Diagnosis and treatment of humeral medial epicondyle fracture combined with radial neck fracture in children and adolescents / 中华创伤骨科杂志

Objective:To explore the diagnosis and treatment of humeral medial epicondyle fracture combined with radial neck fracture in children and adolescents.Methods:The clinical data were retro-spectively analyzed of the 12 pediatric patients with fractures of the humeral medial epicondyle plus the radial neck who had been admitted from February 2015 to August 2021 to Department of Pediatric Orthopedics, The Second Hospital of Fuzhou. There were 6 males and 6 females, with an age of (11.1 ± 2.5) years. According to the Papavasiliou classification, the humeral medial epicondyle fractures were type Ⅱ in 7 cases, type Ⅲ in 2 cases and type Ⅳ in 3 cases; according to the Judet classification, the radial neck fractures were type Ⅰ in 3 cases, type Ⅱ in 4 cases and type Ⅲ in 5 cases. Two Judet-Ⅰ radial neck fractures were missed by X-ray exam-ination but diagnosed by CT examination. Of the humeral medial epicondylar fractures, 9 were treated by open reduction and hollow screwing and 3 by closed reduction and Kirschner wiring. Of the radial neck fractures, 8 were treated by closed reduction and elastic intramedullary nailing and 4 conservatively. Fracture healing was followed up by postoperative radiographs. At the last follow-up, the carrying angles were measured, Kim Elbow Function Score (KEPS) was used to evaluate the functional recovery of the injured limb, and related complications were recorded.Results:All the 12 patients were followed up for (40.0±25.6) months. Fractures headed after (6.3±1.2) weeks. At the last follow-up, the carrying angle was 15.5°±2.6° on the injured side and 14.7°±2.0° on the healthy side, showing no significant difference ( P>0.05); KEPS was (96.3±5.3) points on the injured side and (98.8±2.3) points on the healthy side, showing no significant difference either ( P>0.05). No incision infection, bone nonunion, elbow valgus, joint stiffness or other complications were found; the postoperative elbow stability recovered well. Conclusions:As the fracture of the humeral medial epicondyle combined with the radial neck fracture is a special type of injury of straightened elbow during valgus stress in children and adolescents, it is likely to be missed in diagnosis. The goal of treatment is good functional recovery by restoring the articular match and elbow stability.

Acceptable residual rotational deformity after supracondylar fracture of the humerus in children / 中华创伤骨科杂志

Objective:To explore the effects of residual rotational deformity after supracondylar fractures of the humerus on the surgical efficacy in children.Methods:From January 2020 to December 2021, 453 patients with Gardland type Ⅲ supracondylar humeral fracture were treated with closed reduction and percutaneous pinning at Department of Pediatric Orthopedics, The Second Hospital of Fuzhou. They were assigned into 2 groups according to the quality of reduction. In the group of residual rotational deformity of 69 cases (group A), there were 44 boys and 25 girls, with an age of (6.3±2.9) years. The Baumann angle was maintained at 65° to 80° on the anteroposterior view of intraoperative fluoroscopy and the anterior humeral line passed through the anterior 1/3 of the capitellum on the lateral view with a normal carrying angle (from 4° to 23°). In the anatomical reduction group of 384 patients (group B), there were 242 boys and 142 girls, with an age of (5.9±2.7) years. The anteroposterior view and the lateral view of intraoperative fluoroscopy showed anatomical reduction of the fracture ends. The fluoroscopy frequency, operation time, intraoperative carrying angle, the carrying angle at 6 months after operation and the Flynn score at 6 months after operation were recorded and compared between the 2 groups.Results:There was no significant difference in gender, age, side or fixation time between the 2 groups before operation, showing they were comparable ( P>0.05). All patients were followed up for (6.3±2.9) months after operation. The median intraoperative fluoroscopy frequency was 6 (4, 6) times in group A, significantly lower than that in group B [8(6, 8)], and the median operation time was 20 (20, 25) min in group A, significantly shorter than that in group B [30(25, 30) min] ( P<0.05). There was no significant difference between group A and group B in the intraoperative rying angle (19.7°±2.7° versus 20.2°±2.8°) or in the carrying angle at 6 months after operation (17.4°±2.7° versus 17.6°±2.7°) ( P>0.05). By the Flynn scoring for the elbow joint at 6 months after operation, group A had 28 excellent cases, 30 good cases, 9 moderate cases, and 2 poor cases, yielding an excellent and good rate of 84.1%(58/69); group B had 241 excellent cases, 104 good cases, 34 moderate cases, and 5 poor cases, yielding an excellent and good rate of 89.8%(345/384). There was no statistically significant difference between the 2 groups ( P>0.05). No cubitus varus, delayed union, non-union, compartment syndrome, or iatrogenic ulnar nerve injury was observed in either group at postoperative 6-month follow-up. Conclusions:A certain degree of residual rotational deformity is acceptable after supracondylar fracture of the humerus in children, because it may have a little significant effect on the postoperative outcomes but may reduce fluoroscopy frequency and shorten operation time.

Bouquet technique in treatment of unstable pediatric femoral shaft fractures / 中华创伤骨科杂志

Objective:To investigate the clinical results of Bouquet technique [multiple elastic stable intramedullary nails (ESIN)] in the treatment of unstable pediatric femoral shaft fractures.Methods:From August 2016 to October 2019, 25 pediatric patients (26 sides) with unstable femoral shaft fracture were treated with Bouquet technique at Department of Pediatric Orthopedics, The Second Fuzhou Hospital Affiliated to Xiamen University. They were 17 boys and 8 girls, with a mean age of 7.8 years at injury (from 5 to 11 years). Their body weight ranged from 23 kg to 62 kg, with an average of 36.3 kg. Long oblique fractures happened in 6 cases (6 sides) and comminuted fractures in 19 cases (20 sides). Ten cases (11 sides) were fixated with 3 ESINs (type 3A) and 15 cases (15 sides) with 4 ESINs (type 4A in 6 cases and type 2A+2B in 9 cases). The multiple ESINs were inserted from the medial and lateral cortex of the distal femur through the fracture sides until the head ends of the nails were distributed evenly at the proximal femur. Recorded were the fracture healing time, complications, fracture reduction quality and hip function at the last follow-up.Results:All the 25 patients were followed up for 18 to 27 months (mean, 22.4 months). Their fractures got united after 4 to 8 weeks (mean, 6.3 weeks). One case presented with femoral overgrowth of 1.1 cm and another case with nail tail irritation. Follow-ups revealed that none of the patients had such complications as incision infection, limited joint movement, nonunion or delayed fracture union. The limb alignment recovered well with no angulation, shortening or rotational deformity. At the last follow-up, according to the efficacy evaluation system for intramedullary nails by Flynn et al., the quality of reduction of femoral shaft fractures was assessed as excellent in 24 sides and as good in 2 sides, giving an excellent and good rate of 100% (26/26). According to the hip Harris scoring system, the hip function was assessed as excellent in all the 26 sides, giving an excellent rate of 100% (26/26).Conclusion:Bouquet technique is safe and effective in the treatment of unstable pediatric femoral shaft fractures, leading to fine clinical results.

Clinical application of percutaneous iliosacral screws combined with pubic ramus screws in Tile B pelvic fracture / 中国骨伤

<p><b>OBJECTIVE</b>To investigate the application and effect of minimally invasive percutaneous anterior pelvic pubic ramus screw fixation in Tile B fractures.</p><p><b>METHODS</b>A retrospective review was conducted on 56 patients with posterior pelvic ring injury combined with fractures of anterior pubic and ischiadic ramus treated between May 2010 and August 2015, including 31 males and 25 females with an average age of 36.8 years old ranging from 35 to 65 years old. Based on the Tile classification, there were 13 cases of Tile B1 type, 28 cases of Tile B2 type and 15 cases of Tile B3 type. Among them, 26 patients were treated with sacroiliac screws combined with external fixation (external fixator group) and the other 30 patients underwent sacroiliac screw fixation combined with anterior screw fixation (pubic ramus screw group). Postoperative complications, postoperative ambulation time, fracture healing, blood loss, Majeed pelvic function score and visual analogue scale(VAS) were compared between two groups.</p><p><b>RESULTS</b>Fifty-four patients were followed up from 3 to 24 months with a mean of 12 months. There were no significant difference in the peri-operative bleeding and operation time between two groups(>0.05). The postoperative activity time and fracture healing time of pubic ramus screw group were shorter than those of the external fixator group, the differences were statistically significant(<0.05). The Majeed score, VAS score of pubic ramus screw group were higher than those of the external fixator group, the differences were statistically significant(<0.05). The incidence of postoperative complications of pubic ramus screw was lower than that of the external fixator group, the difference was statistically significant (<0.05).</p><p><b>CONCLUSIONS</b>Percutaneous iliosacral screws fixation combined with the pubic ramus screw is an effective and safty treatment method to the Tile B pelvic fracture. It has advantages of early ambulation, relief of the pain and few complications.</p>

Study on intestinal absorption features of oligosaccharides in Morinda officinalis How. with sigle-pass perfusion / 中国中药杂志

To study the in situ intestinal absorption of five oligosaccharides contained in Morinda officinalis How. (sucrose, kestose, nystose, 1F-Fructofuranosyinystose and Bajijiasu). The absorption of the five oligosaccharides in small intestine (duodenum, jejunum and ileum) and colon of rats and their contents were investigated by using in situ single-pass perfusion model and HPLC-ELSD. The effects of drug concentration, pH in perfusate and P-glycoprotein inhibitor on the intestinal absorption were investigated to define the intestinal absorption mechanism of the five oligosaccharides in rats. According to the results, all of the five oligosaccharides were absorbed in the whole intestine, and their absorption rates were affected by the pH of the perfusion solution, drug concentration and intestinal segments. Verapamil Hydrochloride could significantly increase the absorptive amount of sucrose and Bajijiasu, suggesting sucrose and Bajijiasu are P-gp's substrate. The five oligosaccharides are absorbed mainly through passive diffusion in the intestinal segments, without saturated absorption. They are absorbed well in all intestines and mainly in duodenum and jejunum.

Detecting the isoflurane in the air of workplaces with chromatographic method / 中华劳动卫生职业病杂志

<p><b>OBJECTIVE</b>To establish a solvent desorption Gas chromatographic method for detecting the isoflurane in air of workplaces.</p><p><b>METHODS</b>This method is based on "Standardization of methods for determination of toxic substances in workplace air".</p><p><b>RESULTS</b>This method presents the linear relation with the minimum detectable limit 1.0 µg/ml and the minimum detectable concentration 0.07 mg/m(3). The precision (RSD) was 0.5% ∼ 5.0%, the mean dsorption efficiencies were 96.7% ∼ 98.9%, the absorption efficiencies were 92.1% ∼ 100%, the breakthrough volume was 3.7 mg isoflurane/100 mg active carbon. Other volatile organic solvents (Sevoflurane, Enflurane and Ethyl Alcohol) did not interfere the detection. The sample could be stored in the active carbon tube at least for 10 days.</p><p><b>CONCLUSION</b>This method is meet the requirement of GBZ/T 210.4-2008 "Guide for establishing occupational health standards-Part4: Determination methods of air chemicals in workplace" and is feasible for determining the isoflurane in the air of workplaces.</p>

HILIC-eLSD determination of five oligosaccharides contained in Morinda officinalis / 中国中药杂志

<p><b>OBJECTIVE</b>To determine determinate five oligosaccharides, namely sucrose, 1-kestose, nystose, 1F-fructofurano-syinystose, bajijiasu contained in Morinda officinalis with an HILIC-ELSDI) method.</p><p><b>METHOD</b>Waters XBridge Amide (4.6 mm x 150 mm, 3.5 microm) hilic column was adopted for gradient elution, with acetonitrile (A) and 0.2% triethylamine (B) as the mobile phase. The column temperature was set at 40 degrees C, with the flow rate of 0.8 mL x min. Waters 2424 evaporative light scattering detector (ESLD) was used as detector, with the gas flow of 275.79 kPa and drift tube temperature of 90 degrees C.</p><p><b>RESULT</b>The detection range for the five oligosaccharides were 2.128-21.28 microg for sucrose (r = 0.999 3), 1.864-18.64 microg for 1-kestose (r = 0.999 6), 1.92-19.2 microg for nystose (r = 0.999 8), 1.912-19. 12 microg for 1F-fructofuranosyinystose (r = 0.999 5), 2.368-23.68 microg for bajijiasu (r = 0.999 4), respectively. The recovery of the five oligosaccharides ranged between 92.81%-102.8% (n = 6).</p><p><b>CONCLUSION</b>The method is so simple, accurate and highly reproducible that it can be used as an analytical method for effective evaluation of the quality of M. officinalis herbs.</p>

Simultaneous determination of seven chemicals of halogenated alkanes and aromatic hydrocarbons in the air of workplace by gas chromatography / 中华劳动卫生职业病杂志

<p><b>OBJECTIVE</b>To establish a gas chromatographic method for determination of halogenated alkanes and aromatic hydrocarbons including trichloromethane, 1,2-dichloroethane, carbon tetrachloride, benzene, toluene, ethylbenzene and xylene in the air of workplace.</p><p><b>METHODS</b>After the air samples collected with activated carbon tubes and desorbed with CS(2), the target toxicants were separated with FFAP capillary columns and detected with flame ionization detector.</p><p><b>RESULTS</b>The coefficient of correlation was above 0.999 and the lowest detectable concentrations were 0.2 ∼ 3.6 mg/m(3) with the RSD of 1.2% ∼ 4.6%. The desorption efficiencies was 94.9% ∼ 100.7%.</p><p><b>CONCLUSION</b>The method shows lower detection limit, high accuracy and precision. It is feasible for determination of the seven halogenated alkanes and aromatic hydrocarbons in the air of workplace.</p>

Aromatase inhibitor letrozole induces sex inversion in the protogynous red spotted grouper (Epinephelus akaara) / 生理学报

The objective of this study was to investigate the effects of the aromatase inhibitor (AI) letrozole on gonadal development, serum steroids and aromatase activities in 2-year-old female red spotted grouper (Epinephelus akaara) during reproductive season. Groupers were divided into two groups, one implanted with aromatase inhibitor (AI, 5 mg/kg body weight) and the other elastomer without AI into peritoneal cavity once every four weeks for 8 weeks. Spermiation was checked through gentle abdominal pressure every 2 weeks. Blood samples were obtained from 6 fish of each group every 4 weeks for later analysis of sex steroids. After blood samples were collected, forebrain, midbrain, hindbrain, and gonads were collected and stored at -70 degrees C for later aromatase activity measurement and gonadal histological study. Significantly lower gondadosomatic index (GSI) was observed in AI-implanted group. Fish implanted with AI once showed complete degradation of oocytes and sex inversion with developing testicular tissues in the 4th week. AI induced females to develop into functional males with authentic males testes similar in structure to those in normal males. Spermiating rate of AI-treated males were 14.3%, 35.3%, and 48.4%in the 4th, 6th, and 8th week, respectively, while all fish in the control group were still female with developing ovaries. Aromatase activities in gonads decreased significantly after implantation with aromatase inhibitor, but showed no significant difference between control and AI-implanted group. No difference in serum testosterone (T) levels was observed in control and AI-treated group, while serum levels of 17beta-estradiol (E(2)) decreased but 11-ketotestosterone (11-KT) concentration increased significantly. The present results suggest that the decrease in serum 17beta-estradiol (E(2)) and increase in 11-KT levels may be important for sex inversion induced by aromatase inhibitor in red spotted grouper.

Stimulatory effects of gonadotropin-releasing hormone and dopamine on growth hormone release and growth hormone mRNA expression in Epinephelus coioides / 生理学报

Gonadotropin-releasing hormone (GnRH) and dopamine (DA) can stimulate growth hormone (GH) release, but their effects on GH mRNA synthesis are controversial and deficient in fish. Orange-spotted grouper (Epinephelus coioides) is a hermaphroditic marine fish with sex reversal. Few data are available concerning the regulation of GH in grouper. In the present study, the effects of GnRH and DA on GH release and GH mRNA expression were determined using pituitary fragments of orange-spotted grouper under static culture conditions. After incubation from 1 h to 24 h, salmon GnRH (sGnRH, 100 nmol/L) stimulated the release of GH and increased the level of GH mRNA time-dependently. The minimum duration of sGnRH effect was 1 h. Both of sGnRH and mammalian GnRH (mGnRH) augmented the release of GH and the level of GH mRNA in a dose-dependent manner. The potency of sGnRH on both GH release and GH mRNA level was more pronounced than that of mGnRH. The effects of 1 micromol/L APO (Apomorphine), an agonist of D(1)/ D(2) dopamine receptors, significantly stimulated GH release and GH mRNA synthesis after incubation for 12 h. APO stimulated GH release and GH mRNA abundance in a dose-dependent manner. These results demonstrate that both GnRH and DA directly stimulate GH release and GH mRNA expression at the pituitary level, the actions of GnRH are more potent than that of DA in orange-spotted grouper.