Short-term effectiveness of transverse antecubital incision for failed closed reduction of Gartland type Ⅲ supracondylar humerus fractures in children / 中国修复重建外科杂志

OBJECTIVE@#To investigate the short-term effectiveness of transverse antecubital incision in the treatment of failed closed reduction of Gartland type Ⅲ supracondylar humeral fractures (SHFs) in children.@*METHODS@#Between July 2020 and April 2022, 20 children with Gartland type Ⅲ SHFs who failed in closed reduction were treated with internal and external condylar crossing Kirschner wire fixation through transverse antecubital incision. There were 9 boys and 11 girls with an average age of 3.1 years (range, 1.1-6.0 years). The causes of injuries were fall in 12 cases and fall from height in 8 cases. The time from admission to operation ranged from 7 to 18 hours, with an average of 12.4 hours. The healing of the incision and the occurrence of complications such as nerve injury and cubitus varus were observed after operation; the elbow flexion and extension range of motion after removing the gypsum, after removing the Kirschner wire, and at last follow-up were recorded and compared, as well as the elbow flexion and extension and forearm rotation range of motion at last follow-up between healthy and affected sides; the Baumann angle was measured on the X-ray film, and the fracture healing was observed. At last follow-up, the effectiveness was evaluated according to the Flynn elbow function evaluation criteria.@*RESULTS@#All incisions healed by first intention, and there was no skin necrosis, scar contracture, ulnar nerve injury, and cubitus varus. Postoperative pain occurred in the radial-dorsal thumb in 2 cases. The gypsum was removed and elbow flexion and extension exercises were started at 2-4 weeks (mean, 2.7 weeks) after operation, and the Kirschner wire was removed at 4-5 weeks (mean, 4.3 weeks). All the 20 patients were followed up 6-16 months, with an average of 12.4 months. The fracture healing time was 4-5 weeks, with an average of 4.5 weeks, and there was no complication such as delayed healing and myositis ossificans. The flexion and extension range of motion of the elbow joint gradually improved after operation, and there were significant differences between the time after removing the gypsum, after removing the Kirschner wire, and at last follow-up ( P<0.017). There was no significant difference in the flexion and extension of the elbow joint and the forearm rotation range of motion between the healthy and affected sides at last follow-up ( P>0.05). There was no significant difference in Baumann angle between the time of immediate after operation, after removing the Kirschner wire, and at last follow-up ( P>0.05). According to Flynn elbow function evaluation standard, 16 cases were excellent and 4 cases were good, the excellent and good rate was 100%.@*CONCLUSION@#The treatment of Gartland type Ⅲ SHFs in children with failed closed reduction by internal and external condylar crossing Kirschner wire fixation through transverse antecubital incision has the advantages of complete soft tissue hinge behind the fracture for easy reduction and wire fixation, small incision, less complications, fast fracture healing, early functional recovery, reliable reduction and fixation, and can obtain satisfactory results.

Impact of splenectomy on hemorheology and portal vein thrombosis in patients with cirrhosis and portal hypertension / 中华肝胆外科杂志

Objective:To study the changes in hemorheology in cirrhotic patients with portal hypertension before and after splenectomy.Methods:The data on cirrhotic patients with portal hypertension and hypersplenism who underwent splenectomy from January 2018 to May 2019 in the First Affiliated Hospital of Anhui University of Traditional Chinese Medicine was analyzed. The hemorheology indexes were monitored during the perioperative period, and portal vein thrombosis was monitored by Color Doppler ultrasound.Results:A total of 30 patients were included, including 18 males and 12 females; aged 12.0-62.0 (31.7±14.0) years. One week after splenectomy, portal vein thrombosis was found in all the patients and it disappeared after heparin treatment. The leukocyte and bilirubin levels significantly improved after splenectomy ( P<0.05). The viscosity of high, medium and low cut blood, platelet and D-dimer significantly increased ( P<0.05). Conclusions:After splenectomy, blood viscosity and platelets of cirrhotic patients with portal hypertension and hypersplenism increased, and portal vein thrombosis formed easily.

A meta analysis of p53 gene codon72 polymorphism and onset risk of prostate cancer among Asian population / 重庆医学

Objective To systematically evaluate the relationship between p53 gene codon72 polymorphism and onset risk of prostate cancer (PCa) among Asian population by meta-analysis.Methods The databases of PubMed,Medline,Ovid,Wanfang and CNKI were retrieved for screening the case control trials on the relationship between p53 gene codon72 polymorphism and onset risk of PCa among Asian population.The obtained data were statistically analyzed by using the Stata 12.0 software,moreover the data reliability and publication bias of statistical literature were evaluated.Results The meta analysis showed that the p53 gene codon72 polymorphism had no obvious correlation with PCa onset risk in Asian population.The subgroup analysis results on the control source showed the coden72 polymorphism in P vs.A,PP vs.AA,PA+PP vs.AA models based on the hospital source subgroup could significantly decrease the Pca susceptibility among Asian population[P vs.A:OR =0.680,95 ％ CI(0.546,0.847),P=0.001;PP vs.AA:OR=0.409,95％CI(0.260,0.645),P=0.000;PA+PP vs.AA:OR=0.513,95％CI(0.350,0.749),P=0.001],whereas the codon 72 polymorphism in PA vs.AA and PA+PP vs.AA genotypes in the control source subgroup based on the common population increased the PCa onset risk among Asian population [PA vs.AA:OR=1.664,95 ％CI(1.272,2.177),P=0.000;PA+ PP vs.AA:OR =1.314,95 ％ CI(1.020,1.693),P =0.003 6].The subgroup analysis was conducted according to whether conforming to the HWE equilibrium,the results showed p53 gene codon 72 polymorphosm was a protective factor for decreasing PCasusceptibility among Asian population in the subgroup unconforming to the HWE equilibrium [PP vs.AA:OR=0.251,95％CI(0.135,0.467),P=0.000;PA+PPvs.AA:OR=0.564,95％CI=(0.330,0.964),P=0.036].Conclusion p53 gene codon72 polymorphism has no relation with PCa susceptibility among Asian population.

Study on the diagnostic values of virtual touch tissue imaging quantification and virtual touch tissue quantification techniques in differentiating thyroid benign and malignant nodules / 中华医学超声杂志（电子版）

Objective To compare the diagnostic performances of two elastography techniques, virtual touch tissue imaging quantification (VTIQ) and virtual touch tissue quantification (VTQ), in differentiating between benign and malignant thyroid nodules. Methods A total of 182 patients with 186 nodules evaluated by VTQ and VTIQ were enrolled in this study. Shear wave velocities (SWV) of benign and malignant nodules were measured and compared between different groups by t test . The receiver operating characteristic curve (ROC) was used to assess the value of VTIQ and VTQ in differentiating benign and malignant nodules. And the sensitivity, specificity, accuracy, positive predictive value (PPV) and negative predictive value (NPV) of VTIQ and VTQ were calculated. According to areas under the curve (AUC), the diagnostic values of these two elastography techniques for thyroid nodules′ qualitative diagnosis were compared by Z test. Results In pathology, 104 thyroid nodules were benign and 82 were malignant. AUC of VTIQ SWV mean, VTIQ SWV median, VTQ SWV mean, VTQ SWV median were 0.848, 0.790, 0.759, 0.717, respectively. In the VTIQ and VTQ techniques, the SWV mean had higher diagnostic efficacy than the SWV median (VTIQ techniques: Z=2.104, P=0.0354; VTQ techniques: Z=2.190, P=0.0285). There were statistical differences in the diagnosis performance between VTIQ SWV mean and VTQ SWV mean (Z =2.115, P=0.0344). The VTIQ SWV mean value in the nodule had the best diagnostic value in comparison with other SWV values. The cut-off value of VTIQ SWV mean was 2.91 m/s. According to ROC curve analysis, the sensitivity, specificity, accuracy, PPV and NPV for VTIQ SWV mean were 72.12%, 87.80%, 79.03%, 88.24%, 71.29%, respectively. Conclusions The results demonstrated that VTQ and VTIQ have good diagnostic performance on distinguishing malignant from benign thyroid nodules. VTIQ SWV mean shows a better diagnostic performance than VTQ SWV mean.

Correlation of platelet parameters with delayed graft function after kidney transplantation / 南方医科大学学报

<p><b>OBJECTIVE</b>To investigate the relationship between platelet parameters and delayed graft function (DGF) early after kidney transplantation.</p><p><b>METHODS</b>We retrospectively analyzed the clinical data of 232 recipients within 2 months following kidney transplantation performed between January, 2009 and September, 2013, among whom 29 experienced DGF. The laboratory data of the preoperative and postoperative platelets were collected from all the recipients.</p><p><b>RESULTS</b>Compared with the preoperative levels, the platelet number (PLT) and platelet hematocrit (PCT) were decreased on day 1 after kidney transplantation and was the lowest on day 5 (P<0.05), followed by gradual increase till reaching the highest levels on day 15 (P<0.05) and recovery of the preoperative level in days 30-60. The average platelet volume (MPV), platelet volume distribution width (PDW) and large platelet ratio (P-LCR) were increased on day 1, highest on day 7 (P<0.05), and reduced to the preoperative level on day 15, but then rose again slowly. MPV and P-LCR in days 30 to 60 and PDW in days 45 to 60 were significantly higher than the preoperative levels (P<0.05). The patients with DGF showed lowered PLT than those without DGF since day 2, and this difference was statistically significant in days 7 to 10, while PCT remained comparable between the two groups; MPV, PDW, and P-LCR were higher in DGF group than in DGF-free group with statistically significant difference on days 7, 10, and 15 (P<0.05).</p><p><b>CONCLUSION</b>Platelet function is associated with postoperative renal graft function recovery, and platelet parameters can provide new markers for monitoring the occurrence and reversion of DGF.</p>