Locking compression plate combined with medial buttress plate for the treatment of osteoporotic comminuted proximal humerus fractures / 中国骨伤

OBJECTIVE@#To explore clinical effect of lateral locking compression plate combined with medial buttress plate in treating osteoporotic comminuted fractures of proximal humerus.@*METHODS@#From May 2017 to December 2021, 12 patients with osteoporotic comminution of proximal humerus were treated by lateral locking compression plates combined with medial buttress plates, including 5 males and 7 females, aged from 55 to 78 years old, bone mineral density(BMD) less than -2.5 g/cm3, the time from injury to operation was from 2 to 6 days. According to Neer classification, 7 patients were type Ⅲ, 4 patients were type Ⅳ and 1 patient was type Ⅵ. Postoperative complications, fracture healing and internal fixation were observed and Constant-Murley score of shoulder joint was used to evaluate clinical effects at 6 months after operation.@*RESULTS@#Postoperative wound healed well at stage I. All patients were followed up from 6 to 18 months. Humeral head collapse and necrosis occurred in 1 patient and humeral head varus in 1 patient. No impact of shoulder joint, internal fixation loosening occurred. Constant-Murley score at 6 months ranged from 45 to 90 points, and 6 patients got excellent result, 3 good, and 3 poor.@*CONCLUSION@#Locking compression plate combined with medial buttress plate could effectively reconstruct medial humeral column support and enhance fracture stability, and receive satisfactory clinical results. However, no control group was established in this study, and function of shoulder joint has not been evaluated many times after operation, so it cannot dynamically reflect changes of shoulder joint function.

Modified osteotomy of olecranon for the management of inter-condylar fracture of the humerus / 中国骨伤

<p><b>OBJECTIVE</b>To explore the surgical method and clinical outcome of modified osteotomy of olecranon for the treatment of inter-condylar fracture of humerus.</p><p><b>METHODS</b>From May 2007 to December 2012, 32 patients of intercondylar fracture of humerus were treated surgically through the approach of modified osteotomy of olecranon. The patients were 21 males and 11 females with a mean age of 46.3 years (ranged 18 to 65 years). Nineteen fractures occurred on the right extremity and 13 on the left extremity. According to the AO classification, type C1 fracture was found in 7, C2 in 11 and C3 in 14. Five patients suffered from open fracture (Gustilo type Iin 3, type II in 2). Other fractures occurred in 6 patients and the primary injury of nerve occurred 6. The healing of the osteotomy was evaluated with physical examination and plain X-ray film, and the function of elbow was assessed according to Cassebaum scale.</p><p><b>RESULTS</b>All the patients were followed from 9 months to 5 years(average, 1.9 years). All the osteotomies healed at 7.4 weeks averagely after operation, and no nonunion, delayed union, fracture of ulna olecranon were found. Two cases had little pain on the elbow, heterotopic ossification occurred in 2 cases and cutting bone block loosed in 1 case. The function of the elbow showed excellent in 19 cases, good in 8, fair in 4 and poor in 1.</p><p><b>CONCLUSIONS</b>The use of the approach of modified olecranon osteotomy for surgical management of intercondylar fracture of humerus has some advantages, it provides satisfactory stability with simple technical procedures avoiding inter-articular invasion, and it facilitates rehabilitation exercises and providing good results with low complication rates.</p>

Salvianolate reduces murine myocardial ischemia and reperfusion injury via ERK1/2 signaling pathways in vivo / 中国结合医学杂志

<p><b>OBJECTIVE</b>To analyze the effects of salvianolate on myocardial infarction in a murine in vivo model of ischemia and reperfusion (I/R) injury.</p><p><b>METHODS</b>Myocardial I/R injury model was constructed in mice by 30 min of coronary occlusion followed by 24 h of reperfusion and pretreated with salvianolate 30 min before I/R (SAL group). The SAL group was compared with SHAM (no I/R and no salvianolate), I/R (no salvianolate), and ischemia preconditioning (IPC) groups. Furthermore, an ERK1/2 inhibitor PD98059 (1 mg/kg), and a phosphatidylinositol-3-kinase (PI3-K) inhibitor, LY294002 (7.5 mg/kg), were administered intraperitoneal injection (i.p) for 30 min prior to salvianolate, followed by I/R surgery in LY and PD groups. By using a double staining method, the ratio of the infarct size (IS) to left ventricle (LV) and of risk region (RR) to LV were compared among the groups. Correlations between IS and RR were analyzed. Western-blot was used to detect the extracellular signal-regulated kinase 1/2 (ERK1/2) and protein kinase B (AKT) phosphorylation changes.</p><p><b>RESULTS</b>There were no significant differences between RR to LV ratio among the SHAM, I/R, IPC and SAL groups (P>0.05). The SAL and IPC groups had IS of 26.1%±1.4% and 22.3%±2.9% of RR, respectively, both of which were significantly smaller than the I/R group (38.5%±2.9% of RR, P<0.05, P<0.01, respectively). Moreover, the phosphorylation of ERK1/2 was increased in SAL group (P<0.05), while AKT had no significant change. LY294002 further reduced IS, whereas the protective role of salvianolate could be attenuated by PD98059, which increased the IS. Additionally, the IS was not linearly related to the RR (r=0.23, 0.45, 0.62, 0.17, and 0.52 in the SHAM, I/R, SAL, LY and PD groups, respectively).</p><p><b>CONCLUSION</b>Salvianolate could reduce myocardial I/R injury in mice in vivo, which involves an ERK1/2 pathway, but not a PI3-K signaling pathway.</p>

Diagnostic Value of Soluble Suppression of Tumorigenicity-2 for Heart Failure / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Many studies have explored the diagnostic performance of soluble suppression of tumorigenicity-2 (sST2) for heart failure (HF), but the results are inconsistent. Here, we performed a meta-analysis to assess the role of sST2 in the diagnosis of HF.</p><p><b>METHODS</b>We searched PubMed, Web of Science, Cochrane Library, China National Knowledge Infrastructure, and Wanfang Database from inception to April 2015. Studies that investigated the diagnostic role of sST2 for HF were reviewed. The numbers of true-positive, false-positive, false-negative, and true-negative results were extracted to calculate pooled diagnostic odds ratio (DOR) with 95% confidence interval (CI) and the summary receiver operating characteristic curve and area under the curve (AUC). The Spearman correlation coefficient was used to check the threshold effect. The Cochran Q statistic (P < 0.05) and the inconsistency index (I2 > 50%) were used to assess the nonthreshold effect. Meta-regression was conducted to explore the source of heterogeneity; subgroup analysis showed the results in different subgroups. Finally, the Deeks' test was performed to assess the publication bias.</p><p><b>RESULTS</b>Nine articles including 10 studies were included in the meta-analysis. The pooled sensitivity was 0.84 (95% CI: 0.81-0.86), and pooled specificity was 0.74 (95% CI: 0.72-0.76). The summary DOR was 8.49 (95% CI: 4.54-15.86), and AUC was 0.81 (standard error: 0.03). The Spearman correlation coefficient identified the nonsignificant threshold effect (coefficient = 0.49, P = 0.148), but the nonthreshold effect heterogeneity was significant (Cochran Q = 58.52, P < 0.0001; I2 = 84.6%). Meta-regression found that characteristics of controls might be the suggestive source of nonthreshold effect heterogeneity (P = 0.095). Subgroup analysis found that DOR was 5.65 and 7.86, respectively for the controls of hospital patients and healthy populations. Deeks' test demonstrated that there was no publication bias (P = 0.616).</p><p><b>CONCLUSION</b>The meta-analysis illustrated that sST2 might play a role in diagnosing HF.</p>

Modified Stoppa approach in treatment of bilateral pubic branch fractures / 中国骨伤

<p><b>OBJECTIVE</b>To investigate the feasibility and effectiveness of modified Stoppa approach in treatment of bilateral pubic fractures of pelvic.</p><p><b>METHODS</b>The therapeutic effects of 16 patients with bilateral pubic fractures treated through the modified Stoppa approach from January 2010 to January 2014 were summarized and analyzed, involved 11 males and 5 females with an average age of 40.5 years old ranging from 17 to 59 years. According to Tile classification, there were 8 patients with type A, 6 with type B and 2 with type C. For 16 pelvic fractures, the modified Stoppa approach was used exclusively 11 cases, in combination with the iliac fossa approach in 4 cases, and in combination with the posterior approach in 1 case. The operation incision length, operation time , intra-operative blood loss and postoperative complications were observed. The fracture reduction and post-operative function were assessed by Matta criteria and Majeed system respectively.</p><p><b>RESULTS</b>The incision length of the modified Stoppa approach ranged from 8 to 10 cm (averaged in 9 cm). The operation time ranged from 75 to 135 minutes (averaged in 95 minutes). The intra-operative blood loss ranged from 400 to 900 ml (averaged in 600 ml). Sixteen patients were followed up from 7 to 18 months (averaged in 12.5 months). The fractures were all healed, the fracture healing time was 2.7 to 5 months (means 3.1 months). There were no infections, ectopic ossification, screw loosening, plate breakage and lateral ventral syndrome. According to Matta criteria for pubic fracture reduction, the result was excellent in 9 cases, good in 6, fair in 1. The Majeed function scores at 6 months after operation was 85.32±8.50; the result was excellent in 8 cases, good in 6 cases, fair in 2 cases.</p><p><b>CONCLUSION</b>The modified Stoppa approach has characteristics of convenience and directness of incisions, clear operation field, easy reduction, few complications and fast recovery , it is an ideal choice in surgical treatment of bilateral pubic fractures.</p>

Surgical treatment of tibia plateau fractures with external fixator and the locking plate / 中国骨伤

<p><b>OBJECTIVE</b>To observe the clinical effect of the treatment for complex fractures of the tibial plateau through the application of the external fixator and the locking plate.</p><p><b>METHODS</b>From Feb. 2006 to Oct. 2008,12 patients with tibial plateau fractures were treated with external fixator and locking plate included 8 males and 4 females with an average age of 38 years ranging from 23 to 59. According to Schatzker type, 7 cases were type V and 5 cases were type VI. Using an anteromedial incision and an anterolateral approach, the locking plate were fixed in the tibia lateral. The collapse and height lossing of tibial plateau was observed through X-ray film before and after operation. The function of knee joint was evaluated according to HSS scoring.</p><p><b>RESULTS</b>These patients were followed up for 4 to 18 months (means 9.79 months). Eleven cases had bone primary union,and 1 delayed union. No deep phlebothrombosis and osteofascial compartment syndrome occurened. The average healing time was 3.1 months. Between the preoperative and postoperative X-ray film there were no second stage depression fracture of the tibial plateau,postoperative reduction loss and bad alignment. The range of knee flexion was 90 degrees to 110 degrees. The HSS knee functional scoring was(75.50 +/- 10.01)scores after operation and (21.50 +/- 11.68) scores before operation.</p><p><b>CONCLUSION</b>The treatment with the external fixator and the locking plate for complex fractures of the tibial plateau could provid continuous stability of fixation,prevent the fracture from second stage displacement and the knee force line change, protect the soft-tissue around the knee, reduce the postoperative complications. The knee joint function is satisfied.</p>

Gene expression changes of urokinase plasminogen activator and urokinase receptor in rat testes at postnatal stages / 亚洲男科学杂志(英文版)

<p><b>AIM</b>To investigate the gene expression changes of urokinase plasminogen activator (uPA)/urokinase receptor (uPAR) in rat testes at postnatal stages and explore the effects of uPA/uPAR system on the rat spermatogenesis.</p><p><b>METHODS</b>The mRNAs of uPA and uPAR in rat testes were measured by using real-time quantitative polymerase chain reaction (PCR) at postnatal days 0, 5, 10, 15, 21, 28, 35, 42, 49 and 56, respectively.</p><p><b>RESULTS</b>The tendencies of uPA and uPAR mRNA expression were similar at most postnatal stages except for D(0). The expression of uPAR mRNA in rats testes was relatively higher than that of uPA at postnatal D(0), and both were decreased until D(21), increased obviously at postnatal D(28), reached a peak at postnatal D(35), then declined sharply at postnatal D(42) and retained at a low level afterwards.</p><p><b>CONCLUSION</b>The uPA/uPAR system may be strongly linked to spermiation and spermatogenesis via regulating germ cell migration and proliferation, as well as promoting the spermiation and detached residual bodies from the mature spermatids.</p>

Effects of union of albumin and egg yolk on human semen cryopreservation / 中华男科学杂志

<p><b>OBJECTIVE</b>To provide a more effective cryoprotective medium (CPM), effect of union of albumin and egg yolk on human sperm cryopreservation was studied.</p><p><b>METHODS</b>Egg yolk-glycerol-sodium citrate was regarded as CPM of the control group and egg yolk-glycerol-sodium citrate with different concentrations of albumin (1, 2, 3, 4, 5 g/L) were regarded as CPMs of experiment groups. Before and after cryopreservation, sperm movement parameters were assessed by using computer-aided sperm analyzer (CASA) system, and then egg yolk-glycerol-sodium citrate group added 1 g/L albumin was selected, whose movement parameters were the best among the experimental groups, and egg yolk-glycerol-sodium citrateto group as the control to compare sperm survival rate, membrane integrity, function of mitochondrion and ultrastruction.</p><p><b>RESULTS</b>Sperm in egg yolk-glycerol-sodium citrate added I g/L albumin showed significantly higher motility, viability than those in the control group and other experimental groups (P < 0.05). Sperm in egg yolk-glycerol-sodium citrate group added 1 g/L albumin had significantly higher survival rate, head unpigmenting rate than those in control group (P < 0.05). Sperm in egg yolk-glycerol-sodium citrate group added I g/L albumin manifested significantly higher succinate dehydrogenase (SDH) activity than that in control group (P < 0.05) and had better ultrastructure than that in control group.</p><p><b>CONCLUSION</b>Union of two kinds of albumin and egg yolk has better effects on human sperm cryopreservation than those of solitary use of egg yolk. The action of albumin is related to its concentration, and albumin combining with egg yolk may have plus and complementary effects on human sperm cryopreservation.</p>

Analysis of the changes of movement function and viability in human spermatozoa induced by reactive oxygen species / 中华男科学杂志

<p><b>OBJECTIVES</b>To analyze the changes of movement function and viability in human spermatozoa induced by reactive oxygen species(ROS), and to prove whether ROS were one of the causes of the movement dysfunction of spermatozoa.</p><p><b>METHODS</b>Spermatozoa with normal physiological functions selected from semen samples by Percoll gradient centrifugation technique were regarded as normal sperm models. ROS were generated by hypoxanthine-xanthine oxidase system and then incubated with normal sperm models under aerobic environment. After model spermatozoa were incubated with ROS, movement parameters of spermatozoa were analyzed by computer-assisted semen analysis (CASA) system.</p><p><b>RESULTS</b>Compared with the control group, after model spermatozoa were incubated with ROS for 30 minutes, motility, curvilinear velocity(VCL), straight line velocity (VSL) and average path velocity (VAP) of the spermatozoa were significantly decreased (P < 0.001), but amplitude of lateral head displacement (ALH) was insignificant (P > 0.05). When incubated with ROS for 60 minutes, spermatozoa almost lost movement function and all movement parameters of spermatozoa inclined to zero.</p><p><b>CONCLUSIONS</b>When normal spermatozoa were incubated with ROS, movement functions of sperm were decreased. It was demonstrated that ROS were one of the causes of the movement dysfunction of spermatozoa.</p>

Effects of cryopreservation on human sperm genetic substance / 中华男科学杂志

Sperm cryopreservation is essential link of assisted reproductive techniques. Because of widespread application for AID and establish of human sperm storeroom, the effects of cryopreservation on human sperm genetic substance have been paid more and more attention. This report summarizes the effects of cryopreservation on human sperm genetic substance and preventive measures.