Manejo de fracturas conminutas del polo distal de la patela con asas verticales de alambre: reporte de casos / Management of comminuted fractures of the distal pole of the patela with vertical wire loops: case report

INTRODUCCIÓN Las fracturas conminutas del polo distal de la patela representan un desafío para el cirujano de rodilla, pues no existe un tratamiento estándar que permita una rehabilitación acelerada. Recientemente se han descrito la osteosíntesis y la reinserción del polo distal utilizando asas de alambre verticales. MATERIALES Y MÉTODOS Presentamos dos casos de fractura conminuta del polo distal de la patela resueltos con asas de alambre verticales y modificaciones de esta técnica. RESULTADOS Se realizó osteosíntesis del polo distal de la patela, y se logró una reducción radiográfica satisfactoria, lo que permitió una rehabilitación acelerada, con un rango de movilidad progresivo a tolerancia desde el día siguiente tras la cirugía. Los pacientes lograron recuperar el rango de movimiento completo a los dos y tres meses de operados, evolucionaron satisfactoriamente, sin complicaciones relacionadas a esta técnica y sus variaciones, y recibieron el alta médica tras cuatro meses de la reducción y osteosíntesis. DISCUSIÓN Las técnicas tradicionales para el manejo de fracturas del polo distal implican consideraciones especiales en la rehabilitación y complicaciones asociadas. Se utilizó la técnica de asas de alambres verticales en dos pacientes: en uno de ellos, el procedimiento fue complementado con sutura tipo Krackow; y, en el otro, con una placa para minifragmentos, lo que permitió una rehabilitación acelerada y retorno precoz a sus actividades laborales. CONCLUSIÓN El uso de asas de alambre vertical aparece como una técnica segura, que permite una rehabilitación acelerada y un reintegro laboral precoz.

INTRODUCTION Comminuted fractures of the distal pole of the patella represent a challenge for the knee surgeon, as there is no standard treatment that enables accelerated rehabilitation. Osteosynthesis and reattachment of the distal pole using vertical wire loops has recently been described. MATERIALS AND METHODS We herein present two cases of omminuted fracture of the distal pole of the patella resolved with vertical wire loops and modifications of this technique. RESULTS Osteosynthesis of the distal pole of the patella was performed, achieving a satisfactory radiographic reduction and enabling accelerated rehabilitation, with a progressive range of motion the day after the surgery. The patients achieved full range of motion two and three months after surgery. They progressed satisfactorily, without complications related to this technique and its variations, and were discharged four months after the reduction and osteosynthesis. DISCUSSION The traditional techniques for the management of distal pole fractures involve special considerations regarding rehabilitation and associated complications. The vertical wire loop technique was used in two patients: in one of them, it was supplemented with a Krackow suture; and, in the other, with a mini-fragment plate, which enabled accelerated rehabilitation and early return to work. CONCLUSION The use of vertical wire loops appears to be a safe technique, which enables accelerated rehabilitation and early return to work.

Surgical management of total cavopulmonary connection procedure in functional single ventricle with separate hepatic venous drainage / 中国胸心血管外科临床杂志

@#Objective    To investigate the management of hepatic vein (HV) in patients with functional single ventricle (FSV) and separate hepatic venous drainage (SHVD) undergoing total cavopulmonary connection (TCPC) and evaluate this kind of surgery. Methods    The clinical data of 32 consecutive patients with SHVD who underwent modified TCPC operation from August 2005 to January 2017 in our center were retrospectively analyzed. There were 25 males and 7 females with an average age of 2-19 (8.0±5.0) years and body weight of 11-66 (25.4±15.8) kg. Results    There were 20 patients with heterotaxy syndrome and 12 patients with other types of FSV. SHVD was diagnosed preoperatively in 27 patients, among whom 20 patients were connected by intra-extracardiac Gore-Tex conduit, and the other 7 patients were connected by extracardiac Gore-Tex conduit. Because of the missed diagnosis of SHVD, the other 5 patients showed severe decrease of blood oxygen saturation in the early postoperative period and underwent re-operation soon. The postoperative blood oxygen saturation was 92.0% (90.0%, 96.0%), central venous pressure was 10-23 (15.5±3.5) mm Hg, mechanical ventilation assisted time was 16.0 (7.5, 24.0) h, and ICU stay time was 3.0 (2.0, 5.5) d. There were 3 early and 1 late deaths. Conclusion    Intra-extracardiac conduit is an effective and feasible modified TCPC operation for patients with FSV and SHVD, while the surgical details need to be formulated in combination with individual anatomical structure. Preoperative missed diagnosis of SHVD must be avoided. Otherwise, after TCPC, a large amount of stealing blood from HV with low circulation pressure into atrium would lead to unacceptable hypoxemia.

Fast Separation Method of Continuous Recording Data in Dynamic Electrocardiogram Database / 中国医疗器械杂志

The square waves and pulses with obvious porter characteristics are inserted into each different adjacent existing dynamic electrocardiogram data to solve the time-consuming problem in the currently used manual input verification method. The standard database files are converted into analog siginals, then output automatically to the ECG acquisition device according to the sequence of the database files in one time. The data recorded in the acquisition equipment is separated according to the interval data protocol, so as to achieve the purpose of rapid digital examination of dynamic electrocardiogram.

Structure and identification of immune fragments of acid-degraded oligosaccharides from active Astragalus polysaccharides APS-Ⅱ / 药学学报

We previously reported that active Astragalus polysaccharides APS-Ⅱ generate strong immune activity. Here we establish the optimal method for APS-II acid degradation. After preliminary structural studies and separation and preparation of the degradation products, the oligosaccharide active center with the strongest immune activity was identified by in vitro immune cell culture experiments. The optimum acid degradation conditions for APS-II were determined by a single factor experiment and an orthogonal experiment. Astragalus oligosaccharides prepared under the optimal conditions were subjected to structural analysis by hydrophilic interaction chromatography - electrospray ionization source - high resolution time-of-flight mass spectrometry. The products were separated and oligosaccharide fragments with different degrees of polymerization were isolated by preparative purification chromatography. Finally, fragments of the immunologically active centers were identified by in vitro immune cell cultures from multiple perspectives. The results show that the optimal acid hydrolysis conditions for APS-Ⅱ are hydrolysis temperature 80 ℃, trifluoroacetic acid concentration 1.0 mol·L-1, hydrolysis time 1 h. The degradation conditions have good repeatability. The degradation product is a six-carbon aldehyde glycan structure with the main chain 1→4 connected. The immune activity screening experiment for six oligosaccharide fragments showed that larger molecular weight oligosaccharides have stronger immune-promoting effects. It is speculated that the immunologically active center of Astragalus oligosaccharide is located in the sugar chain of DP9-DP19. The animal welfare and the experimental process in this study follow the requirements of the Animal Ethics Committee of Shanxi University. This result suggests a foundation for the structural characterization and structure-activity relationship research of Astragalus oligosaccharides, and may promote the development of Astragalus oligosaccharide drugs.

Casais que moram separados (Living Apart Together): Novas perspectivas para configurações familiares / Living apart together: new perspectives on family configurations / Parejas que viven separadas (Living Apart Together): nuevas perspectivas para configuración familiar

Casais que vivem em residências separadas (LAT - Living Apart Together) representam uma configuração conjugal diferente da tradicional. O objetivo deste estudo foi investigar a configuração conjugal de alguns casais LAT no norte do Rio Grande do Sul. Realizou-se uma pesquisa qualitativa e exploratória por meio de amostragem de conveniência. Foram entrevistados cinco casais, com base em um questionário sociodemográfico e entrevistas semiestruturadas. Os dados foram submetidos à análise temática e geraram duas categorias principais: relacionamentos LAT permanente e provisório. Os subtemas comuns às duas categorias foram conjugalidade, coparentalidade e suporte social. O desejo de coabitar mostrou-se presente somente na configuração LAT provisório e nenhum casal reportou experiência de preconceito contra seu tipo de relacionamento.

Couples who living apart together (LAT) represent a new marital relationship, different from the traditional. The aim of this study was to investigate some LAT couples' marital relationships in the north of Rio Grande do Sul. Qualitative and exploratory research was designed with a convenience sample. We interviewed five couples with a sociodemographic questionnaire and a semi-structured interview. The material was submitted to thematic analysis, which results in two main categories: LAT relationships that are permanent and transitory. Common subthemes to both categories were conjugality, co-parenthood, and social support. The desire for cohabitation was present only in transitory LAT configuration and no couple reported experience of prejudice against their relationship.

Parejas que viven en residencias separadas (LAT - Living Apart Together) representan una configuración conyugal distinta de la tradicional. Este estudio objetivó investigar la configuración conyugal de dos parejas LAT al norte del estado de Rio Grande do Sul. Se realizó una investigación cualitativa y exploratoria en un muestreo por conveniencia y se entrevistó cinco parejas, con un cuestionario sociodemográfico y entrevistas semiestructuradas. Un análisis temático mostró la presencia de dos tipos de relaciones de pareja LAT, el permanente y el transitorio. Subtemas comunes a las categorías fueron configuración conyugal, coparentalidad y suporte social. El deseo de cohabitación estuvo presente solamente en la configuración LAT transitoria y ninguna de las parejas reportaron experiencias de prejuicio.

The problems of a separate bill on physical therapists

Recently, various health associations have been attempting to establish separate bills favorable to their societies. A separate bill governing physical therapists was proposed at the 20th National Assembly in May 2019. The Korean Medical Association expressed strong concern about the introduction of the bill, while the Korean Physical Therapy Association welcomed it. Fortunately, the bill is currently pending in the National Assembly. Given the variety of opinions that coexist in the bill, this paper aims to point out the problems of separate bills and to suggest a proper response strategy by the medical community to the bill. First, we look at the original tasks of physical therapists throughout history. Second, we focus on legal problems regarding the physical therapist bill, based on the Constitutional Court's past rulings. Third, we seek response strategies of the medical community. In conclusion, the bill does not reflect the reality of medical care and makes many dangerous public health provisions. The National Assembly should carefully review the bill and listen to the opinions of the medical community.

New superior modified fornix-based twin-site phacotrabeculectomy

Phacotrabeculectomy is the preferred surgical management of coexisting visually significant cataract and moderate to advanced glaucoma. We report the surgical technique of a new modified fornix-based separate-site phacotrabeculectomy, with mitomycin C (MMC) application, in both primary open angle and angle closure glaucoma. In this new separate-site technique, both phaco and filtration are accommodated superiorly, side by side, hence called twin-site. This was achieved in an efficacious and safe manner with sparing of limbal stem cells without compromising safety. It is not only MMC-compatible but also has a low incidence of wound leak. The technique has no adverse consequence on the survival of the bleb, and we achieved complete success in 79.2% and total success in 93.1% in 130 eyes of 117 patients, in the intermediate term. Furthermore, the time taken for this separate-site surgical technique is comparable to published one-site procedures.

The evaluation of effectiveness of separate kangaroo mother care ward on implementation of kangaroo mother care in tertiary care hospital: a before and after study

Background: Kangaroo mother care (KMC) is a standard of care for preterm and low birth weight babies. To implement KMC in institutional care it was often practiced inside intensive care unit and also in separate ward. In present study authors have tried to evaluate effect of separate kangaroo mother care ward on implementation of kangaroo mother care in tertiary care hospital.Methods: Uncontrolled study before and after establishment of separate kangaroo mother care ward comparing kangaroo mother care in sick new-born care unit versus kangaroo mother care in separate ward.Results: In separate ward, as compared to kangaroo mother care practice in sick newborn care unit, mean (SD) duration of kangaroo mother care increased from 5.3 (1.6) to 11.4 (7.4) hours/day (95%CI 5.0-7.1, p value <0.0001). Mean (SD) weight gain increased from 10.7 (7.0) g/day to 13.7 (11.1) g/day (95% CI 1.0-4.8, p value <0.0024). Incidence of sepsis diminished from 14.0% to 28.9% (95% CI 6.4-23, p value <0.0006). Exclusive breast-feeding rate at discharge (42.3% vs. 57.3%) (95% CI 4.8- 24.9, p value <0.0041) and follow up (49.4% vs. 65.0%) (95% CI 1-29.4, p value <0.0378) increased. Mortality also decreased in this group of patients (8.6% vs.2.3%) (95% CI-1.6-11.4, p value <0.0082).Conclusions: Kangaroo mother care ward is better place than sick new born care unit for providing kangaroo mother care in tertiary care hospital.

Study on Chemical Constituents of n-Butanol Part from the Roots of Camellia oleifera / 中国药房

OBJECTIVE： To study the chemical constituents of n-Butanol part from the roots of Camellia oleifera， and to provide reference for elucidating the pharmacodynamic substance basis of it’s anti-tumor effect. METHODS： The ethanol extracts were obtained by using 95％ ethanol as extraction solvent to extract the roots of C. oleifera， and the n-Butanol part was obatined after the extracts were extratced with ethyl acetate and water-saturated n-butanol solution in turn. The chemical constituents of n-butanol part were isolated and purified by D101 macroporous resin column， silica gel， atmospheric pressure reversed phase column chromatography， sephadex gel SephadexLH-20 column chromatogram and preparative HPLC. The structure of the compounds was identified by spectroscopic analysis of physicochemical constants， electrospray ionization mass spectrometry， 1H-NMR and 13C-NMR. RESULTS： Eight compounds were isolated from the roots of C. oleifera and elucidated as quercetin 3′ -O-β-D-glucoside （compound 1）， apigenin-7-O-β-D-glucoside （compound 2）， （+）-lyoniresinol-3α-O-β-D-glucopyranoside （compound 3）， rubusoside （compound 4）， dulcoside B （compound 5）， 4-hydroxy-3-methoxyphenol 1-O-β-D-[6-O-（4-hydroxy-3，5-dimethoxylbenzoate）-glucopyranoside （compound 6）， 3，4，5-trimethoxyphenyl-6-O- syringoyl-β-D-glucopyranoside （compound 7）， gordonoside P （compound 8）.  CONCLUSIONS： Compounds 1-8 were isolated from this plant for the first time. This not only enriches the chemical constituents of this genus， but also provides a reference for elucidating the anti-tumor bioactive substances in this part.

The Change in Coloration of Aluminum Silicate Hydrate with Silicon Dioxide to Bright Blue when Cinnamon Bark and Atractylodes Rhizome are Combined / 日本東洋医学雑誌

The change in color tone of crude drugs during storage of decoctions is one of the factors leading to poor drug compliance of decoctions. We experienced a case of a decoction including Aluminum Silicate Hydrate with Silicon Dioxide (Kasseki) turned into bright blue color after it was combined with goreisan. We therefore examined to find out possible causative crude drugs using an airtight container and performed a component analysis by the TLC. As a result, we found the following: Kasseki under the coexistence of Cinnamon Bark (C. Bark) and Atractylodes Rhizome (A. Rhizome) turned into a bright blue color in several hours. In this coloration, aluminum silicate hydrate, cinnamaldehyde and atractylon, which derive from these 3 crude drugs, were involved. This coloration change of Kasseki under coexistence of C. Bark and A. Rhizome was a vivid and sharp reaction generated in several hours. From the perspective of maintaining medication compliance, it is important to provide a full explanation to patients about the change in coloration of Kasseki, when decocting crude drugs that contain C. Bark, A. Rhizome, and Kasseki. To avoid coloration, it is considered useful to put Kasseki in a separate sachet, isolated from other crude drugs in storage, and to mix in Kasseki just before decocting.

Arthroscopic bursal layer-only double-row suture-bridge repair for delaminated rotator cuff tear difficult to reposit / 中华创伤骨科杂志

Objective To evaluate the clinical efficacy of arthroscopic bursal layer-only double-row suture-bridge repair for delaminated rotator cuff tear which is difficult to reposit in comparison with separate double-layer repair and whole-layer repair.Methods From May 2013 through June 2016,82 patients with delaminated rotator cuff tear difficult to reposit were treated at Department of Joint Surgery,The Affiliate Hospital to Chengde Medical University.They were 47 males and 35 females with a mean age of 53.0 ± 7.9 years.They were divided into 3 groups according to their surgical procedures.In group A,28 cases were treated by arthroscopic whole-layer double-row suture-bridge procedure;in group B,29 cases were treated by arthroscopic separate double-layer double-row suture-bridge procedure;in group C,25 cases were treated by arthroscopic bursal layer-only double-row suture-bridge procedure.The 3 groups were compared in terms of University of California Los Angeles (UCLA) score,American Shoulder and Elbow Surgeons (ASES) score,visual analogue scale (VAS),Constant shoulder score,range of motion of shoulder joint and rotator cuff retear preoperatively and postoperatively.Results The patients in the 3 groups were comparable because their preoperative general data showed no significant significances (P ＞ 0.05).The operation time for groups A,B and C was respectively 105.5 ±5.6 min,117.4 ±6.9 min and 88.0 ±4.2 min,showing significant differences between the 3 groups (P ＜ 0.05).The 82 patients were followed up for 21 to 24 months (average,23.3 months).At 24 months postoperatively,UCLA,ASES,VAS,Constant score,shoulder anteflexion and lateral extorsion were respectively 32.4 ± 2.5,12.8 ± 0.9,1.0 ± 1.1,93.4 ± 5.6,158.3° ± 9.3°and 58.9°±5.0°in group A,32.2±2.5,12.9±1.0,0.9±1.0,92.8±6.0,156.4°±9.5°and 59.3°± 5.6° in groups B,and32.4±2.4,12.9±0.9,0.7±0.9,94.3±5.2,156.0°±9.5°and57.6°°5.4°in group C,showing no significant differences between the 3 groups (P ＞ 0.05).The occurrence of rotator cuff retear in groups A,B and C were respectively 17.9％ (5/28),13.8％ (4/29) and 12.0％ (3/25),showing no significant differences between the 3 groups (P ＞ 0.05).Conclusions In repair of delaminated rotator cuff tear difficult to reposit,although the arthroscopic bursal layer-only double-row suture-bridge repair is similar to conventional arthroscopic whole-layer double-row suture-bridge repair and arthroscopic separate double-layer double-row suture-bridge repair in functional recovery and range of motion of the shoulder and incidence of rotator cuff retear,it can reduce obviously operation time and make the operation easier.

Analysis on the clinical efficacy of locking plate fixation with different operative approaches for the treatment of proximal humeral fractures / 中国综合临床

Objective To evaluate the clinical efficacy of the dehopectoral approach and and the deltoid lateral longitudinal separate approach of locking plate fixation for the treatment of proximal humeral fractures.Methods Fifty-seven cases of proximal humerus fracture treated in Chaoyang Central Hospital from March 2010 to May 2015 were selected and were divided into the conventional group(30 cases)and the treatment group(27 cases)according to the different operative approaches.The patients in the conventional group were treated with locking plate fixation by dehopectoral approach and the patients in the treatment group were treated with locking plate fixation by deltoid lateral longitudinal separate approach.The operation time, intraoperative blood loss,fracture healing time,postoperative complication rate were observed in the two groups.Constant scores at different times after operation and the evaluation of shoulder function recovery were observed in the two groups.Results All patients were followed up for 10-25 months,with an average of 19 months.The blood loss in the treatment group was(89.7± 31.5)ml and the fracture healing time was(79.6 ±1.8)d,compared with(243.1±65.7)ml and(90.1±2)d in the conventional group,the differences between the two groups were statistically significant(P=0.000,0.035).There was no significant difference between the two groups in the operation time(P=0.079).Constant scores in the treatment group at 3 weeks and 3 months after operation were better than those in the conventional group,the differences between the two groups were statistically significant(P<0.05).At the last follow-up,there was no significant difference in Constant scores between the two groups(P>0.05).There were significant differences in the incidence of postoperative complications between the conventional group and the treatment group(13.3% vs.3.7%,P = 0.045).Conclusion In the treatment of proximal humeral fractures,the deltoid lateral longitudinal separate approach has advantages of less intraoperative blood loss,shorter fracture healing time,faster recovery of shoulder function and less postoperative complications,which is a safe and effective method for the treatment of proximal humeral fractures.

Bioequivalence data analysis for the case of separate hospitalization

A bioequivalence study is usually conducted with the same-day drug administration. However, hospitalization is occasionally separated for logistical, operational, or other reasons. Recently, there was a case of separate hospitalization because of difficulties in subject recruitment. This article suggests a better way of bioequivalence data analysis for the case of separate hospitalization. The key features are (1) considering the hospitalization date as a random effect than a fixed effect and 2) using “PROC MIXED” instead of “PROC GLM” to include incomplete subject data.

The Early- and Med-term Outcomes of Modified Fontan Operation in Patients With Functional Single Ventricle and Separate Hepatic Venous Drainage / 中国循环杂志

Objective: To summarize the early- and med-term outcomes of modified Fontan operation in patients with functional single ventricle and separate hepatic venous (SHV) drainage. Methods: A total of 39 patients with functional single ventricle and SHV drainage received modified Fontan operation in our hospital from 2009-01 to 2015-12 were retrospectively analyzed. There were 26 (66.7%) male, the average age was (6.98±3.62) years, body weight was (20.79±9.66) kg and pre-operative mean pulmonary artery pressure was (9.77±2.51) mmHg. Based on if SHV combining Apicocaval Juxtaposition (ACJ), the patients were divided into 2 groups: SHV group,n=29 and SHV+CAJ group,n=10. The early (3 months) - and med (5 years)-term post-operative outcomes were analyzed. Results: General clinical data was similar between 2 groups,P>0.05. There were 20/39 patients with one-stage operation, 19 with two-stage operation (18 after Glenn operation and 1 after B-T operation). Modified Fontan operation method was mainly used extracardiac conduit-common open technique (30 patients, 76.9%). 19 patients had CPB with aorta clamping, CPB time was 72-446 (189.74±84.96) min and aorta clamping time was 26-171 (89.05±43.96) min; the other 19 patients had CPB without aorta clamping, CPB time was 60-209 (109.99±98.86) min. 10 patients received re-surgery due to early post-operative complications. 3 patients died at early post-operation with the mortality at 7.7%. The average follow-up time was 3.9 (0.83-7.17) years, 1 patient had cardiac function at NYHA II and the others at NYHA I; the 5-year survival rate was 100%. Conclusion: The early- and med-term outcomes of modified Fontan operation were good in patients with functional single ventricle and SHV drainage. Selection of modified Fontan operation method should be based on the distance form inferior vena cava to SHV and presence of ACJ.

Effects of Separate and Direct Bee Sting Punctures at Acupoints on ESR and RF in Rheumatoid Arthritis / 上海针灸杂志

Objective To investigate the effects of separate and direct bee sting punctures at acupoints on ESR and RF in rheumatoid arthritis. Method Seventy-two patients with rheumatoid arthritis were randomized to observation and control groups, 36 cases each. The observation group received separate bee sting puncture at acupoints and the control group, direct bee sting puncture at acupoints. In both groups, treatment was given once every other day, three times a week, one week as a course, for two courses. ESR and RF were measured in the two groups before treatment and at one and two weeks after. Result ESR and RF changed significantly in both groups after treatment compared with before (P<0.05). The effects of the two treatments on rheumatoid arthritis-related ESR and RF were equal and there was no statistically significant difference between the two groups (P>0.05). Conclusion Both separate and direct bee sting punctures at acupoints can reduce ESR and RF in rheumatoid arthritis. Separate bee sting puncture at acupoints is easy for the patients to accept.

Analysis on the clinical efficacy of locking plate fixation with different operative approaches for the treatment of proximal humeral fractures / 中国综合临床

Objective To evaluate the clinical efficacy of the dehopectoral approach and and the deltoid lateral longitudinal separate approach of locking plate fixation for the treatment of proximal humeral fractures.Methods Fifty-seven cases of proximal humerus fracture treated in Chaoyang Central Hospital from March 2010 to May 2015 were selected and were divided into the conventional group(30 cases)and the treatment group(27 cases)according to the different operative approaches.The patients in the conventional group were treated with locking plate fixation by dehopectoral approach and the patients in the treatment group were treated with locking plate fixation by deltoid lateral longitudinal separate approach.The operation time, intraoperative blood loss,fracture healing time,postoperative complication rate were observed in the two groups.Constant scores at different times after operation and the evaluation of shoulder function recovery were observed in the two groups.Results All patients were followed up for 10-25 months,with an average of 19 months.The blood loss in the treatment group was(89.7± 31.5)ml and the fracture healing time was(79.6 ±1.8)d,compared with(243.1±65.7)ml and(90.1±2)d in the conventional group,the differences between the two groups were statistically significant(P=0.000,0.035).There was no significant difference between the two groups in the operation time(P=0.079).Constant scores in the treatment group at 3 weeks and 3 months after operation were better than those in the conventional group,the differences between the two groups were statistically significant(P<0.05).At the last follow-up,there was no significant difference in Constant scores between the two groups(P>0.05).There were significant differences in the incidence of postoperative complications between the conventional group and the treatment group(13.3% vs.3.7%,P = 0.045).Conclusion In the treatment of proximal humeral fractures,the deltoid lateral longitudinal separate approach has advantages of less intraoperative blood loss,shorter fracture healing time,faster recovery of shoulder function and less postoperative complications,which is a safe and effective method for the treatment of proximal humeral fractures.

The Clinical Significance of Separate Measurements of Carotid Arterial Wall to Assess the Risk Factor for Atherosclerosis

BACKGROUND: Carotid intima-media thickness (CIMT) is associated with several risk factors for atherosclerosis and has been consistently linked to cardiovascular and cerebrovascular disease. The clinical significance of separate measurements of CIMT, which is the sum of the intima (IT) and media thickness (MT), to use as an assessment of risk for atherosclerosis has not yet been fully established. METHODS: Among 3377 patients who underwent B-mode ultrasound of carotid arteries and coronary angiography in the Medical Department of St. Mary's Hospital from September 2003 to March 2009, 1146 subjects (M:F = 616:530; mean age, 57.7 ± 12.1 years) who were diagnosed with normal coronary arteries were enrolled in this study. IT, MT, and CIMT of the enrolled patients were manually measured using high-frequency ultrasonography (15 MHz linear array transducer). RESULTS: In multivariate logistic regression analysis, age (β = 0.063, p < 0.0001), body mass index (BMI) (β = 0.028, p = 0.018), and hypertension (HTN) (β = 0.046, p = 0.0002) were associated with MT (R2 = 0.256) and the IT/MT ratio (R2 = 0.209). Age (β = 0.065, p < 0.0001), BMI (β = 0.025, p = 0.038), hemoglobin A1c (β = 0.045, p = 0.045), and HTN (β = 0.043, p = 0.0006) correlated with mean CIMT (R2 = 0.230). Age (β = -0.071, p < 0.0001) and BMI (β = -0.046, p = 0.002) were associated with the IT/MT ratio (R2 = 0.219) on the left side. Age (β = 0.093, p < 0.0001) was related to MT (R2 = 0.265) and mean CIMT (R2 = 0.243) on the left side. CONCLUSION: We noted different atherosclerotic risk factors were related to measurements of the arterial wall in different ways. Therefore, separate measurements of CIMT might be a useful method to assess the risk for atherosclerosis.

Comparison of Insecticidal Efficacy of Commonly Used TCM Pesticides and Preliminary Research on Compatibility / 中国中医药信息杂志

Objective To lay the foundation of new botanical pesticides by screening the insecticidal efficacy of 10 commonly used TCM pesticides.Methods Slide immersion method, trace intravenous drip method and insect body dipping method were respectively used to measure contact action of water extract and ethanol extract of the 10 commonly used TCM pesticides toTeranychus cinnbarinus,Brevicoryne brassicaeandMythimna separate, with herbal extracts to three kinds of insect pests of corrected mortality as observation indexes,Results Alcohol extracts for three kinds of insect pests were found to have contact action, and water extracts had no obvious effect. The Stemonae Radix alcohol extract had obvious contact action on three kinds of insect pests, and corrected mortality rates were 78.7%, 85.9%, and 96.7%, respectively; ethanol extracts of Angled Bittersweet, Sophorae Flavescentis Radix, Xanthii Fructus and Kansui Radix showed good contact action to Teranychus cinnbarinus,. The volume ratio of compatibility among Angled Bittersweet, Sophorae Flavescentis Radix, Xanthii Fructus and Kansui Radix was 2:1:1.5:1.5:1.5:1.5. The insecticidal activity to Teranychus cinnbarinus, was stronger than extracts of single herbs, and corrected mortality was 96.5%. Alcohol extracts of Stellera, hellebore, white mustard seed, and Xanthii Fructus showed good contact action toBrevicoryne brassicae. When the volume ratio of compatibility among Xanthii Fructus, Stemonae Radix, Stellera, and hellebore was 1:1.5:2:2, the activity toBrevicoryne brassicae increased. and corrected mortality was 93.1%.Conclusion The insecticidal activity will be enhanced after TCM extracts are under compatibility.

Establishment of methods to evaluate the quality of two different separate gel tubes during ISO15189 accreditation / 国际检验医学杂志

Objective To explore the establishment of methods to evaluate the quality of two different separate gel tubes .Meth-ods An evaluation comparing two separate gel tubes with silicate glass tubes ,which are the standard tubes ,was performed using data from 50 subjects .The serum samples were assayed for routine chemistry or immunology after centrifugation using the quantita-tive or qualitative detection methods such as ECL ,enzyme-linked immunosorbent assay (ELISA) ,reflection luminescence or immu-nofluorescence .The data were collect for further statistical analysis .Results For quantitative results of the items ,the two separate gel tubes ,compared with the standard glass tube ,there was no significant difference between the test results (P>0 .05);for quali-tative projects ,two separate plastic tube ,compared with the standard glass tube ,really the positive rate and the true negative rate was no significant difference (P>0 .05 ,K>0 .75) .Conclusion By using different detection methods and test items ,it is demon-strated that using two separate gel tube for items assay does not affect the accuracy and consistency of the test results .As a result , the method for external supplies quality assessment is established in the laboratory for ISO15189 quality control .

Step-by-step external fixation of unstable pelvis with separate anterior and posterior modules

Objective: To evaluate the treatment outcomes of patients with pelvic ring injury by applying step-by-step external pelvic fixation and circular external fixation device. Methods: A total of 28 patients suffering from disintegrated pelvic ring injury are involved in the study. Fourteen patients (the treatment group) underwent step-by-step external pelvic fixation by applying anterior (anti-shock) and posterior modules. For the rest 14 patients (the experimental group), the osteosynthesis were conducted by means of a circular external fixation device. The long-term outcomes were evaluated in a year after the injury. Results: The residual deformity of 5 (4-7) mm was observed in 10 patients (71.4%) from the experimental group. In the treatment group, the residual deformity was evident only in 4 (28.6%) cases being 2.5 (2-3) mm (P = 0.000. 319) on the average. The functional result (according to the Majeed scale) was statistically better in the treatment group (P = 0.000. 319). Nine (64.3%) and five (35.7%) patients in treatment group showed excellent and positive results, respectively. The excellent result was demonstrated by 3 patients (21.4%) of the experimental group, the positive outcomes were observed in 6 cases (42.9%) and the unsatisfactory one was displayed by 1 patient (7.1%) of the same group. Conclusions: The modular approach applied is the advantage of the transosseous osteosynthesis allowing for a separate anterior (anti-shock) fixation and final posterior reposition of the pelvic ring preceded by the stabilization of vital functions. The above mentioned method gives an opportunity to increase the amount of techniques applied for the pelvic external fixation in polytrauma cases.