Treatment of fresh Monteggia fractures of Bado type I and II in children by closed reduction and ulna intramedullary nail fixation / 中国骨伤

<p><b>OBJECTIVE</b>To investigate the effects of closed reduction and ulna intramedullary nail fixation for the treatment of fresh Monteggia fractures of Bado type I and II in children.</p><p><b>METHODS</b>Twenty-three children patients with Monteggia fracture during July 2010 to September 2013 were treated by closed reduction and ulna intramedullary nail fixaion including 18 boys and 5 girls with an average age of 9.3 years old ranging from 6 to 13 years old. Among them,15 cases were Bado type I and 8 cases were Bado type II. There were 9 cases with radial nerve injury. The operation time,the recovery of nerve injury, the fracture healing and the function of elbow were observed and recorded.</p><p><b>RESULTS</b>All patients were followed up for 6 to 24 months (12 months on average). All patients were obtained bone healing. According to Anderson standard, at the final follow-up, 20 cases got excellent result, 2 cases got good result, and one case got fair result.</p><p><b>CONCLUSION</b>Treatment of the fresh Monteggia fractures in children by closed reduction and ulna intramedullary nail fixation has advantages of simple operation, less trauma and good results.</p>

Closed reduction and three Kirschner pin fixation at the radial side for the treatment of supracondylar fracture in children with Gartland type II and type III / 中国骨伤

<p><b>OBJECTIVE</b>To investigate the characteristics of supracondylar fracture of humerus in children and to explore the effect of closed reduction and internal fixation at radial side on the fracture.</p><p><b>METHODS</b>The children with fractures of Gartland type II and type III in our hospital from June 2010 to June 2013 were reviewed. There were 28 males and 7 females, ranging in age from 1 year and 1 month to 2 years and 6 months, with an average of 2 years and 1 month. According to Gartland classification, 19 cases were type II, 16 cases were type III. There were 3 patients with radial nerve injuries, and 5 patients with anterior interosseous nerve injuries. There were no vascular injuries. All the patients were treated with closed reduction and three Kirschner fixation at the radial side, followed by the plaster external fixation with elbowed flexion at 90 °. The X-ray examination was performed at the second day after operation. The joint function exercise began about at 2 to 3 weeks after operation when the plaster fixation was removed, and opportune time for removal of Kirschners depends on the situation of fracture healing. The operation time, nerve recovery, and the elbow joint function were observed.</p><p><b>RESULTS</b>All the children were followed up, and all the fractures had bony union. According to Flynn score system at the final follow-up, 28 patients got an excellent result, 4 good, 1 poor and 2 bad.</p><p><b>CONCLUSION</b>Three Kirschner fixation at the radial side for the treatment of supracondylar fracture of humerus has advantages of minimally invasive, shorter time of hospitalization, simple removal of the internal fixation and reliable therapeutic effects.</p>

Design and application of inflatable pressure applicator on the treatment of femoral shaft fractures: case control study / 中国骨伤

<p><b>OBJECTIVE</b>To compare the influence on the postoperative wound healing between inflatable pressure applicator and traditional pressure dressing.</p><p><b>METHODS</b>From May 2009 to February 2010, 50 patients with closed femoral shaft fractures were randomly divided into group A and group B, with 25 patients in each group. There were 13 males and 12 females in group A, ranging in age from 38 to 60 years, with an average of (55.1 +/- 9.5) years; of them, road accident was in 18 cases, fall from heigh was in 6 cases, accidental falling injury was in 1 case. There were 15 males and 10 females in group B, ranging in age from 40 to 65 years, with an average of (56.5 +/- 9.2) years; of them, road accident was in 13 cases, fall from heigh was in 6 cases, accidental falling injury was in 6 cases. There was no significant difference between two groups in clinical data. The postoperative wounds of group A were binded with dressing of inflatable pressure applicator; and of group B with traditional pressure dressing. Volume of drainage at 12 h after operation, saturation of blood oxygen at 12, 24 h after operation, satisfactory rate of patients were compared between two groups.</p><p><b>RESULTS</b>Postoperative volume of drainage in group A was lower than that of group B, respectively was (77.5 +/- 4.6), (94.3 +/- 3.8) ml. Saturation of blood oxygen at 12, 24 h after operation in A group was respectively (98.3 +/- 1.1)%, (98.9 +/- 0.8)%, and in group B was respectively (96.5 +/- 0.4)%, ( 97.0 +/- 0.3)%; there was significant difference between two groups at the same time. Satisfactory rate of patients in A group was better than that of group B.</p><p><b>CONCLUSION</b>Inflatable pressure applicator can obviously pressurize and stop bleeding for postoperative wounds, but no affect on peripheral blood supply and can improve discomfort of patients.</p>

Microsurgical treatment of intramedullary tumor in the superior cervical spinal cord / 南方医科大学学报

<p><b>OBJECTIVE</b>To evaluate the curative effect of microsurgery for intramedullary tumor in the superior cervical spinal cord.</p><p><b>METHODS</b>The clinical manifestations, microsurgical methods and results were reviewed retrospectively in 12 patients with intramedullary tumors in the superior cervical spinal cord.</p><p><b>RESULTS</b>No death occurred in these cases after the operations. The intramedullary tumors were totally resected in 10 patients including 8 with ependymomas and 2 with astrocytomas, and subtotally in 2 patients with astrocytomas. The spinal functions of patients, graded by McCormick scale system 3 months after the operations, were improved in 8 cases and remained unchanged in 4 cases. Nine patients were followed up for 1-3 years after the operations, and no tumor recurrence was found in 8 cases with total tumor resection.</p><p><b>CONCLUSION</b>Radical microneurosurgery is currently the best choice for the treatment of intradullary tumor in the superior cervical spinal cord.</p>

Connective tissue growth factor is associated with the early renal hypertrophy in uninephrectomized diabetic rats / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Renal hypertrophy has been regarded as the early feature of diabetic nephropathy (DN), which may eventually lead to proteinuria and renal fibrosis. However, the exact mechanism of renal hypertrophy is still unclear. The aim of this study was to investigate the possible association of connective tissue growth factor (CTGF) with renal hypertrophy in uninephrectomized diabetic rats.</p><p><b>METHODS</b>Seventy-two Sprague-Dawley (SD) rats were randomly divided into two groups: control group (group C, n = 32) and diabetic nephropathy (group DN, n = 40). Each group was re-divided into 4 subgroups according to the experimental period. The rats were sacrificed at 1, 2, 4, and 8 weeks respectively after induction of diabetes. Diabetes was induced by intraperitoneal injection of streptozotocin (STZ) after rats had received uninephrectomy. Blood glucose (BG), body weight (BW), 24-h urinary albumin excretion (24hUalb), kidney weight (KW), KW/BW, glomerular tuft area (AG), glomerular tuft volume (VG), proximal tubular area (AT) at each time point, the width of glomerular basement membrane (GBM) and tubular basement membrane (TBM) at week 8 were measured when the rats were sacrificed. Renal expression of CTGF and p27kip1 were detected by immunohistochemical staining. The relationship between CTGF expression and increasing of VG and AT was analyzed.</p><p><b>RESULTS</b>There was a significant increase of 24hUalb, KW, and KW/BW from week 1 onward in diabetic rats compared to those in group C (P < 0.05, respectively), diabetic rats also had a significant increase of AG, VG, and AT from week 1 onward. It was also shown that diabetic rats had a thickening of GBM [(245.7 +/- 103.0) nm vs (121.8 +/- 19.1) nm, P < 0.01] and TBM [(767.7 +/- 331.1) nm vs (293.0 +/- 110.5) nm, P < 0.01] at week 8. There was a weak expression for CTGF and p27kip1 in normal glomeruli and tubuli, while a significant increasing expression of CTGF and p27kip1 was found in glomeruli and tubuli in diabetic kidney from week 1 onward (P < 0.05, respectively), and the extent of CTGF expression was positively correlated with AG (r = 0.92, P < 0.05), VG (r = 0.86, P < 0.05), AT (r = 0.94, P < 0.01) and positively correlated with the expression of p27kip1 (r = 0.96, P < 0.01).</p><p><b>CONCLUSION</b>The expression of CTGF increases in diabetic rat kidney at the early stage, which might be an important mediator of renal hypertrophy through arresting cell cycling.</p>

Effect of irbesartan on angiotensin II-induced hypertrophy of human proximal tubular cells / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Intrarenal activation of the renin angiotensin system (RAS) plays an important role in mediating renal fibrosis. Both angiotensin converting enzyme inhibitors (ACEIs) and angiotensin II (AngII) receptor antagonists have been shown to exert a protective role against diabetic and non-diabetic nephropathy. However, the exact mechanism of how blocking local RAS prevents renal fibrosis is unclear. The present study was to investigate the influence of a new AngII receptor antagonist, irbesartan (Irb), on AngII-induced hypertrophy in human proximal tubular cell line (HK-2).</p><p><b>METHODS</b>The cell line, HK-2, was grown in Dulbeccos's Modified Eagle's Medium containing 10% heat-inactivated fetal calf serum. After rested in serum-free medium for 24 hours, the effects of Irb on AngII (10(-7) mol/L)-induced [(3)H]-leucine incorporation, total protein content (measured by the Coomassie brilliant blue G250 method), and change in cell size (determined by scanning electron microscopy) were observed. The influence of Irb on the cell cycle was analyzed by fluorescence activated cell sorter (FACS) flow cytometry.</p><p><b>RESULTS</b>AngII induced cell hypertrophy in a time and dose dependent manner. Stimulation of cells with AngII for 48 hours resulted in a increase in [(3)H]-leucine incorporation [0 hour: (5584 +/- 1016) cpm/10(5) cells vs 48 hours: (10741 +/- 802) cpm/10(5) cells, P < 0.05], which was significantly attenuated by treatment with Irb. AngII significantly increased the total protein content in HK-2 cells [control: (0.169 +/- 0.011) mg/10(5) cells vs AngII group: (0.202 +/- 0.010) mg/10(5) cells, P < 0.05], which was also markedly inhibited by cotreatment with Irb (P < 0.01). Scanning electron microscopy showed that AngII induced an increase in average physical cell size, which was significantly inhibited by Irb [control: (11.92 +/- 1.62) microm; AngII group: (20.63 +/- 3.83) micro m; AngII + Irb group: (13.59 +/- 3.15) micro m; P < 0.01 vs control, respectively]. Furthermore, flow cytometry revealed that AngII arrested cells in the G(0)-G(1) phase, which was significantly reversed by treatment with Irb [G(0)-G(1) cells in AngII group: (76.09 +/- 1.82)%, in AngII + Irb group: (67.00 +/- 2.52)%, P < 0.05].</p><p><b>CONCLUSION</b>Irb can inhibit AngII-induced hypertrophy in HK-2 cells.</p>