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Objective To introduce a novel femoral distractor which is applied in close reduction and internal fixation (CRIF) with antegrade intramedullary nail for femoral shaft fractures.Methods From September 2010 to March 2015,85 patients with femoral shaft fracture were treated by CRIF with antegrade intramedullary nail in which our self-designed novel distractor was used.They were 64 males and 21 females,with an average age of 36.6 years.By AO classification,we had 32 cases of type 32-A,40 cases of type 32-B,and 13 cases of type 32-C.The intervals between injury and surgery averaged 7.5 days (range,from 1 to 16 days).The fracture was located at the upper shaft in 26 cases,at the middle shaft in 57 cases,at the middle shaft and ipsilateral neck in one,and at the lower shaft and ipsilateral intertrochanteric site in one.Their operation time,intraoperative blood loss,intra-and post-operative complications,and fracture union time were recorded and analyzed.Results Successful close reduction was achieved in all the 85 patients with no iatrogenic injury to major vessels or nerves.Operation time averaged 105.5 minutes;time for X-ray exposure averaged 25.8 seconds;intraoperative blood loss averaged 209.2 mL.The 85 patients received follow-ups from 8 to 24 months (mean,16.3 months).Fracture union was achieved in 83 cases after an average duration of 7.8 weeks (range,from 4 to 12 weeks),but nonunion occurred in 2 cases.One-year follow-ups revealed recovery of normal function of the affected knee in all,with no limb shortening ＞ 10 mm,rotational angulation ＞ 15°,or lateral or anteroposterior angulation ＞ 10°.No incision infection,deep vein thrombosis or pulmonary embolism happened during the entire follow-up.Conclusion Our self-designed novel distractor can facilitate CRIF with antegrade intramedullary nail for femoral shaft fractures,and avoid the complications and inconvenience associated with a traction table.
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BACKGROUND:Many scholars researched the biomechanics of middle clavicle fracture plate fixation, but little researched the plate position. OBJECTIVE:To observe the biomechanical characteristics ofanterior and superior plates for clavicle fracture with three-dimensional finite element models. METHODS:Three-dimensional finite element models of clavicle fracture with anterior and superior plates were established. The stress after anterior and superior plate fixation was analyzed. The maximum stress and displacement of plate fixation for clavicular fracture were observed under compression, torsion and three-point bending. RESULTS AND CONCLUSION:(1) In the compressed condition, the maximum stressand maximum fracture displacement were similar between the superior and anterior plate fixation (P> 0.05). (2) Under clockwise twist condition, the maximum stress and maximum fracture displacement were smaler in the superior plate fixation group than inthe anterior plate fixation group (P 0.05). (4) Under three-point bending condition, the maximum stress was similar between the superior and anterior plate fixation groups (P> 0.05). The maximum fracture displacement was bigger in the superior plate fixation group than in the anterior plate fixation group (P< 0.05). (5) These findings suggest that superior fixation of clavicle fracture reconstruction plate has more advantages than the anterior plate fixation.
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Objective To study the relationship between adiponectin and pulmonary function, age and gender in pa-tients with chronic obstructive pulmonary disease (COPD). Methods A total of 120 COPD patients with normal body mass index (BMI＜24 kg/m2 ) were selected and divided into acute exacerbation group (n=60) and stable group (n=60). And 60 healthy people were included as controls. There were equal numbers of male and female in each group. The serum level of ad-iponectin was sdetected by ELISA in there groups. The pulmonary function was collected,and values of FEV1/FVC, FEV1%predicted and RV/TLC were calculated in three groups. Results The serum level of adiponectin was significantly higher in acute exacerbation group than that of stable group and control group (P＜0.05). And the serum level of adiponectin was significantly higher in stable group than that of control group (P＜0.05). The serum levels of adiponectin were signifi-cantly higher in female patients than those of male patients (P＜0.05). The values of FEV1%, FEV1/FVC and FEV1%pre-dicted were significantly lower in acute exacerbation group and stable group than those of control group. The value of RV/TLC was significantly higher in acute exacerbation group and stable group than that of control group (P＜0.05). There was a negative correlation in serum levels of adiponectin, FEV1%predicted and FEV1/FVC between acute exacerbation group and stable group. But there was a negative correlation in serum levels of adiponectin and RV/TLC between these two groups ( P＜0.01). There was a positive correlation between serum level of adiponectin and age in male patients (r=0.943,P＜0.01). Con-clusion The serum level of adiponectin was significantly increased in patients with COPD, which suggested that adiponec-tin played an important part in proinflammatory and might be closely related with airway resistance. The serum level of adipo-nectin might exist gender differences and may be related with age.
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OBJECTIVE: To investigate the effects of Tongluo Recipe (TLR), a compound Chinese herbal medicine, on experimental diabetic peripheral neuropathy in rats. METHODS: Diabetes was induced by streptozocin in rats. Eight weeks later, the diabetic rats were assigned to 3 groups according to different body weights: untreated group, low-dose TLR-treated group and high-dose TLR-treated group. Eight normal rats were assigned to normal control group. Systemic and sciatic nerve intrinsic antioxidant enzyme activities, lipid peroxide levels, hemorheology and sciatic nerve conduction velocity and ultrastructure changes were evaluated. RESULTS: Glutathione peroxidase (GSH-Px) and superoxide dismutase (SOD) activities were lower, and lipid peroxide levels were higher in plasma and sciatic nerve of the untreated group than those in the normal control group (P<0.05). Blood glucose and viscosity in the untreated group were higher than those in the normal control group. Sciatic nerve showed demyelination changes and decrease of conduction velocity. Vasa nervorum expanded and erythrocyte deposited in the capillary in the untreated group. TLR obviously improved sciatic nerve conduction velocity and ameliorated morphology changes, decreased blood viscosity, improved SOD and GSH-Px activities. CONCLUSION: TLR can obviously improve sciatic nerve function and ameliorate morphology changes in rats with diabetic peripheral neuropathy, probably through depleting free radical production, improving endothelial cell function and ameliorating hemorheology changes.
