OBJECTIVE: To evaluate the effect of uncemented total hip arthroplasty(THA) on treatment of traumatic arthritis caused by intramedullary nailing interfixation of intertrochanteric fractures. METHODS: Total of 22 patients treated with THA due to traumatic arthritis caused by intramedullary nailing interfixation of intertrochanteric fractures from January 2012 to January 2017 were studied retrospectively, including 10 males and 12 females with a mean age of (72.5±9.8) years old ranging from 61 to 84 years old. Initial internal fixation method:14 patients were treated with Gamma nails and 8 patients were treated wit PFNA.The time from internal fixation surgery to THA was 10 to 68 months with an average of (32.2±21.3) months.Harris scores of the hip joint before and after surgery were compared, and the position of the prosthesis through postoperative imaging at 3, 6, 12 months and the last follow-up were evaluated. RESULTS: One patient was died due to heart failure 1 year after operation. Two patients was died to advanced tumor 2 years after operation. The other 19 patients were followed up for 36 to 64 months with an average of (48.5±11.9) months. At final follow up, 14 patients regained the ability to walk independently, 4 patients needed support of a cane, 1 patient needed assistance of a walker. No serious complications such as joint dislocation, periprosthetic fracture and deep venous thrombosis occurred during follow-up. There were no signs of loosening and subsidence of the prosthesis at the final follow-up. Mean Harris hip score increased from (29.2±12.9) points preoperatively to (74.2±11.2) points at the final follow up(P<0.05);the score was excellent in 9 patients, good in 7 and fair in 3. CONCLUSION Uncemented total hip arthroplasty for traumatic arthritis after intramedullary nail fixation of femoral intertrochanteric fracture can significantly improve hip function and effectively avoid bone cement implantation syndrome. The medium-term effect is satisfactory.
Male ; Female ; Humans ; Middle Aged ; Aged ; Aged, 80 and over ; Arthroplasty, Replacement, Hip/methods* ; Follow-Up Studies ; Treatment Outcome ; Retrospective Studies ; Bone Nails ; Hip Fractures/surgery* ; Fracture Fixation, Intramedullary/adverse effects* ; Arthritis/surgery*

OBJECTIVE: To explore the relationship between spinous process deviation and lumbar disc herniation in young patients. METHODS: From March 2015 to January 2022, 30 treated young (under the age of 30) patients with lumbar disc herniation were included as the young group. In addition 30 middle-aged patients (quinquagenarian group) with lumbar disc herniation and 30 patients with non-degenerative spinal diseases (young non-degenerative group) were selected as control groups. The angle of the spinous process deviation was measured on CT and statistically analyzed by various groups. All the data were measured twice and the average value was taken and recorded. RESULTS: The average angle of spinous process deviation in the degenerative lumbar vertebra of young patients were (3.89±3.77) degrees, similar to the (3.72±2.98) degrees of quinquagenarian patients(P=0.851). The average angle of s spinous process deviation young non-degenerative group were (2.20±2.28) degrees, significantly less than young group(P=0.040). The spinous process deviation angle of the superior vertebral of the degenerative lumbar in the young group was (4.10±3.44) degrees, which similar to the (3.47±2.87) degrees in the quinquagenarian group (P=0.447). A total of 19 young patients had the opposite deviation direction of the spinous process of the degenerative lumbar vertebra and upper vertebra, while only 7 quinquagenarian patients had this condition(P=0.02). The type of lumbar disc herniation in young patients had no significant relationship with the direction of spinous process deflection of the degenerative or upper lumbar vertebra (P>0.05). CONCLUSION Spinous process deviation is a risk factor of young lumbar disc herniation patients. If the deviation directions of adjacent lumbar spinous processes are opposite, it will increase the incidence of lumbar disc herniation in young patients. There was no significant correlation between the type of disc herniation and the deviation direction of the spinous process of the degenerative or upper lumbar vertebra. People with such anatomical variation can strengthen the stability of spine and prevent lumbar disc herniation through reasonable exercise.
Middle Aged ; Humans ; Intervertebral Disc Displacement/complications* ; Vertebral Body ; Spinal Diseases ; Spinal Fusion/adverse effects* ; Lumbar Vertebrae/diagnostic imaging* ; Intervertebral Disc Degeneration/etiology*

When this paper was first published the following ethical statement was omitted in error: All animal experimental protocols were approved by the Animal Ethics Committee of Guangdong Provincial Engineering Technology Institute of Traditional Chinese Medicine (Guangzhou, Guangdong, China, Approval NO: 048483). Further, all methods were performed in accordance with the relevant guidelines and regulations. NIH mice were purchased from the Guangdong Medical Laboratory Animal Center (Guangzhou, Guangdong, China, Certificate NO.44007200031795). The authors would like to apologise for any inconvenience caused.

Shengjiangsan was recorded in a medical book Treatise on Cold-induced Disorders and Plague written in the Qing Dynasty. This prescription， consisting of four drugs： Bombyx， cicada slough， Turmeric and Rhubarb， is simple but effective in regulating Qi and eliminating pathogenic factors. In recent years， the researches on the mechanism of this prescription have been continuously expanded and deepened. According to the collected data， Shengjiangsan is widely used in the treatment of various clinical diseases. The concept of systemic inflammatory response syndrome （SIRS） was first proposed in the 1990s， and it refers to the pathophysiological state caused by self-amplified cascade inflammatory response and inflammatory factor storm arising from infectious or non-infectious factors. In recent years， the treatment of SIRS has gradually become the current focus and hotspot. Patients with severe acute respiratory syndrome （SARS） and novel coronavirus pneumonia （COVID-19） often die from SIRS progression to multiple organ dysfunction syndrome （MODS） or even multiple organ failure （MOF）. Interleukin -1 receptor antagonist， anti-bradykinin， platelet activating factor receptor antagonist and other commonly used drugs in clinical treatment of SIRS have not achieved satisfactory results， so it is urgent to find drugs to improve SIRS status. Shengjiangsan is recommended as an initial prescription in traditional Chinese medicine diagnosis and treatment plan for SARS and COVID-19， and its antiviral effect may be related to preventing SIRS from transforming into MODS. Pharmacological studies have shown that Shengjiangsan can regulate the immune imbalance of SIRS to achieve a balance by intervening various inflammatory factors and their signaling pathways. At present， there are few reports on the treatment of SIRS with Shengjiangsan. Therefore， the theoretical analysis of Shengjiangsan and its clinical research and pharmacological mechanism in the treatment of SIRS are discussed here to broaden the thinking for clinical practice and experimental research.

OBJECTIVETo investigate the clinical usage of percutanious retrograde acetabular anterior horn screw fixation.

METHODSFrom June 2006 to November 2011,27 patients with anterior horn accetabular fractures were treated with percutaneous retrograde screw. There were 20 males and 7 females with an average age of 35 years (ranged,20 to 61). According to Tile classification,type A was in 5 cases,type B was in 18 cases and type C was in 4 cases. The intra-operative blood loss volume, fractured reduction and screw location were observed.

RESULTSPostoperative X-ray and CT scan showed good reduction. According to the standard of Matta, 10 cases got excellent results, 15 good and 2 poor. All fractures healed and no complications such as neurovascular injuries and femoral head necrosis were found.

CONCLUSIONPercutanious retrograde acetabular anterior horn screw technique have advantages of little trauma, less blood loss volume, reliable fixation, which can be effectively used in clinic.

Acetabulum ; diagnostic imaging ; injuries ; surgery ; Adult ; Bone Screws ; Female ; Fracture Fixation, Internal ; methods ; Fractures, Bone ; diagnostic imaging ; surgery ; Humans ; Male ; Middle Aged ; Radiography

OBJECTIVE: To explore the mechanism that how human enterovirus 71 (EV71) invades the brainstem and how intercellular adhesion molecules-1 (ICAM-1) participates by analyzing the expression and distribution of human EV71, and ICAM-1 in brainstem of infants with brain stem encephalitis. METHODS: Twenty-two brainstem of infants with brain stem encephalitis were collected as the experimental group and 10 brainstems of fatal congenital heart disease were selected as the control group. The sections with perivascular cuffings were selected to observe EV71-VP1 expression by immunohistochemistry method and ICAM-1 expression was detected for the sections with EV71-VP1 positive expression. The staining image analysis and statistics analysis were performed. The experiment and control groups were compared. RESULTS: (1) EV71-VP1 positive cells in the experimental group were mainly astrocytes in brainstem with [dark]-brown particles, and the control group was negative. (2) ICAM-1 positive cells showed [dark]-brown. The expression in inflammatory cells (around blood vessels of brain stem and in glial nodules) and gliocytes increased. The results showed statistical difference comparing with control group (P < 0.05). CONCLUSION The brainstem encephalitis can be used to diagnose fatal EV71 infection in infants. EV71 can invade the brainstem via hematogenous route. ICAM-1 may play an important role in the pathogenic process.
Astrocytes/pathology* ; Brain Stem/virology* ; Case-Control Studies ; Encephalitis, Viral/virology* ; Enterovirus A, Human/metabolism* ; Female ; Hand, Foot and Mouth Disease/virology* ; Humans ; Immunohistochemistry ; Infant ; Intercellular Adhesion Molecule-1/metabolism* ; Male

OBJECTIVETo investigate the feasibility of in vitro proliferation of rat Leydig cells by modifying the cell culture system.

METHODSLeydig cells were isolated from three-week-old rats by a procedure combining collagenase dispersion, stainless steel mesh infiltration and differential adhesion. The isolated cells were cultured in DMEM/F12 and modified media for stem cell proliferation, and the proliferation of the cultured cells was evaluated by cell counting and MTP test. The expression of 3beta-HSD in the cultured cells was detected by immunohistochemistry and flow cytometry, and testosterone productivity in the isolated Leydig cells with or without hCG stimulation was determined at 2 hours and 4 days after cell isolation.

RESULTSThe Leydig cells cultured in the modified media proliferated actively, with a doubling time of (2.26 +/- .31) days, as compared with (16.32 +/- 2.14) days for those cultured in the traditional media (P <0.05). The 3beta-HSD positive rate in the cultured cells was (554.3 +/- 7.1)% after 2 hours and (93.6 +/- 4.6)% after 4 days of culture. All the proliferated cells exhibited testosterone productivity, and their testosterone secretion was significantly upregulated by hCG stimulation (P <0.05).

CONCLUSIONLeydig cells isolated by differential adhesion proliferate actively in the modified culture media.

Animals ; Cell Count ; Cell Culture Techniques ; Cell Proliferation ; Cells, Cultured ; Leydig Cells ; cytology ; Male ; Rats ; Rats, Wistar ; Testosterone ; secretion

OBJECTIVETo explore the methods of repair of massive deep skin and soft tissue injuries.

METHODSFifty-six patients with deep skin and soft tissue injuries were hospitalized from July 2006 to January 2008. Among them, 23 cases were caused by burn, 17 cases by electric injury, 7 cases by hot crush injury, 6 cases by avulsion injury, and 3 cases due to other reasons (including traffic accident, crush injury, soft tissue infection respectively). Sixty-five skin flaps were raised to repair and reconstruct the injured tissues, including 21 local flaps, 18 distant pedicled skin flaps, and 26 free skin flaps. The area of skin flaps ranged from 1.5 cm x 1.0 cm to 39.0 cm x 23.0 cm.

RESULTSSixty skin flaps survived completely, partial necrosis occurred in 3 flaps, and complete necrosis in 2 flaps. There was no obvious difference in average survival rate among local skin flaps (95.2%), distant pedicled skin flaps (88.8%), and free skin flaps (92.3%, P > 0.05).

CONCLUSIONSSkin flap transposition can be still considered as the major effective method in repair of massive deep skin and soft tissue injury. On the premises of high survival rate, free skin flap transposition can be considered as the first choice.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Burns ; surgery ; Child ; Child, Preschool ; Female ; Humans ; Male ; Middle Aged ; Reconstructive Surgical Procedures ; methods ; Skin ; injuries ; Skin Transplantation ; methods ; Soft Tissue Injuries ; surgery ; Surgical Flaps ; Young Adult

BACKGROUNDDiabetes mellitus has become epidemic in recent years in China. We investigated the prevalence of hyperglycaemia and inadequate glycaemic control among type 2 diabetic inpatients from ten university teaching hospitals in Guangdong Province, China.

METHODSInadequate glycaemic control in diabetic patients was defined as HbA1c = 6.5%. Therapeutic regimens included no-intervention, lifestyle only, oral antiglycemic agents (OA), insulin plus OA (insulin + OA), or insulin only. Antidiabetic managements included monotherapy, double therapy, triple or quadruple therapy.

RESULTSAmong 493 diabetic inpatients with known history, 75% had HbA1c = 6.5%. Inadequate glucose control rates were more frequently seen in patients on insulin + OA regimen (97%) than on OA regimen (71%) (P < 0.001), and more frequent in patients on combination therapy (81% - 96%) than monotherapy (75%) (P < 0.05). Patients on insulin differed significantly from patients on OA by mean HbA1c, glycemic control rate, diabetes duration, microvascular complications, and BMI (P < 0.01).

CONCLUSIONSThis study showed that glycaemic control of type 2 diabetic patients deteriorated for patients who received insulin and initiation time of insulin was usually delayed. It is up to clinicians to move from the traditional stepwise therapy to a more active and early combination antidiabetic therapy to provide better glucose control.

Aged ; China ; epidemiology ; Diabetes Mellitus, Type 2 ; blood ; drug therapy ; Female ; Glycated Hemoglobin A ; analysis ; Humans ; Hyperglycemia ; epidemiology ; Hypoglycemic Agents ; administration & dosage ; Inpatients ; Male ; Middle Aged

To explore new measures for functional reconstruction of multiple severe deformities as a result of extensive deep burn (total burn surface area > or = 90% TBSA, including deep burn > or = 70%TBSA) in late stage. Twelve severe burn patients with above-mentioned deformities were hospitalized in our ward during 1960--2005, the scars resulted from burns were distributed from head to foot with 173 deformities, including 27 scar ulcers. All patients lacked of self-care ability, among them some could not stand. Due to inadequate skin source, deformities were corrected by skin from matured scars expanded with subcutaneous balloon at late postburn stage. Following our former clinical experience, anatomic investigation and experimental research, we chose the following methods to correct deformities and restore functions: application of split-thickness scar skin after expansion (88 wounds); use of scar skin flap/scar-Achilles tendon flaps (59 wounds); combination of thin split-thickness skin grafts from scar and allogeneic acellular dermal matrix (composite skin, 40 wounds). All grafts survived, the appearance and function were improved obviously without complications. Follow-up 1-40 years, all patients could take care themselves with satisfactory function and appearance, and among them 8 patients returned to work (one had worked for 40 years), 2 patients married and had children. The above-mentioned measures are safe, reliable and effective for functional reconstruction of deformities.
Adult ; Burns ; complications ; surgery ; Cicatrix ; etiology ; surgery ; Contracture ; etiology ; surgery ; Female ; Humans ; Male ; Middle Aged ; Reconstructive Surgical Procedures ; methods ; Recovery of Function ; Skin Transplantation ; Skin, Artificial ; Surgical Flaps ; Wound Healing