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Objective To investigate the clinical efficacy and safety of wedge osteotomy combined with internal fixation for ulnar olecranon fracture of Mayo type ⅡB.Methods From July 2014 to December 2017,8 patients with ulnar olecranon fracture of Mayo type ⅡB were treated with wedge osteotomy of the ulnar olecranon combined with internal fixation.They were 6 men and 2 women,from 28 to 45 years of age (mean,31.4 years).The wedge osteotomy was planned preoperatively according to the literature data and the osteotomy lengths were measured postoperatively to confirm the safe range for the surgery.Fracture healing was evaluated by regular X-ray follow-up and therapeutic effects were assessed by the range of elbow motion and the Broberg-Morry scoring system.Results On average in this group,the olecranon osteotomy was 6.2 mm in length on the articular sudace and 14.5 mm at the basal part.The olecranon was shortened by 4.6 cm on average after operation.All the 8 patients were followed up for 14 to 20 months (average,16.4 months).The clinical fracture healing time ranged from 12 to 16 weeks,with an average of 14.3 weeks.Follow-ups revealed no fracture displacement,pain or internal fixation failure.No significant differences were found between the affected and the contralateral sides in the flexion,extension or range of motion of the elbow joint at 3 months or at one year after surgery (P ＞ 0.05).According to the Broberg-Morry scoring system,5 cases were rated as excellent,2 as good and one as fair at 3 months after surgery.The final follow-ups found no traumatic arthritis or joint instability.Conclusions As a new treatment alternative,wedge osteotomy combined with internal fixation can obtain satisfactory curative outcomes for ulnar olecranon fractures of Mayo type ⅡB.The wedge osteotomy was performed in a safe range for this group.
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Objective A method of determination of methamphetamine, ketamine and morphine in saliva was established by super high performance liquid chromatography tandem mass spectrometry(UPLC-MS/MS). Methods The saliva samples after precipitation protein, in the ACQUITY UPLC BEH Phenyl(100mm×2.1mm,1.7μm) column chromatography, after the acetonitrile: 0.3% Formic acid solution gradient elution and through the ESI+ ionization mode MRM analysis and inspection. Results The linearity was estadlished in saliva between 4μg/L and 200μg/L, LOD was 0.2μg/L, LOQ was 4μg/L. the recovery was in the range of 87%-128%. Conclusion The method is simple, rapid and accurate for determination of methamphetamine, ketamine and morphine in saliva.
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Objective To investigate that brucein D (BD) possesses potent anti-colon cancer activity by inhibiting proliferation and inducing apoptosis in colon adenocarcinoma cell.Methods After human colon cancer cell line PANC-1 was treated with BD (0,5,10,20,30,80)μmol/L for 24,48,72h,the cell proliferation was detected by cell counting kit-8 (CCK-8)assay.The apoptosis of colon cancer cells was detected using Annexin V-FITC/PI.The protein expressions of JNK and p-JNK were detected using Western blot.Results After human colon cancer cell line PANC-1 was treated with BD for 24,48,72h,the cell survival rates decreased lower and apoptosis rate increased in concentration-and time-dependent manners.AS the concentration of BD got higher or the time got longer,the protein expression of JNK was down-regulated and that of p-JNK up-regulated significantly.In vivo,with the prolonged administration,the mean volume of xenograft tumor grew slowly.The protein expression of JNK was down-regulated and that of p-JNK up-regulated significantly in colon xenograft tumors cells.Conclusion With the increase of time and BD's concentration,the survival rates of colon cancer HT29 cells could be lower.Instead,the apoptosis rate has increased in a concentration-time-dependent manners.
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Heilongjiang Provincial Hospital has scored an initial success in dealing with medical disputes since the medical liability insurance and third-party mediation mechanism were introduced into the hospital in 2013.The paper identified problems found in the practice,and recommended the following:rationalizing the cost of insurance coverage,expanding scope of third-party mediation properly,enhancing professional authority in assessment of medical dispute cases,simplifying insurance compensation procedure,and consolidating the legal status of the medical dispute mediation institutions,for better resolution of such disputes.
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Objective To investigate the risk factors related with the recurrence of multifocal papillary thyroid microcarcinoma(PTMC).Methods The data of 126 patients undergoing surgery from Jan.2001 to Jun.2011 proved to be multifocal PTMC by pathology were rctrospcctively analyzed.Logistic multifactor regression analysis was used to analyze the clinicopathological factors that may influence the recurrence of PTMC.Results The median age of the 126 patients was 46 years(ranging from 15 to 78 years old).The recurrence rate was 14.3％ (18/126) and the overall survival rate was 98.4％ with the medium follow-up of 75 months (ranging from 24 to 150 months).Multivariate analysis showed that extra-thyoidal extension,neck lymph node metastasis and non-total(or near total)thyroidectomy were the independent risk factors for the recurrence of multifocal PTMC (P =0.008,0.027,0.022 respectively).Conclusions Extension beyond the thyroid and metastatic neck lymph node predict a high risk of recurrence.Total or near total thyroidectomy can reduce the risk of recurrence.
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BACKGROUND:For reason of pathological particularity, treatments for young adult patients with lumbar disc herniation require more demanding procedures. Traditional discectomy and rigid fixation and fusion receive a lower clinical satisfaction rate because of their concomitant complications. Waveflex is a semi-rigid fixation system with non-fusion pedicle screws. Once combined with the technology of annulus repair, it can maintain the normal movement of the segments, and can thus raise clinical satisfaction rate. OBJECTIVE:To evaluate the short-term efficacy of the treatment of young adult lumbar disc herniation through the technology of the posterior Waveflex non-fusion pedicle screw elastic fixed smal window nucleus pulposus extirpation associated with annulus repair. METHODS: Thirty-eight patients with lumbar disc herniation were involved in this study, among which, 18 cases in the elastic fixation group were subjected to a posterior lumbar smal window nucleuspulposus extraction along with annulus repair together bound with Waveflex elastic fixation; the rest 20 cases in the nucleus pulposus removal group underwent simple nucleus pulposus extirpation. After these operations, a series of folow-up study was conducted, including: folow-up analysis of clinical efficacy and complications, colection of low-back pain visual analogue scores, colection of Japanese Orthopaedic Association scores (JOA), regular assessment of Oswestry dysfunction index, and reevaluation of the lumbar lateral radiographs related indicators. RESULTS AND CONCLUSION:Folow-up visits to the patients were conducted 12-20 months later since the operations. Both groups showed a better performance than before treatment in the pain visual analogue scale, low back pain JOA score, and Oswestry dysfunction index of low-back pain (P < 0.05) during the last visit. The pain visual analogue scale, low back pain JOA score, and Oswestry dysfunction index of low-back pain in the dynamic fixation group were superior to those in the nucleus pulposus removal group (P <0.05). Stil in the last folow-up, operative segment disc height in the dynamic fixation group was greater than that before treatment, and the operative segment range of motion was smaler than that before treatment (P <0.05). These results suggest that compared to nucleus pulposus removal, Waveflex system associated with nucleus pulposus excision annulus repair has a more satisfactory effect in the early recovery of lumbar spine function and exerts a positive effect on the stability of the operated segments in the treatment of lumbar protrusion of the intervertebral disc in young adults.
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BACKGROUND:Spinal posterior surgery is the most common treatment method for thoracolumbar fracture. During exposure of conventional posterior surgery, a wide-range stripping and pul ing of paraspinal muscles easily induced failure syndrome of lumbar surgery. OBJECTIVE:To compare the reset conditions and stability of thoracolumbar fractures after treatment with pedicle screw paraspinal muscle approach and conventional posterior median approach fixation. METHODA total of 62 patients with thoracolumbar fractures without nerve injury were retrospectively analyzed. 22 patients were treated with paraspinal muscle approach and general spine system. 21 patients were treated with conventional median approach and general spine system. 19 patients were treated with conventional median approach and AF internal fixation system. The therapeutic effects of the three kinds of fixation methods were compared by comparing clinical indexes in patients of the three groups, including operation time, intraoperative blood loss, postoperative drainage, dead space volume, scores of the Visual Analogue Scale of back pain, wound complications, height of injured vertebrae and the Cobb angle. RESULTS AND CONCLUSION:Operation time, intraoperative blood loss, postoperative drainage and dead space volume were better in the paraspinal muscle approach and general spine system group than in the conventional median approach and general spine system group and conventional median approach and AF internal fixation system group (P0.05). No significant difference in scores of the Visual Analogue Scale of back pain was visible among the three groups at 1 week after fixation (P>0.05). The scores of the Visual Analogue Scale of back pain were apparently lower in the paraspinal muscle approach and general spine system group than in the conventional median approach and general spine system group and conventional median approach and AF internal fixation system group at 3 and 6 months after fixation. No incision infection was observed in patients of the three groups. These results suggested that compared with conventional posterior median approach, paraspinal muscle approach has some advantages, such as smal trauma, less bleeding, postoperative rapid recovery, and high degree of satisfaction. The effects of general spine system and AF internal fixation system in the repair of thoracolumbar fractures on internal fixation are similar, but general spine system has some advantages such as simple to be operated, save time, less bleeding, stable fixation and good reduction. General spine system combined with paraspinal muscle approach is a good method to repair thoracolumbar spine fracture.
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Objective To investigate the values of the APACHE O,APACHE-Ⅲ,Ranson and Balthazar CT(CTSI) scoring systems in predicting prognosis of severe acute pancreatitis.Methods Data were collected prospectively from 321 consecutive patients who were admitted into our hospital from 2005-01-01 to 2011-01-01 with acute pancreatitis (AP).The sensitivity,specificity and accuracy of the APACHE-O,APACHE-Ⅱ,Ranson,Balthazar CT scoring systems at different cut-off levels were calculated.The receiver-operating curves (ROC) for the prediction of severe AP in the early period were calculated using the APACHE-O,APACHE-Ⅱ,Ranson and Balthazar CT scores in different cut-off levels on hospital admission.The area under the curve (AUC) was used to compare the predictive accuracy.Using ROC curves,the values in predicting systemic complications,local complications and morbidities were also compared.Results At a cut-off point of 7,the APACHE O had a sensitivity of 95.4％,a specificity of 76.6％ and an overall accuracy of 79.4％.The Youden's index and the AUC of the APACHE-O score were 0.720 and 0.736,respectively.At a cut-off point of 8,the APACHE-Ⅱ had a sensitivity of 90.4％,a specificity of 81.0％ and an overall accuracy of 842.6％.The Youden's index and the AUC of the APACHE-Ⅱ were 0.714 and 0.699,respectively.At a cut-off point of 3,the Ranson had a sensitivity of 75.0％,a specificity of 78.1％ and an overall accuracy of 77.6％,respectively.The Youden’s index and the AUC of the Ranson were 0.531 and 0.703,respectively.At a cut-off point of 5,the CTSI had a sensitivity of 82.7％,a specificity of 91.4％ and an overall accuracy of 90.0％,respectively.The Youden's index and the AUC of the CTSI were 0.741 and 0.777,respectively.The CTSI system was the best in predicting local complications with a Youden’s index of 0.766,and an AUC of 0.777,respectively. At a cut-off point of 5,the CTSI had a sensitivity of 85.4％,a specificity of 91.2％ and an overall accuracy of 90.3％,respectively.The APACHE-O system was the best in predicting systematic complications with a Youden’s index of 0.789 and an AUC of 0.779,respectively.At a cut -off point of 8,the CTSI had a sensitivity of 91.1 ％,a specificity of 87.8％ and an overall accuracy of 88.2％,respectively.The CTSI system was the best in predicting local complications with a Youden’s index 0.952 and an AUC of 0.847,respectively.At a cut-off point of 8,the CTSI had a sensitivity of 100％,a specificity of 95.2％,and an overall accuracy of 95.3％,respectively.Conclusions The results suggested that the CTSI is the most useful system in predicting local complications and morbidities of severe AP in the early period.The APACHE-O is most useful in predicting systemic complications of severe AP.
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In view of gemcitabine resistance has limited clinical activity of gemcitabine as a cellulotoxic drug in pancreatic cancer patients, this study is designed to investigate the effect of emodin on the sensitivity of pancreatic cancer to gemcitabine as well as its mechanism. After gemcitabine-resistant pancreatic cancer cell line (SW1990/GZ) was established by escalating doses of gemcitabine serially in pancreatic cancer cell line (SW1990). The cellular proliferation was detected by cell counting kit-8 (CCK-8) assay. Flow cytometry (FCM) was used to determine apoptosis of pancreatic cancer cells. The activity of NF-kappaB in pancreatic cancer cells was measured by electrophoretic mobility shift assay (EMSA). Western blotting was used to detect the protein expression of Bcl-2 and Survivin in SW1990/GZ cells. Metastatic model simulating human pancreatic cancer was established by orthotopic implantation of histologically intact human tumor tissue into pancreatic wall of nude mice. Also, immunohistochemistry was used to detect the positive expression of Ki-67, NF-kappaB, Bcl-2 and Survivin in the tumors. The results show that pretreatment of cells with emodin followed by gemcitabine induced a higher percentage of growth inhibition and apoptosis of pancreatic cancer cells than that of gemcitabine alone. In addition to in vitro results, emodin in combination with gemcitabine is much more effective as an antitumor agent compared to either agent alone in the orthotopic tumor model. Further study showed that the emodin with or without gemcitabine significantly down-regulates NF-kappaB and its regulated molecules such as Bcl-2 and Survivin proteins both in vitro and in vivo. It is concluded that inactivation of NF-kappaB signaling pathway by emodin resulting in the chemosensitization of pancreatic cancer to gemcitabine, which is likely to be an important and novel strategy for the treatment of pancreatic cancer.
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Objective To investigate the effect of Chinese medicine Louxie mixture on vascular reactivity in atherosclerosis rats. Methods Forty male rats were randomly divided into four groups: the control group (A group, n＝10) was fed with normal diet; the model group (B group, n＝10), atorvastatin treated group (C group, n＝10 and Louxie mixture group (D group, n＝10) were fed with high fat/cholesterol diet. Atorvastatin 10 mg/kg·d-1 was administered to C group and Louxie mixture to D group for 10 weeks by gavages. Serum endothelin-1 (ET-1), nitric oxide (NO) and nitric oxide syntheses (NOS) were observed in different groups before and after the treatment. Vascular reactivity of aortic rings was measured by both the sodium nitroprusside(SNP)-induced endothelium-independent relaxation (NEDR) and the acetylcholine (Ach)-induced endothelium-dependent relaxation (EDR) in different groups. Results After treatment, the (19.03±1.72)μmol/l; NOS (24.78±0.25)U/ml vs (15.36±0.24U/ml), P＜0.01], while the level of ET-1in B levels of NO and NOS in B group were significantly lower than those in A group [NO(35.73±3.72)μmol/l vs group was higher than that in A group [(34.58±4.00) pg/ml vs (117.58±5.34)pg/ml,P＜0.01]. The levels of NO and NOS were significantly increased and the level of ET-1 was decreased in C and D groups after the treatment [NO(C: 31.30±1.96 umol/l;D: 32.85±3.70 umol/l); NOS (C: 21.96±1.07 U/ml ; D: 19.78± 1.20U/ml ); ET (C:58.26±5.14 pg/ml; D:59.30±5.73 pg/ml), P＜0.01]. The activities of NEDR were similar in four groups[SNP Emax (A: 97.33±1.31; B: 98.24±1.04;C: 97.52±1.09; D: 97.91±1.59)%, P＞0.05], but the level of EDR in the B group (P＜0.01) was the lowest among four groups [Ach Emax (A: 72.65±3.31; B: 32.68±2.39;C: 61.63±2.07; D: 57.58±2.43)%, P＜0.01]. Conclusion Chinese medicine Louxie mixture can protect vascular function in atherosclerosis rats.
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Objective To establish a method for quantitative determination of triptolide and triptonide in human plasma samples by HPLC.Methods The samples were extracted with Oasis HLB solid phase extraction cartridge and analyzed with reserved phase HPLC coupled with diode array detection.Results Recoveries rates obtained from spiked plasma for the two diterpenoid were higher than 80%.The linearity ranged from 10 ng/ml to 1 000 ng/ml.Detection limits of the method were 3.0ng/ml for triptolide and 4.5ng/ml for triptonide.Conclusion The method is fast and accurate,which is applicable to determination of diterpenoid in cases of suspected poisoning of Triptergium wilfordii Hook.f. in forensic practice.
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Objective To establish a method used for quantitative determination of bufadienolides in human liver tissues by HPLC. Methods using solid phase extraction of human liver with Oasis (HLB car-tridge coupled with reserved phase HPLC and diode array detection. Results Recoveries obtained from spiked liver for the bufadienolides were better than 70% . The linearity was studied up to 1200ng/g and the detection limits of the method was 0.4ng for cinobufotalin and bufalin, 0.5ng for cinobufagin and resibufo-genin. Conclusion This method is fast and accurate. It is useful for forensic medicine detection.
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Objective To establish a method used for qualitative determination of aconitine in biological samples by GC/MS. Methods using MSTFA as derivative reagent and pyridine as solvent leaving in 60℃ for 30min then detected by GC/MS-SIM. Results The limit of detection of aconitine was 20ng (S/N≥100). Conclusion This method is sensitive, fast, and accurate. It is useful for forensic medical practice.
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Objective A LC/MS/MS method is developed for determination of paraquat in biological tissue.Methods The samples were pretreated with solid phase extraction using Oasis WCX cartridges and separated with HPLC,paraquat could be identified by LC/MS/MS.Result Calibration curves were linear on injection of amounts ranging from 0.02～20?g/ml and the limit of detection was 10ng/ml(S/N≥3).Conclusion The described menthod was proved to be sensitive,rapid and accurate,it will be applied in identification and determination of paraquat in biological tissues.