Objective To probe the effects of interlocking intramedullary nail fixation in treatment of long bone fractures, evaluate the application of intramedullary nail fixation treatment of long bone fractures, and explore the complications and their management. Methods Retrospective study of 2126 cases with long bone fracture treated with interlocking intramedullary nail from January 1996 to January 2004 was carried out. Of them, 1089 cases were followed up, and the average follow-up duration was 4 years (1 to 8 years). The locations of fracture were tibial and fibular in 603 cases, which were left in 237 cases and right in 331 cases and bilateral in 35 cases, close fracture in 511 cases of type C 240 cases, type A of 134 cases and type B 137 cases, open fracture 92 cases of Gustilo Ⅰ type 63 cases and Gustilo Ⅱ type 29 cases; femoral fractures in 360 cases, which were left 136 cases, right 205 cases and bilateral 19 cases, close fracture 319 cases of type C 191 cases, type A 103 cases, type B 25 cases; Open fracture 41 cases; Humeral fractures in 126 cases, which were left 49 cases, right 71 cases and bilateral 6 cases, close fracture 113 cases of type C 24 cases, type A 64 cases and type B 25 cases; Open fracture 13 cases. Results Fracture healing rate was 93% in interlocking intramedullary nail fixation treatment of long bone fracture. Complication included fracture nonunion rate 7%, infection rate 3%, fat embolism syndrome 2%, nail and locking bolts broke 2%, iatrogenic fracture 1.3%, knee pain in patients with tibia shaft fracture after interlocking intramedullary nail treatment 35%. Conclusion Interlocking intramedullary nail is more suitable for long bone fracture because it can result in more reliable fixation, less operative trauma. It can be used as the first alternative to treat long bone fractures.

[Objective]To explore a new therapy for postoperative non-union distal humeral frature.[Method]From January 2000 to January 2005,27 cases of non-union after internal fixation operations of distal humeral fractures were treated with retrograde intramedullary nailing combined with bone graft.[Result]All cases were followed up form 6 months to 32 months,with an average of 16 months.All the non-union were healed and joint function resumed to normal.No infection,no nail and locking bolts broken and no humeral distal fracture were found.[Conclusion]Retrograde intramedullary nailing combined with bone graft is an effective therapy for postoperative non-union of distal humeral fracture.

Objective To analyze the reasons of cesarean section in primiparae without operation indications ,in order to provide foundation for reducing the rate of cesarean section .Methods 640 cases of primipara were randomly divided into cesarean section with no operation indications(observation group) and spontaneous labor group(control group) ,320 cases in each each .The general data was investigated and analyzed ,the scale of cesarean section causes ,scale of cesarean section and pregnancy knowledge were compared between the two groups .Results The average age of the observation group was significant higher than that of the control group ,the percentage of monthly income of over 2 000 yuan and the proportion of level of education for college or above was signifi-cant higher than that of the observation group(P<0 .05) .In terms of pain tolerance ,no confidence in the natural delivery ,timing production ,family members will ,elderly parturient women ,the observation group were significant higher than the control group (P<0 .05) .The pregnancy knowledge level of observation group was significant lower than the control group (P<0 .05) .Multi-fac-tor analysis showed that ,high education level ,no tolerence of pain ,no confidence in the natural delivery ,timing production ,elderly parturient women ,and low degree of knowledge during pregnancy were major cause of of cesarean section rate .Conclusion The ap-propriate analgesia and encourage should be adopted for pregnant women who can′t stand the pain ,without confidence in the natural delivery .Education should be strengthen for pregnant women who timing production ,elderly parturient women ,low degree of knowledge .

Objective To observe the results of treatment by open reduction and humeral head replacement for proximal humeral fracture-dislocation. Methods According to Neers classification, the cases included two-part proximal humeral fracture-dislocation 15 cases, three-part proximal humeral fracture-dislocation 29 cases, and four-part proximal humeral fracture-dislocation 21 cases. Fifty-four patients received T shaped steel plate and 11 patients received humeral head replacement. Early rehabilitation was started postoperatively. Results Fifty-four patients who received T shaped steel plate were followed up from 1 to 5 years (in average of 2.5 years), final results of all the patients were evaluated according to the HUANG Gong-yi′s criterion. The rate of excellent or good in patients of two-part fracture-dislocation were 100%, three-part fracture-dislocation was 79%, humeral head necrosis was 25%, four-part fracture-dislocation was 60%, and humeral head necrosis was 53%. Eleven patients who received humeral head replacement were followed up from 6 months to 5 years (in average of 1.5 years). According to SSMH of UCLA, the average score was 25.6. Score was above 27 in 1 case, 24~27 in 8 cases, 18~ 23 in 2 cases, less than 18 in 0. These cases were with an excellence rate of 82%. Average score was 9.0 in pain, 8.2 in function and 7.5 in muscle power. Conclusions T shaped steel plate to treat the two-part proximal humeral fracture-dislocation is effective in the functional recovery of the shoulder joint, but the rate of satisfaction as well as the necrosis in the three-part and four-part is poor. Satisfactory results can be obtained in humeral head replacement for the treatment of proximal humeral fractures especially for the treatment of three and four-part fracture-dislocation.

Objective To investigate the effect and mechanism of Huanglian Jiedu Decoction in improving the itching symptoms of 1-chloro-2,4-dinitrobenzene(DNCB)-induced atopic dermatitis(AD)in mice.Methods Thirty-six Balb/c mice were randomly divided into normal group,model group,Dexamethasone(positive control,2.5 mg·kg-1)group and Huanglian Jiedu Decoction low-,medium-and high-dose groups(0.4,0.8 and 1.6 g·kg-1),6 mice in each group.After shaving the back of the mice,200 μL of DNCB solution was applied to the back of the mice for sensitisation(1%DNCB for 3 consecutive days)and excitation(1.5%DNCB,starting from the fourteenth day,excitation was performed once every 3 days for a total of 5 times).The stimulation and drug interventions were carried out simultaneously,and each group was administered by gavage at a set dose once daily for 14 days.The severity score of the skin lesions was calculated with reference to the Scoring Atopic Dermatitis(SCORAD),and the number of times the mice scratched within 20 minutes was recorded.The pathological changes of the lesions were observed by HE staining;mast cell infiltration was observed by toluidine blue staining;and the mRNA expression levels of thymic stromal lymphopoietin(TSLP),interleukin(IL)13,histamine H4 receptor(HRH4),and IL-31 in the lesions were detected by RT-qPCR.Results Compared with the normal group,the dorsal skin of the mice in the model group showed obvious erythema,mossification,crusting and epidermal shedding after DNCB excitation,and the severity score of the lesions was significantly increased(P＜0.001);the hyperkeratosis of epidermis,the thickness of spinous layer was significantly increased(P＜0.001),sponge oedema,and a large number of inflammatory cells infiltration was seen in the dermis;and the number of mast cells was significantly increased(P＜0.001);the times of scratches within 20 minutes was significantly increased(P＜0.01);and the mRNA expression levels of TSLP,IL-13,HRH4,and IL-31 in the skin lesion tissue were all significantly elevated(P＜0.05,P＜0.01).Compared with the model group,the skin lesions on the backs of mice in the low-,medium-and high-dose groups of Huanglian Jiedu Decoction were significantly improved,the mossy area was significantly reduced,the severity was significantly reduced,and the severity score of skin lesions was significantly reduced(P＜0.001),and the number of mast cells and the mRNA expression levels of IL-13,HRH4,and IL-31 were significantly reduced in the skin lesion tissues(P＜0.05,P＜0.01,P＜0.001);the thickness of the stratum spinosum was significantly reduced in the medium-and high-dose groups of Huanglian Jiedu Decoction(P＜0.001),and the number of inflammatory cells in the dermis was significantly reduced;the number of scratching in mice in the high-dose group of Huanglian Jiedu Decoction was significantly reduced within 20 minutes(P＜0.01),and the mRNA expression level of TSLP in the lesion tissue was significantly reduced(P＜0.05).Conclusion Huanglian Jiedu Decoction can alleviate itching symptoms in AD mice,and its mechanism of action may be related to repairing the skin barrier in AD mice,attenuating the infiltration of inflammatory cells and mast cells,and down-regulating the mRNA expressions of itch-associated factors TSLP,IL-13,IL-31 and HRH4 in skin tissues.

Objective:To compare the consistency and detection capability of seven 2019-nCoV nucleic acid detection kits, and provide reference for detection method selection of clinical laboratory and diagnosis of new coronavirus pneumonia.Methods:Two batches of pharyngeal swab samples were collected from tenpatients with confirmed infection of 2019-nCoV and 10 suspected patients with negative 2019-nCoV test results during January 29 to February 5, 2020 in Shenzhen Luohu People′s Hospital. Seven kinds of kits were labeled as ato g and used for nucleic acid detection respectively to evaluate the consistency of the test results of the clinical samples. A 2019-nCoV positive specimen was selected and diluted to 5-concentration gradient plates (Level-1 to 5) with RNase-free water. The positive detection rate and intra-batch repeatability of different brands of kits were compared.Results:The negative and positive coincidence rates of twenty clinical samples tested by six kinds of kits were 100%, and the positive and negative coincidence rate was 8/10 and 10/10 for the other kit, respectively. The results of intra-batch repeatability showed the CVs of viral loads tested by these seven kits were all less than 5%. In the concentration range of Level-1 to 3, the detection capability for open reading frame (ORF)1ab gene of Kit b,d and f was lower than Kit a,c,e and g, and the detection capability of kit e and g was the highest (14/15). The detection capability for N gene of Kit a (15/15) was higher than the other 5 kits. The comprehensive analysis of the detection capability for ORF1ab and N gene showedthat Kit d had the lowest detection capability (ORF1ab:40%,N:53%), and there was no significant difference in the detection capability of Kit a, b, c, e, and f.Conclusions:There was no significant difference in the accuracy and repeatability of the seven kits for positive samples with high viral loads, and the detection performance was good; but some kits had poor detection capability for weak positive samples. It is suggested that the weak positive samples should be rechecked by at least two manufacturers′ kits to ensure the accuracy of the results.

Antipyretic-analgesics are currently one of the most prescribed drugs in children.The clinical application of antipyretic-analgesics for children in our country still have irrational phenomenon, which affects the therapeutic effect and even poses hidden dangers to the safety of children.In this paper, suggestions were put forward from the indications, dosage form/route, dosage suitability, pathophysiological characteristics of children with individual differences and drug interactions in the symptomatic treatment of febrile children, so as to provide reference for the general pharmacists when conducting prescription review.