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Objective To evaluate the treatment effects of the olecranon comminuted fracture by the angle stability prin-ciple combined with support under the articular surface. Methods From November 2008 to June 2012, 13 patients (7 male and 6 female, aged from 20 to 77 years) suffered from olecranon comminuted fracture were treated with Synthes anatomy locking com-pression plate and screws combined with Kirschner wires supporting under the articular surface through the posterior median ap-proach. Fractures occurred in the left elbow in 9 and in the right elbow in 4. According to the Mayo classification, 11 cases were classified as Mayo type IIB and 2 as IIIB. According to the Schatzker-Schmeling classification, 2 fractures were type A2, 9 type C, and 2 type D. One patient with type C fracture also had type I coronoid fracture according to Regan and Morrey classification. The Mayo elbow performance index (MEPI) and the shortened disabilities of the arm shoulder and hand (Quick-DASH) were employed to evaluate the functions. All patients took the satisfaction survey and X-ray during the follow-up. Results All patients were fol-lowed-up for 8 to 41 months. The mean ROM of the elbow joint was 112° (range, 65°-140° ), and the mean rotation angle of the forearm was 170° (range, 150°-180°). The mean score for the MEPI was 96 (range, 85-100), excellent 12, good 1. The mean score for the Quick-DASH was 6.2 (range, 0-16.7). In the satisfaction survey, 8 patients were very satisfied, 4 satisfied, 1 common level. All patients took the X-ray during the follow-up and all of them had achieved fracture union completely with the mean time period as 12.7 weeks (range, 11-24 weeks). No cubitus varus, valgus, and instability were found in all patients. No complication, such as infection, ulnar nerve injuries and etc. was found. Five patients complained about mild discomfort caused by internal fixation at 3 months after surgery. Three of them were diagnosed as joint stiffness because of ROM within 100° . One case in 3 elbow stiffness patients developed osteoarthritis after eight months, but no pain during joint activity. Internal fixation was removed in one case;an-other young patient took the operation for removal of internal fixation and release of medial ligament;the third patient refused oper-ation. Conclusion Angle stability principle (Synthes anatomy locking compression plate and screws) combined with supporting under the articular surface (Kirschner wires) can achieve stable fixation in treating olecranon comminuted fracture. It may realize the early exercise of the elbow joint with excellent clinical results. Therefore, it may be an optional choice in clinical practice.
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Objective To observe the effect of valsartan combined with salvia miltiorrhiza ligustrazine in treating early diabetic nephropathy(DN),looking for an effective method for the treatment of early DN.Methods 51 DN patients were divided into two groups,28 cases in the treatment group were treated with valsartan and salvia miltiorrhiza ligustrazine therapy,23 cases in the control group only received valsartan treatment.Fasting blood glucose before and after treatment (FPG),2h postprandial blood glucose (2hPG),glycosylated hemoglobin (HbA1 c),BUN,Scr,urine albumin excretion rate(UAER) index were detected.Results Before and after treatment,FPG,2hPG,HbA1c,UAER in the two groups had statistically significant differences (t =5.361,6.458,3.026,7.894,5.648,7.604,6.590,8.652,all P ＜ 0.05).After treatment,2hPG,HbA1c,UAER between the two groups had statistically significant differences (t =3.125,3.520,3.881,all P ＜ 0.05).No statistical difference was observed before and after treatment in two groups of BUN,Scr (P ＞ 0.05).Conclusion Valsartan combined with salvia tetramethylpyrazine in treatment of early DN was more effective than single valsartan treatment,and no significant adverse reactions was found in combined treatment.Therefore,the combined treatment can be used as a new method for clinical treatment of early DN.
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Tetramethylpyrazine(TMP)is a main active alkaloid ingredient of Traditional Chinese Medicine Ligusticum chuanqiong Hort. The article reviews the protection of TMP against pathological damage and nervous retardation disease in central nervous and peripheral nervous system and summarizes the mechanisms in basic research,clinical practice and so on.