Objective:To introduce a surgical technique utilizing suture plate fixation for the treatment of elbow "terrible triad" injuries and to evaluate its clinical outcomes.Methods:A retrospective analysis was conducted on 11 patients (9 males and 2 females; mean age: 40.5±9.0 years, range: 26-53 years) with elbow terrible triad injuries who underwent treatment via a single lateral approach (Kaplan approach) combined with loop plate fixation at the Trauma Emergency Center of the Third Hospital of Hebei Medical University between January 2018 and July 2022. During surgery, coronoid process fractures were stabilized using loop plates. Among the radial head fractures, 7 cases were fixed with headless compression screws, while 4 cases underwent radial head prosthetic replacement. Additionally, the lateral collateral ligament complex and common extensor tendon origin were repaired using one suture anchor in all cases. Postoperative evaluations included elbow range of motion (ROM), encompassing flexion-extension and forearm pronation-supination. Radiographic assessments were performed to evaluate the alignment of the humeroradial and humeroulnar joints, degenerative changes, and heterotopic ossification. Functional outcomes were assessed using the Mayo elbow performance score (MEPS) during follow-up.Results:All surgeries were successfully completed without intraoperative complications such as neurovascular injuries. Primary wound healing was achieved in all cases, with no instances of infection or other early complications. The mean follow-up duration was 15.55±3.78 months (range, 12-24 months). At 2 weeks postoperatively, the mean flexion-extension ROM was 66.82°±6.69°, forearm rotation ROM was 132.55°±10.61°, and MEPS was 62.73±3.44 points. By 3 months postoperatively, these values improved to 99.27°±10.82°, 159.18°±9.18°, and 83.18±10.31 points, respectively. At the final follow-up, further improvements were observed, with flexion-extension ROM reaching 115.18°±4.29°, forearm rotation ROM 164.73°±8.71°, and MEPS 95.45±7.89 points. Statistical analysis revealed significant increases in flexion-extension ROM ( F=268.014, P<0.001), forearm rotation ROM ( F=67.621, P<0.001), and MEPS ( F= 63.100, P<0.001) over time. At the final follow-up, MEPS outcomes were rated as excellent in 9 cases and good in 2 cases, yielding an excellent-to-good rate of 100%. Radiographic evaluation confirmed satisfactory joint alignment and bony union in all patients, with no reports of significant pain, elbow instability, or neurological deficits. Mild heterotopic ossification was observed in 2 cases but did not impair daily activities or necessitate additional treatment. Conclusion:The suture plate technique significantly reduced operative time, minimized surgical trauma, and lowered the risks of elbow infection and stiffness, demonstrating favorable clinical outcomes.

Objective:To introduce a surgical technique utilizing suture plate fixation for the treatment of elbow "terrible triad" injuries and to evaluate its clinical outcomes.Methods:A retrospective analysis was conducted on 11 patients (9 males and 2 females; mean age: 40.5±9.0 years, range: 26-53 years) with elbow terrible triad injuries who underwent treatment via a single lateral approach (Kaplan approach) combined with loop plate fixation at the Trauma Emergency Center of the Third Hospital of Hebei Medical University between January 2018 and July 2022. During surgery, coronoid process fractures were stabilized using loop plates. Among the radial head fractures, 7 cases were fixed with headless compression screws, while 4 cases underwent radial head prosthetic replacement. Additionally, the lateral collateral ligament complex and common extensor tendon origin were repaired using one suture anchor in all cases. Postoperative evaluations included elbow range of motion (ROM), encompassing flexion-extension and forearm pronation-supination. Radiographic assessments were performed to evaluate the alignment of the humeroradial and humeroulnar joints, degenerative changes, and heterotopic ossification. Functional outcomes were assessed using the Mayo elbow performance score (MEPS) during follow-up.Results:All surgeries were successfully completed without intraoperative complications such as neurovascular injuries. Primary wound healing was achieved in all cases, with no instances of infection or other early complications. The mean follow-up duration was 15.55±3.78 months (range, 12-24 months). At 2 weeks postoperatively, the mean flexion-extension ROM was 66.82°±6.69°, forearm rotation ROM was 132.55°±10.61°, and MEPS was 62.73±3.44 points. By 3 months postoperatively, these values improved to 99.27°±10.82°, 159.18°±9.18°, and 83.18±10.31 points, respectively. At the final follow-up, further improvements were observed, with flexion-extension ROM reaching 115.18°±4.29°, forearm rotation ROM 164.73°±8.71°, and MEPS 95.45±7.89 points. Statistical analysis revealed significant increases in flexion-extension ROM ( F=268.014, P<0.001), forearm rotation ROM ( F=67.621, P<0.001), and MEPS ( F= 63.100, P<0.001) over time. At the final follow-up, MEPS outcomes were rated as excellent in 9 cases and good in 2 cases, yielding an excellent-to-good rate of 100%. Radiographic evaluation confirmed satisfactory joint alignment and bony union in all patients, with no reports of significant pain, elbow instability, or neurological deficits. Mild heterotopic ossification was observed in 2 cases but did not impair daily activities or necessitate additional treatment. Conclusion:The suture plate technique significantly reduced operative time, minimized surgical trauma, and lowered the risks of elbow infection and stiffness, demonstrating favorable clinical outcomes.

Three hundred and nine patients with thyroid nodules detected by physical examination in Harrison International Peace Hospital from October 2013 to October 2017 were divided into intervention group (155 cases) and control group (154 cases). Patients in intervention group received oral levothyroxine sodium 25 g / d for 12 months and those in control group had no treatment, patients were followed up every 3 months to 12 months. After treatment, the maximum diameter and thyroid nodule volume of the intervention group were (31.87±3.84) mm and (17.32±0.94) cm3, which were significantly smaller than those of the control group [(34.01±3.72) mm and (24.25±1.21)cm3, P<0.05]. TSH in intervention group was lower than that in control group [(2.24±0.41) vs. (2.52±0.58) mIU/L, P<0.05] and free T4 (FT4) was higher than that in control group [(25.64 ± 3.85) vs. (16.39 ± 3.28) pmol/ L, P<0.05]. TC, TG and LDL?C in intervention group, were lower than those in the control group .The HDL?C level in intervention group was higher than that in control group (all P<0.05). After treatment, there were no malignant changes in the intervention group, while the malignant change rate in control group was 2.6％ (4/154). It is suggested that levothyroxine treatment can reduce TSH level in patients with benign thyroid nodules, inhibit the growth of thyroid nodules.

Objective To analyze the clinical features and risk factors of isolated calf deep vein thrombosis (ICDVT).Methods Age,gender,locations,clinical symptoms,and risk factors of the hospitalized patients who diagnosed with ICDVT in the Department of Vascular Surgery,the First Affiliated Hospital of Zhengzhou University in 2015 were retrospectively analyzed.Results 122 hospitalized ICDVT patients were enrolled,accounting for 25.7％ of the patients with lower extremity deep vein thrombosis.Among them,41 cases (33.6％) were male,81 cases(66.4％) were female.The average age was 56.41 ±13.87 years.49 cases (40.0％) had left lower limb ICDVT,39 cases (32.0％) had right lower limb ICDVT;34 cases (28.0％) had both two lower limbs involved.Muscular calf vein thrombosis accounted for 77.9％ (95 cases).76 cases (62.3％) were painful.91 cases (74.6％) had swelling.Common risk factors included age (≥ 45 years) (85.2％),deficiency of natural anticoagulants (83.0％),surgery (45.9％) and malignant tumors (28.7％).Conclusions Pain and swelling were the main clinical symptoms of ICDVT.Age ≥ 45 years,deficiency of natural anticoagulants,surgery,and malignancy were main risk factors of ICDVT.

Objective To investigate the relationship between impaired fracture healing and the expression of peroxisome proliferator activated-receptor gamma (PPARγ) and core binding factor alpha 1 (Cbfα1) mRNA in the bone marrow of Type 2 diabetic rats.Methods Thirty male Sprague-Dawley rats were divided into a control group (n=15, normal diet) and an experiment group (n=20, high fat and sucrosum diet). After 8 weeks, one eyeball was culled for blood collection. The experiment group was intraperitoneally injected with streptozotocin and the control group received citrate buffer. After another 2 weeks, the other eyeball was culled again to collect blood. The model of distraction osteogenesis in the left tibias of the rats was established. After 14 days, we sacrificed all the rats and collected the blood and left tibias. Both femurs were harvested with germ free. We observed the callus formation in the distraction gap by X-ray and the formation of primary matrix front and microcolumn by histological examination. We observed adipocytes in adjacent bone marrow of left tibia and computed the percentage of adipocytes accounting for the area of bone cavity. We measured the expression of PPARγ and Cbfα1 mRNA in femurs marrow by RT-PCR.Results In the experimental rats, the level of triglyceride was obviously elevated (P＜0.01), so was the total cholesterol (P＜0.05), while the level of fasting blood glucose and serum insulin did not obviously differ (P＞0.05) after 8 weeks. The level of fasting blood glucose and triglyceride was obviously elevated (P＜0.01), and so was the total cholesterol (P＜0.05), while the level of serum insulin was not obviously different in the experiment group after 10 and 12 weeks. Callus formation in the distraction gap was obviously diminished by X-ray in the experimental rats. The array of microcolumn formation was disordered and the area of primary matrix front was catachromasis in the controls by histology examination. The number of adipocytes in both the bone marrow and the percentage of adipocyte accounting for the area of bone cavity increased (P＜0.01) in the experiment group. In the experiment group, the expression of PPARγ mRNA was up-regulated (P＜0.05) while Cbfα1 mRNA was down-regulated (P＜0.05) in double femur marrow. Conclusion Increased expression of PPARγ mRNA and decreased expression of Cbfα1 mRNA in the bone marrow may cause impaired fracture healing in rats with Type 2 diabetes.