Treatment of proximal humeral fracture by proximal humerus internal locking system via minimally invasive plate osteosynthesis / 中华创伤骨科杂志

Objective:To evaluate the efficacy of proximal humerus internal locking system (PHILOS) via the minimally invasive plate osteosynthesis (MIPO) in the treatment of proximal humeral fractures.Methods:This retrospective study analyzed 30 elderly patients with proximal humeral fracture who had been treated by PHILOS via MIPO from September 2016 to March 2020 at Department of Orthopedic Surgery, People’s Hospital of Zhuxi County. They were 19 females and 11 males with an average age of 60.96 years (from 45 to 80 years). All patients were treated by closed reduction. After fracture reduction was confirmed by fluoroscopy, a minimally invasive incision was made below the acromion, with a couple of suture wires reserved at the rotator cuff attachments. A PHILOS plate was inserted at 4 mm lateral to the intertubercular sulcus, with the suture wires passing through the proximal suture holes on the PHILOS. After a lag screw was first screwed up into the compression hole on the PHILOS plate, the crossing suture wires were tightened up to resist the rotator cuff stress and maintain the internal inclination of the humeral head. Kirschner wires were used to temporarily stabilize the reduction. After satisfactory reduction and fine plate positions were confirmed by fluoroscopy, locking nails were screwed up. The internal inclination of the affected humeral head was compared between preoperation and the last follow-up. The therapeutic efficacy was evaluated by the shoulder Neer scoring system, and the visual analogue scale (VAS) pain scores and complications were recorded at the last follow-up.Results:All the 30 patients were followed for 6 to 18 months (average, 12 months). There was no incision infection, neurovascular injury, or internal fixation failure. Anatomical reduction was achieved in 25 patients and functional reduction in 5. The inclination of the humeral head was significantly improved. The VAS scores at the last follow-up averaged 1.9. Follow-up X-ray examination showed that bony union was achieved after 6 to 18 months (average, 9 months) for all patients. At the last follow-up, the inclination angle of the affected humeral head was 130°±5°, significantly improved compared with the preoperative 90°±11.2° ( P<0.05). All patients had good functional recovery of the shoulder. The efficacy was, according to the Neer shoulder scores at the last follow-up, excellent in 22, good in 6 and fair in 2 cases. Conclusions:Treatment of proximal humeral fractures using PHILOS via MIPO technique is suitable for patients with osteoporotic fracture, and may lead to fine therapeutic efficacy.

Improvement of glycyrrhetinic acid on damage of synaptic ultrastructures of hippocampus induced by realgar in mice / 吉林大学学报(医学版)

Objective: To explore the improvement of glycyrrhetinic acid (G A) on the damage of synaptic ultrastructures of hippocampus induced by realgar in the mice, and to clarify the related mechanisms. Methods: Sixty ICR mice were randomly divided into three groups with twenty mice in each group: control group (intragastrically treated with 0. 5 % CMC-Na), realgar group (intragatrically treated with realgar 1. 35 g • kg- 1), and GA intervention group (intragastrically administered with GA 48 mg • kgx and realgar 1. 35 g • kg1). The mice were administrated once a day for eight consecutive weeks. The cognitive and memory abilities were tested using object recognition task (ORT). The levels of glutathione (GSH) in the hippocampus in the mice in various groups were detected. The changes of the ultrastructures of synapse in hippocampal CA1 region, the width of synaptic cleft, the length of synaptic active zone, the thickness of post synaptic density (PSD) and the curvature of synaptic interface were observed by transmission electron microscope. Results: Compared with control group, the preferential index (PI) for the novel object and the level of GSH in the hippocampus tissue of the mice in realgar group were significantly decreased (P 0 . 05), and the level of GSH in the hippocampus tissue of the mice in GA intervention group was significantly increased (P 0 . 05). Conclusion: Realgar can change the synaptic structural parameters and cause deficits in cognitive and memory abilities. GA can alleviate the abnormal ultrastructural changes in the hippocampal synapses of the mice.

Preliminary report on prospective, multicenter, open research of selective surgery after expandable stent combined with neoadjuvant chemotherapy in the treatment of obstructive left hemicolon cancer / 中华胃肠外科杂志

OBJECTIVE@#To evaluate the safety and feasibility of neoadjuvant chemotherapy prior elective surgery following self-expanding metallic stents (SEMS) for complete obstructive left hemicolon cancer.@*METHODS@#This prospective, multicenter, open-labelled trial was approved by the Ethics Committee of Beijing Chaoyang Hospital, Capital Medical University(2016-ke-161-1) and registered in Clinicaltrials.gov (NCT02972541).@*INCLUSION CRITERIA@#(1)age between 18 and 75 years old;(2) adenocarcinoma confirmed by pathology;(3) left hemicolon cancer confirmed by clinical manifestations and imaging examinations with the distance to anal verge > 15 cm; (4) resectable cancer evaluated by imaging examination without distant metastasis; (5) Eastern Cooperative Oncology Group (ECOG) score ≤ 1 or Karnofsky Performance Scale (KPS) > 70, indicating tolerance of neoadjuvant chemotherapy and operation; (6) absence of chemotherapy or radiotherapy within past six months; (7) bone marrow system and hepatorenal function: hemoglobin ≥ 90 g/L, neutrophil ≥ 1.5×10/L, platelet ≥ 80×10/L, total bilirubin ≤ 1.5×ULN(upper limits of normal), serum transaminase ≤ 2.5×ULN, serum creatinine ≤ 1.0×ULN, endogenous creatinine clearance rate > 50 ml/min; (8) sign for informed consent.@*EXCLUSION CRITERIA@#(1) multiple primary colorectal cancer; (2) rejection of operation;(3) presenting peritonitis or bowel perforation before SEMS; (4) unqualified conditions proved by inspector from registration data. According to inclusion criteria, 62 consecutive patients receiving neoadjuvant chemotherapy prior to elective surgery following SEMS for complete obstructive left hemicolon cancer from Beijing Chaoyang Hospital of Capital Medical University (n=31), Qilu Hospital of Shandong University (n=14), the Third Xiangya Hospital of Central South University (n=13), Zhongnan Hospital of Wuhan University (n=2), the Fourth Hospital of Hebei Medical University (n=2) between December 2015 and December 2017 were prospectively enrolled in this study. Patients were divided into neoadjuvant chemotherapy group and elective surgery group according to the investigator's clinical experience and patient's preference. Patients in the elective surgery group received surgery within one to two weeks after SEMS placement without neoadjuvant chemotherapy. Those in the neoadjuvant chemotherapy group received 2 cycles of CapeOX or 3 cycles of mFOLFOX6 neoadjuvant chemotherapy within one to two weeks after SEMS placement, and then underwent surgery within 3 weeks after finishing neoadjuvant chemotherapy. Data between groups were compared using Student t-test, chi-square analysis or Fisher exact test analysis, including basic clinical informations, operational conditions and postoperative complications. The adverse reactions during the neoadjuvant chemotherapy were recorded. Surgical difficulty was assessed using visual analog scales ranging from 1 to 10, where 1 represented the lowest and 10 the highest degree of surgical difficulty, as judged by the surgeon.@*RESULTS@#The study included 38 males and 24 females with mean age of (64.8±8.8) years. The clinical baseline data between 2 groups were not significantly different (all P>0.05) except the average time interval between SEMS and surgery was significantly longer in neoadjuvant chemotherapy group [(61.6±13.5) days vs. (10.4±5.2) days, t=16.679, P0.05).@*CONCLUSION@#Neoadjuvant chemotherapy prior elective surgery following SEMS is a relatively safe and feasible approach in the treatment for obstructive left hemicolon cancer, and is associated with less stoma, more laparoscopic surgery, shorter operative time, less blood loss, lower surgical difficulty, and faster postoperative recovery as compared with conventional elective surgery.

Effect of sodium aescinate on oxidative stress and pulmonary function during acute exacerbation of chronic obstructive pulmonary disease / 中国综合临床

Objective To investigate the effects of sodium aescinate(SA)on oxidative stress and pulmonary function during acute exacerbation of chronic obstructive pulmonary disease(COPD).Methods One hundred and twenty patients with COPD were randomly divided into two groups:the control group(n =60) and the treatment group(n =60).All patients were treated with routine anti-infection,oxygen inhalation,relieving phlegm and anti-asthma The treatment group took SA in addition to the routine beteropathy.The changes of serum SOD,MDA,GSH-Px,T-AOC,pulmonary functions and 6 minute walk distance(6MWD) were detected before and after two-week treatment in patients of the two groups to compare with 60 healthy subjects.Results The total effective rate in the treatment group was 91.67％,while 76.67％ in the control group.The difference was statistically significant(x2 =5.065,P ＜0.05).Serum MDA level in both groups were comparatively higher than the healthy controls(9.25±1.55) μmol/L vs.(9.74±1.50) μmol/L vs.(2.06±0.29) μmol/L,P ＜0.001),while the levels of SOD,GSH-Px and T-AOC were lower than the healthy controls[SOD:(91.14±9.54) kU/L vs.(90.61±8.01) kU/L vs.(116.63±6.57) kU/L; GSH-Px:(139.38±36.56) U vs.(137.57±34.19) U/L vs.(189.34±35.54) U/L; T-AOC:(6.48±1.15) kU/L vs.(6.39±1.13) kU/L vs.(13.34±1.23)kU/L;P < 0.001].After treatment,all indexes of the two groups were obviously ameliorated in comparison with before treatment(P ＜ 0.001),but the level of MDA[(4.56±1.39) μmol/L]in the treatment group decreased more greatly than in the control groups(P ＜ 0.001).The levels of SOD[(103.85±7.07) kU/L],GSH-Px[(169.65±34.51) U/L],T-AOC[(10.52±1.09) KU/L],forced expiratory volume in 1 second/forced vital capacity(FEV1/FVC)[(60.49±6.11)％],FEVI％[(76.62±6.35)％]and 6MWD [(394.83±10.11)m]increased considerably more than those in the control group(P ＜ 0.001).Conclusion Oxidative stress might be involved in the course of acute exacerbation of COPD.Sodium aeseinate can improve the pulmonary functions by ameliorating the oxidative stress during acute exacerbation in patients with COPD.

An adaptive filtering algorithm applied to inhibit the interference from the ventricular during atrial epicardial mapping experiment / 中国医疗器械杂志

This paper introduces an adaptive filtering algorithm based on the LMS principle to inhibit the ventricular interference in the atrial epicardial mapping experiments.

The development for real-time sampling and display in epicardial mapping system / 中国医疗器械杂志

In order to realize real-time sampling and display in 128-channeled Epicardial Mapping System whose sampling frequency is 2 kHz per channel, the article introduces a mapping software and preliminarily validates its practicability. The software is designed in MFC, using multiple-thread technology and buffering and pumping values method.

Protective Effect of Gardenia Jasminoides Ellis on Lipid Peroxidation Injury of Pancreatic Subcellular Fraction Following Severe Acute Pancreatitis / 天津医药

Objective: To explore lipid peroxidation injuries of pancreatic mitochondria and lysosome following severe acute pancreatitis (SAP) and the protective effects of gardenia jasminoides ellis (GJE) thereof. Methods: SAP models were induced by retrograde injection of 1.5% sodium deoxycholate. The rats were randomly divided into three groups: sham group, SAP group and GJE group. The changes were measured in superoxide dismutase (SOD), malondialdehyde (MDA), membrane fluidity of mitochondria and lysosome in pancreas and succinic dehydrogenase (SDH) in mitochondria, acid phosphatase (ACP) in lysosome.The effects of GJE were also observed. Results: Compared with Sham group, the activity of SOD and membrane fluidity of mitochondria and lysosome were decreased in pancreas, and the content of MDA were increased; the releasing rate of ACP was significantly higher in lysosome; SDH in mitochondria was lower in SAP group(P < 0.01). The above-mentioned indexes were obviously ameliorated in GJE group than those in SAP group(P < 0.01). The correlation analysis indicated that MDA was negatively correlated with SOD, positively correlated with membrane fluidity (P < 0.01). Conclusion: GJE can alleviate lipid peroxidation by getting rid of oxygen free radicals of pancreatic subcellular fraction in the course of SAP, and protect the structure and function of pancreatic subcellular fraction.

Difference of Responses of Males and Females under-30? Head-down Tilt / 航天医学与医学工程

Objective To find out the difference of responses to HDT between females and males of different occupations.Methods Healthy female employees(group A,n=11)and female pilots(group B,n=10)and male special pilots(group C,n=14)and male employees(group D,n=7)were tested with-30? head-down tilt for 45 min.Results Heart rate(HR)of females and males all decreased with time during HDT,especially male employees group and female pilots group(P

Clinical Application of Laparoscopy in Treatment of Pancreatic Diseases (Report of 12 Cases) / 中国普外基础与临床杂志

Objective To explore the clinical value of laparoscopy in the treatment of pancreatic diseases.Methods Twelve patients with pancreatic diseases received laparoscopic surgery.Among which 9 patients with cystic diseases,4 cases underwent laparoscopic spleen-preserving distal pancreatectomy,2 cases received distal pancreatectomy and splenectomy,and 3 cases underwent pancreatic cystectomy.Laparoscopic insulinoma enucleation was performed for 2 patients who suffered from insulinoma.Besides,a patient suffered from pancreatic carcinoma recurrence received left thoracoscopic splanchnicectomy.Results All the operations were accomplished successfully,including 8 total laparoscopic surgery and 4 laparoscopic assisted surgery.The average operative time was 225 min(range 100-420 min),and the average volume of blood loss was 80 ml(range 2-150 ml).Pancreatic fistula was observed in 1 patient which was cured by conservative therapy.The postoperative average hospital stay was 7.2 d(range 5-13 d).The patient with recurrent pancreatic carcinoma survived for 6 months after operation and the pain-killing effect was satisfactory.With a follow-up of 10-36 months for other patients,the surgical effects were ideal and no recurrence occurred.Conclusion With the advantages of less trauma,less pain,fast recovery,and low morbidity rate,laparoscopic surgery is an effective and safe method for the treatment of pancreatic diseases,and thus may be widely used in the clinical settings in the future.