Objective To study whether closed reduction and interlocking intramedullary nailing will worsen the injured radial nerve associated with the fracture of humeral shaft.Methods Of the 353 patients with fracture of humeral shaft who received operation from January 2002 to January 2005,63 ones were complicated with preoperative injury to their radial nerve.A retrospective analysis was done of their physical examination records, operative records,X-ray films and results of the treatment.Eleven cases were treated with closed reduction and interlocking intramedullary nailing,and 52 cases with open reduction and internal fixation of plates and screws fol- lowed by exploration to the radial nerve.Chisquare test of PEMS 3.1 system was adopted to analyze the clinical data. Results The radial nerve was embedded by the fracture ends in nine cases(17.3%)of the 52 cases,and con- tused in the other 43 ones.In the 63 cases,The injured nerves recovered spontaneously 2 to 12 weeks postoperatively except in twn cases.All the eases got bony union 3 to 4 months after operation.Closed reduction and interlocking intramedullary nailing has hardly more harmful effects on the injured radial nerve assoeiated with the fracture of humeral shaft than open reduction and internal fixation of plates and screws followed by neural exploration.Con- clusion Closed reduction and interlocking intramedullary nailing is fit for the freatment of fractures of humeral shaft with radial nerve injury.

Arthroplasty, Replacement ; Elbow Joint ; injuries ; surgery ; Humans ; Joint Instability ; therapy ; Tennis Elbow ; therapy

Total elbow arthroplasty was initially used to manage the rheumatoid arthritis of elbow. With the developement of technology in recent decades, the indication of total elbow arthroplasty include the trauma associated unstable joint, traumatic arthritis and distal humerus fractures in elderly. But the high risk of complications, which includes infection, ulnar nerve deficit and tricep insufficiency, is still an unsolved issue. The most widely used approach nowadays is the Bryan-Morrey approach, while some authors also report triceps on approach recently. This article is an overview in approaches and biomechanical researches of total elbow arthroplasy by reviewing the domestic and overseas involved literatures.
Arthroplasty, Replacement, Elbow ; adverse effects ; methods ; Humans ; Muscles ; physiopathology ; Recovery of Function ; Ulnar Nerve ; injuries

Objective To establish a method for the determination of berberine and salvianolic acid B in Fuyankang En- ema.Methods The chromatograhie separation was performed on a Kromasil C_(18) column (250 mm?4.6 mm,5?m) with a gradient elution of acetonitrile-0.04 mol/L potassium dihydrogen phosphate solution containing 0.1% phosphoric acid.The flow rate was 1.0 mL/min and column temperature was set at 30℃.The detection wavelength was 230 nm.Results There was a good linearity in the range of 0.0924～2.3100?g (r=0.999 9) for berbeine,and 0.1000～2.5000?g (r=0.999 9) for salvianolic acid B.The average recoveries of berberine at high,middle and low concentra- tions were 100.40 %,99.51% and 99.15 % respectively with RSD being 0.59 %,0.67 %and 1.02 % (n=3) re- spectively.The average recoveries for salvianolic acid B were 101.52 %,99.32 % and 98.68 % respectively with RSD being 0.60 %,0.92 % and 1.00 % (n=3),respectively.Conclusions This method is convenient,specific and re- producible for the determination of berbeine and salvianolic acid B in Fuyankang Enema by HPLC.

Objective:To evaluate the role of hemopexin (HPX) in cerebral ischemia-reperfusion (I/R) injury in rats.Methods:One hundred and twenty healthy male Sprague-Dawley rats, aged 7-8 weeks, weighing 250-280 g, were divided into sham operation group (S group, n=36), cerebral I/R group (I/R group, n=36), vehicle group (V group, n=24), and HPX group ( n=24). The model of cerebral I/R injury was established by 120 min middle cerebral artery occlusion followed by reperfusion in anesthetized rats.At 6, 12 and 24 h of reperfusion, 4 rats in S group and I/R group were sacrificed, and the ischemic penumbra of the ipsilateral cerebral cortex was obtained to detect the expression of HPX by Western blot.In I/R, V and HPX groups, 0.9% normal saline 10 μl, 0.1% NaN 3 10 μl, and 1.86 mg/ml HPX 10 μl were injected into the lateral ventricle, respectively, immediately after reperfusion.Eight rats in each group were selected, and neurological deficit was scored at 1-7 days of reperfusion.Eight rats in each group were sacrificed at 1 and 7 days of reperfusion, brains were removed, and brain tissues were obtained for measurement of infarct size, and the percentage of infarct size was calculated. Results:Compared with S group, the expression of HPX in cerebral ischemic penumbra was significantly up-regulated at 24 h of reperfusion in I/R group, and the neurological deficit scores were significantly decreased at 1-7 days of reperfusion, and the percentage of cerebral infarct size was increased at 1 and 7 days of reperfusion in I/R, V and HPX groups ( P<0.05). Compared with I/R group, the neurological deficit scores were significantly increased at 1-7 days of reperfusion, and the percentage of cerebral infarct size was decreased at 1 and 7 days of reperfusion in HPX group ( P<0.05), and no significant change was found in the above indicators in V and I/R groups ( P>0.05). Conclusion:Up-regulation of HPX expression is the endogenous protective mechanism of cerebral I/R injury in rats.

AIM: To explore the immunity modulation function of aqueous of Forsythia suspense (AFS) and its possible mechanisms. METHODS: Rats of burned model group were burned with vapor under 3mpa pressure and 108℃ temperature for 8 seconds to achieve deep partialthickness bum, to make a thirty percent total body surface area (TBSA)bum. The experiment were divided into five groups: Control group: without any treatment; 8 PBH group: 8 h after burn; the rats of AFS1 guoup, AFS2 group and AFS3 group of them were given AFS 5 g/kg, 2.5 g/kg, 1.25 g/kg once a day by Po. pathway for seven days before burns, respectively. Rats were sacrificed before and 8h after burn, The percentage of Treg cells in CD4~+ T cells was detected by flow cytometry(FCM) ; the expression of Foxp3 mRNA on splenocytes were measured by RT-PCR, and the protein of Foxp3 activity was evaluated by immunohistochemistry staining. RESULTS: Compared with Control group, the expression of Foxp3mRNA and protein on the splenocytes were upregulated markedly(P <0.01), and the percentage of Treg were significantly increased (P < 0.01) in the 8PBH group. AFS1, AFS2 and AFS3 significantly attenuated these increases (P < 0.01), which was dose-dependent. CONCLUSION: AFS has immunity modulation function and mechanism of it is corrected with Foxp3 mRNA on splenocytes.

Medicine, Chinese Traditional ; methods

Arthroplasty, Replacement ; Elbow Joint ; injuries ; surgery ; Fractures, Bone ; therapy ; Humans ; Joint Dislocations ; therapy

Child ; Fracture Fixation ; methods ; Humans ; Humeral Fractures ; surgery

OBJECTIVETo explore clinical effects of three nonparallel screws in treating femoral neck fractures.

METHODSFrom September 2008 and May 2009, 29 patients were treated, including 12 males and 17 females with an average age of 52 years (ranged from 27 to 62 years). Before operation, according to Garden classification system, 2 cases were Garden type II (undisplaced fracture), 18 cases were Garden type III (partial displaced fracture) and 9 cases were Garden type IV (complete displaced fracture). After fracture reduction in operation, Pauwels classification system was used to classify the type, and 12 cases were type II, 17 cases were type III Closed reduction and internal fixation with three non-parallel screws were used to treat. The surgery X-ray and follow-up X-ray were compared to observe whether femoral neck abbreviate and screw exit appeare. Harris scoring was used to evaluate function.

RESULTSAll patients were followed-up from 34 to 44 months with an average of 38 months. The mean time of bone union was 7 (ranged, 3 to 12) months. Nonunion occured in 4 cases with Garden IV, and femoral head necrosis occurred in 2 cases. For Harris scoring, two cases with nondisplaced fracture were 100. Among 27 cases with displaced fractures, 23 cases achieved bone union without femoral head necrosis, average Harris scale was 91.35 +/- 8.00, and the average Harris scale of 4 cases with bone nonunion was 61.23 +/- 5.12. For all but one, there was no femoral neck crispation after bone union.

CONCLUSIONNonparallel screws for femoral neck fractures can effectively control abbreviation and screw tail exit after fracture healing.

Adult ; Bone Screws ; Female ; Femoral Neck Fractures ; diagnostic imaging ; surgery ; Follow-Up Studies ; Fracture Fixation, Internal ; instrumentation ; Humans ; Male ; Middle Aged ; Tomography, X-Ray Computed