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Objective To evaluate the clinical outcomes of periprosthetic femoral fractures (PFF) following hip arthroplasty utilizing locking compression plates (LCP) in regard to tips and tricks on the construction of LCP augmented with locking attachment plate (LAP) and titanium cables (TC).Methods A total of 41 cases of PFF follow hip arthroplasty (THA 3,Hemi-arthroplasty 2) between May 2008 to April 2016 have been retrospectively analyzed.There were 13 males and 28 females with an average age of 70.5±8.6 years,including 11 case of Unified Classification System (UCS) type Ⅳ.3B1.1,21 cases of B2.1 and 9 cases of type C.All were closed fractures caused by simple fall in terms of low-energy injury.Surgical options depended on individual configuration of the fractures with the combination of LCP and LAP or TC.In respect of reduction techniques,minimally invasive plate osteosynthesis (MIPO) was used in 5 cases for type B1.1 and 8 cases for type C,Mini-open in 6 cases for type B1.1 and 1 case for type C.Posterolateral approach with open reduction internal fixation were selected for type B2.1.The patients were followed up periodically.Harris score,Mukundan criteria and complications were recorded.Results Five cases died of the comorbidities (heart failure 3,pulmonary infection 1,multiple organs failure 1) within 1 year postoperatively.The follow-up rate was 78.0％ (32 out of 41 cases) and the average follow-up time was 41 months (ranging 11 to 71 months).No malunion,no reduction lost,no hardware failure,no hip dislocation and revision surgery following PFF care found.All cases showed the signs of fracture healing from 8 to 12 (average 10 weeks) postoperatively except 2 cases of delay union.The postoperative complications shown in 11 cases,including 2 cases of superficial infection of the wound,6 cases of deep vein thrombosis (popliteal vein 2,intramural gastrocnemius vein 4) and 3 cases of the prosthetic loosening.Harris score at the latest follow-up were 91.5±2.1 for group B1.1,77.5±4.2 for group B2.1 and 83.5±3.8 for group C.The LCP lengths were 248.9±24.3 mm,258.6±25.2 mm,280.4±24.0 mm for group B1.1,B2.1 and C respectively.The LCP length of group B1.1 was short than that of group C (P＜0.05).The screw numbers for the proximal fragments were 6.1±1.8,6.5±0.7 and 3.8±0.7 for group B1.1,B2.1 and C respectively.The number of screws used in B1.1 and B2.1 were more than that in C (P＜0.05).The screw numbers for the distal fragments were 3.5±0.5,3.9±0.5 and 5.1±0.8 for group B1.1,B2.1 and C respectively,indicating less screws used in B1.1 and B2.1 than that in C (P＜0.05).The cable numbers were 1.9±1.3,2.5±0.9 and 3.7±0.7 respectively for group B1.1,B2.1 and C (P＜0.05).The LAP used in 2,12 and 6 cases for type B 1.1,B2.1 and C respectively without significant difference statistically (P＞0.05).Conclusion Utilizing LCP for PFF following hip arthroplasty can achieve satisfactory short and mid-term clinical outcomes with the prerequisites of precise and individualized preoperative planning.LCP augmented by LAP and TC is a reliable option with low complication rate.However,type C PFF needs longer plate with more screws at distal fragment and more titanium cables.
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Objective To investigate the diagnosis and treatment characteristics of pure red cell aplasia (PRCA)caused by human parvovirus (HPV)B19 infection after renal transplantation.Methods Two cases with PRCA caused by HPV B19-induced after renal transplantation,who were treated in the Department of Organ Transplantation,Nanfang Hospital,Southern Medical University,were summarized.Combined with literature review,the clinical characteristics,diagnostic method,course of treatment and prognosis of such disease were investigated.Results Two renal transplant recipients developed severe anemia early after transplantation with progressive deterioration and failed transfusion therapy.Other causes of anemia were ruled out and two patients were diagnosed as PRCA caused by HPV B19 infection according to bone marrow aspiration and biopsy as well as HPV DNA detection by fluorescent polymerase chain reaction (PCR).The symptoms of anemia were improved significantly after adjustment of immunosuppressive treatment protocol and intravenous immunoglobulin (IVIG).Conclusions For patients with unexplained and progressed anemia early after renal transplantation,especially those complicated with reticulocyte deficiency,the possibility of PRCA caused by HPV B19 infection shall be considered.The results of bone marrow aspiration and fluorescent PCR are the main bases for diagnosing PRCA.Immunosuppressive agents reduction and application of IVIG are the major treatment measures.Most of patients have great prognosis after treatment,but this disease is likely to recur.
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<p><b>OBJECTIVE</b>To study ingredients penetrable through placental barrier by administering pregnant rats with Scutellaria Radix extract using HPLC-MS.</p><p><b>METHOD</b>Rats in early, middle and late pregnancy were intragastrically administered with Scutellaria Radix extract for 5 days. Maternal plasma and embryonic tissues were obtained at 1.5, 12 h after the final administration of Scutellaria Radix extract to determine ingredients of biological specimens.</p><p><b>RESULT</b>Under the optimum experimental conditions, seven compounds were detected in all pregnant rat plasma, specifically including baicalin, wogonoside, baicalein, wogonin and oroxylin A. The seven compounds were also discovered in embryonic tissues of rats in early pregnancy, including the five detected compounds. But they were not detected in embryonic tissues of rats in middle pregnancy, and six compounds except baicalein were detected embryonic tissues of rats in late pregnancy.</p><p><b>CONCLUSION</b>Ingredients contained in Scutellaria Radix are detected in pregnant rats at different stages, except those in middle pregnancy, indicating a potential in utero exposure in case of oral administration of Scutellaria Radix pregnancy. Therefore, a study of embryotoxicity shall be continued to evaluate the safety of Scutellaria Radix extract.</p>