ABSTRACT
Objective To explore the clinical efficacy of secondary unreamed intramedullary nailing following primary external fixation for open tibial shaft fractures.Methods From March 2011 to June 2014,we treated 28 open tibial shaft fractures.They were 17 men and 11 women,aged from 21 to 62 years (average,38.2 years).After thorough debridement,the tibia was stabilized temporarily with external fixation.The wounds were handled with primary closure or secondary repair with skin grafts or tissue flaps.After the wounds healed,the external fixation was replaced by unreamed intramedullary nailing.Fracture union and complications were documented.The clinical efficacy was evaluated at the final follow-ups according to the Johner-Wruhs scoring system.Results All the 28 patients were followed up for 12 to 18 months (average,13.5 months).Bony union was achieved in all after 4 to 15 months (average,4.9 months).Delayed union was observed in 4 cases which were healed after dynamic fixation.There was no deep infection,nail breakage,malunion or limb shortening in any one.Mild knee pain was reported by 5 cases after surgery.According to the Johner-Wruhs criteria,18 cases were excellent,7 good,and 3 moderate,giving an excellent to good rate of 89.3％.Conclusion Primary external fixation and secondary unreamed intramedullary nailing can result in good fracture union with satisfactory biomechanical stability and favorable early rehabilitation in the treatmeut of open tibial shaft fractures.
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Objective To investigate the apoptosis-inducing effect of the Tongbu-Xiaoji decoction on A549 cells.Methods A549 cell lines were cultured with normal serum and different concentration of serum containing Tongbu-Xiaoji decoction.The cells were stained with PI and Annexin V,and were evaluated by flowcytometry.Resnlts A549 cells were treated by Tongbu-Xiaoji decoction with low、median and high dose medicated serum,the rate of apoptosis in 24h were (5.92±2.04)％,(12.57±1.96)％,and (16.51±1.52)％respectively; the rate of apoptosis in 48h were (13.15±1.60)％,(26.42±2.30)％,and (31.47±2.08)％respectively and the rate of apoptosis in 72 h were (18.73 ± 1.89) ％,(31.72± 1.99) ％,and (36.92± 1.38) ％respectively,all were lower than compared with the model control group in 24 h were (0.40±0.08)％,48 h were (0.58± 0.16)％,72 h were (0.85 ± 0.13)％.Conclusion Tongbu-Xiaoji decoction has the apoptosis-inducing effect on A549 cells.
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Objective To evaluate the value of haptoglobin (HPT),α1-acid glycoprotein (AAG)and C-reactive protein (CRP) in the differential diagnosis of bacterial and viral infection in children. Methods Serum CRP, AAG and HPT levels were measured in 64 children with bacterial infection and 64 children with viral infection during acute stage. These indicators were also measured in 31 normal control children. The sensitivity ,specificity ,positive and negative predictive values, Youden's index for HPT,AAG and CRP were calculated. These values were compared among three groups. Their early diagnostic value on bacterial infection and virus infection was evaluated. Results (1) These markers were considered positive if HP≥2 g/L,AAG≥2 g/L,CRP≥10 mg/L. (2) The serum CRP [(2.70 ±0.99) g/L vs (1.42 ±0.75) g/L] ,AAG [(0.91 +0.38) g/L vs (0.30+0.08) g/L] and HPT [(6.40 ±0.89) mg/L vs (1.38 +0.80) mg/L]levels were significantly higher in children with bacterial infection compared with those with viral infection during the acute stage (P ＜ 0. 05,P ＜ 0. 01). The serum CRP, AAG and HPT levels were significantly higher in children with bacterial infection compared with normal control children during the acute stage (P ＜ 0. 05);while the levels of these indicators showed no differences between viral infection children and normal control children (P ＞ 0. 05). Conclusion The measurement of serum CRP, AAG and HPT levels has clinical value in the differential diagnosis of bacterial and viral infection in children. Among these indicators, CRP has the highest specificity,positive predictive,negative predictive values and Youden's index.