OBJECTIVETo explore the improvement of the method for the treatment of supracondylar fractures of humerus in order to prevent and decrease the occurrence of cubitus varus.

METHODSOne hundred and ninety-seven patients with supracondylar fractures of humerus included 167 males and 30 females with an average age of 8.7 years old ranging from 3 to 12 years. There were 179 cases of extention and 18 cases of flexion. Six cases were open fractures. Thirty-four patients of fractures underwent fixation by only plaster slab, 53 underwent manipulative reduction and fixation by plaster slab, 23 underwent traction reduction and fixation by plaster slab, 87 underwent surgical operation. Among the cases of operation, 29 cases adopted anterior-lateral incision of elbow and 85 adopted posterior-interior incision of elbow.

RESULTSAmong the 197 cases, 191 cases were followed up for 1 to 5 years with an average of 3.7 years. According to the correlated curative effect evaluation of supracondylar fractures of humerus, the results were excellent in 142 cases, good in 27, fair in 13, poor in 9. Cubitus varus occurred in 8 cases.

CONCLUSIONThe objective factors for the occurrence of elbow varus do exist. However, during the treatment of these fracture, if strict correction of the ulnar deviation and stability are maintained during the reduction, the rate of occurrence of elbow varus could made to decreased a minimum.

Child ; Child, Preschool ; Elbow ; physiopathology ; Female ; Fracture Fixation ; methods ; Humans ; Humeral Fractures ; complications ; surgery ; Male ; Muscle, Skeletal ; physiopathology ; Postoperative Complications ; Treatment Outcome

Objective To identify the glycometabolism features ofC57BL/Ksj db/+ mice at gestational period and provide the evidence for the mice used as the animal model of gestational diabetes mellitus (GDM).Methods Ten C57BL/Ksj db/+ female mice and ten wild female mice were randomly selected and mated with wild male mice respectively.Day 3 before mating,days 6,11 and 17 of pregnancy,and day 6 after delivery represented pre pregnancy,early-pregnancy,mid-pregnancy,late-pregnancy and post-pregnancy periods,respectively.The levels of glucose tolerance and fasting insulin of female mice were compared at progestation,different gestational periods and puerperium between the two groups.Days 6,11,14,17 and 20 (before labor) of pregnancy served as five time-points of pregnancy,leptin levels of female mice of the two groups were dynamically monitored during pregnancy,and analyzed at different gestational ages.The data were analyzed by Tukey test of one-way ANOVA.Results (1) Compared with the normal pregnant mice,the levels of glucose tolerance of C57BL/Ksj db/+ female mice were significantly decreased,while the levels of fasting insulin were dramatically increased with the progression of pregnancy [day 6 of pregnancy,(8.6 ± 0.6) mU/L vs (7.5 ±1.1) mU/L; day 11 of pregnancy,(9.8±0.6) mU/L vs (8.5± 1.1) mU/L; day 17 of pregnancy,(10.4±0.8) mU/L vs (9.9±0.5) mU/L; t=1.859,4.056 and 3.078,P=0.085,0.000 and 0.000] and recovered to the pre-pregnancy level after delivery.(2) The level of leptin in serum of C57BL/Ksj db/+ pregnant mice was significantly higher than that at non-pregnant period [pre-pregnancy and days 6,11,14,17 and 20 of pregnancy:(911.0±238.8) ng/L,(1 342.2± 132.3) ng/L,(1 821.9±238.2) ng/L,(1 816.3± 142.3) ng/L,(1 752.4± 126.6) ng/L,and (1 926.4±61.6) ng/L,respectively; t=3.887,8.210,8.161,7.585 and 9.153,P=0.005,0.000,0.000,0.000 and 0.000],but showed no apparent change with the gestational ages after mid-gestation.Conclusion Changes of glycometabolism and the levels of leptin and insulin of C57BL/Ksj db/+ pregnant mice during pregnancy are similar to those of GDM patients,the levels of fasting insulin are dramatically increased with the progression of pregnancy,and return to normal after delivery,the level of leptin is higher than that at non-pregnant period,but is not correlated with the gestational ages.C57BL/Ksj db/+ pregnant mice can be used as the animal model of GDM.

This study was aimed to evaluate the clinical effect of 66 yin-deficiency acne cases treated with body constitution adjustment using acupuncture and moxibustion. In this research, 66 acne patients with the body con-stitution of yin-deficiency were selected . These patients were randomly divided into two groups ( 33 every group ) . The acupuncture treatment group was treated by acupuncture and local treatment. And moxibustion treatment group was treated by indirect moxibustion and local treatment. The treatment was given twice a week. And the improvement condition of acne skin lesions and yin-deficiency body constitution were evaluated after 12-week treatment. The results showed that certain curative effects were received in both groups. However, the moxibustion treatment group had higher curative effect compared with the acupuncture treatment group. There were significant statistical differences between two groups ( P < 0 . 05 ) , which meant moxibustion with local treatment had a higher curative effect than acupuncture with local treatment to acne. In the aspect of skin lesion improvement, according to the statistics, the moxibustion treatment group were statistically significant compared with acupuncture group (P< 0.05), which meant more obvious improvement of skin in the moxibustion treatment group. In the aspect of body constitution, the body constitution scores in both groups were significantly declined and the moxibustion treatment group was more obvious. There was statistical significance between two groups (P < 0.05), which meant patients in the moxibustion treatment group obtained a more obvious body constitution improvement. After the treatment, follow-up was given to all patients for 4 weeks. The results showed that both the acne skin lesion con-dition and yin-deficiency body constitution score were decreased and not achieve the recurrence diagnostic stan-dard. It showed that acupuncture and moxibustion are able to activate the self-regulation and disease resistibility of the body. It was concluded that acupuncture and moxibustion not only improve skin lesion of acne patients with the body constitution of yin-deficiency with inner heat , but also regulate yin-deficiency body constitution . Moxibustion had higher efficacy in the treatment of yin-deficiency with inner heat acne than acupuncture.

In order to identify host factors which interact with the movement protein (MP) of Apple chlorotic leaf spot virus (ACLSV), ACLSV MP was cloned into the bait vector pGBKT7 and used to screen a cDNA library of Malus sylvestris cv. R12740-7A, which had previously been constructed by yeast two-hybrid sequencing transformation. The protein functions of the identified host factors were determined according to their gene annotations in GenBank. The result showed that the bait plasmid pGBKT7-MP showed no virulence or self-activating effect on yeast strain Y2H Gold. Sixty-nine interactor proteins were identified, which were divided into the following 10 classes according to their described functions: hydrolases; pathogenesis-related proteins; DNA binding proteins; phosphatases; ligases; proteins with catalytic activity; phenylalanine ammonialyases; peroxidases; NAD binding proteins; and proteins of unknown function. Bioinformatic analysis of gene homology suggested that phosphatases, pathogenesis-related proteins and glyceraldehyde-3-phosphate dehydrogenase A may play an important role in the interaction between virus and host. This study may provide a theoretical basis for the further study of viral pathogenesis and virus-host interaction mechanisms.
Flexiviridae ; genetics ; metabolism ; Malus ; genetics ; metabolism ; virology ; Molecular Sequence Data ; Plant Diseases ; genetics ; virology ; Plant Proteins ; genetics ; metabolism ; Plant Viral Movement Proteins ; genetics ; metabolism ; Protein Binding ; Two-Hybrid System Techniques

Aim To investigate the change of coagulation and fibrinolysis functions of human microvascular endothelial cells (HMEC) induced by activated complement alternative pathway and effect of pyrrolidine-dithiocarbamate (PDTC) and resveratrol (Res) on intervention.Methods Normal human serum was activated by cobra venom factor (CVF).After exposure of HMEC to activated complement for various time points, supernatant was removed and assayed for activities of hydrolysing chromogenic substrate and affecting activated partial thromboplastin time (APTT) and prothrombin time (PT).The cells exposed to activated complement were collected and washed, and then the cell suspension was assayed for activity of affecting coagulation function of normal plasma.Lastly, the coagulation and fibrinolysis functions of HMEC pretreated with PDTC and Res were also investigated after HMEC was exposed to activated complement alternative pathway.Results The hydrolysis activity of chromogenic substrate of supernatant was up-regulated significantly after HMEC exposed to activated complement alternative pathway.The supernatant induced APTT decreased significantly, and also shortened PT.The cell suspension of various time points induced APTT decreased significantly, and also shortened PT by suspension of 6 h time point.PDTC and Res failed to inhibit the up-regulation of the chromogenic hydrolysis activity, but Res showed significant intervention on decrease of APTT, and PDTC had better effect on inhibiting the decrease of PT than that of Res.Conclusion Activated complement alternative pathway can induce abnormality of coagulation and fibrinolysis functions of HMEC, and PDTC and Res can affect this change.

Objective To investigate the score changes of graduates majoring in clinical medicine after using the method of “role of identification”. Methods Sixty students who were undertaking internship in Endocrinology Department of Shanghai Traditional Chinese Medicine Hospital received three-week clinical teaching and examination. Then they got into one-week “role of identification”, and were appointed as clinical teachers to teach what they have learned during the last 3 weeks to the next batch of interns and make another examination. Scores of the two examinations were compared. Results Scores of the examination after received the method in“role of identification”improved significantly (P<0.01). Conclusion The method of“role of identification”can enhance clinical medicine graduates’ mastery of professional knowledge.

Objective To analyze the difference and correlation of the evaluation of the medical students' communication ability between the examiners,standardized patients (SP) and medical students themselves in objective structured clinical examination (OSCE),and to provide scientific basis for the appropriate evaluation method of medical students' communication ability.Methods OSCE was used to evaluate the communication ability of 90 medical students in Daping Hospital,Chongqing,and the three parties were evaluated by the examiners,SP and medical students themselves.Excel and SPSS 17.0 statistical analysis software were used,through Friendman M.test,t test and correlation analysis to analyze the differences and correlation of the three parties evaluations.Results The different evaluation between the three parties on the communication ability of medical students was as follows.Examiner's evaluation was the lowest (8.39 ± 1.18),SP's evaluation was the highest (9.62 ± 0.73),Medical students themselves' evaluation was higher (9.28± 1.09);The examiner's evaluation of Medical students' empathy,verbal communication ability,nonverbal communication ability and etiquette was lower (P=0.00).The correlation analysis of the three parties' evaluation showed that there was a significant correlation between the three parties on the connnunication ability,empathy and nonverbal communication ability (P＜0.05).The evaluation of SP and medical students themselves on medical students' language communication ability and etiquette was significantly correlated (P＜0.05).Conclusions Using examiner or SP or medical students themselves only to evaluate the communication ability of medical students is not accurate,The Examiner and SP as the main trial test personnel should collaborate to evaluate medical students' communication ability.The examiner can evaluate three projects such as what is medical ethics and law,empathy,nonverbal communication ability,while the SP can evaluate the two projects:what is language communication ability and etiquette.The collaborative evaluation of the two sides can be more accurate to reflect the doctor-patient communication ability of medical students.

Objective To investigate the changes of serum copper in mice after whole-body irradiation and analyze the feasibility of these changes as a biological dosimeter.Methods Serum copper in mice exposed to 60 Co γ-rays(0,1,2,3,5 Gy) was collected from the orbital of mice and detected with 5-Br-PADAP colorimetric method at 30 min and 7 d after radiation.One-way analysis of variance was used to analyze the difference of serum copper in each group and Dunnett-t test was used to compare the difference between control group and irradiated groups.Linear and quadratic linear fitting function was used to analyze the relationship between serum copper and radiation dose.The change of serum copper was detected at 30 min,1,3,5,7,10,13 and 16 d after radiation to observe the persistence of serum copper.The established relationships were used to estimate the dose in 8 mice irradiated by a blind dose.Results The amount of serum copper in irradiated mice were significantly (F =208.20,145.98,P ＜ 0.05)dependent on the radiation doses with dose responses of y =-0.091x + 0.936 and y =-0.011x2-0.032x + 0.962 (r =0.989,0.995) at 30 min and 7 d post-irradiation,respectively.The concentration of serum copper at 2.0 Gy decreased at 30 min post-irradiation,increased at 1-7 d,then kept at a stable level at 7-14 d even increased slightly after 14 d.With these dose response curves,after radiation with a blind dose of 2 Gy,the absorb doses of mice were assessed to be (1.83-2.25) Gy and (1.82-2.11) Gy at 30 min and 7 d in 95％ confidence interval,respectively.Conclusions The serum copper is a quick,simple,and sensitive biomarker for the early assessment of absorb dose of irradiated mice.

Objective To evaluate the practicability of using flow cytometry analysis for diagnosis of non-hodgkin′s lymphoma ( NHL) among children with serous effusion.Methods Twelve children who were diagnosed with malignant lymphoma from February 2011 to November 2013 at Shanghai Children′s hos-pital were recruited in this study.Pleural effusion and ascites samples were collected from those children who showed serous effusion as initial symptoms and analyzed by using flow cytometry based immunophenotyping. The antibodies used for immunophenotyping included CD45, CD10, CD33, CD7, CD1a, MPO, cCD3, CD79a, CD22, CD19, CD20, CD5, CD3,κ,λ,αβ,γδ,CD56 and other common markers for T, B and NK cells.Anti-CD30 antibody was used when necessary.Results All of the twelve cases with serous effusion were diagnosed with aggressive NHL.Six out of the twelve children including five cases with ascites and one case with pleural effusion showed high expression of CD20 and were classified as NHL-B type by flow cytom-etry.Three children with pleural effusion and one child with both pleural effusion and ascites were typed as NHL-T as characterized by monoclonal expression of αβorγδ.The other two children with pleural effusion were diagnosed with anaplastic large cell lymphoma with positive expression of CD30 and morphological het-erogeneity.Conclusion Flow cytometry analysis based immunophenotyping could be used as an auxiliary method for rapid and accurate diagnosis of lymphoma in children with serous effusions.

SUMMARY Anaphylaxis is an acute and fatal systemic allergic reaction to an allergen , and it could be an unpre-dictable and life-threatening cause during anesthesia .The main purpose of this paper is to report a case of anaphy-lactic shock during the anesthesia induction and to review the prophylaxis and treatment of anaphylactic reactions and anaphylactoid reactions during the anesthesia period .A 63-year-old man, with a mass on his adrenal , was scheduled to a laparoscopic adrenal tumor excision .During the anesthesia induction period , after administrated sul-fentanil, propofol and rocuronium , the blood pressure was decreased and the heart rate was increased .Then, the patient had rash on his whole body and developed an anaphylactic shock .After being treated with the anti-allergic agents and norepinephrine , the rash disappeared and the vital sign become stable .The patient felt nothing uncom-fortable during the two weeks ’ follow-up.Anaphylactic reactions and anaphylactoid reactions are not rare during the anesthesia period .The most common inducements are muscle relaxant , latex and antibiotics .Anaphylactic reac-tions in the perioperative period are often serious and potentially life-threatening conditions , involving multiple or-gan systems in which the clinical manifestations are the consequence of the release of preformed mediators from mast cells and basophils .Before anesthesia , we should acquire the allergic history .During the anesthesia period , the vi-tal sign and the skin should be observed carefully .