OBJECTIVETo evaluate the efficacy of Kirschner wires and tension-band fixation through posterolateral minimal incision for the treatment of displaced supracondylar humeral fractures in children.

METHODSFrom January 2005 to December 2010, there were 62 children (38 males and 24 females, ranging in age from 2 to 14 years, averaged 6.8 years) with Gartland type III supracondylar humeral fractures. All the injuries were caused by falling, and all the fractures were fresh injuries. The duration from injury to surgery ranged from 5 to 20 hours. All the children were treated with open reduction through a posterolateral minimal approach, Kirschnere wires and tension-band fixation were fixed with plaster at 90 degrees of elbow flexion, forearm supination, and palms facing upwards. The kirschner pins and wires were removed after fractures healing. The Flynn's criterion was used to evaluate therapeutic effects.

RESULTSThe operation time ranged from 30 to 50 min (averaged 45 min). All the patients achieved solid union. Sixty patients were followed up, and the mean follow-up time was 15 months (ranged from 6 to 24 months). At the 6th month after operation, 48 patients got an excellent result, 9 good, 3 bad (light cubitus varus with varus angle about 6 degree, without infection on function) according to Flynn's criteria. There were no complications such as procedure-related pin tract infection, iatrogenic nerve and vascular injuries and myositis ossificans.

CONCLUSIONThe Kirschner wires and tension-band fixation through posterolateral minimal incision approach can obtain clearer surgical field, simple in operation, and few wound complications. Therefore, this modified treatment is an effective and reliable method for pediatric displaced Gartland type III supracondylar humeral fractures.

Adolescent ; Bone Wires ; Casts, Surgical ; Child ; Child, Preschool ; Female ; Fracture Fixation, Internal ; methods ; Humans ; Humeral Fractures ; surgery ; Male ; Supine Position

Objective To explore the effect of different proportions of mixed blood exchange transfusion on blood circulation in neonates with hemolytic disease.Methods Thirty-one newborn infants with hemolytic disease were treated by peripheral arteriovenous synchronization of exchange transfusion with different proportions mixed blood.AB type plasma was mixed with O type red blood cell(RBC) washing.The proportion for the treatment group was 1:1(the O type RBCs 2 U:the AB type plasma 200 mL),by exchange transfusion of haplotypes,in accordance with 80?mL/kg;the proportion for control group was 2:1(the O type RBC 4 U:the AB type plasma 200 mL),by exchange transfusion of double in accordance with 150-180 mL/kg.The indicators were detected,such as the exchange rate of neonatal serum bilirubin,RBC,hemoglobin(Hb),hematocrit(HCT),and the exchange transfusion quantity and days of hospitalization before and after the exchange transfusion were analyzed.Results The exchange rate of serum bilirubin of treatment group and control group was (44.92?3.99)% and (45.69?5.06)%,respectively,there was no significant difference between 2 groups(P=0.639),there was no significant difference of hospitalization days[(8.13?1.13) d vs(8.19?0.91) d]between 2 groups(P=0.884).After exchange transfusion in treatment group,the average level of the RBC,Hb and HCT were increased(P

OBJECTIVETo investigate the feasibility and clinical significance of posterior vertebra column resection and reconstruction in the treatment of severe kyphosis.

METHODSWe retrospectively analyzed the clinical data of 12 patients with severe kyphosis who received posterior vertebra column resection and reconstruction from January 2003 to July 2007.

RESULTSThe mean operation time was 5.0 h (4.0 - 7.8 h) and the evaluated blood loss during operation was 1 800 ml (800-3,000 ml). No neurologic complications or post-operative infections were noted. The patients became ambulatory 8 days after operation. Before operation, 5 patients were found to have neurological deficit, including Frankel grade A in 1 patient and D in 4 patients. After operation, the grades were all recovered to Frankel E. After operation, the Cobb angle of the kyphosis was corrected to 38 degrees, with an average correction rate of 63%.

CONCLUSIONSPosterior vertebra column resection and reconstruction may be a safe and effective technique for the treatment of severe kyphosis. It can fully decompress the neurological structures, correct the kyphosis deformity, and achieve early weight-bearing. It is especially useful to avoid neurological injury.

Adolescent ; Adult ; Female ; Humans ; Kyphosis ; surgery ; Male ; Middle Aged ; Osteotomy ; methods ; Reconstructive Surgical Procedures ; methods ; Retrospective Studies ; Spine ; surgery ; Treatment Outcome ; Young Adult

OBJECTIVETo compare the results of endoscopic surgical decompression of carpal tunnel release (CTR) with open CTR in patients with idiopathic carpal tunnel syndrome (CTS).

METHODSForty patients with CTS were randomly chosen for a prospective study from April 2000 to August 2002. Endoscopic CTR was performed in 23 CTS patients (26 sides) and open CTR was performed in 17 CTS patients (21 sides). Five parameters were evaluated, including each patient's symptom amelioration, complication, operation time, hospitalization time, and the time needed to resume normal lifestyle. The mean follow-up time was 2 years.

RESULTSNo significant difference was observed between the endoscopic CTR group and open CTR group in regard to symptom amelioration, electromyographic testing, and complications. In comparison to open CTR, endoscopic CTR significantly decreased operation time, hospitalization time, and the time needed to resume normal lifestyle and activity (P < 0.01).

CONCLUSIONCompared with open CTR, endoscopic CTR has the advantage of reduced pain of scar and shortened time of hospitalization and recovery. It is a safe and effective method for treating idiopathic CTS.

Adult ; Aged ; Arthroscopy ; methods ; Carpal Tunnel Syndrome ; surgery ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Prospective Studies ; Recovery of Function ; Wrist ; surgery

Long non-coding RNAs(lncRNAs) defined as RNAs of more than 200 nucleotides in length don't en-code protein but are closely related to the development of breast cancer.Plenty of lncRNAs are dysregulated in breast cancer,and they can regulate the invasion and metastasis of breast cancer through various mechanisms such as transcription and post-transcriptional regulation which is greatly important to guide the treatment and prognosis of breast cancer.

Adolescent ; Female ; Humans ; Scoliosis ; congenital ; etiology ; surgery ; Spinal Fusion ; Spine ; abnormalities ; surgery

OBJECTIVETo investigate the correlation between subaxial cervical spine instability and cervical spondylotic sympathetic symptoms as well as the difference of cervical spondylotic subaxial instability between male and female patients.

METHODSWe analyzed retrospectively 318 surgical cases of cervical spondylosis treated at Department of Orthopedic Surgery of Peking Union Medical College Hospital between July 2003 and December 2007. All cases were divided into group A without sympathetic symptoms (n=284) and group B with sympathetic symptoms (n=34). Angular and horizontal translation values between two adjacent vertebral bodies from C2 to C7 were measured separately on hyperflexion and hyperextension lateral cervical spine radiographs. Fisher's exact test was used to evaluate the correlation between subaxial cervical instability and sympathetic symptoms. Intragroup correlation between patient gender and subaxial cervical instability was also evaluated.

RESULTSSubaxial instability incidences in groups A and B were 21.8% (62/284) and 55.9% (19/34), respectively. Statistical analysis indicated a definite correlation between subaxial cervical instability and sympathetic symptoms (P=0.000). Among patients without sympathetic symptoms, subaxial instability incidences were 21.4% (37/173) in males and 22.5% (25/111) in females, respectively (P=0.883). While among patients with sympathetic symptoms, subaxial instability incidences were 27.3% (3/11) in males and 69.6% (16/23) in females, respectively, indicating significant difference (P=0.030). Subaxial instability was most commonly seen at C4-C5 intervertebral space in sympathetic cervical spondylosis patients.

CONCLUSIONSHigh correlation exists between subaxial cervical spine instability and cervical spondylotic sympathetic symptoms, especially in female patients. Hyperextension and hyperflexion radiographs of cervical spine are important to assess sympathetic cervical spondylotic subaxial instability.

Cervical Vertebrae ; diagnostic imaging ; pathology ; Female ; Humans ; Male ; Middle Aged ; Radiography ; Retrospective Studies ; Sex Characteristics ; Spine ; diagnostic imaging ; pathology ; Spondylosis ; diagnostic imaging ; pathology

Objective To observe the effects of cell cycle inhibitor on astrocytic proliferation and scar formation and to study neuronal apoptosis after focal cerebral ischemia in rats.Methods Ischemic model was established by photochemistry method.T_2-weighted MRI was performed on the 3rd, 7th, and 30th day after focal cerebral ischemia.The expression of glial fibrillary acidic protein(GFAP)and apoptosis was observed by immunofluorescence.The protein levels of GFAP and proliferation cell nuclear antigen (PCNA), CyelinA and CyclinB1 were measured by Western blotting from the ischemic and sham animals finished on the 3rd, 7th, and 30th day.Results A marked and significant reduction of brain infarction volume was found in Olomoucine-treated ischemic animals(2.27%?0.28% , 1.87%?0.19%, 1.08%? 0.18%)as compared with controls(5.10%?0.35%, 4.60%?0.26%, 3.96%?0.28%, P

Objective:To assess the degree of labor pain at the time of intraspinal labor analgesia in women influencing the incidence of cesarean delivery.Methods:Five hundred and ninety patients were enrolled in the study and divided into 3 groups in the light of numeric rating scale (NRS).The woman was with singleton pregnancies, with cervical dilatation of less than 4 cm and vertex fetal presentations.Namely, L group:1-4;M group:5-7;H group:8-10, respectively.The EA procedure was performed at the lumbar spine between 2-3 or 3-4.We inserted a catheter into the epidural space started with 1.0% carbonated Lidocaine to make the volume 5 mL.After the block plane arising, injected a mixture of 0.1% Ropivacaine co-administered with 5 μg of Sufentanil to make the total volume 10 mL in all cases, and connected the patient controlled epidueal analgesia (PCEA) thirty minutes later.The CSEA procedure was started with an intrathecal standard mixture of 0.1% Ropivacaine co-administered with 3 μg of Sufentanil to make the total volume 3 mL in all cases, then connected the PCEA ninety minutes later.To observe and record the NRS score when analgesia was performed.The time of the first stage of labor, the time of the second stage of labor and the way of delivery were recorded in our study respectively.Results:There was no statistically significant differences among the three pain groups in the NRS score after 30 min, dilatation, duration of first stage of labor and duration of second stage of labor, respectively.There was no statistically significant differences among the three pain groups in the incidence of instrumental delivery and cesarean delivery.Conclusions:There is no effect of the degree of labor pain at the time of intraspinal labor analgesia in women on the incidence of cesarean delivery.

The limitation of traditional Ad vectors result in wide application of capsid-incorporation of antigens into adenovirus capsid proteins, but usually it can't rescue virus successfully when we engineered the hypervariable regions (HVRs) of hexon in adenovirus serotype 3(Ad3) vector. So we deleted or retained some amino acids in HVR1, HVR2, HVR5, HVR7 predicted by bioinformatics, constructed recombinant Ad3 vector pBRAddeltaE3GFP-mHexon, and transfected it into AD293 cell to confirm the influence on the virus rescue. These data of amino acids that can be deleted or retained in the HVRs of Ad3 vector should provide operating foundation for antigen capsid-incorporation strategy in human adenovirus serotype 3, and also lay the groundwork for application of expressing foreign antigens in the hexon of human adenovirus serotype 3 as a platform of multivalent vaccine vectors.
Adenoviruses, Human ; genetics ; immunology ; Amino Acid Sequence ; Cell Line ; Computational Biology ; DNA, Recombinant ; genetics ; Genetic Engineering ; methods ; Genetic Vectors ; genetics ; Humans ; Models, Molecular ; Molecular Sequence Data ; Plasmids ; genetics ; Protein Conformation ; Species Specificity ; Viral Envelope Proteins ; chemistry ; genetics ; immunology