OBJECTIVETo explore the effect of treatment of humeral supracondylar fracture with Kirschner and tension band wire fixation through small lateral incision.

METHODSFifty-eight patients of humeral supracondylar fractures included 42 males and 16 females with the average age of 9.4 years ranging from 3 to 65 years old. All patients were treated with Kirschner and tension band fixation through small lateral incision of 4 to 5 cm after reduction through lateral approach from the inter muscular space between the lateral of triceps brachii and the brachioradial muscle. Two Kirschner were insterted from the lateral condylars to humeral medial. Drill plumb on the humeral above fracture line distance 2 to 3 cm. A wire through bended on the lateral two Kirschners nails crossed in the shape of "8" figure.

RESULTSThe fracture obtained accurately reduction and rigidly fixation. All patients were followed up for 1 to 5 years (mean 2.4 years). According to Flynn clinical evaluation, the results were excellent in 48 cases, good in 6,fair in 3 and poor in 1.

CONCLUSIONThis method has advantages of minimal trauma, easy manipulation, less operative time, early exercises and rapid recovery for the treatment of humeral supracondylar fracture.

Adolescent ; Adult ; Aged ; Bone Nails ; Child ; Child, Preschool ; Female ; Follow-Up Studies ; Fracture Fixation ; instrumentation ; methods ; Humans ; Humeral Fractures ; pathology ; physiopathology ; surgery ; Male ; Middle Aged ; Recovery of Function ; Time Factors ; Young Adult

Objective To compare the EEG complexity between rats under awaking and differ-ent depth of anesthesia via analyzing sample entropy and fractal dimension.Methods Sixteen SD rats were intraperitoneally injected with urethane twice,first with 500 mg/kg and second with 800 mg/kg one hour later.The scalp EEG was collected in stage of awaking (W),light anesthesia (LA)and heavy anesthesia (HA).The sample entropy (SampEn)and fractal dimension (FD)were computed by MATLAB.The characteristic values were denoised by linear dynamic system method during the whole process.Results The value of SampEn and FD gradually dropped from awaking to heavy anes-thesia.The SampEn and FD in W was significantly higher than the value in LA or in HA (P <0.05). The SampEn and FD in HA was significantly lower than that in LA (P < 0.05 ).Conclusion The SampEn and FD of EEG could be used to monitor the depth of anesthesia.

Objective To compare short-term therapeutic outcomes and the safety of percutane-ous radiofrequency ablation (PRFA) with left single lung ventilation (LSLV) for liver cancer of the hepatic dome (LCHD) and that of PRFA for right liver carcinoma in favorable location. Methods Thirty one patients with hepatocellular carcinoma (belonging to LCHD) receiving PRFA with LSLV (Group LCHD) between January 2006 and January 2009 in our hospital were selected, and 45 control patients with right lobe HCC ≥1 cm away from the liver capsule, gallbladder, and main portal bran-ches were also included. One month after PRFA, residual tumors were followed up with contrast en-hanced CT and alpha fetal protein and PRFA was repeated in the presence of residual foci. Tumor-free survival time was defined as the duration from complete ablation to diagnosed local tumor progression.The Mann-Whitney test was used to compare age, tumor diameter, and average number of punctures between LCHD patients and controls. A χ2 test was used for comparison of the incidence of complica-tions and incomplete tumor ablation rate. The Kaplan-Meier's method was used for calculation of local tumor-free survival rate compared with a log-rank test. Results The incidence of right shoulder pain was significantly higher in LCHD patients than in controls (87. 1% vs 11. 1%, P<0. 01). LCHD pa-tients showed no difference from controls in the average number of punctures (2. 8±. 5 vs 3. 2±. 5,P>0. 05). Meanwhile, there was no difference between the 2 groups in average duration of treatment and hospitalization, and the complete tumor ablation rate at first PRFA. No differences were observed in the 1-, 2- and 3-year local tumor-free survival rates between LCHD patients (85. 5% , 65. 8% , and 36. 4% ,respectively) and controls (87.7%, 62. 3% , and 34.0% , respectively). Conclusion PRFA with LSLV for LCHD seems to promise comparable short-term outcomes and safety to PRFA for right liver carcinoma of fa-vorable location and should be preferred as one of the therapeutic options for LCHD patients with tumor di-ameters≤5 cm regardless of its unique location.

Objective To investigate the expression of miR-424* in 2 and 4 Gy X-ray irradiated A549 cells in vitro and in vivo,as well as in clinical lung tissues and serum sample of non-small cell lung cancer(NSCLC) patients,and to explore its potential role in the diagnosis and prognosis of lung cancer.Methods A549 cells were irradiated with 2 and 4 Gy X-rays,and some of irradiated cells were injected into nude mice through tail vein.Real time quantitative PCR (RT-qPCR) assay was employed to detect the expression of miR-424 * in 2 and 4 Gy X-ray irradiated A549 cells in vitro and in vivo,as well as in clinical lung tissues and serum sample of lung cancer patients.Results Compared with the control group,the expression of miR-424* was up-regulated significantly in X-ray irradiated A549 cells at 1,2,12,24 and 48 hpost irradiation,respectively (2 Gy:t =-45.886--6.709,P ＜0.05;4 Gy:t =-29.087--7.833,P ＜ 0.05).Furthermore,the expression of miR-424 * was up-regulated in the lung and serum of nude mice with injection of 0,2 and 4 Gy X-ray irradiated A549 cells,compared with control group (fold change was 9.72,8.58 and 4.7 with 2 Gy irradiation and 11.93,9.22 and 8.99 with 4 Gy irradiation,t=-13.243,-12.409,-9.833 in lung andt=-6.436,-3.052,-3.609 in serum,respectively,P ＜ 0.05).Out of 11 tissue samples of NSCLC patients,6 were detected with up-regulated miR-424* expression,and no significant discrepancy of miR-424* expression was detected in two type of NSCLC tissue samples.On the contrary,43 serum samples were detected with up-regulated miR-424* expression out of 84 serum samples (51.20％) of NSCLC patients (fold change range 1.97 to 17.71),and significant discrepancy of miR-424* expression was shown in two subtypes of NSCLC serum samples [adenocarcinoma:39.10％ (18/46) and squamous carcinoma:65.8％ (25/38)],as well as in serum samples of NSCLC patients with radiotherapy [41.5％ (22/53)] and without radiotherapy [67.7％ (21/31)] (t=5.919,5.387,P ＜0.05,respectively).Conclusions 2 and 4 Gy X-ray irradiation could up-regulate the expression of miR-424* in A549 cells,which might be correlated with the enhanced metastasis of A549 cells induced by X-ray in vivo and in vitro.Furthermore,the expression of miR-424* was up-regulated in over 50％ of the tissue and serum samples of NSCLC patients,which might be correlated with the diagnosis of NSCLC subtype and prognosis of radiotherapy.

Objective:To investigate the efficacy of fruquintinib in the treatment of advanced colorectal cancer, and to analyze the risk factors for all-cause death of fruquintinib.Methods:The clinical data of 82 patients with advanced colorectal cancer in the First Affiliated Hospital of Bengbu Medical College from December 2020 to April 2022 were retrospectively analyzed. The basic clinical data, efficacy and adverse reactions were recorded. The patients were followed up to October 2022, and all-cause death was recorded. Multivariate Logistic regression was used to analyze the risk factors of all-cause death in patients with advanced colorectal cancer treated with fruquintinib.Results:After treatment, partial remission was found in 9 cases, stable disease in 42 cases, disease progression in 31 cases. The objective remission rate was 10.98% (9/82), and the disease control rate was 62.20% (51/82). The incidence of adverse reactions was 75.61% (62/82), mainly hypertension and hand-foot syndrome. By the end of follow-up, 19 patients died and 63 survived. The incidences of body mass index (BMI)≥24 kg/m 2, lymph node metastasis, tumor located in the right colon and lactate dehydrogenase >200 U/L in all-cause death patients were significantly higher than those in survival patients: 36.51% (23/63) vs. 16/19, 39.68% (25/63) vs. 13/19, 44.44% (28/63) vs. 15/19 and 41.27% (26/63) vs. 14/19, and there were statistical differences ( P<0.01 or <0.05); there were no statistical differences in gender composition, age, smoking history, hypertension and postoperative complications between the two groups ( P>0.05). Multivariate Logistic regression analysis result showed that BMI≥24 kg/m 2, lymph node metastasis, tumor located in the right colon and lactate dehydrogenase >200 U/L were independent risk factors for all-cause death in patients with advanced colorectal cancer treated with fruquintinib ( OR = 9.275, 3.293, 4.687 and 3.985; 95% CI 2.440 to 35.265, 1.106 to 9.806, 1.398 to 15.715 and 1.277 to 12.430; P<0.01 or <0.05). Conclusions:Fruquintinib is effective in the treatment of advanced colorectal cancer. The BMI≥24 kg/m 2, lymph node metastasis, tumor located in the right colon and lactate dehydrogenase >200 U/L are independent risk factors for all-cause death in patients with advanced colorectal cancer treated with fruquintinib.

Objective:To explore the effect of individualized strength training based on adjustable sandbags in early rehabilitation after total knee arthroplasty.Methods:From November 2019 to November 2020, convenience sampling was used to select 60 patients admitted to the Joint Surgery Department of the Affiliated Huaian First People's Hospital of Nanjing Medical University as the research object. According to the random number table, the patients were divided into the experimental group and the control group, 30 cases in each group. The patients in the control group were given routine rehabilitation after operation, and the patients in the experimental group received individualized strength training using adjustable sandbags in the early postoperative period. The Hospital for Special Surgery (HSS) and the range of motion of the knee joint were compared between the two groups on the third day, the seventh day after operation and at the time of discharge.Results:On the third and seventh days after operation and at the time of discharge, the HSS score and the range of motion of the knee joint in the experimental group were higher than those in the control group, and the differences were statistically significant ( P<0.05) . Conclusions:Early implementation of individualized strength training based on adjustable sandbags can promote postoperative rehabilitation of patients undergoing total knee arthroplasty, and improve their ability to adapt to early ambulation.

To summarize the nursing care experience of a case of idiopathic multicentric Castleman's disease TAFRO syndrome complicated with diffuse alveolar hemorrhage.Key points of nursing:prone position ventilation with high blood risk nursing observation and bleeding prevention;early rehabilitation exercise and the reduction of the lymphedema;the optimization of transitional care to avoid unplanned returns to the ICU.The patient was transferred to the respiratory ward for further treatment after 19 days,and 33 days later,she recovered and was discharged.At 1 month of follow-up after discharge,the patient recovered well.

Objective To explore the impact of knocking down Sec31A on the malignant phenotype of head and neck squamous cell carcinoma(HNSCC)and its possible mechanisms.Methods Transcriptome sequencing data of HNSCC tissues and adjacent tissues were obtained from the TCGA database,and the expression levels of Sec31A were compared.Immunohistochemical staining was used to analyze the expression of Sec31A in HNSCC tissues.Kaplan-Meier survival analysis was used to compare the relationship between Sec31A and the prognosis of HNSCC patients.Small interfering plasmids si-Sec31A and si-NC were transfected into HNSCC cell lines HN6 and HN4,and the impact of knocking down Sec31A on the biological behavior of HNSCC cells was detected through CCK-8 exper-iments,plate cloning experiments,scratch healing experiments,and Transwell experiments.Changes in the expression levels of PI3K/AKT/mTOR pathway related proteins in cells were detected after knocking down Sec31A with HN6 and HN4 through Western Blot(WB)experiments.Stable transfected cell lines of HN6 siSec31A and HN6 siNC were constructed and inoculated subcutaneously in nude mice to further verify the tumorigenic effect of Sec31A in vivo.Results TCGA data showed that Sec31A was higher in HNSCC tissues than in adjacent normal tissues(P＜0.01),and high expression of Sec31A was significantly correlated with poor prognosis in pa-tients(P＜0.05).Immunohistochemical staining showed that Sec31A was expressed stronger in HNSCC tissues than in normal tissues.In HN6 and HN4 cells,knocking down Sec31A resulted in significantly weaker proliferation,migration,and invasion abilities compared to the control group.Through WB experiments,it was found that transfection of si-Sec31A with HN6 and HN4 significantly reduced the expression levels of p-PI3K,p-AKT,and p-mTOR proteins.After knocking down Sec31A with HN6,the transplanted tumor volume in nude mice was significantly smaller than that in the control group.Conclusion Knocking down Sec31A can inhibit the proliferation,migration and invasion of HNSCC cells,possibly through the PI3K/AKT/mTOR pathway.

Tablets represent the most widely used oral solid dosage form in the pharmaceutical industry. Puerarin monohydrate (PUEM), a solid form of the natural antihypertensive drug puerarin, is commercially available. However, the low solubility of PUEM poses a significant challenge for the development of its tablet dosage form. In this study, we successfully prepared the sodium chelates of puerarin (PUE-Na·7H₂O) using reactive crystallization techniques. The crystal structure of PUE-Na·7H₂O was analyzed using single crystal technology, which revealed the structural characteristics of its metal chelate. Our thermodynamic studies demonstrated that the formation of PUE-Na·7H₂O involved the simultaneous deprotonation of PUE and the chelation of PUE^- and Na⁺. This reaction process was spontaneous and exothermic (ΔG < 0, ΔH < 0), and reducing the temperature facilitated the formation of the chelate. Nucleation kinetics studies revealed that chelate molecules were more likely to nucleate and crystallize under low temperature, high concentration, and high rotational speed conditions. Compared to commercially available PUEM, PUE-Na·7H₂O showed significantly improved water solubility, with a 33.5-fold increase in solubility and a 37.6-fold decrease in intrinsic dissolution rate. Our study identified drug-sodium chelation as an effective means for improving drug solubility and elucidated the mechanisms governing its formation kinetics and thermodynamics. These findings could provide new solutions for related product development and tremendous commercial opportunities.