OBJECTIVETo explore clinical effectiveness of internal fixation and semi-shoulder arthroplasty in treating proximal humerus comminuted fractures in elderly.

METHODSFrom October 2009 and October 2011, 32 patients aged over 60 years old with three and four-part fractures of proximal humeral were treated with internal fixation (20 cases) and semi-shoulder arthroplasty (12 cases). In internal fixation group, there were 6 males and 14 females aged from 63 to 82 years old (ranged, 71.50 +/- 5.45), 8 cases with three-part fracture and 12 cases with four-part fracture, and treated with open reduction and locking plate internal fixation. While in semi-shoulder arthroplasty group, there were 4 males and 8 females aged from 61 to 85 years old (ranged, 72.80 +/- 6.80), 5 cases with three-part fracture and 7 cases with four-part fracture, and treated with semi-shoulder arthroplasty. Postoperative complications were observed, EQ-5D was used to evaluate quality of life, and Constant-Murley score was used to assess functional outcomes.

RESULTSAll patients were followed up from 12 to 24 months with an average of 18 months. All injuries were healed at stage I . Two cases in internal fixation group occurred severe complications, including 1 case with screw fracture, 1 case with avascular necrosis of humeral head. EQ-5D in interal fixation group and semi-shoulder arthroplasty group were respectively 0.65 +/- 0.12, 0.67 +/- 0.12, Constant-Murley score respectively was 63.20 +/- 11.35 and 66.80 +/- 11.96, and with no statistical meaning between two goups (P>0.05).

CONCLUSIONThere is no difference in qulity of life and functional recovery for the treatment of proximal humerus comminuted fractures by open reduction and internal fixation and semi-shoulder arthroplasty. However, the complication rate in semi-shoulder arthroplasty was lower than that of internal fixation group.

Aged ; Aged, 80 and over ; Arthroplasty ; methods ; Case-Control Studies ; Female ; Fracture Fixation, Internal ; methods ; Fractures, Comminuted ; surgery ; Humans ; Humeral Fractures ; surgery ; Male ; Middle Aged ; Shoulder Fractures ; surgery ; Treatment Outcome

Antidiuretic Hormone Receptor Antagonists ; Heart Failure ; drug therapy ; Humans

Objective To investigate new cases of endemic cretinism in high-risk areas of Inner Mongolia, the prevalence of endemic goiter, the implementation of comprehensive measures, and to provide scientific basis for developing control strategies against iodine deficiency disorders (IDD). Methods In 2007 and 2008, a search for new cretin cases was conducted among children under the age of 10 in 11 historical serious epidemic cretinism prevalent areas of Songshan district, Keshiketeng qi, Kalaqin qi, Zhalaite qi, Zhuozi county,Liangcheng county, Qingshuihe county, Helin county, Dongsheng district, Zhungeer qi and Yinjinhuoluo qi. Three to 5 towns were selected in each qi(county, district) and 3 to 5 village primary schools were selected in each town.One hundred and twenty to 200 children aged 8 to 10 were selected in each school to inspect thyroid by B ultrasound and palpation and to test intelligence and urinary iodine. Two villages were selected in each town and 30 households were selected to determine urinary iodine of housewives and salt iodine. Results A total of 56 cases of suspected cases of endemic cretinism were found from the 11 counties but no case was confirmed. The goiter rate of children aged 8 to 10 was 5.2% (309/5922) by palpation and 4.3% (252/5922) by B-ultrasound. The median urinary iodine of children aged 8 to 10 was 241.5 μg/L, and urinary iodine was 100 to 300 μg/L, accounted 65.9%(3901/5920). Median urinary iodine of the 9 Qis(counties, districts) was in the range of 200 and 300μg/L.Higher than 5% of the 11 Qis(counties, districts) with urinary iodine lower than 50 μg/L was zero. Higher than 10% of the 11 Qis(counties, districts) with urinary iodine lower than 100 μg/L was 1. The median urinary iodine of housewives was 225.6 μg/L, and lower than 50 μg/L accounted for 2.2%(35/1597). Higher than 10% of the 11 Qis(counties, districts) with urinary iodine lower than 100 μg/L was 4. A total of 2109 households were investigated and 97.45%(2055/2109) of them ate iodized salt and 2.55%(54/2109) of them ate non-iodized salt. Conclusions In the 11 investigated counties, goiter rate of children has decreased to less than 10%, and no new cretin was found. It could be concluded that the fulfillment of prevention and control of IDD is effective. The iodine nutrition of children and women of childbearing age is in an adequate level. The coverage rate of iodized salt has maintained at a higher level, the sales network is sound, the salt price is reasonable and salt is easy to get and the children's intelligence is protected effectively. But, the health education about IDD is still weak, need to be reinforced.

Aged ; Diabetes Mellitus, Type 2 ; Exercise ; Humans ; Physical Fitness

Adult ; Eye Injuries ; surgery ; Female ; Humans ; Orbital Fractures ; surgery

Ear ; Eosinophilic Granuloma ; Facial Neoplasms ; Humans ; Male ; Middle Aged ; Parotid Gland

Chromosome Aberrations ; Combined Modality Therapy ; Humans ; Killer Cells, Natural ; pathology ; Lymphoma, T-Cell ; etiology ; genetics ; pathology ; therapy ; Nose Neoplasms ; etiology ; genetics ; pathology ; therapy ; Prognosis

Objective To evaluate the usefulness of magnetic resonance spectroscopic imaging in detecting local recurrence in patients with T3N0M0 prostate cancer after cryotherapy.Methods Sixty-five patients with T3N0M0 prostate cancer underwent cryotherapy.The preoperative data of conventional MRI,MRS,transrectal ultrasound (TRUS)-guided prostate biopsy were collected.After cryotherapy,the prostate specific antigen (PSA) of all patients was detected monthly.If PSA ＞5 μg/L,MRI,MRS,and TRUS-guided prostate biopsy were planned within a week.If PSA was unremarkable,MRI,MRS,and TRUS-guided prostate biopsy were planned 12 months after cryotherapy.The prostate was divided 6 regions and the cancerous and noncancerous were marked.The signal-to-noise ratio(S/N) of choline (Cho),citrate (Cit)and the ratios of Cho + creatine ( Cre)/Cit of each regions were measured in pre-operation and postoperation.The patients were divided into non-recurrence and recurrence group according to TRUS-guided biopsy.The S/N of Cho,Cit,and the ratio of Cho + Cre/Cit were compared between the groups before and after cryotherapy by using independent samples t-test.Results ( 1) Fifteen patients were confirmed local recurrence 12 months after cryotherapy,including 11patients with an evaluate PSA level and 4 patients with PSA umemarkable.(2) The S/N of Cho,Cit and the ratios of Cho + Cre/Cit in the cancerous and noncancerous regions before cryotherapy in the sixty-five patients were 25 + 9,11+ 5,and 18 + 5,and 39 ±12,2.33 +0.60,and 0.53 ± 0.19.There had significant difference between that of two groups ( t values were 11.36,9.81,and 13.39,respectively,P =0.00).(3) In the patients with non-recurrence,The S/N of Cho,Cit in the cancerous and noncancerous regions were 4 ± 2 and 3 ± 2 ( t =1.024,P =0.305 ),and 2 +2 and 4 ±3 (t =1.147,P =0.178) and no difference was found.In necrotic area,the ratios of Cho + Cre/Cit could not be calculated because of low level of the S/N of Cho and Cit.(4)In the patients with local recurrence after cryotherapy,the S/N of Cho and Cit in the cancerous and noncancerous regions were 17 ±3 and 3 ± 2 ( t =17.24,p =0.00 ),9 ± 2 and 3 ± 3 ( t =23.66,P =0.00 ) and a significant difference was found.The ratio of Cho + Cre/Cit in the recurrent area was no significant different compared with that of preoperation(t =1.214,P =0.256 ).In necrotic area,the ratios of Cho + Cre/Cit could not be calculated because of low level of the S/N of Cho and Cit.Conclusions MRS is a useful tool to evaluate the changes of the S/N of Cho and Cit,the ratios of the Cho + Cre/Cit and help diagnosis of local recurrence.

Adenocarcinoma ; diagnosis ; genetics ; Carcinoma, Non-Small-Cell Lung ; diagnosis ; genetics ; Carcinoma, Squamous Cell ; diagnosis ; genetics ; Cyclin-Dependent Kinase Inhibitor p16 ; blood ; metabolism ; DNA Methylation ; Genes, p16 ; Humans ; Lung Neoplasms ; diagnosis ; genetics ; Tumor Suppressor Proteins ; blood ; metabolism

Objective To establish a desirable quantitative assay system to evaluate the correlation between surgical manipulation and micrometastasis in primary esophageal cancer patients.Methods 118 pe- ripheral blood samples from 40 esophageal cancer patients undergoing radical resection were collected before surgery(B-1),immediately after surgery(B0)and at the third day postoperatively(B+3).Based on real-time quantitative reverse transcription-PCR,carcinoembryonic antigen(CEA)mRNA gene was used in the detec- tion.12 patients with benign tumor and 13 healthy volunteers were collected as negative control groups.Re- sults The median of CEA mRNA copies at B-1,B0 and B+3 were 1592,13 314 and 6221 copies/ml blood, respectively.CEA mRNA expression levels were found to be significantly higher at both B0 and B+3 than that of B-1(P=0.0001 and 0.0209,respectively).No significant difference was found between B0 and B+3(P= 0.4396).Conclusion Surgical manipulation on esophageal cancer patients increases the probability of mi- crometastasis.Therefore,adjuvant therapy is needed during perioperative stage.