OBJECTIVETo compare therapeutic effects of locking plates for the treatment of Neer 3-and 4-part proximal humerus fractures.

METHODSFrom January 2009 to June 2011, 64 patients with Neer 3-and 4-part proximal humerus fractures were treated with locked plate fixation. There were 39 patients in the 3-part group including 16 males and 23 females, with an average age of (55.12 +/- 12.52) years old; and 25 patients in the 4-part fractures group including 9 males and 16 females,with an average age of (57.92 +/- 13.14) years old. The American Shoulder and Elbow Surgeons score (ASES), visual analogue scale (VAS) and complications were documented for analysis before and after treatment.

RESULTSAll the patients had incision healing at the first stage. All the patients were followed up, and the duration ranged from 12 to 30 months, with a mean of 16.5 months. Comparably better shoulder function recovery was achieved in the 3-part fractures group with regard to the ASES (76.14 +/- 14.10 in the 3-part fractures group vs. 65.93 +/- 11.82 in the 4-part fractures group, P < 0.05). Moreover,a statistical difference (P < 0.05) was observed regarding the VAS pain score (2.12 +/- 1.63 in the 3-part fractures group vs. 3.90 +/- 2.21 in the 4-part fractures group). For the complications rate,no statistical difference was noted between 3-part fractures group and 4-part fractures group (20.51% vs. 36.00%).

CONCLUSIONThe clinical outcomes of the 3-part proximal humerus fractures is better than the 4-part fractures proximal humerus fractures treated with locking plate. Complex proximal humeral fractures treated with locking plates can be achieved a satisfactory outcome when attention is paid to anatomic reduction, stable fixation, proper screws and plate placement, and reasonable functional exercise postoperative.

Adult ; Aged ; Aged, 80 and over ; Bone Plates ; Case-Control Studies ; Female ; Fracture Fixation, Internal ; instrumentation ; methods ; Humans ; Male ; Middle Aged ; Shoulder Fractures ; diagnostic imaging ; surgery ; Tomography, X-Ray Computed ; Treatment Outcome

Objective In order to study the hemodynamics changes of the Budd Chiari syndrome vascular based on Computer Sim-ulation.Methods Three dimensional reconstruction model is established based on MRA medical images.Then take use of Ansys Fluent software to simulate hemodynamic parameters.Results Budd Chiari syndrome vascular model is established successfully. The hemodynamics changes on/above the vascular confluence of inferior vena cava with three main hepatic veins.Contract to the flow inlet of inferior vena cava,blood pressure becomes larger,the speed becomes slower and shear stress becomes smaller.Conclu-sion The inferior vena venous hemodynamics changes region is almost consistent with inferior vena venous predilection location. The study lays the groundwork for future study of Budd Chiari syndrome negotiations.

Objective To evaluate the diagnostic value of detection of IgM antibodies to EV71-infection patients,and compared characterisation of RT-PCR,IgM capture ELISA and neutralization test.Methods Virus RNA,neutralization titer and IgM antibody in 115 EV71-infection patients were detected by EV71 real-time RT-PCR kit( EV71-PCR kit),neutralization test,and EV71 IgM-capture ELISA kit (EV71-IgM kit),respectively.Results Using EV71-IgM kit,the detection rate was 80.9％ (93/115,95％ CI:72.5-87.6) among the 115 EV71-infection patients,and was 2.6％ among the 228 healthy children.Simultaneously,sera collected after 1-2 day of disease onset showed an IgM positivity of 70.4％ (38/ 54).The positive rate of EV71-PCR among these patients was 82.6％ (95/115,95％ CI:74.4-89.0),so there was no statistically significant differences between it and EV71-IgM kit.In addition,the detection rate in EV71-infection patients could increase to 92.2％ by combined detection of EV71-PCR and EV71-IgM kit.Conclusion EV71-IgM kit was a rapid and valuable way for the early diagnosis of EV71 infection,and could significantly improve detection rate for EV71 infection by combining with EV71-PCR kit.

Objective To observe the clinical efficacy of acupoint iontophoresis with Sinomenine hydrochloride in treating knee osteoarthritis (KOA).Method Sixty KOA patients were randomized into a treatment group and a control group, 30 cases each. The treatment group was intervened by iontophoresis with Sinomenine hydrochloride into specific acupoints via a direct current iontophoresis appliance; the control group was intervened by oral administration of Meloxicam tablets. The Lequesne index, Visual Analogue Scale (VAS) and knee joint space were observed before and after the intervention.Result The Lequesne and VAS scores were significantly changed after the treatment in the two groups (P<0.01,P<0.05). After the intervention, there was a significant difference in the Lequesne score between the two groups (P<0.01). After the treatment, the knee joint space didn't show significant intra-group or between- group differences (P>0.05).Conclusion Acupoint iontophoresis with Sinomenine hydrochloride is an effecttive method in treating KOA.

OBJECTIVETo study the antiproliferation effect on HepG2 cells and its underlying mechanism of the active chemical composition of the Viburnum Odoratissimum.

METHODS3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl tetrazolium bromide (MTT) reduction assay and trypan blue dye exclusion assay were used to assess the effect of vibsane-type diterpenoids on the proliferation of various tumor cells. Alterations in cell cycle and apoptosis were determined by flowcytometry. The enzymatic activity of caspase-3/7 was measured by Apo-ONE homogeneous Caspase-3/7 Assay kit.

RESULTSCompound 1 #, a vibsane-type diterpenoid, was found to significantly inhibit the growth of HepG2 cells by anticancer proliferation activity screening. It was demonstrated that the modified groups on side chain coupled to C11 site affected the cell growth-inhibition activity of compounds by structure-activity analysis. In addition, HepG2 cell line was most sensitive to compound 1 #, which induced growth arrest of HepG2 cells in a dose- and time-dependent manner. Study on the mechanisms underlying these effects indicated that compound 1 # induced significant G0/G1 phase arrest of HepG2 cells in a time- and concentration-dependent manner. Meanwhile, It was found that higher concentrations of compound (5-10 micromol/L) caused evident increase in the unmber of apoptotic cells and dose-dependent activation of caspase-3/7.

CONCLUSIONVibsane-type diterpenoids could significantly inhibit the growth of HCC HepG2 cells. Induction of cell cycle arrest and apoptosis may play important roles in their anticancer effects.

Apoptosis ; drug effects ; Cell Cycle Checkpoints ; drug effects ; Cell Proliferation ; drug effects ; Diterpenes ; pharmacology ; Hep G2 Cells ; Humans ; Viburnum ; chemistry

OBJECTIVETo evaluate clinical outcome after anterior cruciate ligament (ACL) reconstruction with double-bundle or single-bundle by meta-analysis.

METHODSRandomized controlled trials (RCTs) on differences of clinical outcomes of ACL reconstruction were retrieved in Ovid Medline, PubMed, Embase, Cochrane Library, CBM and VIP database. Relevant journals or conference proceedings were also searched manually. Then extracted the date of KT-1000 arthrometer, pivot-shift testing, Lysholm score and IKDC final score in these researches. RevMan 5.0.23 software was used for data analyses.

RESULTSEight prospective RCTs met the inclusion criteria. The combined results of meta-analysis indicated that there was statistical difference between two operative procedures on postoperative KT-1000 arthrometer side-to-side [WMD = -0.35, 95%CI (-0.61, -0.08), P = 0.01], Lysholm score [WMD = -1.91, 95%CI (-3.45, -0.37), P = 0.01]. But the difference of KT-1000 arthrometer side-to-side is demonstrated to be clinically insignificant. Others indicated that there was no statistical differences with respect to IKDC final score [OR = 1.80, 95%CI (0.98, 3.31), P = 0.06], having a normal or nearly normal pivot-shift testing [OR = 1.64, 95%CI (0.85, 3.16), P = 0.14].

CONCLUSIONSDouble-bundle reconstruction does not result in clinically significant advantage when compared with single-bundle. The results do not support the theory that double-bundle reconstruction controls knee rotation better.

Anterior Cruciate Ligament ; surgery ; Humans ; Joint Instability ; surgery ; Reconstructive Surgical Procedures ; methods ; Treatment Outcome

PURPOSETo discuss surgical technique, operative efficacy and clinical outcome of intramedullary fixation in the treatment of subtrochanteric femur fractures.

METHODSFrom February 2011 to February 2013, 76 cases of subtrochanteric femur fractures were treated by intramedullary fixation in our hospital, including 53 males and 23 females, with the age range of 37 -72 years (mean 53.5 years). According to Seinsheimer classification, there were 2 cases of type I, 7 type II, 15 type III, 23 type IV and 29 type V. Firstly, all patients underwent closed reduction with the guidance of C-arm fluoroscopy in a traction table. Two cases of type I and 3 cases of type III fractures had ideal closed reduction followed by internal fixation. The others needed additional limited open reduction. Radiographic examination was used to evaluate callus formation and fracture healing in postoperative 1, 3, 6 and 12 months follow-up. Functional recovery was evaluated by Harris Hip Scoring (HHS) system.

RESULTSPatients were followed up for 6-12 months. All fractures were healed except one patient with delayed union. The average bone union time was 4.5 months. According to HHS system, 65 cases were considered as excellent in functional recovery, 8 good, 2 fair and 1 poor. The proportion of the patients with excellent and good recovery was 96.05%.

CONCLUSIONIntramedullary fixation is feasible for the treatment of subtrochanteric femur fracture. The accuracy of intraoperative reduction and surgical skill are important for the clinical outcome and the patients' prognosis.

Adult ; Aged ; Female ; Femoral Fractures ; classification ; surgery ; Fluoroscopy ; Fracture Fixation, Intramedullary ; methods ; Humans ; Male ; Middle Aged ; Prognosis ; Recovery of Function ; Treatment Outcome

OBJECTIVETo observe the effect of Yanggan Yishui Granule (YGYSG) on collagen protein I, III, and IV, as well as fibronection (EN) in spontaneously hypertensive rats (SHR), and to explore its possible renal protective mechanisms.

METHODSFourty SHR were randomly divided into four groups, i.e., the model group, the Benazepril group, the low dose YGYSG group, and the high dose YGYSG group, 10 in each group. A normal control group was set up with recruited Wistar-Kyoto (WKY) rats. After 6 weeks of treatment, the expression of collagen protein I, III, and IV, as well as FN in the 5.1 image analysis system.

RESULTSIn the WKY-control group, there was only a small amount of brown particles in the mesenchymal region, the glomerular basement membrane, or the mesangial region. The expression of collagen I, Ill, and IV, as well as EN significantly increased more in the model group than in the normal control group (P < 0.01). After treatment, the expression of collagen I, III, and IV, as well as FN significantly decreased in each treated group, showing statistical difference when compared with the model group (P < 0.01). Besides, decresed expression of collagen I, III, and IV was shown in the low dose YGYSG group and the Benazepril group (P > 0.05). The expression of collagen I, III, and IV could be further reduced in the high dose YGYSG group, showing statistical difference when compared with the Benazepril group and the low dose YGYSG group (P < 0.05, P < 0.01).

CONCLUSIONYGYSG might play an important role in the renal protective effect through reducing the synthesis of renal collagen I, III, and IV, as well as FN, increasing the degradation of renal collagen I, III, and IV, as well as FN, thereby reducing excessive deposition of renal extracellular matrix (ECM).

Animals ; Collagen ; metabolism ; Drugs, Chinese Herbal ; pharmacology ; Fibronectins ; metabolism ; Hypertension ; drug therapy ; metabolism ; Kidney ; metabolism ; Male ; Rats ; Rats, Inbred SHR ; Rats, Inbred WKY

Objective To explore the importance and methods of retaining articularis during pri- mary total hip arthroplasty(THA)and reconstruct soft tissue balance of hip joint after THA.Methods From February 2003 to August 2005,41 eases(43 hips)including 19 males and 22 females at age of 46- 80 years(mean 66.5 years)were treated with THA with retained capsule(Group R)and other 42 cases (44 hips)including 20 males and 22 females at age of 43-80 years(mean 64.3 years)with standard THA (Group S).Preoperative diagnosis found femoral neck fractures(GardenⅢⅣ)in 13 cases(13 hips)in Group R and 14(14 hips)in Group S;acetabular dysplasia(CroweⅢ)in 9(9 hips)in Group R and 8 (hips)in Group S;Osteoarthritis in 6(8 hips)in Group R and 7(8 hips)in Group S;and femoral head osteonecrosis(FicatⅢⅣ)in 13(13 hips)in Group R and 13(14 hips)in Group S.There were 13 hips of cement prostheses in Group R and 11 in Group S,8 cementless prostheses in Group R and 8 in Group S, 22 cement and cementless prostheses in Group R and 23 in Group S.Gibson's approach was used in both groups.Group R used the method of retaining capsule and little supination muscles during the operation to reconstruct responsibly soft tissue balancing of postoperation for THA.For comparison,Group S used the method of standard which resected a lots of capsule and didn't reconstruct it.The comparative items between Group R and Group S included incisional length,operative time,operative bleeding,drainage transfusion, infection,dislocation,postoperation standing,postoperation walking and Harris's score.Results All cases in Group R and Group S were followed for 6-22 months(mean 16.5 months in Group R and 16.7 months in Group S).There was significantly statistical difference upon interoperative and postoperative data between Group R and Group S.The result of Group R was significantly better than that of GS.Conclu- sion Retaining articularis during primary THA can minimize operative trauma,reconstruct soft tissue bal- ance and augment hip stability to get postoperative functional recovery.

Objective To compare the histologic grade between biopsy and postoperative specimen in bladder urothelial carcinoma,and approach the state and the reasons of underestimate the histologic grade preoperative.Methods We retrospectively 82 cases of urothelial carcinoma at the Third Affiliated Hospi- tal of the Sun Yat-Sen University.For all the cases in this study,the histologic grade,using the 1998 World Health Organization and International Society of Urological Pathologists(WHO/ISUP)classification,was i- dentical when the biopsy specimen and postoperative specimen were compared.Results In this study,35 cases,28 cases and 19 cases were G_1、G_2、G_3 by biopsy preoperative,respectively;while 22 cases,32 cases、28 cases were G_1、G_2、G_3 postoperative,respectively.There were 24 cases(29.3%)underestimate the histo- logic grade by biopsy preoperative in the 82 cases,while 4 cases(4.9%)overestimate preoperative.The state of underestimate the histologic grade is correlated with the location of biopsy,tissue dose and the conser- vation of pathology judgment.Conclusions There were 24 cases(29.3%)underestimate the histologic grade by biopsy preoperative.We should pay more attention to this state of underestimate the histologic grade preoperative in the treatment of bladder urothelial carcinoma.