Plaster combined with splint for the treatment of gartland type III humeral supracondylar fractures in children / 中国骨伤

<p><b>OBJECTIVE</b>To study clinical effects of plaster combined with splint for the treatment of Gartland type 1I humeral fractures.</p><p><b>METHODS</b>From March 2002 to May 2006, 24 children with humeral supracondylar fractures of Gartland type ill were reviewed. Among the patients, 14 patients were male and 10 patients were female, ranging in age from 4 to 12 years, averaged 6.6 years. Ten patients had injuries in the left and other 14 patients had injuries in the right limb. Firstly, the patients were treated with manipulative reduction to maintain the length of humerus without emphasis on anatomic reduction. Then, the patients were treated with external fixation using plaster for 5 to 7 days, and secondary manipulative reduction after swelling disappeared. Lastly, the patients were treated with external fixation using splint for 4 to 5 weeks until fracture union.</p><p><b>RESULTS</b>All the patients were followed up, and the duration ranged from 5 months to 2 years, with an average of 1.2 years. All the patients had no complications such as neurovascular injury, myositis ossificans, forearm compartment syndrome and Volkmann contracture. According to ZHU Xiao-ting evaluation criteria for humeral supracondylar fractures in children, 12 patients got an excellent result, 8 good, 3 poor and 1 bad.</p><p><b>CONCLUSION</b>Treatment of child humeral supracondylar fractures with plaster and splint has several advantages such as avoiding serious soft tissue injuries around fractures due to many times reduction, fracture dynamic correction to obtain satisfactory reduction, reducing complications, obtaining good reduction, and restoring elbow function in a relatively short period of time.</p>

Repeated oral treatment with polysaccharide sulfate reduces insulin resistance and dyslipidemia in diabetic dyslipidemic rat model / 药学学报

Polysaccharide sulfate (PSS) is a new type of antiatherosclerotic medicine for its effects of anticoagulation, anti-thrombosis and modulation of dyslipidemia. However, it is still uncertain whether PSS could modulate the diabetic dyslipidemia or not. Here, the rat model of diabetic dyslipidemia was developed and the effects of PSS on glucose and lipid levels were investigated in this animal model. Wistar rats were iv injected with streptozotocin 20 mg x kg(-1) after feeding with high fat diet for one and a half month. Then, rats received orally PSS (30, 90, and 180 mg x kg(-1)) for 1 month. After oral treatment with PSS (90 and 180 mg x kg(-1)) for 1 month, the levels of triglyceride (TG), total cholesterol (TC), low density lipoprotein-cholesterol (LDL-C) were significantly reduced and the level of high density lipoprotein-cholesterol (HDL-C) increased, compared with diabetic control rats. Moreover, PSS (30, 90, and 180 mg x kg(-1)) had a tendency to reduce glucose and insulin levels, and significantly increased insulin sensitivity index. Our results suggest that PSS could improve insulin sensitivity and relieve dyslipidemia in diabetic dyslipidemic rats.

Respiratory Failure Caused by Laryngotracheal Disorders in 15 Children / 实用儿科临床杂志

Objective To explore the clinical modalities and diagnosis of respiratory failure due to laryngotracheal disorders in children,in order to reduce the misdiagnosis.Methods Fifteen patients(11 cases were male,4 cases were female) with respiratory failure in Intensive Care Unit, Tianjin Children′s Hospital from Jul.2006 to Jul.2009 were selected.Data including history,characteristics and results of spiral computerized tomography(CT) and reconstruction and magnetic resonance imaging(MRI) were reviewed.Results The major clinical manifestations indicated that 7 cases had laryngeal stridor,6 cases had recurrent pneumonia,5 cases had cyanosis after crying,and 12 patients were complicated with respiratory failure in 12 hours.Nine cases were recovered,3 cases were given up,and 3 cases died.All patients were performed with CT about laryngohypopharynx,and the results were cyst of root of tongue in 3 cases,trachea pressed by cyst of parapharyngeal space in 1 case.There were 11 cases examined by spiral CT and reconstruction,in which 6 cases were confirmed as tracheal stenosis,2 cases were left bifid tracheostoma,2 cases were pulmonary artery sling,and 1 case was diagnosed as tracheomalacia.Chest X-ray radiograph indicated that bronchopneumonia in 8 cases,bronchitis in 3 cases and negative in 4 cases.Echocardiograph examination was performed among 11 cases,in which 2 cases were pulmonary artery sling,2 cases were atrial septal defect,1 case was patent ductus arteriosus, and 6 cases were negative.Conclusions There is high morbidity of respiratory failure caused by laryngotracheal disorders in infants,but misdiagnosis ccures usually because of non-specific symptoms.If the infant must depend on mechanic ventilation for a long time and has airway obstruction,he should be examined early by using spiral CT.

Analysis of Risk Factors Associated with Death of Children with Septic Shock / 实用儿科临床杂志

Objective To investigate the risk factors associated with the death of pediatric septic shock,for improving prognosis and decreasing mortality.Methods Sixty-four patients in intensive care unit diagnosed as septic shock were enrolled from Apr.2002 to Apr.2008.The factors such as age,sex,C-reacted protein,WBC,platelet count,blood glucose,procalcitonin(PCT),serum lactic acid,pediatric critical illness score(PCIS),ventilator using and complication of multiple organ dysfuction syndrome(MODS) were researched,these research factors were analyzed by univariate analysis,then to be analyzed by Logistic regression.Results The mortality was 59.38%(38/64 cases).Twenty patients with severe septic shock were all died.Thirty-four patients had breath failure and 26 cases had MODS,the mortality were 62.50%,76.92%,100.00% in patients complicated with 2,3,4 organs dysfunction.In the univariate analysis,variables significantly associated with death in septic shock were PCT,lactic acid,PCIS,MODS.In the Logistic regression,variables significantly associa-ted with death were PCT,lactic acid,PCIS and MODS.Conclusions The mortality of septic shock was high,and decreased PCIS,elevated serum lactic acid level and PCT,and multiple organ dysfuction are the risk factors associated with the death of septic shock.

Methylprednisolone and cyclophosphamide pulse therapy of severe systemic lupus erythematosus in children / 中华儿科杂志

<p><b>OBJECTIVE</b>To study the effect of methylprednisolone (MP) and cyclophosphamide (CPA) intermittent intravenous pulse therapy and the clinical prognosis in children with severe juvenile onset systemic lupus erythematosus (JOSLE).</p><p><b>METHODS</b>Thirty patients with JOSLE, diagnosed by clinical, laboratory or renal histological examinations, were enrolled in this study. Of the 30 patients, 27 were females and 3 were males, the mean age was (12 +/- 3) years, and 20 of the 22 patients who had undergone initial therapy had LN, and the clinical courses before being involved in the study were 3 to 12 months in nine patients. Twenty-three of the 30 patients had clinical manifestations of renal damages, of whom 4 patients were proven by initial renal biopsy to have WHO type IV, 2 had type II,1 had type V and 1 had type III, and 7 patients had one or more manifestations of central nervous system, including chorea, seizures, cerebrovascular accident (CVA) and organic brain syndrome (OBS), simultaneously, 9 patients had nervous system symptoms without the clinical manifestations of renal damages, 3 patients had lupus crisis, 7 patients did not have any manifestations of renal or neurological damages. According to the protocol of the therapy, the patients were divided into 3 groups: group A (n = 18) patients were treated with MP plus CPA intermittent intravenous pulse for children with lupus nephritis, and with or without neuropsychiatric lupus erythematosus (NPLE), group B (n = 7) with pulsed doses of MP, followed by prednisone and tripterygium wilfordii hook f(T(whf)) for patients without renal or central nerves system damage, and group C (n = 5) with prednisone alone for patients with LN determined by clinical and laboratory features. The effects of those regimes and the clinical prognosis were observed.</p><p><b>RESULTS</b>On short-term follow-up, the SLEDAI-2K (by weight of the renal damage) showed significant difference between group A and group B, but there was no significant difference at the 9th months of the therapy. The long-term follow-up lasted in average for (37.2 +/- 24.8) months. Nineteen patients were followed up for more than 18 months. At the end of follow-up, the mean age was 14 to 19 years. There was no difference on the effect of both group A and group B, and no frequent infections were seen, ANAs were negative and SLEDAI-2K = 0-point in two patients of each group 12 months after discontinuation of the therapy. Four patients in group C died within 18 months.</p><p><b>CONCLUSION</b>The immunosuppressive regimen MP + CPA in patients with severe JOSLE and MP + prednisone + T(whf) in patients without major organs damage were superior to the regimen of prednisone alone.</p>

Clinical Analysis of Complications of 115 Children with Serious Pneumonia with Ventilatory Support / 实用儿科临床杂志

Objective To explore the clinical characteristics of children with serious pneumonia with ventilatory support,and combined with heart failure,encephalopathy,hyponatramia,acute respiratory distress syndrome(ARDS) and multiple organ dysfunction syndrome(MODS).Methods One hundred and fifteen children(81 males,34 females) with serious pneumonia in ICU from Jul.2005 to Jul.2007 were reviewed,The duration of ventilation support was over 48 h.And blood electrolyte,blood gas,cerebrospinal fluid and CT were detected.Results Ninety-three cases had a good outcome,7 cases were given up,15 cases were dead.The complications included heart failure in 60 cases(52.17%);encephalopathy in 40 cases(34.78%),in which tics type in 38 cases(95%),apnea type in 11 cases(27.5%);hyponatremia in 42 cases(36.52%),of which tics type in 31 cases(73.81%),syndrome of inappropriate secretion of antidiuetic hormone in 27 cases(72.97%)resulted in hyponatremia;ARDS in 8 cases(6.96%),pa(O2)/FiO2

Isolation of Biodesulfurization Bacteria Pseudomonas stutzeri UP-1 for Petroleum / 微生物学通报

Dibenzothiophene (DBT) was used as a model compound. A bacteria strain, which can degrade dibenzo-thiophene efficiently, was obtained. This strain was identified as Pseudomonas stutzeris UP-1 according to its morphological, physiological and biochemical characters, and 16S rDNA sequence. The strain exhibits strong degradation capacity of DBT, and the end product of degradation is a kind of soluble compound. After the analysis of product of DBT degradation, it was deduced that the degradation of DBT by Pseudomonas stutzeri UP-1 is in accordance with the Kodama mechanism.