Small splint external fixation combined with 3D printing brace for the treatment of Colles fractures / 中国骨伤

OBJECTIVE@#To explore the short-term clinical efficacy of manipulation reduction-combined with small splint and 3D printing wrist brace external fixation of wrist brace for Colles fracture and the advantages of using the brace.@*METHODS@#A total of 60 patients with Colles fractures who were treated in Zhongshan Hospital of Traditional Chinese Medicine from February to December 2017 were selected. Patients were randomly divided into 2 groups according to the order of treatment, with 30 patients in the control group, including 13 males and 17 females, aged from 16 to 66 years, with a mean of (49.46±12.63) years; the time from injury to consultation ranged from 3 to 18 h, averaged (6.86±3.15) h. In the experimental group, there were 30 cases, 12 males and 18 females, ranging in age from 14 to 68 years old, with a mean of (46.73±14.40) years old; the time from injury to consultation ranged from 3 to 19 h, averaged(7.06±3.45)h. All the patients in the experimental group and the control group were treated with the same doctor's manipulation to reduce the fracture. The small splints were applied for external fixation after the satisfactory reduction shown in the X-ray. After 1 week of fracture treatment, the small splints were removed from the patients in the experimental group and the 3D printing braces were replaced to maintain fixation until the fracture healed. In the control group, small splints were maintained until the fracture healed. Wrist joint X-ray films were taken before and after reduction and 4 weeks after reduction to observe the palmar inclination angle, ulnar deviation angle, radius height and compare; VAS score and swelling degree score were recorded before and after reduction for 1 and 2 weeks; Cooney and PRWE score of wrist joint were compared after 6 to 8 weeks of reduction.@*RESULTS@#The VAS score of 2 weeks after reduction was 2.40±0.49 in the experimental group and 2.43±0.50 in the control group. There was no statistical difference in the VAS score between the two groups before and after reduction(=0.364). The swelling degree of 2 weeks after reduction was 0.50±0.50 in the experimental group and 0.53±0.50 in the control group. There was no statistical difference in the swelling degree between the two groups before and after reduction(=0.746). The Cooney and PRWE scores of the experimental group were better than those of the control group 6 to 8 weeks after reduction (<0.05), and the anatomical characteristics of palmar inclination, ulnar deviation and radial shortening of the experimental group were better than those of the control group(<0.05).@*CONCLUSIONS@#3D printing braces are light and breathable, comfortable and beautiful, and convenient for dressing. The combination of small splint sequentially applied to Colles fracture has a definite clinical effect, which enriches the means of external fixation treatment. It is believed that with the deepening of clinical research, the design and materials of 3D printing braces as well as their application in future medical treatment will be further developed.

Effect of different blood pressure control targets within 48 h after hypertensive cerebral hemorrhage on hematoma enlargement and prognosis / 南方医科大学学报

<p><b>OBJECTIVE</b>To study the effect of different blood pressure control targets on hematoma enlargement and prognosis in patients within 48 h after hypertensive cerebral hemorrhage (HCH).</p><p><b>METHODS</b>Between January, 2013 and July, 2016, 102 patients with HCH were randomized into group A (51 cases) and group B (51 cases) with different systolic blood pressure (SBP) control targets within 48 h. The patients in group A were given early active antihypertensive treatment with SBP control target of 130-140 mm Hg; those in group B received standard antihypertensive treatment with SBP control target of 170-180 mm Hg. The changes in the volume of hematomas and the patients' prognosis were compared between the two groups.</p><p><b>RESULTS</b>After 48 h of treatment, SBP, hematoma volume and the National Institutes of Health Stroke Scale (NIHSS) score were significantly lower and Glasgou Coma Scale (GCS) score was significantly higher in group A than in group B (P<0.01 or 0.05). After 30 days of treatment, the patients in group A showed significantly better indicators of treatment efficacy than those in group B (Z=2.331, P=0.020). The mortality rate was lower in group A than in group B, but the difference was not statistically significant (Χ=2.772, P=0.096).</p><p><b>CONCLUSION</b>Early active antihypertensive treatment is safe and feasible in patients with HCH and can reduce the enlargement of the hematomas, alleviate deterioration of neurological function, and improve the prognosis of the patients.</p>

Finite element analysis on relationship between wearing high-heeled shoes and stresses in intermetatarsal region of foot / 医用生物力学

Objective To study stress changes in forefoot intermetatarsal region when wearing high-heeled shoes, so as to provide references for quantitative analysis on inducement mechanism of intermetatarsal neuroma and corresponding treatment strategy. Methods Based on the validated foot-ankle-shoe finite element platform, changes of stress levels and tendency in intermetatarsal region were analyzed for both in balanced standing when wearing 0-3 inch (0, 2.54, 5.08, 7.62 cm) high-heeled shoes and walking when wearing 5.08 cm high-heeled shoes in a gait cycle. Results With the increase of heel height, the stresses in intermetatarsal region were significantly increased, and the stress in the third web space of toes when wearing 7.62 cm high-heeled shoes reached 312% of that when wearing flat shoes (0 cm high-heeled shoes). When walking with 5.08 cm high-heeled shoes, the third web space of toes at push-off instance had the largest stress, reaching 90 kPa, which agreed with the most commonly pathogenic site of intermetatarsal neuroma in clinic. Conclusions Wearing high-heeled shoes can obviously increase the stress in intermetatarsal region. Squeezing by upper extrusion of shoes can result in the largest stresses in the third web space of toes region, which is most likely to cause the development of intermetatarsal neuroma.

Proteomic analysis for finding serum pathogenic factors and potential biomarkers in multiple myeloma / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Multiple myeloma (MM) is a malignant tumor, which takes the second place in malignant blood disease. The clinical symptoms are complicated that make more difficult to diagnose and therapy. Lots of researches focus on the proteins about MM in order to solve those problems. We used proteomic methods to find potential biomarkers in MM patients.</p><p><b>METHODS</b>We applied the peptide ligand library beads (PLLBs) to deplete high abundance proteins in serum for finding potential pathogenic factors and biomarkers of MM. Using 1D-Gel-liquid chromatography-tandem mass spectrometry (LC-MS/MS), we identified 789 and 849 unique serum proteins in MM patients and in healthy controls, respectively.</p><p><b>RESULTS</b>Twenty-two proteins were found differentially expressed between the two groups including serum amyloid A protein, vitamin D-binding protein isoform-1 precursor, plasma kallikrein, and apolipoprotein A-I. Changes of integrin alpha-11 and isoform-1 of multimerin-1 were validated with Western blotting. The linkage of the differentially expressed proteins and the pathogenesis pathways of MM were discussed.</p><p><b>CONCLUSIONS</b>PLLB combined with 1D-gel-LC-MS/MS analysis is an efficient method to identify differentially expressed proteins in serum from patients with MM.</p>

Observation on the clinical efficacy of spasmodic torticollis treated with matrix needling technique and acupuncture at "Wuxin points" mainly / 中国针灸

<p><b>OBJECTIVE</b>To compare the difference in the efficacy on spasmodic torticollis between matrix needling technique combined with puncturing "Wuxin points" and the local injection of botox type A.</p><p><b>METHODS</b>Forty-two cases were randomized into an acupuncture group and a botox group, 21 cases in each one. In the acupuncture group, the matrix needling technique was used and acupuncture was adopted at Fengchi (GB 20), "Wuxin points" [Shuigou (GV 26), bilateral Laogong (PC 8) and bilateral Yongquan (KI 1)] and local Ashi points. In the botox group, botox type A was injected at several spots of local region. The treatment course was 1 month in the two groups. The efficacy in each weekend and the results of follow-up visit in half a year after treatment were compared between the two groups.</p><p><b>RESULTS</b>In the 1st weekend, the markedly effective rate was 42.8% (9/21) and the total effective rate was 90.5% (19/21) in the botox group, which were better than those of 4.8% (1/21) and 28.6% (6/21) respectively in the acupuncture group (both P < 0.01). In the 2nd weekend, the markedly effective rate was 71.4% (15/21) and the total effective rate was 95.2% (20/21) in the botox group, which were better than those of 19.1% (4/21) and 61.9% (13/21) respectively in the acupuncture group (both P < 0.01). In the 3rd weekend, the markedly effective rate was 66.7% (14/21) and the total effective rate was 95.2% (20/21) in the botox group, which were better than those of 38.1% (8/21) and 71.4% (15/21) respectively in the acupuncture group (both P < 0.05). The markedly effective rate and the total effective rate were not different significantly between the two groups in the treatment of 1 month and the follow-up visit in half a year (all P > 0.05). There was no adverse reaction in the acupuncture group. There were 14 cases of adverse reactions in the botox group, in which 9 cases of neck muscular weakness and 5 cases of neck muscular pain.</p><p><b>CONCLUSION</b>The treatment of matrix needling technique and combined with acupuncture at "Wuxin points" achieves the significant efficacy on spasmodic torticollis. Although the effect is not obtained as quickly as the local injection of botox, the efficacy of matrix needling technique is similar to that of botox in the treatment of 1 month and the follow-up visit in half a year. Moreover, this therapy has no adverse reaction.</p>

How to Prevent Leaving "Needle Cast" or "Cement Tail" in Vertebroplasty and Kyphoplasty

No abstract available.

Vertebral artery dominance affects basilar artery curvature and vertebrobasilar junctional infarct / 中华神经医学杂志

Objective To investigate the effect of vertebral artery (VA) dominance on basilar artery (BA) curvature and pontine or cerebellar infarct occurring around the vertebrobasilar junction of VA. Methods Radiological data (infarct laterality,VA dominance,BA curvature and their directional relationships) were analyzed in 91 patients with acute unilateral pontine or posterior inferior cerebellar artery (PICA) territory infarcts.Multiple regression analysis was performed to predict the moderate to severe BA curvature. Results The dominant VA frequently happened on the left side.Most patients had an opposite directional relationship between the dominant VA and BA curvature. Pontine infarct frequently happened opposite to the side of BA curvature and PICA infarct on the same side as the non-dominant VA side.The VA diameter was the only independent predictor for moderate to severe BA curvature (OR: 2.70; 95％CI: 1.22-5.98). Conclusion VA dominance is an important predictive factor of BA curvature,and BA curvature is usually opposite to the side of BA curvature; VA dominance and BA curvature caused by VA dominance increase the incidence of vertebrobasilar junctional infarcts.

Comparison of Yersinia pestis genomes from a new natural foci in China / 中国地方病学杂志

Objective Measurement and analysis of the complete genome sequences of Yersinia Pestis from a new plague natural foci and adjacent foci in China, to know the genetic relationship among the epidemic strain isolated in Yulong (D 106004) and Jianchuan strains (D 182038) and the Tibetan strain ( Z 176003 ). Methods Three complete genome sequences were sequenced using the whole-genome shotgun and Solexa method and comparative genomics analysis was done among the three sequences. Genome comparative analysis among the coding sequences was done by BLAST software, SNPs finding was done by the program, genome rearrangements were analyzed using MAUVE software. Results All of the genomes of Yersinia pestis strains D182038, D106004 and Z176003 consist of a single circular chromosome and three virulence plasmids, pMT1, pCD1 and pPCP1. They had similar characteristics in chromosome and plasmid features, and there were no significant difference in coming sequence (CDS) of the cluster of orthologous groups of proteins (COG) functional classification and the number of insertion sequence in the three strains (x2 =3.03, 0.257, all P ＞ 0.05). The comparative genomics results showed that the three bacteria had 2882 genes with 100％ homology, of 3636 genes predicted in D106004, 2994 were identical with D182038's and 3113 with Z176003's, and of which 240 had 90％ homology with D182038's and 200 with Z176003 's. Synonymous single nucleotide polymorphisms(sSNPs) were 59 and 68, and non-synonymous SNPs(nsSNPs) were 104 and 203 between strains D106004 and Z176003/D182038. There were 11 segments rearrangements between D106004 and Z176003, which was less than 16 segments rearrangements between D106004 and D182038. ConclusionsThe three strains are highly homologous, the Yulong strain has more similarity with Tibet strain than with Jianchuan strain, the strain from Yulong foci may be evolved from Tibet foci.

Study on dosimetry of 125I seed in-plane implantation / 中华核医学杂志

Objective To study the dosimetry of different arrangements of 125I seeds in one plane.Methods Nine different in-plane arrangements of 9 125I seeds (2.035 × 107 Bq/seed) were simulated according to distance (cm) along x (horizontal)- and y( longitudinal )-axis using the 3-dimensional treatment planning system (TPS) (3D-TPS): x0.5, y0. 5; x0. 5, y1.0; x0. 5, y1.5; x1.0, y1.0; x1.0, y1.5;x1.5, y1.5; x0. 5, y0. 5 (2)1.0; x0.5, y1.0 (2)0.5; x1.0, y1.0 (2)0.5. The isodose curves of 40,80, 130, 145 and 200 Gy were created and the area, radius and medical cost under the 40, 80, 130, 145and 200 Gy isodose curves were calculated. Results The area, radius and medical cost under the same isodose curves were significantly different with each 125I seed arrangement. The arrangements which had the biggest area under curves of 40, 80, 130, 145 and 200 Gy isodose were x1. 5, y1. 5; x1. 0, y1. 0; x1. 0,y1. 0; x0. 5, y1. 0 and x0. 5, y1. 0, respectively. Conclusion The matched peripheral dose and therapeutic effect were affected significantly by the geometric arrangement of 125I seeds.

Primary intracraniai tumors of multiple cellular origins: analysis of 8 cases / 中华神经医学杂志

Objective To investigate the clinical manifestations, diagnosis and treatment of primary intracranial tumors of multiple cellular origins. Methods The clinical data including the clinical manifestations, imaging findings, and treatment of 8 patients with primary intracranial tumors of multiple cellular origins were retrospectively analyzed, and the possible mechanism of these tumors were explored. Results A total of 16 primary intraeranial tumors were found in the 8 patients, including intraeranial meningioma (8 tumors), pituitary adenoma (3 tumors), schwannoma (2 tumors), and glioma (2 tumors). The tumors were resected in a single operation in 5 cases, and in two surgical sessions in 3 cases. Twelve tumors were radically resected, 3 were subtotally resected, and 1 was partially resected. Conclusion MR is an important diagnostic modality for primary intraeranial tumors of multiple cellular origins. Tumor resection in one or staged operations combined with radiotherapy or chemotherapy is the primary treatment option for these tumors.

Encapsidating artificial human papillomavirus-16 mE7 protein in human papillomavirus-6b L1/L2 virus like particles / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Human papillomaviruses (HPVs) can infect squamous or mucosal epithelia and cause cervical cancer or genital warts. Coinfection with multiple HPV types is a common finding of many epidemiological studies. Therefore, it is necessary to develop a vaccine, which can eradicate established HPV infections and prevent other HPV infections. In this study, we generated chimeric virus like particles (cVLPs) composed of HPV-6b L1, HPV-6b L2 and one artificial HPV-16 mE7 proteins.</p><p><b>METHODS</b>The artificial HPV-16 mE7 gene was designed by codon modification, point mutation and gene shuffling then chemically synthesized and subcloned behind HPV-6b L2. HPV-6b L1 and L2-mE7 were expressed in insect cells by using Bac-to-Bac system. The generated cVLPs were purified by CsCl gradient ultracentrifuge and analyzed by immunoblot, electron microscope and haemagglutination assay.</p><p><b>RESULTS</b>The HPV-6b L1 and L2-mE7 proteins were well expressed in insect cells and could selfassemble into cVLPs, whose diameter was about 55 nm and similar to that of HPV-6b L1/L2 VLPs. Intact cVLPs could be recognized by H6.M48 neutralizing monoclonal antibody and HPV-6b L2 polyclonal antibody, while the denatured cVLPs, but not the intact cVLPs, were reactive to HPV-16 E7 polyclonal antibody. HPV-6b L1/L2-mE7 cVLPs haemagglutinated mouse erythrocytes as efficiently as HPV-6b L1/L2 VLPs did.</p><p><b>CONCLUSIONS</b>The insertion of the 158 amino acid HPV-16 mE7 protein behind L2 did not disrupt the correct assembling of cVLPs. The morphological characteristics and haemagglutinating activity of cVLPs were similar to those of HPV-6b L1/L2 VLPs. The cVLPs retained conformational B cell epitopes of HPV-6 VLPs and HPV-16 mE7 protein had an internal location in the cVLPs. Therefore, large modified E7 protein with higher immunogenicity could be incorporated into cVLPs by fusing to the C-terminus of L2, which would help to improve the therapeutic effects of L1/L2-E7 cVLPs.</p>

Functional expression of an omega-3 fatty acid desaturase gene from Glycine max in Saccharomyces cerevisiae / 生物工程学报

Alpha-linolenic acid(ALA, C18:3delta9,12,15 ) is an essential fatty acid which has many sanitary functions to human. However, its contents in diets are often not enough. In plants, omega-3 fatty acid desaturases(FAD) catalyze linoleic acid(LA, C18:2delta9,12) into ALA. The seed oil of Glycine max contains high level of ALA. To investigate the functions of Glycine max omega-3FAD, the cDNA of GmFAD3 C was amplified by RT-PCR from immature seeds, then cloned into the shuttle expression vector p416 to generate the recombinant vector p4GFAD3C. The resulting vector was transformed into Saccharomyces cerevisiae K601 throuth LiAc method. The positive clones were screened on the CM(Ura-) medium and identified by PCR, and then cultured in CM (Ura-) liquid medium with exogenous LA in 20 degrees C for three days. The intracellular fatty acid composition of the engineering strain Kp416 and Kp4GFAD3C was analyzed by gas chromatography (GC). A novel peak in strain Kp4GFAD3C was detected,which was not detectable in control, Comparison of the retention times of the newly yielded peak with that of authentic standard indicated that the fatty acid is ALA. The content of ALA reached to 3.1% of the total fatty acid in recombinant strain, the content of LA correspondingly decreased from 22% to 16.2% by contrast. It was suggested that the protein encoded by GmFAD3 C can specifically catalyze 18 carbon PUFA substrate of LA into ALA by taking off hydrogen atoms at delta15 location. In this study, we expressed a Glycine max omega-3 fatty acid desaturase gene in S. cerevisiae; An efficient and economical yeast expressing system(K601-p416 system) which is suitable for the expression of FAD was built.

Development of a nitric oxide inhaling equipment cooperated with the ventilator synchronously / 中国医疗器械杂志

A nitric oxide inhaling equipment cooperated with the ventilator synchronously, is introduced in this paper. This equipment monitors the inspiratory flow of the ventilator by a gas flow meter, and works out the flow value of NO on the therapeutic condition using the formula of gas dilution. Then its mass flow controller controls the flow of NO and delivers it to the respiratory circuit. At the same time, the concentrations of NO and NO2 are detected by the electrochemical NO/NO2 sensors before the therapeutic gas enters into the patient. The experimental result shows that this equipment can work with the ventilator in-phase periodically, the volume of E/(I+E) NO be saved, and the output of NO2 < or = 0.7 x 10(-6). Thus the equipment not only has realized the intellectual monitoring and gas-dispensing, but also has improved the precision of inhaled NO concentration with a better reliability and security during the therapy.

The research actualities and developing trend of nitric oxide (NO) inhalation systems / 中国医疗器械杂志

This paper discusses the limitations of current NO inhalation systems, based on the research in collocation of NO, inspection of NO/NO2 and synchronous working of NO inhalation systems with ventilators. And then, the developing trend of NO inhalation systems is put forward here too.

Clinical analysis of conversion from gynecological laparoscopic surgery to laparotomy / 中华妇产科杂志

Objective To discuss the causes and clinical significance of conversion to laparotomy during laparoscopic surgery.Method Three thousand two hundred and three cases who underwent laparoscopic surgery during the past five years were analyzed retrospectively.Results Three thousand one hundred and eighty cases underwent laparoscopic surgery,in which 23 cases were converted to laparotomy due to factors including severe pelvic adhesions(6 cases),complex disease with difficulties in laparoscopy (7 cases),massive haemorrhage(3 cases),bladder trauma(1 case),gastric trauma(1 case),intestinal trauma(1 case),as well as unexpected malignant genitalia neoplasm(4 cases).Conclusion The major causes for the conversion to laparotomy during gynecology laparoscopic surgery are severe pelvic adhesion and complex disease with difficulties in laparoscopy.Careful evaluation before surgery and conversion to laparotomy at the right moment can decrease the complication.