[Objective]To explore the effective treatment method of the articular fracture in distal radius.[Method]Severely comminuted AO type-C3 intra-articular fractures of the distal end of the radius were treated with combined internal and external fixation.The Gartland and Werley system and the Green and O'Brien system were used for comparison of the pre-operative and after operative evaluation.Total articular congruity had been assessed with both clinical rating systems.[Result]At a mean of ninteen months following-up,the mean arc of flexion-extension was 78% of that on the uninjured side and the mean grip strength was 82% of that on the uninjured side.The mean total articular incongruity(the gap plus the step-off)averaged 2 mm,and the radial length was restored to a mean of 11 mm.According to the Gartland and Werley demerit-point system,seventeen of the patients had a good or excellent result.According to the modified Green and O'Brien clinical rating system,eleven had a good or excellent result.Postoperative total articular incongruity had a moderately strong correlation with the outcome as assessed with both clinical rating systems.[Conclusion]Open reduction and combined internal and external fixation of AO type-C3 fractures can restore radiographic parameters to nearly normal values,maintain reduction throughout the period of fracture-healing,and provide satisfactory functional results.

Objective To investigate the predictive value of fluid overload for mortality in children with severe sepsis.Methods In this retrospective study,the children with severe sepsis who were admitted to the Pediatric Intensive Care Unit (PICU),Children's Hospital of Soochow University between January 2011 and March 2015.Fluid accumulation was calculated in the first 72 hours after admission.Pediatric index of mortality Ⅱ (PIM2) score was calculated during the first 1 hour after admission.Multivariate Logistic regression analysis assessed the relationship between fluid overload and mortality after adjustment for confounding factors.The predictive value of fluid overload for mortality was assessed by the receiver operating characteristic curve and au area under the receiver-operating-characteristic curve (AUC).Results Of the 199 children admitted,62 cases (31.2％) died during PICU stay.Among the children,133 cases (66.8％) had fluid overload of＜5％,55 cases (27.6％)had fluid overload of≥5％-10％,and 11 cases (5.6％) had fluid overload of≥ 10％.Multivariate regression analysis showed that a high fluid overload percent (OR =1.263,95 ％ CI:1.113-1.434,P ＜ 0.001),a high PIM2 score (OR =1.028,95 ％ CI:1.012-1.043,P ＜ 0.001) and multiple organ dysfunction syndrome(OR =4.160,95％ CI:1.728-10.012,P =0.001) were independent risk factors for mortality in children with severe sepsis.The fluid overload was significantly associated with mortality (OR =1.309,95％ CI:1.158-1.480,P ＜0.001),even after adjustment for age and illness severity assessed by PIM2 scores.Fluid overload achieved AUC of 0.741 (95％ CI:0.661-0.820,P ＜ 0.001) for predicting mortality in children with severe sepsis.Conclusion Fluid overload developed during the first 72 hours after admission is independently associated with and predictive of PICU mortality in children with severe sepsis.

Background The fundus autofluorescence (FAF)can reflect the function of retinal pigment epithelium(RPE) cell.As an invasive examination,it has been extensive used in retina disease,but there has not any report in syphilitic posterior uveitis.Objective This study was to characterize and contrast the FAF and fundus fluorescein angiography (FFA),indocyanine green angiography (ICGA) findings in patients with syphilitic posterior uveitis.Methods A retrospective series of cases observational study was designed.The clinical data of 27 eyes from 18 patients with syphilitic posterior uveitis were included in Shanghai First People's Hospital from 2010 May to 2012 October,and all the patients were diagnosed by serologic and ophthalmic tests.The patients were assigned to acute stage group(with the course ＜2 months)and chronic stage group(with the course ≥ 2 months).FFA,ICGA and FAF were performed respectively on all the patients,and the examination results were compared and analyzed.Results In the affected eyes with syphilitic posterior uveitis,the FFA image showed a retinal vasculitis sign and mottle-like fluorescence appearance in posterior pole and equator zone,and some affected eyes exhibited edema of optic disc and macula.Hypoautofluorescence zone was seen in the acute stage group and cystoid macular edema was found in the chronic stage group.ICGA presented with a wider damage of RPE,especially in the later phase of ICGA.A confluent of hyperautofluorescence with hypoautofluorescence in the posterior fundus,punctiform hyperautofluorescence as well as hypoautofluorescence in papillitis and macular edema were found on the FAF image.Conclusions The pathological basis of syphilitic posterior uveitis is retinal vasculitis and papillitis.ICGA indicates the damage of choroid membranes and RPE,and FAF reflects a metabolism disorder of RPE in the acute stage and atrophy and loss of RPE in the chronic stage.FAF is helpful for the diagnosis of syphilitic posterior uveitis as an assistant index.

[Objective]The purpose of this study was to describe mid report the result of the ulnar nerve transfer to biceps muscle to restore elbow flexion after acute and delayed upper brachial plexus injuries.[Methods]Two patients with acute brachial plexus injury (the time between the injury and the operation were six and eight months) and three patients with delayed brachial plexus injury(the time between the injury and the operation were from twevle to eighteen months) underwent nerve transfer using fascicles of the ulnar nerve to the motor branch of the biceis muscle. The average age of the patients was twenty eight and the mean follow-up periods were nine months after the surgery. Patients were evaluated with regard to reinnervation of the biceps, ulnar nerve function, elbow flexion strength, and grip strength.[Results]For the two acute patients, the first sign of biceps muscle contraction were observed within 1 week, the average time required for reinnervation of the biceps after nerve fascicle transfer was within six months. For the three delayed patients, the first sign of bicep muscle contraction was observed in about three month, and the average time required for reinnervation of the biceps was ten months.Hypoesthesia of the ulnar nerve was clinically abserved in three patients, but this symptom disappeared within month with no treatment.Compared with those delayed cases, the acute patients had faster and better recovery of their olbow flexion function.However, all patients achieved grade-3 or better elbow flexion strength according to the grading system of the Medical Research Council.[Conclusion]The author recommend this safe, simple and effective Oberlin procedure for brachial plexus injuries involving the C5、6 or C5~7 nerve roots.

In this paper, miRNAs features were briefly introduced and agreeable points were discussed from 4 aspects: organs relationship, syndrome research, Chinese medical pathogeneses, and actions of Chinese herbs. miRNAs, as information media for organs interrelation, was believed to explain Chinese medical pathogeneses and reveal partial molecular mechanisms of Chinese medicine. miRNAs in the body fluid could be taken as one of biological bases of syndromes.
Biomedical Research ; China ; Humans ; Medicine, Chinese Traditional ; trends ; MicroRNAs ; Syndrome

0.05).There was significant difference between normal control group and group A and B(P0.05 ).Neuron counting was significantly higher in group B than that in group A 4 weeks after treatment(P

Objective To investigate the therapeutic effect of medication-based acupuncture on osteoporotic compression fracture and explore clinical effective intervention in the patients. Method Fifty-six patients were randomized to acupuncture-medicine and medicine groups, 28 cases each. The clinical therapeutic effects were evaluated after treatment. Bone density, BGP and IL-6 were measured before and after treatment. Result BGP and IL-6 decreased significantly in the two groups after treatment compared with before (P<0.01) and decreased more in the acupuncture-medicine group than in the medicine group (P<0.05). BMD increased significantly in the acupuncture-medicine group after treatment compared with before (P<0.05) and did not increased significantly in the medicine group after treatment (P>0.05). Conclusion Warm needling moxibustion plus medication is effective than medication alone in treating osteoporotic compression fracture. It can decrease serum BGP and IL-6 contents and relieve the clinical symptoms in the patients. Acupuncture plus medicine not only produces a marked analgesic effect but also has a positive role in preventing the aggravation of osteoporosis and avoiding second fracture.

Objective: The current study was designed to investigate the retreatment of locally recurrent nasopharyngeal carcinoma (NPC) with three-dimensional conformal radiation therapy (3-D CRT). Methods: From April 1998 to October 1999, 26 patients with locally recurrent NPC (25 patients were poorly differentiated squamous cell carcinoma, 1 poorly differentiated adenoma) were retreated by 3-D CRT. The patients were restaged according to the Huaqing staging system with the following distribution: rT1N0M0 4, rT2N0M0 8, rT3N0M0 9, rT4N0M0 5. The maximal dimension of gross tumor volume (GTV) ranged from 1.0 cm to 5.0 cm (median: 3.1 cm). Among 5- 7 static conformal portals were delivered with coplanar or noncoplanar isocentric irradiation technique in this trial. The mean value of the maximal dose, the minimal dose and the average dose of the planning target volume (PTV) were 104.1± 1.3％ ,92.1± 2.8％ ,and 99.2± 1.7％ ， respectively. The prescription dose-fractionation-time was 65- 70 Gy/26- 28 F/5- 5.5 W. The median fellow-up time after 3-D CRT was 17 months(range:8- 26 months). Results:In the follow-up time,2 patients occurred marginal recurrence, 3 patients occurred regional failure, 2 patients occurred distant metastasis, and 4 patients died. No evidence of local failure was found in 88.5％ (23/26) of the patients, and 84.6％ (22/26) of the patients survived during the follow-up time. The acute and self-limiting complications from reirradiation were slight and few. The overall incidence of late radiation complications after reirradiation was 19.2％ (5/26). Functional impairment developed in 15.4％ (4/26) of the patients after reirradiation. Conclusion:3-D CRT,for locally recurrent NPC, had an obvious advantage on dose distribution. This preliminary result indicated that this new radiotherapy technique had a high local control rate and low complication rate. But its long term curative effect and sequelae need to be further observed.

OBJECTIVE: To summarize the method and experience of direct observation of the effect of mitral valvuloplasty on beating heart. METHODS: Twelve patients with mitral regurgitation underwent mitral valvuloplasty. When the heart was beating slowly before releasing the aorta, the morphology and function of the mitral valve were evaluated by direct observation. If the results were unsatisfactory, further techniques were used to reach the goal. RESULTS: During the operation 2 patients needed further techniques to make the mitral valve work well. No operative death and only 1 complication (low cardiac output syndrome) occurred. After 1 month follow-up later, mild regurgitation was found in 5 patients, moderate regurgitation in 1 and no obvious regurgitation in 6. CONCLUSION Evaluating the effect of mitral valvuloplasty by direct observation on beating heart is practicable.
Adolescent ; Adult ; Child ; Child, Preschool ; Female ; Heart ; physiology ; Humans ; Male ; Mitral Valve ; surgery ; Mitral Valve Insufficiency ; surgery ; Retrospective Studies ; Treatment Outcome ; Young Adult

To explore the growth and development and analyze the quality of the parthenocarpy fruit induced by exogenous hormones of Siraitia grosvenorii. the horizontal and vertical diameter, volume of the fruit were respectively measured by morphological and the content of endogenous hormones were determined by ELISA. The size and seed and content of mogrosides of mature fruit were determined. The results showed that the fruit of parthenocarpy was seedless and its growth and development is similar to the diploid fruit by hand pollination and triploid fruit by hand pollination or hormones. But the absolute value of horizontal and vertical diameter, volume of parthenocarpy fruit was less than those of fruit by hand pollination, while triploid was opposite. The content of IAA, ABA and ratio of ABA/GA was obviously wavy. At 0-30 d the content of IAA and ABA of parthenocarpy fruit first reduced then increased, content of IAA and GA parthenocarpy fruit was higher than that of fruit by hand pollination. Mogrosides of parthenocarpy fruit was close to pollination fruit. Hormones can induce S. grosvenorii parthenocarpy to get seedless fruit and the fruit shape and size and quality is close to normal diploid fruit by hand pollination and better than triploid fruit by hormone or hand pollination.
Cucurbitaceae ; chemistry ; drug effects ; genetics ; growth & development ; Diploidy ; Fruit ; chemistry ; genetics ; growth & development ; Plant Growth Regulators ; pharmacology