BACKGROUND:The current fixation methods for clavicle fracture are mainly anatomy plate or reconstruction plate. The specific devices for maintaining fracture alignment and fixation are rarely reported. The majority of physicians prefer reduction forceps to maintain fracture alignment and retain plate for internal fixation. However, reduction forceps have many disadvantages, such as large damage, instable fixation and difficult to bend or mould plates.
OBJECTIVE:To compare the clinical effect of new-style bone holder and reduction forceps in treatment of clavicular fractures.
METHODA total of 75 patients with clavicular fractures were recruited from Department of Orthopedics, Huai’an First Hospital, Affiliated to Nanjing Medical University, between December 2011 and December 2013. The involved patients were randomly divided into two groups, new-style bone holder (39 cases) and reduction forceps (36 cases). In new-style bone holder group, the wounds were opened and reduced using reduction forceps, then new-style bone holder was applied to maintain fracture alignment and internal fixation;in reduction forceps group, the wounds were opened and reduced using reduction forceps, then reduction forceps was applied to maintain fracture alignment and internal fixation. The length of incision, the time of operation, intraoperative blood loss, fracture healing time and clinical efficacy in two groups were compared.
RESULTS AND CONCLUSION:Al cases were fol owed up for over half a year. There was no significant difference between the two groups in the length of incision (P>0.05). The new-style bone holder group was obviously better than reduction forceps group in the time of operation, intraoperative blood loss and fracture healing time, with significant difference (P<0.01). The clinical efficacy was significantly higher than reduction forceps group. Experimental findings indicate that, new-style bone holder is characterized by simple operation, few trauma, stable fixation, short operation time, and rapid fracture healing.

Objective To compare the clinical effect of tube bone fractures with a modified bone holding and the traditional three -claw bone holding. Methods 94 cases of tube bone fractures were compared based on their sequence,the odd number (group A) were treated with the modified bone holding; the even number (group B) were treated with the traditional three-claw bone holding; and then the length of incision,the time of operation,the lost blood during the operation,the reduction of those fractures,the time for those fractures to get cicatrization were compared. Results All cases were followed up over half a year,which was no significant difference between the two groups in the reduction of those fractures. The group A had significant advantages than group B in the length of incision,the time of operation,the lost blood during the operation,the time for those fractures to get cicatrization. Conclusion The modified bone holding is better than the traditional three-claw bone holding in the length of incision,the time of operation,the lost blood during the operation,the time for those fractures to get cicatrization.

Objective To explore the value of cardiac troponin-I (cTnI), B-type natriuretic peptide (BNP) and blood lactic acid (Lac) on evaluation of severity and prognosis in patients with septic myocardial dysfunction (SMD). Methods According to retrospective analysis of clinical data,161 cases with sepsis were divided in to SMD group and non-SMD group. And the SMD group was further divided in to death group and survival group. Blood cTnI, BNP and Lac value in each group were detected respectively. The ROC curve was used to evaluate the forecast value of cTnI, BNP and Lac on prognosis for patients. Results The value of cTnI, BNP and Lac in SMD group were significantly higher than those in non-SMD group(P<0.05);The value of cTnI, BNP and Lac in death group among the SMD patients were significantly higher than those in survival group(P<0.05);cTnI, BNP and Lac contribute to predict the 28 day mortality rate of SMD. Conclusions Blood cTnI, BNP and Lac contributes to the assessment of the severity and the prognosis of septic patients with myocardial dysfunction.

Objective To investigate the effects of microRNA-29a (miR-29a) on lipopolysaccharide (LPS)-induced apoptosis in human monocytes THP-1 cells in order to understand the molecular mechanisms.Methods Human monocytes THP-1 cell line were exposed to LPS after transfected with miR-29a inhibitors (100 nmol/L) or just transfected with miR-29a mimic (100 nmol/L) by lipofectamine RNAiMAX.Flow cytometry (FCM) was used to detect the cell apoptosis.Real-time RT-PCR was employed to measure expressive levels of the gene Bcl-2 and Mcl-1.The luciferase assay was performed in HEK293T cells,which were co-transfected with plasmid DNA and miRNA by using Lipofectamine 2000.Statistical analysis carried out by using SPSS 13.0 software for One-way ANOVA and Student' s t test.Results Transfection with miR-29a mimics for 48 h increased apoptosis rate and significantly reduced the expressions of Bcl-2 and Mcl-1 in THP-1 cells in comparsion with the control group.The apoptosis rate also raised in THP-1 cell stimulated by LPS for 24 h followed by LPS stimulation for 24 h,the apoptosis rate was decreased in comparison with the LPS group.In addition,our luciferase assay data showed that HEK293T cells cotransfected with miR-29a mimics and Bcl-2 3 ' UTR-Wt or Mcl-1 3' UTR-Wt plasmid significantly reduced the luciferase activity compared with the control group.Conclusions The miR-29a may regulate apoptosis by targeting the genes Bcl-2 and Mcl-1,and miR-29a may play a pivotal role in the process of apoptosis in immune cells.

Objective To investigate the effect of oil with medium-long-chain triacylglycerols on blood lip- id and lipoproteins in hyperlipemic patients. Methods Totally, 112 patients with hypertriglyceridemia were en- rolled and randomly divided into MLCT group (consumed oil with medium-long-chain fatty acids) and LCT group (consumed oil with long-chain fatty acids) (both 25-30 g/d for 8 weeks). Patients in both two groups were also instructed to take exercises. Height and weight were measured at baseline and 8 weeks later. Blood glucose, serum levels of aspartate aminotransferase (AST), alanine aminotransferase (ALT), total cholesterols (TC), triglyc- erides (TG), high density lipoprotein cholesterol, low density lipoprotein cholesterol, apolipoprotein Al (ApoAl), ApoB, ApoA II , ApoC2, ApoC3, and ApoE were measured and compared. Results At the end of study, 101 subjects were included. There were 50 subjects left in LCT group and 51 subjects left in MLCT group, respectively. There was no significant difference in weight, ALT, AST, TC, and TG at baseline between two groups (P>0.05). Eight weeks later, weight, serum TG, ApoC2, and ApoC3 were significantly lower and ApoAl level was significantly higher than those at baseline in MLCT group (P < 0.05). At the end of study, the decreases in body weight and blood biochemical variables including TG, ApoB, ApoA II , ApoC2, ApoC3 were significantly much greater in MLCT groups than those in LCT group (P < 0. 05). Conclusion When the diet is reasonably controlled, oil of medium-long-chain triacylglycerols may reduce the concentration of TG and improve the levels of apolipoproteins.

Objective To investigate the effects of medium-and long-chain fatty acid triacylglycerols on blood lipid in hyperltriacylglycerolemic subjects. Method A case-control clinical trial was carried out,in which 112 subjects with hypertriacylglycerolemia were enrolled and divided into two groups. These two groups were randomized to long-chain fatty acid triacylglycerol oil(LCT) ,and medium-and long-chain fatty acid triacylglycerol oil(MLCT) . All subjects were requested to ingest fixed energy intake and perform physical activity daily during the whole study. Both of the oils were asked to consume at 25-30g daily for consecutive 8w. Anthropometric measurements and blood biochemical variables were measured at the initial and final time of the study. Results Eleven subjects were excluded from the study because of various reasons. There were 50 and 51 subjects left in LCT and MLCT group,respectively. No difference of sex distribution was noted between two groups. There were also no significant differences in daily intake of energy,protein,fat and carbohydrate,as well as daily physical activity time between two groups at 0,2,4,6 and 8w. The subjects consuming MLCT demonstrated significant decreasesin body weight,BMI,WC,HC,WHR,body fat,body fat % compared with the initial values after 8w. A greater extent of decrease in body weight,BMI,WC,body fat and body fat% was found in MLCT group than in LCT group. The levels of TG,ApoB,ApoAII,ApoC2,ApoC3 in MLCT group were significantly lower than those in LCT group after 8 w,and the extent of decrease in these indicators was much greater in the former than in the latter. Conclusion Consumption of medium-and long-chain fatty acid oil may help to reduce body weight,body fat and concentration of blood triacylglycerol and improve apolipoprotein metabolism in hypertriacylgly cerolemic subjects under an appropriate dietary regime.

Objective To compare the effects of oil with medium-long-chain triacylglycerols (MLCT) on lipid metabolism in hypertriglyceridemic patients with different sex. Method One hundred and one subjects with hypertriglyceridemia were enrolled and divided into two groups. One group consumed oil with MLCT (50 subjects) and another group with long-chain fatty acid triglyceride LCT (51 subjects) for 8 w. No sex difference was noted between two groups. All subjects were informed to consume 25-30g oils daily with fixed energy and perform exercise informed. Anthropometric measurements of body weight,waist circumference (WC) body fat weight, total visceral and subcutaneous fat area in abdomen and blood biochemical variables of aspartate amino- transferase (AST), alanine aminotransferase (ALT), glucose, total cholesterol (TC), triglyceride (TG), high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C), apolipoprotein A1 (ApoA1), ApoB, ApoAⅡ, ApoC2, ApoC3 and ApoE were measured at initial and final time of the experiment. Results The decreases in body weight, BMI, WC, body fat weight, total and subcutaneous fat area, and blood TG, LDL-C, ApoAⅡ, ApoB, ApoC2, ApoC3, ApoE in male subjects consuming MLCT were much greater than those consuming LCT after 8 w. However, there were no significant differences in these parameters in female subjects between two groups. Conclusion Consumption of oil with MLCT reduces body weight, body fat and blood TG and improves apolipoprotein metabolism in male hypertriacylglycerolemic subjects, but not in female.

Objective To explore the effects of morroniside on the expression of CD34 in ipsilateral cortex of rats after focal cerebral isch-emia-reperfusion. Methods 45 male Sprague-Dawley rats were divided into sham group (n=9), ischemia group (n=9), and morroniside groups (low, medium and high dosage groups, n=9). The middle cerebral artery were occluded for 30 minutes, and reperfused. Morroniside was administered intragastrically once a day at dose of 30 mg/kg, 90 mg/kg, 270 mg/kg after operation. The expression of CD34 in the isch-emic ipsilateral cortex were detected with immunohistochemistry (n=6) and Western blotting (n=3) 7 days after operation. Results The ex-pression of CD34 increased in the ischemia group compared with the sham group, and further increased in the morroniside groups of high dos-age compared with the ischemia group (F>14.865, P<0.001). Conclusion Morroniside could increase the expression of CD34 in the ischemic ipsilateral cortex after ischemia-reperfusion in rats, which may promote the angiogenesis and neurogenesis after ischemia.

Objective: To analyze the epidemiological characteristics, clinical manifestations and imaging charac-teristics of 76 cases with neonatal cerebral infarction, in order to provide evidence for the diagnosis, treatment and prognosis for neonal cerebral infarction. Method: Newborns with cerebral infarction admitted into the Neonatal Center, Beijing Children′s Hospital, Capital Medical University from January 2007 to December 2017 were enrolled.According to neurological sequelae, the participants were divided into good prognosis group and poor prognosis group for retrospective analysis, and their cranial magnetic resonance imaging(MRI) changes and mental development were followed up. Results: The incidence of convulsion was the highest in 76 cases (73.7%, 56/76 cases), among which unilateral limb twitching was characteristic in 39.2% (22/56 cases). Clinical physical examination showed no significant positive signs in 13.2%(10/76 cases) of the patients, but middle cerebral artery involvement accounted for 80.3% (61/76 cases), and there was no abnormal discharge of electroencephalogram in 29.2% (19/65 cases) of the patients.Among 41 children (29.3%) received follow-up, 12 cases had neurological sequelae, and 15 cases (36.6%) received anticoa-gulant therapy.The median area of original damage of T2 sequence cerebral infarction was 10.3%, the median area of diffusion weighted image damage was 2.0%, and the median area of damage of T2 sequence was 1.0%.The median ratio of craniocerebral lesion damage was 8.4%.The ratios of poor prognosis were 14.9%, 4.8%, 0.5% and 14.4%, respectively. Conclusions Neonatal convulsion is the most common manifestation of neonatal cerebral infarction.Unilateral limb clonus is characteristic.The larger the infarct involvement area and the larger the intracranial lesion change area through reexamination, the poorer prognosis of the children.Early anticoagulant therapy could not improve the prognosis of neonatal cerebral infarction.