OBJECTIVETo compare the clinical effects of interlocking intramedullary nail and micro-invasive internal fixation with plate for the treatment of multiple segmental tibiofibular fractures.

METHODSThe clinical data of 39 patients with multiple segmental tibiofibular fractures received treatment from January 2010 to June 2013 were retrospectively analyzed. In the 39 patients, 18 cases were treated by the interlocking intramedullary nail (intramedullary nail group), there were 12 males and 6 females with the mean age of (40.6 ± 9.7) years old (ranged, 24 to 60 years);7 cases were type C2.1, 11 were type C2.2 according to the AO classification. The other 21 cases were treated by micro-invasive internal fixation with plate(plate group), there were 13 males and 8 females with the mean age of (41.7 ± 8.1) years old (ranged, 22 to 52 years), 7 cases were type C2.1, 13 were type C2.2, 1 was type C2.3. Preoperative preparation time, operation time, intraoperative blood loss, postoperative complications, fracture healing time were compared between two groups. Johner-Wruhs evaluation criteria was used to evaluate the clinical effect at last follow-up.

RESULTSAll the patients were followed up from 10 to 28 months with an average of 15.2 months. Operative time, intraoperative blood loss in intramedullary nail group were (62.1 ± 5.8) min, (70.9 ± 7.1) ml, respectively; in plate group were (64.3 ± 7.7) min, (74.1 ± 8.5) ml,respectively. There was no significant difference in operation time and intraoperative blood loss between two groups (P > 0.05). However, preoperative preparation time, fracture healing time in intramedullary nail group were (5.3 ± 0.7) days, (11.1 ± 1.9) months, in plate group were (7.1 ± 0.8) days, (14.1 ± 2.2) months, respectively. No postoperative complications were found in intramedullary nail group, and five cases developed with complications in plate group. There was significant difference in preoperative preparation time, postoperative complications and fracture healing time between two groups (P < 0.05). According to Johner-Wruhs criteria at last follow-up, 11 cases got excellent results, 4 good, 3 fair in intramedullary nail group; 11 excellent, 5 good, 2 poor in plate group.

CONCLUSIONInterlocking intramedullary nail has advantages of shorter preoperative preparation time, less postoperative complications and faster fracture healing time in treating multiple segmental tibiofibular fractures. But the application scope of interlocking intramedullary nail was inferior to micro-invasive internal fixation with plate , and its indications should be strictly controlled.

Adult ; Bone Plates ; Case-Control Studies ; Female ; Fibula ; injuries ; surgery ; Fracture Fixation, Internal ; instrumentation ; Fracture Fixation, Intramedullary ; methods ; Fracture Healing ; Humans ; Male ; Middle Aged ; Operative Time ; Retrospective Studies ; Tibial Fractures ; surgery

Endoscopes ; Humans ; Nasal Cavity ; surgery ; Nasal Septum ; surgery ; Reconstructive Surgical Procedures ; Rhinoplasty ; Surgical Flaps

Aged ; Aged, 80 and over ; Combined Modality Therapy ; Female ; Humans ; Male ; Middle Aged ; Otorhinolaryngologic Diseases ; therapy ; Retrospective Studies

Intermittent hypoxia (IH), or periodic hypoxia is referred as exposure to hypoxia interrupted by normoxia that occurs under many physiological and pathophysiological conditions. A lot of researches showed that IH adaptation, like ischemic preconditioning (IPC) and long-term high-altitude hypoxic adaptation (LHA), had significant cardioprotective effects including increasing the tolerance of myocardium to ischemia/reperfusion injury, limiting infarction size and morphologic damage, inhibiting apoptosis of myocardial cells, enhancing recovery of cardiac function in ischemia/reperfusion, and antiarrhythmia. However, the precise mechanisms underlying the protective effects of IH against ischemia/reperfusion injury are far from clear. The potential candidates participating in the protective effects of IH include oxygen transport, energy metabolism, neurohumoral regulation, antioxidase, stress protein, adenosine, ATP-sensitive potassium channel, mitochondrion, calcium control, nitric oxide and protein kinase. The effects of IH are affected by the protocol of hypoxic exposure, age and sex of experimental animals. IH adaptation, for longer lasting time than IPC and lesser side effect than LHA, might have a practical value for using.
Adaptation, Physiological ; Calcium ; Energy Metabolism ; Humans ; Hypoxia ; Ischemic Preconditioning ; KATP Channels ; Myocardium ; Myocytes, Cardiac ; Potassium Channels ; Reperfusion Injury ; physiopathology ; prevention & control

Objective:To review and analyze the prescriptions for Chinese herbal pieces in an integrative traditional Chinese and western medicine hospital to explore the trend and problems in clinical application for Chinese herbal medicines and provide reference for dispensing in pharmacy of traditional medicine and rational drug use. Methods: Totally 1200 prescriptions for Chinese herbal pieces in our hospital were surveyed from January to December in 2014. The irrational use was analyzed, and reasonable suggestions were provided for the clinical application. Results:The problems in the prescriptions for Chinese herbal pieces included uncompleted diagnosis,incompatible diagnosis and medication,nonstandard Chinese name,unclear footnote,irrational usage or dosage and incompati-bility. The prescriptions including above 15 varieties of Chinese herbal pieces in one accounted for 65. 70%, and those with average dose above 250 g accounted for 40. 25%. Conclusion:Regular inspection and quality supervision on the prescription for Chinese herb-al pieces should be strengthened to improve the quality of prescriptions and guarantee the safety and economy of the medication.

OBJECTIVETo compare the clinical effects of double screws system and compressed three canulated screws in treating femoral neck fractures.

METHODSFrom January 2007 to June 2009, the clinical data of 67 patients with femoral neck fractures underwent operation were retrospectively analyzed. There were 38 males and 29 females,aged from 31 to 71 years with an average of 50.6 years, left was in 41 cases and right was in 26 cases. The patients were divided into two groups (group A and B) based on the different fixation method. Of them, 30 cases (group A,19 males and 11 females) were treated with double screws system and 37 cases (group B, 19 males and 18 females) with compressed three canulated screws. In group A, Pauwells angle was more than or equal 50 degrees in 16 cases and Pauwells angle less 50 degrees in 14 cases; in group B, Pauwells angle was more than or equal 50 degrees in 22 cases and Pauwells angle less 50 degrees in 15 cases. Duration of hospitalization, operative time, intraoperative blood loss, postoperative time in bed, infection of incision, postoperative complication, quality of fracture reduction, position of internal fixation, incidence of non-union and femoral head necrosis, incidence of failure fixation, joint function (Harris score) were compared between two groups.

RESULTSAll patients were followed up from 30 to 59 months with an average of 42 months. There was no significant differences in aspect of duration of hospitalization, infection of incision, intraoperative blood loss, walking time, postoperative complications between two groups(P>0.05). Operative time of group A [(31.1 +/- 9.7) min]was less than that of group B [(40.4 +/- 12.7) min] (P<0.05). There was no significant differences in quality of fracture reduction, position of internal fixation, incidence of non-union and femoral head necrosis between two groups (P>0.05). In the patients with Pauwells angle more than or equal 50 degrees in group A, there was no retreated screws, broken screws, screw cut-off from the femoral head;a head;and in group B, retreated screws occurred in 2 cases, screw cut-off from the femoral head occurred in 2 cases, screws not completely getting in femoral head occurred in 2 cases; there was significant differences between two groups (P<0.05). The patients with Pauwells angle less 50 degrees in group A, screw loosening occurred in one case; and in group B, screw retreating occurred in one cases; there was no significant differences between two groups (P>0.05). All patients who suffered from screw loosening, retreating or cut-off from the femoral head were more than 65 years old. There was no significant differences in the joint function between two groups at 6 and 30 months after operations (P>0.05).

CONCLUSIONDouble screws system has advantages of minimal invasion, easy operation, reliable fixation in treatment of femoral neck fractures. Compared with the traditional compressed three canulated screws,double screws system has less fixation failure rate and higher hip function scoring. It has a good clinical effect especially for the patients with Pauwells angle more than or equal 50 degrees.

Adult ; Aged ; Biomechanical Phenomena ; Bone Screws ; Case-Control Studies ; Female ; Femoral Neck Fractures ; surgery ; Fracture Fixation, Internal ; methods ; Humans ; Male ; Middle Aged ; Postoperative Care ; Retrospective Studies

OBJECTIVE: To screen the differential expression of apoptosis-related protein and stress response protein(APR-SRP) genes after human brain injury by cDNA microrarray. METHODS: The total RNAs were isolated from normal and injured brain tissues of a car-accident victim, and were purified to obtain mRNAs by Oligotex. Both mRNAs from the tissues of the injured and the normal tissue were reversely transcribed to cDNAs with the incorporation of fluorescent dUTP to prepare the hybridization probes. The probes from normal tissue was labeled with Cy3-dUTP, that from the injured tissue with Cy5-dUTP. The mixed probes were hybridized to the BioDoor Chip ARP-SRP-1.0S, a cDNA microarray which contains 77 apoptosis related protein genes and 23 stress protein related genes. After high-stringent washing, the cDNA microarray was scanned for the fluorescent signals and showed differences between two tissues. RESULTS: Among the 100 target genes, Only CLN2 gene (Homo sapiens lysosomal pepstatin insensitive protease gene) showed distinct deference in expression level between the brain injury and normal tissues. CONCLUSION cDNA microarray analysis indicated that CLN2 gene, which is correlated to a fatal childhood neurodegenerative disease, might be related to the brain injury. The expression level of CLN2 gene was significantly decreased in brain injured tissue in comparison to normal tissue. Further analysis of this gene will be helpful to understand the molecular mechanism of brain injury and utilization in forensic medicine.
Apoptosis ; Brain/metabolism* ; Brain Injuries/pathology* ; Gene Expression/genetics* ; Gene Expression Profiling ; Genetic Markers ; Humans ; Oligonucleotide Array Sequence Analysis/methods* ; RNA, Messenger/metabolism* ; Tripeptidyl-Peptidase 1

BACKGROUNDSympathetic ophthalmia (SO), a rare, bilateral, diffuse granulomatous uveitis, usually occurs after open globe injury or intraocular surgery. We sought to identify the risk factors for the development of SO after open globe injury and describe their demographic and clinical features and outcomes of treatments.

METHODSA retrospective study of inpatients with globe injury in 15 tertiary referral hospitals of China from January 2001 to December 2005 was conducted. The information of demography, nature and mechanism of injury, time and ways of treatments and outcomes was reviewed. Diagnosis of SO was made based on a history of ocular trauma or surgery and subsequent development of bilateral or contralateral uveitis consistent with SO. Any association between related parameters and development of SO was analyzed.

RESULTSAmong 9103 patients (9776 eyes) of globe injury, SO occurred after open globe injury in 18 cases with an occurrence rate of 0.37%, vitrectomy of closed globe injury in 2 (0.37%) and perforation of burned eyes in another 2. For open globe injury, the median age ((36.72 +/- 13.59) years, P = 0.01) was higher in patients with SO; there were no significant effects of sexes, injury type, uvea proplaps, once or multi-intraocular surgery, once or multi-vitrectomy and endophthalmitis on incidence of SO; 0.70% endophthalmitis concurred with SO; 83.33% of SO occurred within 1 year after injury or last ocular surgery. SO developed in a fellow eye one week after evisceration of the perforating burned eye. Good final visual acuity was obtained in sympathizing eyes with prompt treatment.

CONCLUSIONSFor open globe injuries, SO sufferers were relatively older and any injury type could induce SO with equal possibility. The initial open globe injury was more likely to be the trigger of SO than subsequent intraocular surgeries including vitrectomy. Prophylactic enucleation after injury is not recommended.

Adolescent ; Adult ; Child ; Eye Enucleation ; adverse effects ; Eye Injuries ; complications ; surgery ; Female ; Humans ; Male ; Middle Aged ; Ophthalmia, Sympathetic ; epidemiology ; etiology ; Retrospective Studies ; Vitrectomy ; adverse effects ; Young Adult

Myocardial ischemia and reperfusion (I/R) is a common problem in clinic and there is no satisfactory method for prevention or treatment of I/R injury so far. Chronic intermittent hypobaric hypoxia (CIHH), similar to the concept of ischemia preconditioning (IPC)or altitude hypoxia adaptation (AHA), has been recognized to confer a protective effect on heart against I/R injury with a longer protective effect than IPC and a less adverse effect than AHA. It has been proved that CIHH increases myocardial tolerance to ischemia or hypoxia, reserving cardiac function and preventing arrhythmia during I/R. Multiple mechanisms or pathway underlying the cardiac protection of CIHH have been proposed, such as induction of heat-shock protein, enhancement of myocardial antioxidation capacity, increase of coronary flow and myocardial capillary angiogenesis, activation of adenosine triphosphate (ATP)-sensitive potassium channels, inhibition of mitochondrial permeability transition pores, and activation of protein kinase C (PKC) and induced nitric oxide synthase (iNOS). In addition, CIHH has been found having many beneficial effects on the body, such as promotion of health, increase of oxygen utilization, and prevention or treatment for some diseases. The beneficial effects of CIHH and potential mechanisms are reviewed mainly based on the researches performed by our group.
Adenosine Triphosphate ; metabolism ; Antioxidants ; metabolism ; Heart ; physiopathology ; Heat-Shock Proteins ; metabolism ; Humans ; Hypoxia ; Myocardial Ischemia ; physiopathology ; Myocardium ; pathology ; Nitric Oxide Synthase Type II ; Potassium Channels ; metabolism ; Protein Kinase C ; metabolism ; Reperfusion Injury ; physiopathology

BACKGROUND: Dietary intervention may be the most available, safe, economic and efficient approach to treat spinal cord injury. OBJECTIVE: To observe the effects of dietary restriction in the form of every-other-day fasting (EODF) on the pathological changes and functional recovery of rats with clip-compression injury of the spinal cord. METHODS: The models of spinal cord injury were established by a medical aneurysm clip in 36 Sprague-Dawley rats, and model rats were then randomized into four groups: group A with spinal cord injury and EODF, group B with spinal cord injury, group C with sham operation and EODF, and group D with sham operation. Food intake and body mass were observed. Motor functional recovery in rats was assessed by Basso, Beattie, Bresnahan scores at preoperative 1 day and postoperative 1 day, 1, 2, 4, 6, 8, 10, and 12 weeks. At 12 weeks after operation, the morphological changes of the spinal cord were observed through hematoxylin-eosin staining. RESULTS AND CONCLUSION: The Basso, Beattie, Bresnahan score in the group B was decreased to the lowest at postoperative 1 day, and gradually increased with time. At 8-12 weeks after operation, the scores in the group A were significantly superior to those in the group B. At 12 weeks after operation, hematoxylin-eosin staining showed less lesion of the spinal cord in the group A than the group B. These results indicate that EODF can improve the motor functional of rats with spinal cord injury, and exerts effective protection on the injured spinal cord.