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Objective:To evaluate the role of N-methyl-D-aspartate receptors (NMDA receptors) in sevoflurane anesthesia-caused necroptosis in hippocampal neurons of aged mice.Methods:Ninety clean-grade healthy male C57BL/6 mice, aged 18 months, weighing 27-30 g, were divided into 3 groups ( n=30 each) using a random number table method: control group (group C), sevoflurane anesthesia group (group S) and sevoflurane anesthesia plus NMDA receptor antagonist memantine hydrochloride group (group S+ M). Mice inhaled 3% sevoflurane for 2 h for 3 consecutive days in S group and S+ M group, and memantine hydrochloride 20 mg/kg was intraperitoneally injected at 1 h before each inhalation of sevoflurane in S+ M group.Mice only inhaled pure oxygen for 2 h in group C. Ten mice of each group were selected on 1 day before anesthesia and 3 and 7 days after anesthesia to perform Morris water maze test.The mice were sacrificed immediately after Morris water maze test, and hippocampus was removed for microscopic examination of pathological changes (with a light microscope) and for determination of the necroptosis rate of neurons and cytoplasmic free calcium concentration([Ca 2+ ] i)(by flow cytometry), and expression of NMDA receptor subtypes GluN2A, GluN2B and receptor-interacting protein kinase 1 (RIP1) (by Western blot). Results:Compared with group C, the escape latency was significantly prolonged, and the frequency of crossing the original platform was decreased, and the [Ca 2+ ] i and neuronal necroptosis rate in the hippocampus were increased at each time point after anesthesia, and the expression of GluN2A, GluN2B and RIP1 was up-regulated( P<0.05), and the pathologic changes were accentuated in S group and S+ M group.Compared with group S, the escape latency was significantly shortened, and the frequency of crossing the original platform was increased, and the [Ca 2+ ] i and neuronal necroptosis rate in the hippocampus were decreased at each time point after anesthesia, and the expression of GluN2A, GluN2B and RIP1 was down-regulated ( P<0.05), and the pathologic changes were attenuated in group S+ M. Conclusions:NMDA receptors are involved in the process of cognitive dysfunction induced by sevoflurane anesthesia in aged mice, and the mechanism may be related to the promotion of necrptosis in hippocampal neurons.
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Objective:This study was to evaluate the effects of comprehensive intervention， at different stages， in community osteoporosis patients. Method:Osteoporosis intervention was set up for years in a follow-up cohort community， in which patients with primary osteoporosis who volunteered to participate in the research were divided into control and intervention groups. The latter received comprehensive intervention consisting of physical therapy with osteoporosis therapeutic instrument， treatment with the prescription of strengthening waist and keeping bones in combination with calcitriol， health Qigong and changing tendon exercise， and health education lectures. The therapeutic effect was assessed at three different stages： prior to intervention， 3 and 6 months after intervention. The effect indicators included the following： visual anologue scale （VAS） pain score， clinical symptom total score， general condition total score， bone density and bone metabolism. Results:VAS pain index， total clinical symptom score and total systemic condition score in the intervention group were significantly lower than those in the control group （P<0.05）. Bone density in the intervention group increased at 6 months and the difference was statistically significant （P<0.05）， compared with the control group （P<0.05）. All the four bone biochemical indexes in the intervention group changed compared with those before intervention， and the improvement of PINP， β-CTX， 25（OH）D in the intervention group was better than that in the control group. Conclusion:Result of effect evaluation with multiple indicators demonstrates that comprehensive intervention is suitable for promotion in prevention and treatment of primary osteoporosis in community.
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Daturae Flos is a traditional antitussive and antiasthmatic medicine， its flowers and leaves are rich in a variety of compounds， including withanolides， alkaloids， terpenes， flavonoids and amides. Because of its antiasthmatic， antitussive， antispasmodic and analgesia effect， it is traditionally used for the treatment of asthma， cough， cold pain in abdominal cavity， rheumatic arthralgia， infantile chronic eclampsia， and can also be used as raw material for surgical anesthesia. Modern pharmacological studies have shown that in addition to the traditional efficacy， Daturae Flos also has anti-inflammatory， immunosuppression， anti-convulsion and other effects， and is often used in the treatment of psoriasis， Parkinson's disease， epilepsy， rheumatoid arthritis and other diseases. At present， the chemical constituents of Daturae Flos are mainly focused on withanolides and alkaloids. At the same time， there is a lack of clear classification of chemical components and the distribution of chemical components in medicinal parts of this medicine， and little information is available for the pharmacological effects of polysaccharides. Based on this， this paper systematically searched relevant literature of Daturae Flos， and summarized and analyzed its chemical composition， pharmacological effect and clinical application， in order to provide reference for further development and utilization of Daturae Flos.
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Objective:To analyze the clinical features related to erectile dysfunction for male patients with spinal cord injury. Methods:From December, 2019 to January, 2021, 28 male patients with spinal cord injury were detected the stiffness and periactivity index of penises during night sleep using RigiScan. The patients were grouped as presence or absence of bulbocavernous reflex, anal autonomic contraction, anal tactile sensation and anal pressure sensation, to compare the stiffness and periactivity index between the groups. Results:The stiffness and periactivity indexes were more in patients presenting bulbocavernosus reflex, anal autonomic contraction, anal tactile sensation and anal deep pressure sensation (|t| > 2.19, P < 0.05). Conclusion:Bulbocavernous reflex, anal autonomic contraction, anal tactile and anal deep pressure response may predict penile erectile function after spinal cord injury.
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Objective:To apply real-time shear wave elastography to observe the effect of instrument-assisted soft tissue mobilization (IASTM) on Achilles tendons for healthy adults. Methods:From July to December, 2020, 52 healthy adults were assigned into control group (n = 15) and experimental group (n = 37) randomly. The experimental group received IASTM on left Achilles tendons, once another day for two weeks, while the control group received no treatment. The thickness and elastic modulus of the left Achilles tendons were measured with high-frequency ultrasound and shear wave ultrasound elastography on all the subjects, before treatment, immediately after the first treatment and three days after treatment, respectively. Results:Five cases dropped down in the experimental group. There was no significant difference in thickness and elastic Young's modulus of the left Achilles tendons between two groups before treatment (t < 0.630, P > 0.05). The thickness of the left Achilles tendons was less in the experimental group than in the control group immediately after the first treatment (t = 2.149, P < 0.05), while average and maximum elastic Young's modulus was less three days after treatment (t > 2.134, P < 0.05). Conclusion:Real-time shear wave elastography could quantify the thickness and elasticity of Achilles tendon, to evaluate the effect of IASTM.
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Skin wound healing is one of the difficult problems in clinical medicine. The long-term wound healing has a great impact on patients and causes huge social and economic burden. Hydrogels have good biocompatibility, biodegradability and plasticity, and have excellent properties of hemostasis, antibacteri-al and water retention. They are widely used as skin wound dressing. The exosomes derived from stem cells contain the unique contents and membrane components of stem cells. These exosomes have the simi-lar repair function as stem cells, and avoid the safety problems of teratoma and graft immune rejection caused by stem cell therapy, and therefore has become the research hotspot of cell-free repair. However, exosomes in the treatment process will face high clearance rate, short half-life and difficulty in large-scale preparation, which limits the therapeutic effect of exosomes. Hydrogel loaded stem cell exosomes can not only prevent exosome from being rapidly removed, but also play the role of exosome and hydrogel in pro-moting wound healing, skin repair synergy, and thereafter has potential application value in wound repair research. In this paper, production and characteristics of exosomes, commonly used hydrogel materials, stem cell exosomes from different sources, exosomes extraction and identification methods have been sum-marized. Furthermore, stem cell exosomes related mechanisms of wound repair, protective and sustained release effects of hydrogel on exosomes, and synergistic effects of hydrogel and exosome are also reviewed. This paper provides a reference for the future research in the field of skin repair.
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Objective:To evaluate the effect of sevoflurane on necroptosis in isolated hippocampal neurons and the relationship with ryanodine receptor.Methods:Primarily cultured hippocampal neurons of fetal rats of Sprague-Dawley rats were inoculated in culture wells (100 μl/well) or culture flasks (3 ml/bottle) at a density of 5×10 5 cells/ml at 7 days of culture and divided into 3 groups ( n=24 each) using a random number table method: control group (group C), sevoflurane group (group S) and ryanodine receptor antagonist group (group R). Group C received routine culture.Ryanodine receptor antagonist Dantrolene at a final concentration of 3 μmol/L was added in group R. Thirty minutes later, the cells were placed in the incubator containing 2% sevoflurane and cultured for 5 h at 37 ℃ in S and R groups.Then cells were collected, the morphology of neurons was observed with an inverted microscope, the concentrations of free calcium ion ([Ca 2+ ] i) in cytoplasm were determined by flow cytometry, the expression of ryanodine receptor and phosphorylated MLKL protein (p-MLKL) was detected by Western blot, the expression of RIP3 was measured by immunofluorescence, and necroptosis rate was calculated. Results:Compared with group C, the [Ca 2+ ] i were significantly increased, the expression of ryanodine receptor and p-MLKL was up-regulated, and the necroptosis rate was increased in S and R groups ( P<0.05). Compared with group S, the expression of ryanodine receptor and p-MLKL was significantly down-regulated, and the [Ca 2+ ] i and necroptosis rate were decreased in group R ( P<0.05). There was no obvious abnormality in the morphology of neurons in group C. The cell body of neurons were shrunk, the processes were broken, and the network between processes was sparse in group S. The cell body was round, and the morphology was close to normal in group R. Conclusion:Sevoflurane can cause necroptosis in isolated hippocampal neurons of rats, and the mechanism is related to up-regulating the expression of ryanodine receptors and leading to calcium overload.
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OBJECTIVE@#To observe the effect of electroacupuncture (EA) at "Jiaji" (EX-B 2) points on the proliferation and differentiation of oligodendrocyte precursor cells in rats with acute incomplete spinal cord injury, and to explore the mechanism of EA on improving motor function of spinal cord injury.@*METHODS@#A total of 72 male SPF SD rats were randomly divided into a sham operation group, a model group, an EA group and a medication group, 18 rats in each group. Each group was further divided into 1-day subgroup, 7-day subgroup and 14-day subgroup, 6 rats in each subgroup. The T acute incomplete spinal cord injury model was established by modified Allen's method in the model group, EA group and medication group. The rats in each group received intraperitoneal injection of 5-bromodeoxyuridine (BrdU, 50 mg/kg), once a day, and each subgroup received continuous injection for 1, 7, 14 times for cell proliferation labeling. The rats in the EA group were treated with EA at "Jiaji" (EX-B 2) points 3-4 mm next the spinous process of the upper and lower segments of the injured spinal cord (T, T) with a frequency of 2 Hz/100 Hz and intensity of 1-2 mA. The muscle twitch at the treatment site was taken as the degree. The treatment was given 20 min each time, once a day. In the medication group, monosialogangliosides (GM1) was injected intraperitoneally (10 mg/kg), once a day. The subgroups of EA group and medication group were treated for 1, 7, 14 times. The score of Basso Beattie Bresnahan (BBB) was used to evaluate the motor function of hind limbs. The co-expression of BrdU/NG2 positive cells was detected by immunofluorescence, and the expression of Olig2 and Sox10 was detected by Western blot.@*RESULTS@#Compared with the sham operation group, the BBB score was decreased 1 day, 7 days and 14 days after operation in the model group (<0.05), the expression of Olig2 and Sox10 was increased (<0.05), and the co-expression of BrdU/NG2 positive cells was increased 7 days and 14 days after operation (<0.05). Seven days and 14 days after operation, the BBB score in the EA group and medication group was higher than that in the model group (<0.05), and the co-expression of BrdU/NG2 in the medication group was higher than that in the model group (<0.05). Fourteen days after operation, the co-expression of BrdU/NG2 in the EA group was higher than that in the model group (<0.05); 1 day, 7 days and 14 days after operation, the expression of Olig2 and Sox10 in the EA group and medication group was higher than that in the model group (<0.05). Compared with the medication group, the co-expression of BrdU/NG2 positive cells in the EA group 14 days after operation was decreased (<0.05); 1 day, 7 days and 14 days after operation, the expression of Olig2 and Sox10 in the EA group was decreased (<0.05).@*CONCLUSION@#EA at "Jiaji" (EX-B 2) points could promote the expression of Olig2 and Sox10 after spinal cord injury, which has similar effects with GM1. It could promote the proliferation and differentiation of oligodendrocyte precursor cells into oligodendrocytes, so as to promote the recovery of motor function of rats.
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Animals , Humans , Male , Rats , Acupuncture Points , Cell Differentiation , Cell Proliferation , Electroacupuncture , Oligodendrocyte Precursor Cells , Cell Biology , Oligodendrocyte Transcription Factor 2 , Metabolism , Random Allocation , Rats, Sprague-Dawley , SOXE Transcription Factors , Metabolism , Spinal Cord , Spinal Cord Injuries , TherapeuticsABSTRACT
Objective:To investigate the ecological environment and associated plants of mountain cultivated Panax ginseng were investigated in Xifeng county，Kuandian Manchu autonomous county and Huanren Manchu autonomous county of Liaoning province，in order to provided suggestions on the development of the mountain cultivated P. ginseng in these areas and necessary reference materials for the analysis of ecological suitability of mountain cultivated P. ginseng. Method:The field survey was conducted through sample plot survey in the survey pattern ofbased on representative area-sample plot-quadrat，literature review and data collation， were conducted to record indicators， calculate relevant parameters and make summary. Result:The associated plants were investigated based on 42 samples of mountain cultivated ginseng collected. A total of 95 plant species were identified. The correlation analysis was made on the six main species with an occurrence frequency of higher than 33%， and they were all positively correlated. Asarum heterotropoides var. mandshuricum was the strongest，which was followed by Schisandra chinensis， and Tilia tuan was the strongest in the arbor layer. The survey also found many problems in these areas，such as fewer large-scale planting bases， more scattered households，mixed germplasms，irregular planting techniques，simple planting mode and less sources of economic income generation. Conclusion:Xifeng county，Kuandian county and Huanren county of Liaoning province boast a superior ecological environment and abundant resources of mountain cultivated P. ginseng. The survey gets the whole picture of the ecological environment and associated plants of mountain cultivated P. ginseng in representative areas of Liaoning province，so as to provide the basis for the further development of mountain cultivated P. ginseng cultivation industry and the promotion of mountain cultivated Panax ginseng economy.
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Objective:To determine the median effective concentration (EC 50) of ropivacaine producing sensory-motor separation when used for femoral nerve block performed under ultrasound guidance. Methods:American Society of Anesthesiologists physical status Ⅰ-Ⅲ patients of both sexes, aged 18-64 yr, with body mass index of 18-30 kg/m 2, scheduled for elective arthroscopic knee surgery under general anesthesia, were enrolled in this study. Femoral nerve block was performed under ultrasound guidance.After successful location, ropivacaine 22 ml was injected with the initial concentration of 0.50%, and the ratio between the two consecutive concentrations was 1.1.The EC 50 of ropivacaine was determined by up-and-down sequential method.The positive response was considered as sensory block without motor block.The negative response was considered as sensory and motor block.When a negative response was found, the concentration was decreased in the next patient.When a positive response occurred, the concentration was increased in the next patient.Probit analysis was used to calculate the EC 50 and 95% confidence interval of ropivacaine producing sensory-motor separation when used for femoral nerve block which was performed under ultrasound guidance. Results:The EC 50 of ropivacaine producing sensory-motor separation was 0.186%, and the 95% confidence interval was 0.155%-0.205% when used for ultrasound-guided femoral nerve block. Conclusion:The EC 50 of ropivacaine producing sensory-motor separation is 0.186% when used for femoral nerve block performed under ultrasound guidance.
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Objective To compare the biomechanical characteristics of medial and lateral locking plates for Schatzker typeⅥfractures of tibial plateau by finite element analysis. Methods A 38 year-old male volunteer was enrolled for CT scan of his lower limbs. His CT images of the left tibial plateau were used for 3D reconstruction of a model of Schatzker type Ⅵ fracture by NX 9.0 software. After the boundary con-ditions were set, a 500 N load was applied to the tibial plateau to simulate the stress on a single leg when an adult weighing 60 kg walked. The displacement and stress on plate and screws were analyzed by Abaqus software. Results The ultimate stress on the model fixated with a medial locking plate was 81.7 MPa, located at the proximal tibiofibular joint surface. The ultimate stress on the model fixated with a lateral locking plate was 487.4 MPa, located at the junction of plate and screws. The ultimate stress on the fibula was much larger in the model fixated with a medial locking plate than in the model fixated with a lateral locking plate. The ultimate displacement was smaller and more homogeneous in the model fixated with a medial locking plate (1.15 mm) than in the model fixated with a lateral locking plate (3.44 mm).Conclusion The Schatzker type Ⅵ fractures of tibial plateau should be fixated with a medial locking plate because it has more biomechanical advantages than a lateral locking plate.
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<p><b>OBJECTIVE</b>To investigate the effect of high-fat diet on the expression of transient receptor potential vanilloid 1 (TRPV1) in the respiratory system and the dorsal root ganglion (DRG) of mice, as well as its effect on the excitability of sensory neurons.</p><p><b>METHODS</b>A total of 20 C57BL/6 mice were randomly divided into normal-diet (ND) group and high-fat diet (HFD) group, with 10 mice in each group. The mice were given corresponding diets and body weights were monitored. After 7 weeks of feeding, lung tissue, bronchial tissue, and DRG at thoracic segments 3-4 were collected and immunohistochemical staining was performed. A patch clamp was used to measure the number of action potentials and TRPV1 current intensity in the DRG.</p><p><b>RESULTS</b>After 7 weeks of feeding, the HFD group had significantly greater mean weight gain than the ND group (6.4±2.6 g vs 2.3±0.5 g; P<0.001). The HFD group had significantly higher expression of TRPV1 in the bronchus, pulmonary alveoli, and DRG than the ND group (P<0.05). Compared with the ND group, the HFD group had significant increases in the TRPV1 current intensity and number of action potentials in the DRG (P<0.05).</p><p><b>CONCLUSIONS</b>High-fat diet induces a significant increase in body weight and leads to high expression of TRPV1 and high excitability in the respiratory system and the peripheral sensory neurons. This suggests that TRPV1 may be an important factor in the physiopathological mechanisms of bronchial hyperresponsiveness.</p>
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Animals , Male , Mice , Action Potentials , Body Weight , Diet, High-Fat , Ganglia, Spinal , Chemistry , Mice, Inbred C57BL , Respiratory System , Chemistry , TRPV Cation Channels , PhysiologyABSTRACT
Two new flavonoid glycosides were isolated from the aerial parts of Nervilia fordii by various chromatographies such as D101 macroporous resin, ODS and preparative HPLC chromatographic techniques. Their structures were elucidated as rhamnocitrin-3-O-β-glucopyranosyl-4'-O-β-galactosyl-(1→3)-glucopyranoside (1) and 7, 3'-di-O-methylquercetin-4'-O-[β-galactosyl-(1→3)-β-glucopyranosyl]-3-O-β-glucopyranoside (2) on the basis of extensive spectroscopic analyses, including 1D-, 2D-NMR, HR-ESI-MS and analytical hydrolysis.
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This review article introduces the research advances in the pathophysiological mechanism of obesity in inducing pediatric bronchial asthma, including the role of leptin in obesity and asthma, the association of plasminogen activator inhibitor-1 with obesity and asthma, the association of adiponectin and interleukins with obesity and asthma, and the influence of neurotransmitter on asthma. In particular, this article introduces the latest research on the inhibition of allergic asthma through targeting at the nociceptor of dorsal root ganglion and blocking the signaling pathway of the nociceptor.
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Humans , Asthma , Leptin , Physiology , Nerve Growth Factor , Physiology , Neurotransmitter Agents , Physiology , Obesity , Plasminogen Activator Inhibitor 1 , PhysiologyABSTRACT
Objective To study the relationship between suicidal attitude and childhood trauma in bipolar disorders.Methods 67 patients with bipolar disorder and 101 healthy individuals were assessed with the Questionnaire of Suicidal Attitude (QSA) and Childhood Trauma Questionnaire(CTQ).Results There was no statistical difference between the patients group and healthy control group in the results of suicidal attitude (P＞0.05).The scores of emotional neglect (M =10)and physical neglect (M =9) in patients group were significantly higher than those of the healthy control group(M =8,M =6)(P＜0.05).The attitude to suicidal behavior was negative correlation with emotion neglect(r=-0.181,P＜0.05)in patients group.Conclusion Emotional and physical neglect are the main types of trauma in patients with BD,and may increase the risk of suicide.It is important to survey the patients with BD on childhood trauma,and intervention is necessary.
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Objective To identify immunodominant B linear cell epitopes in capsid proteins VP1 to VP3 of Coxsackievirus A16 (CVA16) strain YY157.Methods The protean algorithms of bioinformatic software Lasergene were used to analyze antigenicity, hydrophilicity and surface probability of amino acid sequence of CVA16 capsid proteins VP1 to VP3.Multiple regions containing potential lineal B cell epitopes were predicted and their corresponding average indexes were calculated by BepiPred 1.0 Server.Corresponding peptides were synthesized and examined in peptide-enzyme-linked immunosorbent assay (ELISA) individually to check whether it reacted positively or negatively toward sera from children with confirmed CVA16 infection.Results Totally 21 possible B cell linear epitopes were predicted according to their relatively strong antigenicity, hydrophilicity and surface probability.The corresponding synthetic peptides reacted positively with sera of CVA16-infected children in a varying extent.Conclusion Immunodominant B cell linear epitopes of capsid proteins VP1 to VP3 of CVA16 strain YY157 are successfully predicted and confirmed.
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BACKGROUND:In consideration of skin as the largest organ al over the body and its abundant vessels and vessel plexuses, there would be sufficient adult stem cels for tissue engineering. OBJECTIVE:To investigate the osteogenic potential of dermis-derived bone morphogenetic protein receptor subtype IB (BMPR-IB) positive cels. METHODS:In current study, histochemical analysis was adopted to study the localization and expression of BMPR-IB+ cels in skin. Fresh skin samples were digested into single cel suspension. Then, the surface marker BMPR-IB was used to isolate cel subpopulation by magnetic activated cel sorting from freshly prepared single cel suspension. After that, the osteogenic potential in vitro andin vivo was tested. Alkaline phosphatase staining and alizarin red staining were performed after osteogenic inductionin vitro. The BMPR-IB+ cels were seeded onto coral scaffolds, and the scaffolds were used to repair critical-sized calvarial defects of mice. Histochemical analysis was performed at 6 weeks postoperatively and micro-CT analysis was carried out at 24 weeks postoperatively to evaluate the ability of bone repairment. RESULTS AND CONCLUSION:We localized BMPR-IB cels in situ by immunohistochemistry that turned out to be expressed in the reticular layer of dermis and by single cels. Cel subpopulation which expressed BMPR-IB could be sorted by magnetic activated cel sorting. Alkaline phosphatase staining was obviously positive and lots of calcium modules were confirmed by alizarin red staining after osteogenic induction, indicating that BMPR-IB+ cels had the osteogenic potentialin vitro. Histochemical analysis demonstrated that plenty of new bone formation was found in BMPR-IB+ cels group after 6 weeks in vivo. Micro-CT analysis revealed that BMPR-IB+ cels-coral scaffold complex could repair calvarial defects successfuly after 24 weeksin vivo. These results indicated that dermis-derived BMPR-IB+ cels possessed adequate osteogenic potential. Moreover, they might be promising seed cels for bone tissue engineering.
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At present, the monitoring methods fwor intracranial pressure adopted in clinical practice are almost all invasive. The invasive monitoring methods for intracranial pressure were accurate, but they were harmful to the patient's body. Therefore, non-invasive methods for intracranial pressure monitoring must be developed. Since 1980, many non-invasive methods have been sprung out in succession, but they can not be used clinically. In this paper, research contents and progress of present non-invasive intracranial pressure monitoring are summarized. Advantages and disadvantages of various ways are analyzed. And finally, perspectives of development for intracranial pressure monitoring are presented.
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Humans , Intracranial Pressure , Monitoring, Physiologic , MethodsABSTRACT
<p><b>BACKGROUND</b>Although the use of an intramedullary fibular allograft together with locking plate fixation can provide additional medial support and prevent varus malalignment in displaced proximal humeral fractures with promising results, the fibular autograft donor site often sustains significant trauma and cannot restore the articular surface of comminuted fractures. The aim of this study was to evaluate the clinical and radiographic outcomes of a locking plate and crest bone autologous graft for treating proximal humerus comminuted fractures.</p><p><b>METHODS</b>We assessed the functional outcomes and complication rates in 40 patients with proximal humerus comminuted fractures. Eighteen patients were treated with a locking plate and an autologous crest bone graft (experimental group), and 22 were treated with only the locking plate and no bone graft (control group). Postoperative assessments included radiographic imaging, range of motion analysis, pain level based on the visual analogue scale (VAS), and the SF-36 (Short Form (36) Health Survey), as well as whether patients could return to their previous occupation.</p><p><b>RESULTS</b>All fractures healed both clinically and radiologically in the experimental group. There was no more than 2 mm collapse of the humeral head, and no osteonecrosis or screw penetration of the articular surface. In contrast, two patients had a nonunion in the control group, and they eventually accepted total shoulder replacements. The average time from surgery to radiographic union was significantly shorter in the experimental group ((4.66±1.63) months) compared with the control group ((5.98±1.57) months) (P < 0.05). For the experimental versus controls groups, the mean shoulder active flexion (148.00±18.59 vs. 121.73±17.20) degrees, extension (49.00±2.22 vs. 42.06±2.06) degrees, internal rotation (45.00±5.61 vs. 35.00±3.55) degrees, external rotation (64.00±9.17 vs. 52.14±5.73) degrees, and abduction (138.00±28.78 vs. 105.95±15.66) degrees were all significantly higher (all P < 0.001). The median SF-36 in the experimental group ((88.00±5.71) points) was significantly higher than that of the control group ((69.45±9.45) points; P < 0.001). The median VAS pain level (mean rank, 10.50) in the experimental group was lower than that (mean rank, 47.19) of the control group (P < 0.001). All but one patient (17 of 18, 94.4%) in the experimental group returned to their previous activities or occupations, and that one patient changed to a different occupation because of slight restrictions to activities. On the other hand, four patients could not return to their previous activities or occupations in the control group.</p><p><b>CONCLUSION</b>Locking plate fixation combined with an iliac crest bone graft is an effective technique for treating proximal humerus comminuted fractures.</p>