OBJECTIVE: To explore the clinical effect of minimally invasive technique combined with locking plates for the treatment of osteoporotic humeral shaft fractures in elderly patients. METHODS: From July 2012 to December 2016, 26 patients were treated by minimally invasive technique combined with the locking plate for osteoporotic humeral shaft fractures, including 10 males and 16 females, ranging in age from 61 to 81 years old, with an average of 70.3 years old. The T-score of mean bone density was -2.74. All 26 patients had closed fractures, including 6 cases of type A, 7 cases of type B and 13 cases of type C. All patients were followed up for 12 months after surgery, and the Constant shoulder joint score and Mayo elbow score were calculated before surgery and 12 months after surgery. RESULTS: All 26 patients were followed up, and the duration ranged from 12 to 16 months, with an average of 13.2 months. All fractures healed within 16 weeks, with an average healing time of 14.3 weeks. The average Constant shoulder joint score before surgery and 12 months after surgery was 54.61±2.09, 88.50±2.47. The average score of Mayo elbow joint before surgery and 12 months after surgery was 58.19±2.74, 90.30±2.16. CONCLUSIONS The shoulder and elbow joint function of elderly patients with osteoporotic humeral fractrues treated with minimally invasive technology combined with locking plate recovered well postoperatively. It is an effective method for the treatment of osteoporotic humeral shaft fractures in elderly patients.
Aged ; Aged, 80 and over ; Bone Plates ; Elbow Joint ; Female ; Fracture Fixation, Internal ; Humans ; Humeral Fractures ; Humerus ; Male ; Middle Aged ; Minimally Invasive Surgical Procedures ; Treatment Outcome

Objective: To investigate the clinical value of blood routine tests (RT) and coagulation function in differential diagnosis of mild and severe patients infected with bunyamwera virus. Methods: Twenty-five mild patients and 25 severe patients infected with bunyamwera virus were selected and their blood RT and coagulation function tests were performed. Results: The earliest prothrombin time (PT-early) and activated partial thromboplastin time(APTT-early) were significantly lower than those of severe patients(t=-2.43, P<0.05; t=-2.53, P<0.05). The lowest values of white blood cells (WBC-low) of mild patients were significantly higher than those of severe patients (t=5.66, P<0.01). The highest value of D-dimer (DD-high) of mild patients were significantly lower than that of severe patients (z=1.35, P<0.05). When mild patients values were set as outcome variable, AUC of APTT-early was the highest (AUC=0.713, P<0.05). When values of severe patients were set as outcome variable, AUC of DD-high was the highest (AUC=0.874, P<0.01). Conclusions APTT-early and DD-high are suitable for differential diagnosis of mild and severe patients infected with bunyamwera virus.

OBJECTIVE: To investigate the clinical effect of vancomycin bone cement in the treatment of diabetic foot ulcer (DFU) ruptured Wagner gradeⅡ-Ⅳ. METHODS: From March 2019 to April 2021, 32 patients with Wagner gradeⅡ-Ⅳ diabetic foot were divided into vacuum sealing drainage (VSD) group and bone cement group according to different treatment methods. There were 16 cases in VSD group, 8 males and 8 females;the age ranged from 66 to 81 (70.50±7.20) years, and the course of disease ranged from 8 to 40 (27.56±8.55) months;Wagner gradeⅡin 2 cases, grade Ⅲin 7 cases and grade Ⅳin 7 cases;debridement and VSD were used. There were 16 cases in the bone cement group, 9 males and 7 females;the age ranged from 63 to 79 (69.56±7.29) years, and the course of disease ranged from 11 to 39(22.75±11.43) months;Wagner gradeⅡ in 2 cases, grade Ⅲin 5 cases and grade Ⅳ in 9 cases;vancomycin loaded bone cement was used for treatment. The types of bacteria, negative time of bacterial culture, skin healing time, hospital stay, operation times and complications were observed and compared between two groups. RESULTS: All patients were followed up for 3 to 6 (4.00±1.07) months. The bacterial negative time, skin healing time and hospital stay in bone cement group were significantly lower than those in VSD group ( CONCLUSION Vancomycin loaded bone cement is effective in the treatment of Wagner grade Ⅱ-Ⅳ diabetic foot ulceration wounds. It can reduce the length of hospital stay, shorten the healing time of skin and kill pathogens as soon as possible. It is one of the effective methods to treat Wagner gradeⅡ-Ⅳdiabetic foot ulceration.
Bone Cements/therapeutic use* ; Child ; Child, Preschool ; Diabetes Mellitus ; Diabetic Foot/drug therapy* ; Female ; Humans ; Male ; Treatment Outcome ; Vancomycin ; Wound Healing

OBJECTIVETo report the therapeutic effect of reverse fasciocutaneous flap pedicled with perforator branch of anterior medial malleolus artery for soft tissue defect on the dorsal side of foot.

METHODSThe perforator branch was located under the guidance of Doppler flowmeter. The flap was designed along the saphenous neurovascular axis. Then the flap was transferred reversely with the perforator branch as rotation point.

RESULTSFrom Feb. 2002 to Mar. 2008, 12 cases were treated and followed up for 6 - 18 months. All the flaps survived completely. The flap size ranged from 13.5 cm x 3.0 cm to 8 cm x 3 cm. The perforator branch located at 0.5 - 1.5 cm anterior-inferior to the medial malleolus. Both the cosmetic and functional results were satisfactory.

CONCLUSIONSThe flap has a reliable blood supply and a flexible design. It is easily performed for soft tissue defect on the dorsal side of foot. It is a new type flap which combined neurocutaneous vascular flap with the perforator flap.

Adult ; Fascia ; transplantation ; Female ; Foot Injuries ; surgery ; Humans ; Male ; Skin Transplantation ; Soft Tissue Injuries ; surgery ; Surgical Flaps ; blood supply ; innervation

Objective : To explore the correlation between air pollution and outpatient visits,and to provide evidence for health risk assessment of air pollutants and intervention. Methods : The data of air pollutants and outpatient visits in 2016 in Zhoushan Hospital were collected,and the outpatient volume on the days when the concentration of air pollutants reached and exceeded the standard were compared. Spearman rank correlation analysis was used to explore the relationship between outpatient volume and the concentration of air pollutants. Results : In 2016,the median（inter-quartile range）of daily outpatient volume in Zhoushan Hospital was 3 304（1 638）person-times. O3,PM2.5 and PM10 were the primary air pollutants in Zhoushan in 2016. The average daily outpatient volume of internal medicine,circulatory system,other diseases and all when the air was polluted at light level or above were higher than those when the air quality was good（P< 0.05）. CO concentration was positively correlated with the average daily outpatient volume of respiratory system and circulatory system（P< 0.05）,was negatively correlated with the average daily outpatient volume of all（P< 0.05）. O3-8 h concentration was positively correlated with the average daily outpatient volume of internal medicine,other diseases and all（P< 0.05）,and was negatively correlated with the average daily outpatient volume of respiratory system and pediatrics（P< 0.05）. SO2 concentration was negatively correlated with the average daily outpatient volume of respiratory system,skin and subcutaneous tissue（P< 0.05）. The concentration of NO2,PM10 and PM2.5 were positively correlated with the average daily outpatient volume of respiratory system and pediatrics（P< 0.05）. Conclusion The main air pollutants in Zhoushan were O3,PM2.5 and PM10. When they exceed the limits,the outpatient volume would increase.

OBJECTIVETo introduce the clinical method of blocking screws and rooting technique in the treatment of distal tibial fracture with interlocking intramedullary nails.

METHODSFrom June 2006 to March 2011, 26 patients with distal tibial fracture were treated with interlocking intramedullary nails using blocking screws and rooting technique, included 18 males and 8 females with an average age of 46.2 years old ranging from 24 to 64 years. According to AO classification: 10 cases of type A1, 4 cases of type A2, 8 cases of type B1, 4 cases of type B2. The average distance of the fractures end to the ankle joint was 85 mm ranging from 55 to 125 mm, the mean time between injured and operation was 4.5 days. The patients were evaluated with pain, range of motion, walking.

RESULTSAll cases were followed-up for 6 to 22 months (averaged 15 months). According to Iowa ankle joint grading system,the score was improved from preoperative (66.8 +/- 8.2) to postoperative (94.6 +/- 4.8). All fractures had united, and got satisfactory reduction and stable fixation with no complications had happen such as breakage of screw.

CONCLUSIONFixation with interlocking intramedullary nail using blocking screws and rooting technique in treating distal tibial fracture, is a safe and effective technique for the improvement of stability.

Adult ; Bone Screws ; Female ; Follow-Up Studies ; Fracture Fixation, Intramedullary ; methods ; Humans ; Male ; Middle Aged ; Recovery of Function ; Retrospective Studies ; Tibial Fractures ; diagnostic imaging ; physiopathology ; surgery ; Tomography, X-Ray Computed ; Treatment Outcome ; Young Adult

OBJECTIVETo introduce the use of single arm external fixation assisted reduction and closed complex intramedullary nail fixation for the treatment of femoral shaft fracture operation method and to study its effects.

METHODSFrom June 2008 to October 2012, 24 patients with femoral shaft fractures were treated with unilateral external fixation assisted by closed reduction, interlocking intramedullary nail fixation. Among the patients, 19 patients were male and 5 patients were female, ranging in aged from 20 to 68 years,with an average of 45.6 years old. The fracture was caused by traffic accidents in 14 cases, by falling in 6 cases, by heavy bruising in 4 cases. Admission diagnosis was femoral shaft fracture. Operation was performed after traction from tibial tubercle for about 1 week.

RESULTSAll the patients were followed up, and the duration ranged from 6 to 24 months, with a mean of 16.2 months. The X-ray showed fracture healing time ranging from 11 to 17 weeks, with an average of 13.8 weeks. All fractures healed without nails broken or close joint dysfunction. According to femoral shaft efficacy evaluation standards, 23 patients got an excellent result, 1 good.

CONCLUSIONUnilateral fixator assisted closed reduction and interlocking intramedullary nail fixation for the treatment of femoral shaft fracture has following advantages: less trauma, simple operation, effective reduction, high rate of fracture healing, and low complication rate.

Adult ; Aged ; External Fixators ; Female ; Femoral Fractures ; surgery ; Fracture Fixation, Intramedullary ; methods ; Fracture Healing ; Fractures, Comminuted ; surgery ; Humans ; Male ; Middle Aged ; Traction

Acid-soluble collagen (ASC) and pepsin-soluble collagen (PSC) from the spine (ASC-SP and PSC-SP) and skull (ASC-SK and PSC-SK) of the skipjack tuna, Katsuwonus pelamis, were successfully isolated and characterized. The yields of ASC-SP, PSC-SP, ASC-SK and PSC-SK were (2.47 ± 0.39)%, (5.62 ± 0.82)%, (3.57 ± 0.40)%, and (6.71 ± 0.81)%, respectively, on the basis of dry weight. The four collagens contained Gly (330.2-339.1 residues/1 000 residues) as the major amino acid, and their imino acid contents were between 168.8 and 178.2 residues/1 000 residues. Amino acid composition, SDS-PAGE, and FTIR investigations confirmed that ASC-SP and ASC-SK were mainly composed of type I collagen, and had higher contents of high-molecular weight cross-links than those of PSC-SK and PSC-SP. The FTIR investigation also certified all the collagens had triple helical structure. The denaturation temperatures of ASC-SK, PSC-SK, ASC-SP, and PSC-SP were 17.8, 16.6, 17.6, and 16.5 °C, respectively. All isolated collagens were soluble at acidic pH (1-5) and lost their solubilities when the NaCl concentration was above 2% (W/V). The isolated collagens from the spines and skulls of skipjack tuna could serve as an alternative source of collagens for further application in food, cosmetic, biomedical, and pharmaceutical industries.
Acids ; chemistry ; Amino Acids ; analysis ; Animals ; Collagen ; chemistry ; isolation & purification ; Collagen Type I ; chemistry ; isolation & purification ; Hydrogen-Ion Concentration ; Molecular Structure ; Molecular Weight ; Pepsin A ; chemistry ; Skull ; chemistry ; Sodium Chloride ; Solubility ; Spine ; chemistry ; Temperature ; Tuna

OBJECTIVEThe aim of this research was to investigate the third phase Anisakis simplex larvae (Anisakis L₃) infection in marine fish caught in Zhoushan Fishery and to find out its physicochemical and biological characteristics.

METHODSA total of 444 fish belonging to 29 species were dissected to isolate anisakis larvae which were then morphologically identified. The survival tolerance of Anisakis L₃ were observed in various conditions, such as in different temperature and medium.

RESULTSA total of 218 fish from 21 species were infected by Anisakis simplex larvae, yielding an overall infection rate of 49.10% (218/444). Trichiurus haumela, pneumatophorus japonicus, miichthys miiuy, argyrosomus argentatus and anguilliformes had high infection rate and had an average infection intensity of 15.28 per fish. 3332 Anisakis larvae were detected in 218 fish, among which Anisakis L₃ and Pseudoterranova larvae accounted for 99.46% (3314/3332) and 0.54% (18/3332) respectively. Anisakis L₃ was highly resistant to common condiment. We found the liquor with high concentration of alcohol showed better insecticidal effect than that with low concentration of alcohol (t = 4.105, P < 0.05) and low concentration mebendazole composite was not only more effective than high concentration mebendazole composite (F = 45.198, P < 0.01) but also more effective than other drugs, such as albendazole and mebendazole. Anisakis L₃ could live up to 9 h and 12 h at -20°C, -10°C respectively, however they were very sensitive to high temperature. It has been shown that they could only survive for less than 11 s and 1 s at 50°C and 60°C respectively.

CONCLUSIONThe observed Anisakis L₃ infection rate in the marine fish found in Zhoushan Fishery was very high. Anisakis L₃ showed high resistance to low temperature but not to high temperature.

Animals ; Anisakiasis ; parasitology ; veterinary ; Anisakis ; Fish Diseases ; parasitology ; physiopathology ; Fisheries ; Fishes ; parasitology ; Larva ; Temperature

Objective To study the survival rate,complications and risk factors affecting clinical outcomes in extremely low birth weight (ELBW) premature infants.Method From January 2008 to December 2017,clinical data of ELBW infants admitted to the department of neonatology of our hospital were collected.The survival rates and the incidences of complications were compared between different subgroups of different birth weight (BW) and discharging date.The risk factors affecting the survival rate of ELBW infants were analysed using multivariate unconditional Logistic regression analysis.Result (1) A total of 438 ELBW infants were enrolled,representing 4.9％ (438/8 910) of all discharged preterm infants,and 2.6％ (438/16 948) of all discharged neonates during the study period.Among them,3 were excluded because of incomplete data and lost of follow-up.The BW was 900 (750,950) g and the gestational age was (28.0±2.1) weeks.The overall survival rate was 81.6％ (209/256) with 179 cases excluded for giving up treatment.(2) From 2008 to 2017,the percentages of ELBW infants among all discharged newborns and all discharged premature infants increased annually (x2 trend=6.818,27.850,P=0.009,＜0.001).(3) No significant differences existed in the survival rates of ELBW infants between 2013-2017 and 2008-2012(P＞0.05).The survival rates of different BW groups (＜700 g,700～799 g,800～899 g,and 900～999 g)increased from 40.0％ (6/15) to 88.5％ (139/157) (x2 trend=32.648,P＜0.001).(4) The main complications in ELBW infants were respiratory distress syndrome 87.5％ (224/256),retinopathy of prematurity 63.1％ (123/195),and bronchopulmonary dysplasia 63.0％ (126/200).(5) Multivariate unconditional logistic regression analysis showed that BW＜900 g (＜700 g∶ OR=10.147,95％CI 2.684～38.360;700～799 g∶ OR=6.978,95％CI 1.647～29.555;800～899 g∶ 0R=4.727,95％CI 1.060～21.082,P＜0.05),and gestational age＜28 weeks (OR=3.529,95％CI 1.601～7.778,P=0.002) were the risk factors for survival rate and antenatal steroids was the protective factor(OR=0.155,95％CI 0.069～0.353,P＜0.001).Conclusion The number of ELBW infants discharged from neonatology department increased annually.The survival rate of ELBW infants was positively correlated with BW.Antenatal steroids may improve the survival rate of ELBW infants.