OBJECTIVE:To observe clinical efficacy and safety of Xianlinggubao combined with alendronate sodium in the treatment of osteoporosis. METHODS:112 patients with osteoporosis were randomly divided into treatment group and control group with 56 cases in each group. Both group were given routine treatment as calcium carbonate,vitamin D and life style. Control group were given alendronate sodium 10 mg orally,qd;treatment group was additionally given Xianlinggubao capsule 1.5 g,bid, on the basis of control group. Both groups received 12 weeks of treatment. The levels of S-Ca,S-P,24 h urinary calcium(U-Ca), alkaline phosphatase(ALP),osteocalcin,IL-6,bone mineral density(BMD)of L2-4 lumbar spine and femoral neck were observed in 2 groups before and after treatment. Clinical efficacy and toxic reaction were compared. RESULTS:There was no statistical sig-nificance in the levels of S-P and S-Ca between 2 groups after treatment(P>0.05);the level of ALP、osteocalcin、BMD increased in treatment group after treatment,the level of U-Ca and IL-6 decreased compared to before treatment,and the treatment group was better than the control group,with statistical significance(P<0.05). Total effective rate of treatment group(92.86%)was sig-nificantly higher than that of control group (73.21%),with statistical significance (P<0.05). No obvious toxic side effects was found in 2 groups. CONCLUSIONS:Xianlinggubao combined with alendronate sodium shows significant therapeutic efficacy for patients with osteoporosis with good safety.

Objective:To compare the effects of the fracture line direction in the sagittal profile on the Gartland type Ⅲ supracondylar humerus fractures in children.Methods:A total of 153 cases of Gartland type Ⅲ supracondylar humerus fractures treated in the Department of Pediatric Orthopedics, Qilu Hospital of Shandong University (Qingdao) from January 2017 to April 2019 were retrospectively analyzed.They were categorized into the traditional oblique type (the fracture line went downward in the front and upward in the back), transverse type (the fracture line went horizontally) and reverse oblique type (the fracture line went upward in the front and downward in the back). Gender, age, injury side, cause of injury, ecchymosis before elbow, preoperative neurological symptoms, operation time, incision ratio, and Flynn scores of the elbow joint at the last follow-up were compared among the 3 groups.Results:Patients were followed up for (8.65±2.47) months (6-15 months). There were 60, 64 and 29 patients in the traditional oblique type, transverse type and reserve oblique type groups, respectively.There were no differences in the gender, injury side, and injury causes among the 3 groups (all P>0.05). The age of the traditional oblique type, transverse type and reverse oblique type group were (4.76±2.51) years, (4.71±2.09) years and (6.32±1.98) years, respectively, which was significant different among the 3 groups ( F=5.826, P<0.05). There were 10, 7 and 11 cases of preoperative elbow ecchymosis occurred in children of the traditional oblique type, transverse type and reverse oblique type groups, respectively, which was significant different ( χ2=9.902, P<0.05). No significant differences were found in preoperative neurological symptoms of the 3 groups ( P>0.05). The operative time for the traditional oblique type, transverse type and reverse oblique type group were (43.28±24.25) min, (40.95±27.41) min and (58.66±34.08) min, which was significant different ( F=4.337, P<0.05). The traditional oblique type and transverse type groups had 1 failure case of closed reduction, respectively, and the incision was performed during the operation.There were 4 cases in the reverse oblique type group who underwent the open reduction.The reduction rate was significantly different among 3 groups ( χ2=6.883, P<0.05). There was no significant difference in the excellent to good rate of traditional oblique type (96.67%, 58/60 cases), transverse type(95.31%, 61/64 cases)and reserve oblique type (93.10%, 27/29 cases) among 3 groups ( P>0.05). Conclusions:The reverse oblique Gartland type Ⅲ supracondylar humerus fractures are relatively rare in clinical practice, which involves more severe soft tissue damages and more obvious antecubital ecchymosis.The conventional reduction methods seem to be ineffectual for the reverse oblique supracondylar humerus fractures.

Objective:To construct the intracranial venous sinus thrombosis (CVST) models under plateau hypoxia by simulating plateau hypoxic condition, and further clarify the role of plateau hypoxa in CVST.Methods:Forty-eight 8-week-old male SD rats were randomly divided into sham-operated group, plateau sham-operated group, CVST group, and plateau CVST group ( n=12). CVST models in the CVST group and plateau CVST group were established by ferric chloride wet dressing, and rats in the plateau CVST group were kept in a low-pressure oxygen chamber for 2 d immediately after modeling to simulate plateau hypoxic condition at an altitude of 5,000 m (barometric pressure of 54.047 kPa, oxygen concentration of 10%-11%, and temperature of 18-23 °C). Only the bone flap and dura mater were separated in rats of the sham-operated group, without low-pressure oxygen condition or filter paper dressing. Only the bone flap and dura mater were separated in rats of the plateau sham-operated group, with plateau hypoxic condition at an altitude of 5,000 m for 2 d and without filter paper dressing. Intracranial venous sinus blood flow was detected by Doppler flowmetry before and 48 h after modeling. At 6, 24, and 48 h after modeling, 4 rats in each group were sacrificed; blood vessels at the thrombus of superior sagittal sinus (blood vessels at the superior sagittal sinus in the sham-operated group and plateau sham-operated group) were cut out and weighed; meanwhile, water contents of the brain tissues were calculated. HE staining was employed in the brain, heart, liver, lung, and kidney tissues and veins, and toluidine blue staining was peformed in the brain tissues only at 48 h after modeling. Results:(1) Doppler flowmetry indicated that intracranial venous sinus blood flow was normal in the 4 groups before modeling; intracranial venous sinus blood flow signals were normal in the sham-operated group and plateau sham-operated group and obviously weakened in the CVST group and plateau CVST group 48 h after modeling. (2) No thrombus was formed in the sham-operated group 48 h after modeling. At 6, 24 and 48 h after modeling, the thrombus in the CVST group ([15.44±1.90] mg, [12.63±1.26] mg, and [7.85±0.68] mg) and plateau CVST group ([20.38±1.67] mg, [24.93±2.37] mg, and [20.90±1.30] mg) weighted significantly heavier than those in the plateau sham-operated group ([2.55±0.38] mg, [2.19±0.30] mg, [1.75±0.31] mg), and that in the plateau CVST group weighted significantly heavier than that in the CVST group ( P<0.05); the thrombus weight in both plateau sham-operated group and CVST group decreased sequentially at 6, 24 and 48 h after modeling, with significant differences ( P<0.05); whereas, the thrombus weight in the plateau CVST group at 24 h after modeling increased compared with that at 6 h after modeling, and that at 48 h after modeling decreased compared with that at 24 h after modeling, with significant differences ( P<0.05). (3) At 6 h after modeling, the brain water contents in the sham-operated group, plateau sham-operated group, CVST group and plateau CVST group were (77.56±0.52)%, (77.57±0.92)%, (78.91±0.53)%, and (78.90±0.63)%, respectively, with statistical differences ( P<0.05); the CVST group and plateau CVST group had increased water content compared with the sham-operated group and plateau sham-operated group without significant differences ( P>0.05). At 24 and 48 h after modeling, the brain water content among the 4 groups was not statistically different ( P>0.05). (4) HE staining and toluidine blue staining indicated limited infarction, neuronal edema, and necrotic apoptosis in the brain tissues of plateau CVST group at 24 h after modeling. HE staining showed no obvious pathological changes in the myocardium, liver, lung, or kidney tissues in the 4 groups. Conclusion:CVST models can be successfully established by simulating plateau hypoxic condition through ferric chloride wet dressing and feeding in low-pressure oxygen chamber.