Bilateral triceps tendon approach is flexible and efficient in the treatment of type C distal humerus fractures / 中华创伤杂志(英文版)

PURPOSE@#The purpose of this study was to assess and compare elbow range of motion, triceps extension strength and functional results of type C (AO/OTA) distal humerus fractures treated with bilateral triceps tendon (BTT) approach and olecranon osteotomy (OO). At the same time, we are also trying to know whether BTT approach can provide sufficient vision for comminuted intra-articular fractures of the distal humerus, and whether it is convenient to convert to the treatment to total elbow arthroplasty (TEA) or OO.@*METHODS@#Patients treated with OO and BTT approaches for type C distal humerus fractures between July 2014 and December 2017 were retrospectively reviewed. Inclusion criteria include: (1) patients' age were more than 18 years old, (2) follow-up was no less than 6 months, and (3) patients were diagnosed with type C fractures (based on the AO/OTA classification). Exclusion criteria include: (1) open fractures (Gustillo type 2 or type 3), (2) treated by other approaches, and (3) presented with combined injuries of ipsilateral upper extremities, such as ulnar nerve. Elbow range of motion and triceps extension strength testing were completely valuated, when the fractures had healed. Assessment of functional results using the Mayo elbow performance score and complications were conducted in final follow-up. The data were compared using the two tailed Student's t-test. All data were presented as mean ± standard deviation.@*RESULTS@#Eighty-six patients of type C distal humerus fractures, treated by OO and BTT approach were retrospectively reviewed between July 2014 and December 2017. Fifty-five distal humerus fractures (23 males and 32 females, mean age 52.7 years) treated by BTT approach or OO were included in this study. There were 10 fractures of type C1, 16 type C2 and 29 type C3 according to the AO/OTA classification. Patients were divided into two surgical approach groups chosen by the operators: BTT group (28 patients) and OO group (27 patients). And the mean follow-up time of all patients was 15.6 months (range, 6-36 months). Three cases in BTT group were converted to TEA, and one converted to OO. Only one case in BTT group presented poor articular reduction with a step more than 2 mm. There were not significantly different in functional outcomes according to the Mayo elbow performance score, operation time and extension flexion motion are values between BTT group and OO group (p > 0.05). Complications and reoperation rate were also similar in the two groups. Triceps manual muscle testing were no significant difference in the two groups, even subdivided in elder patients (aged >60 years old).@*CONCLUSION@#BTT is a safe approach to achieve similar functional result comparing with OO. BTT were not suitable for every case with severe comminuted pattern, but it avoids the potential complications related to OO, and has no complications concerning with triceps tendon. It is convenient for open reduction internal fixation and flexible to be converted to OO, as well as available to be converted to TEA in elder patients.

Effects of processing on toxic components of Pinellia Rhizoma and its detoxification mechanism / 中国中药杂志

Pinellia Rhizoma is one of the most commonly used medicinal herbs in clinic, but its toxicity couldn't be ignored. Processing is a detoxification method before the toxic traditional Chinese medicine were given to the patients, and mainly impacted the amount of relevant components in Chinese medicinal herbs (increase or decrease). Although there were still some disputes about the toxic components in Pinelliae Rhizoma (mainly referring to the alkaloid substances), more literatures reported that needle-like calcium oxalate crystals and lectin protein in Pinelliae Rhizoma were the main toxic components, and had a significant effect on inflammation and irritation caused by Pinellia Rhizoma. With the development of research methods and the expansion of research angles, researches for the effect of processing on the detoxification mechanism of Pinelliae Rhizoma have been constantly deepened. The recent reports showed that the detoxification mechanism of the herb was correlated with the dosage of detoxifying components, and the effect of relevant excipients in inhibiting a variety of inflammatory cytokines. However, we shall also pay attention to alum and other processing accessories that could cause new toxicity from residual aluminum, and the impact from processing conditions, origin of Chinese medicinal herbs and their combination with other medicinal herbs on Pinellia Rhizoma's toxicity. This paper describes toxic components, different detoxification methods and relevant detoxification mechanisms in Pinelliae Rhizoma to provide the references for further research and development of the plant.

Application of blending raw materials in quality consistency control of Qianlie Shule Capsule / 中草药

Objective: To develop a method for controlling the quality consistency of Qianlie Shule Capsule (QSC) by blending raw marerials. Methods: Blending raw materials were blended by medicine calculator V2. The content differences of epimedin C and icariine in QSC made from raw materials and their mixtures were compared. Results: The RSD of index component epimedin C from blended and raw materials were 11.2% and 82.5%, the RSD of icariine were 8.70% and 35.5%, the difference between index components decreased obviously, and it showed that the quality consistency in QSC was greatly increased. Conclusion: Using the method to control the quality coherence of Chinese patent medicine has the obvious results, it is easy to operate and suitable for actual production.

Dosimetric benefit to organs at risk following margin reductions in nasopharyngeal carcinoma treated with intensity-modulated radiation therapy / 癌症

<p><b>INTRODUCTION</b>It is important to decrease the radiation exposure of normal tissue in intensity-modulated radiation therapy (IMRT). Minimizing planning target volume (PTV) margins with more precise target localization techniques can achieve this goal. This study aimed to quantify the extent to which organs at risk (OARs) are spared when using reduced margins in the treatment of nasopharyngeal carcinoma (NPC).</p><p><b>METHODS</b>Two IMRT plans were regenerated for 40 patients with NPC based on two PTV margins, which were reduced or unchanged following cone beam computed tomography online correction. The reduced-margin plan was optimized based on maximal dose reduction to OARs without compromising target coverage. Dosimetric comparisons were evaluated in terms of target coverage and OAR sparing.</p><p><b>RESULTS</b>Improvements in target coverage occurred with margin reduction, and significant improvements in dosimetric parameters were observed for all OARs (P < 0.05) except for the right optic nerve, chiasm, and lens. Doses to OARs decreased at a rate of 1.5% to 7.7%. Sparing of the left parotid and right parotid, where the mean dose (Dmean) decreased at a rate of 7.1% and 7.7%, respectively, was greater than the sparing of other OARs.</p><p><b>CONCLUSIONS</b>Significant improvements in OAR sparing were observed with margin reduction, in addition to improvement in target coverage. The parotids benefited most from the online imaging-guided approach.</p>

Effect of ningdong granule on stereotyped behaviors in Tourette syndrome model rats of different Chinese medical syndromes / 中国中西医结合杂志

<p><b>OBJECTIVE</b>To observe the effect of Ningdong Granule (NDG) on stereotyped behaviors in Tourette's syndrome (TS) model rats of different Chinese medical syndromes.</p><p><b>METHODS</b>Thirty-two Wistar rats were used to establish TS models of different Chinese medical syndromes (n =8) induced by TS children patients' sera of 4 syndromes, i.e., Xin-Gan deficiency syndrome (XGDS), Gan-Shen yin deficiency syndrome (GSYDS), sputum-turbid blocking aperture syndrome (STBAS), and Gan hyperactivity Pi deficiency syndrome (GHPDS). Corresponding sera was micro-infused to them while administering NDG (120 mg/kg each time, thrice daily, for 3 successive weeks). Besides, another normal control group (n =8) was set up by injecting sera from healthy children plus intragastric perfusion of normal saline. Stereotyped behaviors were recorded on the 1st, 7th, 14th, and 21st day after administration of NDG.</p><p><b>RESULTS</b>The anti-neural antibody serum concentration in TS children was significantly higher than that in healthy control [(1.28 +/- 0.36) UL vs. (0.52 +/- 0.24) U/L, P < 0.01 ]. It was (1.34 +/- 0.41) U/L in the XGDS group, (1.19 +/- 0.51) U/L in the GSYDS group, (1.29 +/- 0.61) U/L in the STBAS group, and (1. 17 +/- 0.45) U/L in the GHPDS group, showing no statistical difference (P > 0.05). There was no statistical difference in stereotypic behaviors of rats after treatment among the four different Chinese medical syndromes (P > 0.05). At day 7, 14, and 21 after treatment by NDG, the times of stereotyped behaviors were significantly less in the XGDS group than in the other three groups at the same time points except in the GHPDS group at day 14 (P < 0.05, P < 0.01). Meanwhile, the total numbers of stereotyped behaviors in the XGDS group [(42.8 +/- 12.6)] was obviously superior to that in the GSYDS group [(29.3 +/- 13.7)], the STBAS group [(21.9 +/- 10.4)], and the GHPDS group [(30.6 +/- 9.6)], showing statistical difference (P < 0.01, P < 0.05) after treatment by NDG at day 21.</p><p><b>CONCLUSIONS</b>The anti-neural antibody serum concentration in TS children was significantly higher than that in healthy children. Stereotyped behaviors could be induced in rats after intrastriatal micro-infusion of TS sera rich in anti-neural antibody. TS model rats of XGDS were better improved than rats in the other 3 groups after treatment by NDG.</p>