Treatment of displaced midshaft clavicle fracture with convolution method / 中国骨伤

OBJECTIVE@#To explore the clinical effects of convolution method in treating displaced midshaft clavicle fracture.@*METHODS@#From January 2018 to July 2019, 32 patients (21 males and 11 females) with displaced midshaft clavicle fracture were treated, ranging in age from 18 to 65 years old, with a median age of 41.5 years old. Nineteen patients had fractures on the left side and 13 patients had fractures on the right side. The duration from injury to treatment ranged from 30 minutes to 5 days. The patients were treated with convolution method and repeated push and rotation of the affected upper limb, followed by external fixation of clavicle band. The reduction and healing of the fracture and the functional recovery of shoulder joint were observed.@*RESULTS@#After operation, fracture reduction was evaluated by X ray film. Seven patients had an excellent result, 20 good and 5 fair. All the patients were followed up, and the duration ranged from 14 to 18 weeks. The mean Neer score was 89.75±6.88, which included pain score of 32.66±2.54, functional score of 26.44±2.91, range of motion score of 22.38±2.06, and anatomy score of 8.43±0.84;17 patients receive an excellent result, 14 good and 1 fair.@*CONCLUSION@#The rotation method combined with the repeated pushing and rotating of the upper limb of the affected side can well reduce the displaced fracture of the middle clavicle. Bandage and clavicle band can be performed after reduction. Functional exercise runs through the whole course of treatment. Functional recovery of shoulder joint is good and satisfactory therapeutic effect is achieved.

Significance of detecting platelet associated antibody and platelet membrane glycoprotein for diagnosis of immune thrombocytopenia / 中国实验血液学杂志

The aim of this study was to explore application value of detecting platelet associated antibody and platelet membrane glycoprotein in the diagnosis and prognosis for immune thrombocytopenia. The platelet associated immunoglobulin (PAIg) and platelet membrane glycoprotein (CD41, CD61, GPIIb/IIIa) in 76 cases of immune thrombocytopenia and 30 healthy subjects were determined by FCM. The results showed that PAIg level in ITP patients included PAIgG (31.25 +/- 18.06)%, PAIgM (32.41 +/- 15.51)%, PAIgA (23.39 +/- 16.67)% which were remarkedly higher than in health control (10.48 +/- 5.05)%, (9.40 +/- 4.42)% and (7.23 +/- 3.61)% (P < 0.001). In patients with secondary immune thrombocytopenia (chronic aplastic anemia, SLE, Evans syndrome, liver cirrhosis hypersplenism, etc), PAIg level was higher than that in control group, while the platelet membrane glycoprotein in the blood of these patients was lower than that in control group. The level of PAIg decreased (P < 0.05) after treatment, but platelet membrane glycoprotein increased (P < 0.01). The result suggested that measurements for platelet membrane glycoprotein and platelet associated antibody by FCM were practical with high sensitivity, rapidity and simplicity used as a routine method in diagnosis and evaluation of the therapeutic effects in immune thrombocytopenia patients.

Hemodynamic responses in dogs exposed to blast-burn combined injuries followed by immersion in seawater / 解放军医学杂志

Objective A dog model of blast-burn combined injuries followed by immersion in seawater was reproduced in dog to study hemodynamic responses and their mechanism. Methods The dogs which were exposed to blast injuries produced by primer explosion and 10% second degree burn were randomly divided into seawater immersion group and blast-burn only group. The dogs in immersion group were immersed in seawater under anesthesia for 4 hours. The hemodynamics of the dogs was monitored, and blood samples were collected to assay malondialdehyde (MDA), and cultured for bacteria. After the above procedures were completed, the pathological changes in the dogs′ hearts and lungs were observed. The dogs in blast-burn group underwent the same protocol in immersion group except immersion. Results The body temperature (T), cardiac index (CI), mean arterial pressure (MAP), and heart rate (HR) in dogs in the immersion group were remarkably decreased, while the mean pulmonary artery pressure (MPAAP), systemic vascular resistance index (SVRI), and pulmonary vascular resistance index (PVRI) were markedly increased compared with those in blast-burn group. These obvious hemo dynamic disorders occurred during 3h to 6h after the dogs leaving seawater. Plasma MDA level was negatively correlated with CI. The interval between positive blood calture for intestinal bacteria and injury was shorter in immersion group than that of blast-burn group. The gross and histopathological changes in dogs′ hearts and lungs in immersion group injuries were more severe in degree than in blast-burn group. Conclusions Seawater immersion markedly aggravates the hemodynamic disorders in dogs having had blast-burn combined injury. The changes became obvious during 3h to 6h after leaving seawater. The aggravating effect might be related with declination of body temperature, inflammatory response and lipid peroxidation.