Objective:To investigate the clinical efficacy of ultrasound-guided closed reduction and percutaneous Kirschner wire fixation in the treatment of supracondylar fractures of the humerus in children.Methods:The clinical data of 78 children with Gartland type II and type III straight-type supracondylar fractures of the humerus who received treatment in The First Affiliated Hospital of Anhui Medical University from October 2019 to October 2022 were retrospectively analyzed. These children were divided into an observation group ( n = 38) and a control group ( n = 40) according to different treatment methods. The observation group was subjected to ultrasound-guided closed reduction and percutaneous Kirschner wire fixation. The control group was given C-arm fluoroscopy-guided closed reduction and percutaneous Kirschner wire fixation. Mayo elbow performance score (MEPS), clinical healing time, operative time, and the incidence of intraoperative complications such as vascular and nerve injury were compared between the two groups. Results:Both groups of children achieved closed reduction without open reduction. The operative time in the observation group was (30.68 ± 5.45) minutes, which was significantly shorter than (40.54 ± 5.78) minutes in the control group ( t = 2.30, P < 0.05). The healing time of the fracture in the observation and control groups was (32.73 ± 4.56) days and (36.47 ± 6.24) days, respectively, and there was no significant difference between the two groups ( P > 0.05). The range of joint motion and elbow hyperextension angle range in the observation group were (148.78 ± 3.81)° and (8.72 ± 8.92)°, respectively, and they were (147.24 ± 4.36)° and (7.98 ± 8.86)°, respectively in the control group. There were no significant differences in the range of joint motion and elbow hyperextension angle range between the two groups (both P > 0.05). The excellent and good rate of joint function in the control and observation groups was 92.5% (37/40) and 92.1% (35/38), respectively. There was no significant difference in excellent and good rate of joint function between the two groups ( P > 0.05). There were three cases of postoperative nerve damage in the control group and no vascular or nerve damage was observed in the observation group. There were significant differences in the number of cases of vascular or nerve injury between the two groups ( χ2 = 3.97, both P < 0.05). Conclusion:Ultrasound-guided closed reduction and percutaneous Kirschner wire fixation for the treatment of supracondylar fractures of the humerus can shorten the operative time, decrease the incidence of intraoperative nerve injury, and reduce the X-ray exposure time of doctors and patients.

Objective To explore the therapeutic effects of soluble cytokines secreted by mesenchymal stem cells (MSCs) on acute liver failure (ALF).Methods MSCs isolated from Sprague-Dawley rats were determined by FACS analysis.Conditioned medium derived from MSCs (MSCs-CM) was collected and analyzed by a cytokine microarray.SD rats were divided into 3 groups:(1) ALF + dulbecco's modified eagle medium (DMEM) group:1 ml DMEM was injected into SD rats after D-Gal administration;(2) ALF + MSCs group:1 ml MSCs (1 × 106) was injected into SD rats after D-Gal administration;(3) ALF + MSCs-CM group:1 ml MSCs-CM was injected into SD rats after D-Gal administration.Biochemical indicators,survival rate,histology and inflammatory factors were studied.Exogenous recombinant rat IL-10,antirat IL-10 antibody and AG490 (STAT3 signaling pathway inhibitor) were administrated to explore the therapeutic mechanism of MSCs-CM.Results The respective serum biochemical indexes of ALF + DMEM group,ALF + MSCs group,and ALF + MSCs-CM group were:ALT (1 709.8 ± 372.1,865.5 ± 52.8,964.7 ± 414.6 U/L),AST (4234.0 ± 807.3,2440.8 ± 511.9,2739.8 ± 587.3 U/L),andTBil (79.3 ± 10.9,43.8 ± 7.0,61.2 ± 6.7 μg/L).The survival rates of the three groups were 10.0％,80.0％,and 70.0％,respectively.The levels of inflammatory factors in each group were IFN-γ (69.8 ± 4.7,46.4 ± 4.3,54.6 ± 2.4pg/ml),IL-1β (58.5 ± 7.6,40.5 ± 6.9,44.1 ± 6.0pg/ml),IL-6 (71.9 ± 16.1,38.4 ± 7.7,45.3 ± 9.0),and IL-10 (38.3 ± 6.0,75.4 ± 11.1,59.6 ± 11.9 pg/ml).Protein microarray results suggested that MSCs-CM expresses a variety of inflammatory-related cytokines,with IL-10 levels being most pronounced.IL-10 (ALT 1 126.9 ± 419.3 U/L,AST2370.8 ± 561.2 U/L) alone significantly reduced transaminase levels compared with ALF group (ALT 1 709.8 ± 372.1 U/L,AST 4234.0 ± 807.3 U/L),while anti-IL-10 antibody (ALT 1 568.5 ± 325.4 U/L,AST4043.7 ± 819.0 U/L) neutralized the therapeutic effect of MSCs-CM (ALT 964.7 ± 414.6 U/L,AST 2 739.8 ± 587.3 U/L).IL-10 could significantly increase the level of pSTAT3 in ALF rats (0.93 ± 0.03 vs 0.68 ± 0.01),while STAT3 inhibitor AG490 (0.84 ± 0.04) could decrease the expression of pSTAT3 and reverse the therapeutic effect of IL-10.Conclusion The factors released by MSCs,especially IL-10,have the potential therapeutic effect on ALF,and STAT3 signaling pathway may mediate the anti-inflammation effects of IL-10.

Objective To investigate the effects of dopaminergic medication on decision-making un-der ambiguity in patients with early Parkinson's disease( PD) . Methods Using Iowa Gambling Task ( IGT) for 24 early non-medication idiopathic PD patients( Hoehn and Yahr Scale≤Ⅱlevel) ,24 early idiopathic PD patients with regular dopaminergic medication and also for 24 healthy controls( HC) whose age,gender,and education match to PD patients to test their ability of decision-making under ambiguity. Results The results showed non-medication PD group showed impairments on digtal span and verbal fluency and decision-making task. There was significant difference in IGT task scores among the three groups(F=6.024, P=0.004) . The total net scores of advantageous choices in IGT were significantly lower in non-medication PD group( (-4.50 ±22.19) scores) than medication PD group((8.83±23.24)scores) and healthy group((15.92±15.77) scores) . The difference of net scores in block1 to block5 between non-medication PD group and medication PD group was gradually increased,and the difference of net scores in block5 was significant(P<0.05) . There was no significant difference in total net scores and net scores in block1 to block5 between medication PD group and healthy group(P>0.05) . As the game processing,medication PD group gradually shifted their se-lections toward the advantageous choices. But non-medication group did not exhibit this shift pattern and the performance was much poorer. Meanwhile, the study also indicated the total net scores of advantageous choices for non-medication PD group was positive correlation to the MoCA scores ( r=0.614, P=0.001). Conclusion The present study has shown that non-medication PD group has impairment in decision-making under ambiguity risk condition and prefer to choose risky options. when exogenous complement dopaminergic medication,the risk decision-making ability of medication PD group has been improved.

Objective To investigate the therapeutic effect of bone marrow mesenchymal stromal cell (BMSC) transplantation on D-galactosamine-induced acute liver failure in Sprague-Dawley (SD) rats,as well as the mechanism of neutrophils in this process.Methods A total of 39 male SD rats were divided into control group (8 rats,intraperitoneal injection of isotonic saline),model group (10 rats,intraperitoneal injection of D-galactosamine),solvent group (9 rats,tail vein injection of isotonic saline at 2 hours after intraperitoneal injection of D-galactosamine),and treatment group (12 rats,tail vein injection of MSCs at 2 hours after intraperitoneal injection of D-galactosamine).The rats were sacrificed at 24 hours after the model of D-galactosamine-induced acute liver failure was established,and the blood and liver tissue were harvested.The serum levels of alanine aminotransferase (ALT) and aspartate aminotransferase (AST) and total bilirubin (TBil) were measured,and blood analysis was performed to measure the number and percentage of neutrophils in peripheral blood.Immunofluorescence assay was used to measure the expression of the neutrophil marker Ly6g in the liver,the myeloperoxidase (MPO) kit was used to measure the activity of MPO in liver,and RT-PCR was used to measure the mRNA expression of inflammatory cytokines and chemokines in the liver,i.e.,tumor necrosis factor-α (TNF-α),interleukin-1β (IL-1β),interferon-γ (IFN-γ),interleukin-10 (IL-10),CXC chemokine ligand 1 (CXCL1),and CXC chemokine ligand 2 (CXCL2).Another 64 male SD rats were randomly divided into groups,and the survival rates of rats in each group were observed for 7 days.The independent samples t-test was used for comparison between any two groups (Levene homogeneity test of variance,and the corrected t-test was used for a P value of ＜ 0.05),and the log-rank test was used for comparison of survival rates between any two groups.Results At 24 hours after acute liver failure was induced by D-galactosamine in the SD rats,there were significant increases in the liver function parameters (ALT:2884.1±541.0 U/L vs 45.4±11.0 U/L,P ＜ 0.001;AST:3634.9±755.9 U/L vs 143.9±23.7 U/L,P ＜ 0.001;TBil:44.4±8.4 μmmol/L vs 0.9±0.2 μmmol/L,P ＜ 0.001) and the number and percentage of peripheral blood neutrophils [number:(4.7±1.1)×109 vs (1.4±0.4)× 109,P ＜0.001;percentage:44.9％±8.0％ vs 18.3％±4.4％,P ＜ 0.001].A large number of neutrophils aggregated in the liver tissue,and there were significant increases in the MPO activity (4.72±1.09 U/g vs 1.13±0.24 U/g,P ＜ 0.001),inflammatory cytokines,and chemokines.Compared with the model group,the treatment group showed significant improvements in liver function (ALT:1 823.9a389.2 U/L vs 2 884.1±541.0 U/L,P ＜ 0.001;AST:2173.0±567.3U/L vs 3634.9±755.9 U/L,P ＜ 0.001;TBil:30.9±6.5 μmmol/L vs 44.4±8.4 μmmol/L,P ＜ 0.001) and survival rate (50％ vs 12.5％,P=0.023).Meanwhile,the treatment group also showed significant reductions in the number and percentage of peripheral blood neutrophils [number:(3.5±1.0)× 109 vs (4.7±1.1)×109,P =0.012;percentage:35.9％±8.9％ vs 44.9％±8.0％,P =0.021],number of neutrophils in the liver,and MPO activity (3.52±1.03 U/g vs 4.72±1.09 U/g,P =0.040),as well as significantly inhibited expression of inflammatory cytokines and chemokines (TNF-α:2.458±0.762 vs 3.778±1.046,P =0.005;IL-1β:2.498±0.547 vs 4.065 ± 0.953,P =0.002;IFN-γ:3.977±1.039 vs 5.418±1.255,P =0.025;IL-10:6.056±1.542 vs 3.368±0.952,P=0.001;CXCL1:7.988±1.911 vs 10.366±1.239,P =0.010;CXCL2:3.441±1.005 vs 4.847±1.113,P=0.019).Conclusion BMSC transplantation has a therapeutic effect on D-galactosamine-induced acute liver failure in rats,and this process is accompanied by reduced aggregation and activity of neutrophils in peripheral blood and liver.Inflammatory cytokines and chemokines may be involved in the mechanism of regulation of these two aspects.

BACKGROUNDEpisodic memory includes information about item memory and source memory. Many researches support the hypothesis that these two memory systems are implemented by different brain structures. The aim of this study was to investigate the characteristics of item memory and source memory processing in patients with Parkinson's disease (PD), and to further verify the hypothesis of dual-process model of source and item memory.

METHODSWe established a neuropsychological battery to measure the performance of item memory and source memory. Totally 35 PD individuals and 35 matched healthy controls (HC) were administrated with the battery. Item memory task consists of the learning and recognition of high-frequency national Chinese characters; source memory task consists of the learning and recognition of three modes (character, picture, and image) of objects.

RESULTSCompared with the controls, the idiopathic PD patients have been impaired source memory (PD vs. HC: 0.65 ± 0.06 vs. 0.72 ± 0.09, P = 0.001), but not impaired in item memory (PD vs. HC: 0.65 ± 0.07 vs. 0.67 ± 0.08, P = 0.240).

CONCLUSIONSThe present experiment provides evidence for dissociation between item and source memory in PD patients, thereby strengthening the claim that the item or source memory rely on different brain structures. PD patients show poor source memory, in which dopamine plays a critical role.

Aged ; Cognition ; physiology ; Female ; Humans ; Male ; Memory ; physiology ; Middle Aged ; Neuropsychological Tests ; Parkinson Disease ; physiopathology

Objective To observe the effect of nystatin via gastrointestinal tract on the incidence of invasive fungal infections (IFI) and the prognosis of patients with mechanical ventilation in ICU.Methods A total of 118 critical ill patients admitted to ICU needing mechanical ventilation were enrolled.The patients were divided into two groups by random digits table method.Patients in study group (57 cases) were administered nystatin 1 000 kU three times a day via the gastric tube;and patients in control group (61cases) were given gastrointestinal prokinetic drug as placebo three times a day.The specimens were collected on admission,the third,the sixth,the ninth day after admission,the strain distribution was observed,and the corrected colonization index (CCI) of all patients were calculated.The incidence of candidemia and 28-day mortality as well as the duration of stay in ICU and hospital was also recorded.Results A total of 860 strains were isolated from 118 patients.Of which Candida albicans accounted for 56.9％ (489/860).The most frequently colonized body sites was oropharyngeal site [35.9％(309/860)].CCI on the sixth,the ninth day after admission in study group was lower than that in control group (0.18 ±0.09 vs.0.40 ±0.16 and 0.10 ± 0.02 vs.0.45 ± 0.13),28-day mortality in study group was lower than that in control group [17.5％(10/57) vs.34.4％(21/61)],the duration of stay in ICU in study group was shorter than that in control group [(9.45 ± 3.36) d vs.(11.78 ± 6.21) d],and there were significant differences (P ＜ 0.05).There were no significant differences in the incidence of candidemia and the duration of stay in hospital (P ＞0.05).Conclusion Nystatin may reduce the colonization of Candida albicans and is associated with shorter ICU day.

Objective To investigate the ability of decision making under risk condition in patients with Parkinson' s disease (PD),and to explore the neural relationship between basal ganglia and the decision-making ability.Method Twenty-five PD patients and 25 healthy controls (HC) were investigated by Game of Dice Test (GDT) with explicit probability.Results PD patients performed poorly in the entire task,selecting more risky options ( PD:10.88 ± 5.58 ; HC:5.72 ± 3.69 ; t =3.86,P ＜ 0.01 ),compared with healthy controls.In general,the final asset of PD group was negative while the result of HC group was always profitable and the difference was significant ( PD:- 3748.00 ± 3923.87 ; HC:684.00 ± 1764.62 ; t =-5.15,P ＜ 0.01 ).The most frequent choice made by PD patients was one number,which is the most risky one.Accordingly,the most frequent choice made by HC group was three numbers (one number:PD:6.48 ±5.81;HC:1.00 ± 1.44;t =4.58,P ＜0.01; three numbers:PD:2.64 ±2.14;HC:7.04 ±2.54;t =-6.62,P ＜ 0.01 ).The frequency of choosing the risky options was correlated with the rate of using negative feedback( r =-0.59,P =0.003 ),and the result of Stroop test( r =0.55,P =0.004).Conclusion Present study has shown that PD patients have significant impairments in decision-making under risk condition,and the impairments are correlated with executive function and negative feedback.

OBJECTIVETo observe the therapeutic efficacy of Qingxue Granules (QX) in treating postnephrotransplant erythrocytosis (PNTE).

METHODSTwenty patients were randomly divided into two groups according to the randomized table. QX was given to patients in the TCM treated group (QX group) and Enalapril given to patients in the Western medicine treated group (WM group), and the clinical efficacy in the two groups was observed. Results In the QX group, 3 patients got markedly effective, 2 effective, 2 improved, 1 ineffective, 1 dropped from the treatment, 1 absconded, with the total effective rate of 77.78%. The corresponding numbers in the WM group were 4, 2, 2, 1, 1 and 66.67%. There was no significant difference in comparison of the efficacies between the two groups (P > 0.05). There was no difference between the Intent-to-Treat population and Per-protocol Pouplation after statistical management of lost cases.

CONCLUSIONIt has proved that QX has the same therapeutic effects as classic Western medical treatment in treating PNTE. The reliability and scientificity of QX was proved by Intent-to-Treat analysis.

Adult ; Aged ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Humans ; Kidney Transplantation ; adverse effects ; Male ; Middle Aged ; Phytotherapy ; Polycythemia ; drug therapy ; etiology