[Comparison of the efficacy of three types of Kirschner wire tension bands for ulnar olecranal fracture].

OBJECTIVE: To compare the clinical effect of three types of Kirschner wire tension band for olecranon fracture. METHODS: The clinical data of 64 patients with olecranon fracture treated by Kirschner wire tension band fixation from March 2016 to May 2020 were retrospectively analyzed. Among them, 19 patients were treated with intramedullary K-wires fixation(group A) including 8 males and 11 females with an average of (48.2±18.3) years old, 3 patients were typeⅠ, and 16 patients were typeⅡ according to Mayo classification;20 patients were treated with transcortical K-wires fixation (group B) including 13 males and 7 females with an average of (43.5±20.4) years old, 3 patients were typeⅠand 17 patients were typeⅡ according to Mayo classification;25 patients were treated with perforated Kirschner wire(group C) including 15 males and 10 females with an average of (55.2±17.5) years old, 4 patients were typeⅠand 21 patients were typeⅡ according to Mayo classification. The operative time, intraoperative blood loss, times of Intraoperative fluoroscopy, fracture healing time and complications of 3 groups were compared. At the final follow-up, elbow function was assessed using the Mayo Elbow Function Scale. RESULTS: There were differences in operative time, intraoperative fluoroscopy times, postoperative VAS and soft tissue irritation among the three groups(P<0.05). The operative time, intraoperative fluoroscopy times in group A and C was better than that in group B. The postoperative VAS score, skin irritability in group C was better than that of group B. The difference was statistically significant on Mayo elbow function score at the final follow-up among three groups(P<0.05), the scores of group A and C were higher than that of group B. CONCLUSION: Compared with transcortical K-wires screw fixation, both intramedullary K-wires screw fixation and perforated Kirschner wire fixation, which can significantly reduce the occurrence of soft tissue irritation, reduce surgical complications and shorten the operation time.

Impacts of meteorological and environmental factors on allergic rhinitis in children.

Meteorological and environmental factors influence the pathogenesis of allergic rhinitis (AR). An understanding of the risk factors will facilitate the development of diagnostic and preventative tools for AR children and improve their quality of life. However, research on the impact of these factors on subjective symptoms in AR children remains scarce. This study explored the relationships between subjective symptoms in pollen and dust mite positive AR children, and meteorological and environmental factors. Using a linear mixed effect model, we analyzed the correlations between monthly data on the subjective symptoms of 351 AR children (from the Shanghai Children's Medical Center) and meteorological and environmental factors during 2013. The monthly meteorological and environmental data were provided by the Shanghai Meteorological Service and Shanghai Environmental Protection Bureau. Temperature and humidity were negatively correlated with the subjective symptom score, with a 0.04 point increase observed for every 1 °C decrease in temperature (P < 0.0001) or 10 % decline in humidity (P = 0.0412). The particulate matter (PM) 10 and PM2.5 concentrations were positively correlated with the subjective symptom score, with a 10 µg/m3 increase in PM10 and PM2.5 yielding a 0.02 (P = 0.0235) and 0.03 (P = 0.0281) increase in the subjective symptom score, respectively. In conclusion, meteorological and environmental factors were correlated with subjective symptoms in AR children. Low temperatures, lower humidity, and high PM10 and PM2.5 concentrations aggravated subjective symptoms in AR children.

[Effects of meteorological and environmental factors on subjective symptoms of allergic rhinitis in children].

OBJECTIVE: To analyze the possible effects of meteorological and environmental factors on the subjective symptoms of allergic rhinitis (AR) in children. METHOD: According to the daily subjective symptom records in AR children, the relationship between the subjective symptoms of AR in children and the meteorological environmental factors was analyzed. Mixed model was used to analyze the data. RESULT: The temperature and humidity had a negative correlation with symptoms score. Every 1 degrees C of temperature decrease was linked to 0.04 points increase in subjective symptoms scores (P < 0.01). Every 10% e in humidity decrease was linked to 0.04 points increase in subjective symptoms scores (P < 0.05). There was positive relationship between PM2.5, PM10 and symptom scores. Every 10 µg/m3 increase of PM2.5 or PM10 was linked to 0.02 (P = 0.0246) or 0.03 (P = 0.0293) points increase in subjective symptoms scores, indicating that air pollution could aggravate the symptoms of children in AR. CONCLUSION: It suggested that higher temperature and higher humidity may induce lower sympotem while PM2. 5 and PM10 may induce higher sympotem in AR children.

Inverse Correlation between Vitamin D and C-Reactive Protein in Newborns.

Some studies suggested that adequate vitamin D might reduce inflammation in adults. However, little is known about this association in early life. We aimed to determine the relationship between cord blood 25-hydroxyvitamin D (25(OH)D) and C-reactive protein (CRP) in neonates. Cord blood levels of 25(OH)D and CRP were measured in 1491 neonates in Hefei, China. Potential confounders including maternal sociodemographic characteristics, perinatal health status, lifestyle, and birth outcomes were prospectively collected. The average values of cord blood 25(OH)D and CRP were 39.43 nmol/L (SD = 20.35) and 6.71 mg/L (SD = 3.07), respectively. Stratified by 25(OH)D levels, per 10 nmol/L increase in 25(OH)D, CRP decreased by 1.42 mg/L (95% CI: 0.90, 1.95) among neonates with 25(OH)D <25.0 nmol/L, and decreased by 0.49 mg/L (95% CI: 0.17, 0.80) among neonates with 25(OH)D between 25.0 nmol/L and 49.9 nmol/L, after adjusting for potential confounders. However, no significant association between 25(OH)D and CRP was observed among neonates with 25(OH)D ≥50 nmol/L. Cord blood 25(OH)D and CRP levels showed a significant seasonal trend with lower 25(OH)D and higher CRP during winter-spring than summer-autumn. Stratified by season, a significant linear association of 25(OH)D with CRP was observed in neonates born in winter-spring (adjusted ß = -0.11, 95% CI: -0.13, -0.10), but not summer-autumn. Among neonates born in winter-spring, neonates with 25(OH)D <25 nmol/L had higher risk of CRP ≥10 mg/L (adjusted OR = 3.06, 95% CI: 2.00, 4.69), compared to neonates with 25(OH)D ≥25 nmol/L. Neonates with vitamin D deficiency had higher risk of exposure to elevated inflammation at birth.

Cord Blood 25-hydroxyvitamin D and Fetal Growth in the China-Anhui Birth Cohort Study.

We determined the association of cord blood 25-hydroxyvitamin D [25(OH)D] with birth weight and the risk of small for gestational age (SGA). As part of the China-Anhui Birth Cohort (C-ABC) study, we measured cord blood levels of 25(OH)D in 1491 neonates in Hefei, China. The data on maternal sociodemographic characteristics, health status, lifestyle, birth outcomes were prospectively collected. Multiple regression models were used to estimate the association of 25(OH)D levels with birth weight and the risk of SGA. Compared with neonates in the lowest decile of cord blood 25(OH)D levels, neonates in four deciles (the fourth, fifth, sixth and seventh deciles) had significantly increased birth weight and decreased risk of SGA. Multiple linear regression models showed that per 10 nmol/L increase in cord blood 25(OH)D, birth weight increased by 61.0 g (95% CI: 31.9, 89.9) at concentrations less than 40 nmol/L, and then decreased by 68.5 g (95% CI: -110.5, -26.6) at concentrations from 40 to 70 nmol/L. This study provides the first epidemiological evidence that there was an inverted U shaped relationship between neonatal vitamin D status and fetal growth, and the risk of SGA reduced at moderate concentration.

[The effection of environmental and health message forecasting service offer to the allergic rhinitis in children].

OBJECTIVE: To investigate the impact of environment and message information for the treatment efficacy of children with allergic rhinitis (AR). METHOD: To choose 100 cases of children diagnosed with AR. The parents of children record daily symptom scores of AR of children everyday. While the doctors send the short message to the parents by using meteorological environment warning forecast technology to tell the parents the risk of AR attacks. We observe the morbidity of AR of the children and the treatment efficacy of children for 1 year. The 100 cases control group children diagnosed AR, their parents do not record daily symptom scores of AR and the doctors do not give the short message. We also observe the morbidity of AR of the control group children and the treatment efficacy of the children for 1 year. RESULT: The 100 cases intervention group children with AR, there are 11 cases refused to participate the group. We included a total 89 cases, 74 cases of children did a full year of intervention, 15 cases of children gave up. The control group 100 cases, nine cases refused to participate, 91 cases were included. The average episodes in the intervention group was 4. 67 times, the control group was 8. 12 times,--there were significant differences between the groups statistically. The execution rate on the prescribed clinic date in the intervention group visits was 91. 5%, while in the control. group, was only 67%. The compliance of parents of children to complete course of medication in the intervention group was 95. 6%, while the control group was 74.1%. Both sets of data are statistically significant differences. The children with sinusitis in intervention group was 26.97%, significantly lower than the 64.04% in the control group. The incidence in the intervention group and the control group of secretory otitis media was 8.99% and 6.60%, there was no statistically significant differences. CONCLUSION: It can significantly increase the degree of attention of parents of children with AR that the parents of children record daily symptom scores of AR of children everyday, while the doctors send the short message to the parents by using meteorological environment warning forecast technology to tell the parents the risk of AR attacks. It can also improve the execution rate on the prescribed clinic date and improve compliance of parents of children to complete course of medication. It can significantly reduce seizure frequency and severity of episodes of AR, thereby improving the quality of life of children with AR, reduce the economic burden on families and society.

[The causes and preventive methods of misdiagnosis on wrist scaphoid bone fracture].

OBJECTIVE: To retrospectively analysis the curative effect of wrist scaphoid bone fracture,and explore the causes and preventive methods of misdiagnosis. METHODS: From September 2007 to September 2010,16 patients with wrist scaphoid bone fractures were treated with plaster cast and cannulated screws fixation. There were 10 males and 6 females,ranging in age from 26 to 44 years with an average of 35 years. Among them, 12 cases manifested swelling pain of radial lateral wrist, tenderness at snuffbox area, wrist pain aggravated when stretching wrist joint, thumb or forefinger; 4 cases manifested no obviously symptoms and limited movement; 9 cases were early diagnosed; 5 cases were treated by plaster cast; 4 cases were treated with cannulated screws fixation; Among 7 cases with misdiagnosis, there were 4 cases without obvious symptoms and they were dealt with activating blood to dissipate swelling and pain process in preliminary stage. Four cases were treated with plaster cast and 3 cases with cannulated screws fixation. RESULTS: All the patients were followed up from 3 months to 39 months (averaged 21 months). Among 16 patients, 9 cases were early diagnosis, 7 cases were misdiagnosis and the rate of misdiagnosis was 43.8%. Seven cases with screws fixation were no wound infection. There was 1 case with occurred chronic pain and declining wrist mobility in both plaster cast and screw group, and both of them were misdiagnosed. According to curative effect rating criteria,these 2 cases were classified into moderate, other 14 cases were excellent. CONCLUSION: Wrist scaphoid bone fracture are easy to misdiagnose, so early diagnosis and treatment is particularly important. The main causes of misdiagnosis are nonspecific symptoms at early stage, combination with other injuries, lack of knowledge and ignorance of the further examination. Therefore, detailed inquiries and particular examination, multi-dimensional radiography and CT scan or MRI scan are the main measures for prevention.

[Application of endobutton in the treatment of acute acromioclavicular joint dislocation].

OBJECTIVE: To study the clinical efficacy of the endobutton in the treatment of acute acromioclavicular joint dislocation by reconstructing coracoclavicular ligaments. METHODS: From October 2008 to January 2010,12 patients with acute acromioclavicular joint dislocation were immobilized with the endobutton. All the patients had the dislocations of or above type III according to Rockwood classification. Among the patients, 9 patients were male and 3 patients were female, with an average age of 55 years (ranged from 31 to 83 years). Eight patients had injuries in the left, and 4 patients in the right. Four patients had accompanied injuries of rib fractures, 2 patients had brain injuries,and 1 patient had femoral fracture. Seven patients were injured by traffic accident, 4 patients were injured by falling down,and 1 patient was sports injuries. All the patients had pain and tenderness at the shoulder, positive piano sign, and shoulder confined activity. The duration from injury to operation ranged from 2 days to 10 days (averaged 6 days). The therapeutic effects were evaluated by Karlsson criteria based on range of motion of acromioclavicular joint, subjective feeling,and postoperative X-ray. RESULTS: All the patients were followed up, and the duration ranged from 4 months to 19 months (averaged 11 months). The motion of the shoulder joint recovered to normal about 15 to 35 days after operation. There were no displacement, dislocation and redislocation occurred. All the patients got A degree results according to Karlsson criteria. CONCLUSION: Reconstruction of coracoclavicular ligament by using the endobutton to treat acute acromioclavicular dislocation of or above type III is a perfect method with advantage of rigid fixation, micro-injury, and early functional exercise.