phantom by changing the beam entrance angle every 15?clockwise.The MOSFET detector was then used for a breast cancer patient in vivo dose measurement, after the treatment plan was verified in a water phantom using a NE-2571 ion chamber,in vivo measurements were performed in the first and last treatment,and once per week during the whole treatment.The measured doses were then compared with planning dose to evaluate the accuracy of each treatment.Results The MOSFET detector represented a good energy response for X-ray beams of 8 MV and 15 MV,and for electron beams with energy of 6 MeV up to 18 MeV.With the 6 V bias,Dose linearity error of the MOSFET detector was within 3.0% up to approximately 50 Gy,which can be significantly reduced to 1% when the detector was calibrated before and after each measdurement.The MOSFET response varied within 1.5% for angles firm 270?to 90?.However,maximum error of 10.0% was recorded comparing MOSFET response between forward and backward direction.In vivo mea surement for a breast cancer patient using 3DCRT showed that,the average dose.deviation between measurement and calculation was 2.8%,and the maximum error was less then 5.0%.Conclusions The new MOSFET detector,with its advantages of being in size,easy use,good energy response and dose linearity,can be used for in vivo dose measurement.

Objective To evaluate the diagnostic value of contrast-enhanced digital subtraction MRI in vertebra]metastatic tumors.Methods Forty-four vertebral metastatic tumors in thirty patients were scanned by routine MRI including SE T_1WI,SE T_2WI,STIR and enhanced T_1WI with an injection of Gd-DTPA(0.1 mmol/kg).Digital subtraction was performed between pre-contrast and enhanced T_1 weighted images.All the images of vertebral malignant tumors were evaluated by means of signal intensity ratio(SIR) and nose ratio(NR).The quality of images was also evaluated by comparing subtraction MRI with routine MRI.Results SIR and NR of subtraction MRI was 2.93,0.98 respectively.SIR of routine MRI (enhanced T_1WI,SE T_1 WI,SE T_2WI,STIR)was as follows:1.15,1.16,1.26,1.69.While NR of those was 5.25,3.44,4.56,23.32 respectively.SIR and NR of subtraction MRI images had significant statistical differences from those of routine MRI images(P

Air ; analysis ; Air Pollutants, Occupational ; analysis ; Chromatography, Gas ; methods ; Environmental Monitoring ; methods ; Toluene ; analogs & derivatives ; analysis ; Workplace