Objective To evaluate the clinical outcomes of internal fixation with extra-articular distal humerus locking compression plate (LCP) for the treatment of mid-distal humerus diaphyseal fracture.Methods From December 2012 to December 2016,a cohort of 22 patients with mid-distal humerus shaft fracture were treated by open reduction and internal fixation using extra-articular distal humerus LCP.They were 14 males and 8 females with an average age of 42.7 years (range,from 18 to 86 years).According to AO classification,there were 13 cases of type 12-A,7 cases of type 12-B,and 2 cases of type 12-C.The surgical time,intra-operative blood loss and hospital stay were recorded.The clinical outcomes were evaluated by the Mayo elbow performance score (MEPS) at the last follow-ups.Results Surgical time ranged from 46 to 95 minutes with an average of 57 minutes.The average blood loss was 220 mL (range,from 150 to 400 mL).The average hospital stay was 10.5 days (range,from 9 to 13 days).The mean follow-up was 23.8 months (range,from 6 to 48 months).Bone union was achieved in 21 cases after an average of 4.6 months (range,from 3 to 9 months),and one patient experienced bone non-union which was uneventfully healed after secondary auto platelet rich plasma (PRP) graft management.The average MEPS elbow performance score was 88.2,resulting in 16 excellent,4 fine and 2 fair cases (excellent and fine rate:90.9％).Conclusions Since extra-articular distal humerus LCP can provide stable internal fixation,facilitating early postoperative rehabilitation,it may be considered an effective alternative osteosynthesis for mid-distal comminuted humeral diaphyseal fractures.

Objective:To investigate the accuracy of pure titanium and cobalt-chromium alloy frameworks fabricated using the additive manufacturing (AM) of selective laser melting technology (SLM) for the mandibular implant-supported fixed prostheses and the maxillary removable partial denture (RPD), and to provide a reference for clinical application of SLM pure titanium frameworks.Methods:One edentulous mandibular model with implants and screw fixed abutments at bilateral canines and the first molars was selected and used as the mandibular full arch implant-supported model. At the same time, a Kennedy class Ⅰ maxillary dentition defect model was selected. The digital models were obtained by scanning the dental models, and the metal frameworks of the mandibular full arch implant-supported denture and the maxillary RPD (design model) were designed using the 3 Shape software. Meanwhile, 12 mandibular frameworks in the cobalt-chromium alloy and the pure titanium (6 in each group were treated with heat treatment, while the other 6 were not treated), and 7 maxillary frameworks in the cobalt-chromium alloy and the pure titanium were respectively made by SLM with the improved dual-laser metal printer. The axial direction of the printing powder accumulation was taken as the Z-axis. During the design process, the software (3Shape Dental System 2018) automatically generated the X-axis and Y-axis, X axis was the sagittal axis of the dental model and Y axis was the coronal axis of the dental model. The deviation of the interface center of the abutment of the digital model of the mandibular frameworks from the design model in the X, Y and Z axes was analyzed. As for the trueness of the mandibular framework, the larger the deviation data was, the worse the trueness was. The deviation of the whole maxillary framework and 7 measuring points (palatal plate center point and bilateral occlusal rests, I bars, proximal plates) were analyzed. The fitness of the whole maxillary framework to the design model was expressed by root mean square (RMS) of the deviation data, and the fitness of measuring points was expressed by the mean±standard deviation of the data. The trueness differences of each group before and after heat treatment of the mandibular framework and the fitness of the maxillary framework were compared.Results:The cobalt-chromium alloy frameworks showed lower trueness on the X, Y, Z-axes [(96.3±12.1), (86.3±11.4), (61.2±13.2) μm] than did the pure Ti frameworks [(82.3±11.2), (72.2±10.2), (51.2±11.6) μm] by SLM, and the heat treatment could reduce the discrepancy between the SLM frameworks and STL models, for pure titanium frameworks [(62.4±11.3), (55.2±13.2), (41.3±10.8) μm] and for cobalt-chromium alloy [(84.5±10.5), (72.3±11.2), (54.2±11.6) μm]. For the thin RPD major frameworks, pure titanium had better fitness [(121.3±17.0) μm] than cobalt-chromium alloy [(174.0±18.3) μm] by SLM, and the difference was statistically significant ( P<0.05). Conclusions:Pure titanium frameworks fabricated by SLM additive manufacturing technology exhibited better fitness and trueness than did the Co-Cr frameworks after heat treatment respectively, and this satisfied the requirements of implant-supported fixed prostheses and RPD major metal frameworks.

Diarrhea-predominant irritable bowel syndrome(IBS-D)is a clinically common functional gastrointestinal disease,the"SCFAs-intestinal barrier"pathway plays an important role in the pathogenesis of IBS-D.Traditional Chinese medicine monomers/compounds or Chinese medicine compound can treat IBS-D by regulating the"SCFAs-intestinal barrier"through multiple pathways and multiple targets.This article takes the relationship between SCFAs and the four major intestinal barriers,as well as the mediating effect of IBS-D,as the starting point to systematically review and sort out the relevant literature on the targeted regulation of"SCFAs-intestinal barrier"in the treatment of IBS-D by Traditional Chinese medicine monomers/compounds and Chinese medicine compound;explores the theoretical basis of IBS-D caused by"SCFAs-intestinal barrier"from the perspective of"Large intes-tine dominating fluid",in order to provid ideas for Traditional Chinese medicine to establish a precision treatment system with Chinese medicine characteristics.