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BACKGROUND:Proximal humerus internal locking system locking plate is the most commonly used fixation method for proximal humeral fractures,but its failure rate is still high in clinical practice.Reasonable screw placement is an important factor affecting the stability of internal fixation. OBJECTIVE:To investigate the distribution of humeral head screws in the treatment of proximal humeral fractures with proximal humerus internal locking system plate and its influence on internal fixation failure. METHODS:From January 2017 to December 2021,data from patients with proximal humeral fractures undergoing proximal humerus internal locking system plate in Third Affiliated Hospital of Guangzhou University of Chinese Medicine were retrospectively analyzed.A total of 124 patients were enrolled,including 16 males and 108 females,at the age of≥60 years.According to whether there was internal fixation failure after operation,they were divided into normal group(n=101)and internal fixation failure group(n=23).The patient's age,gender,fracture type,the integrity of the medial column,plate height,neck-shaft angle,whether the talus screw was inserted,and the number of humeral head screws,were collected.The humeral head was divided into eight zones according to the postoperative digital radiography anteroposterior film,and the distribution characteristics of the screws in each zone were collected,and the heat map of the screw distribution was drawn. RESULTS AND CONCLUSION:(1)There were no significant differences between the two groups in age,gender,fracture type,the integrity of the medial column,plate height,neck-shaft angle,whether to insert talus screws,and the number of humeral head screws(P>0.05).(2)The heat map showed that the humeral head screws were evenly distributed in the normal group,mainly scattered in zones 4,6,and 7.However,the screw distribution in the internal fixation failure group was not uniform,mainly concentrated in zones 4 and 6.In addition,in the ideal area of talus screws(7/8 zone),there were significantly more screws in the normal group than in the internal fixation failure group.(3)It is indicated that in the treatment of proximal humeral fractures with proximal humerus internal locking system plate,the uniform distribution of humeral head screws is the key to ensuring the internal fixation effect.A reasonable distribution of humeral head screws helps to improve the treatment effect and the success rate of internal fixation.
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[Objective]To evaluate the efficacy of topical use of 1 g/L tacrolimus eye drops in the treatment of ocular alkali burns.[Methods]A prospective study was performed to evaluate the efficacy of 1 g/L tacrolimus eye drops in the treatment of 12 patients with ocular alkali burns admittedin Zhongshan Ophthalmic Center of Sun Yat-sen University between May 23,2016 and Jan-uary 18,2017. The patients were treated for 1 ~ 18 weeks,with an average of 8.91 ± 5.56 weeks.The degree of ocular alkali burns was evaluated according to Roper-Hall classification system. In this group of patients,there were 2 cases of gradeⅡburns,5 cases of gradeⅢburns and 5 cases of gradeⅣburns. Each patient was given 1 g/L tacrolimus eye drops 2 times a day after admission. The slit lamp microscope and corneal fluorescein sodium staining examination were performed before and 1th week,2nd week,3rd week, 4th week,6th week,8th week respectively after performing topical tacrolimus treatment. Photos were taken to keep records to dynami-cally observe the epithelial repair and anterior segment lesions. Adobe Photoshop CS6 image processing software was used to calculate the area of corneal epithelium repair. The therapeutic effect was evaluated according to the corneal epithelial repair ,visual acuity and complications. The statistical analysis was carried out by SPSS 19.0 software.[Results]4 cases reached good prognosis ,including 2 cases of gradeⅡ and 2 cases of gradeⅢ burns,the corneal epithelium healed and the visual acuity was greater than 0.3. 5 cases had guarded prognosis,including 3 cases of gradeⅢand 2 cases of gradeⅣburns,corneal epithelium healed in 2 cases,corneal epi-thelial repair rate was greater than 50%in 3 cases,in which corneal neovascularization or corneal conjunctiva occurred,and the visu-al acuity was less than 0.3. 3 cases of gradeⅣ burns had poor prognosis:1 had corneal perforation,1 had long term corneal ulcer, and 1 had secondary glaucoma. In 12 cases,the corneal epithelial healing rate reached 99% in 50% patients,and the healing rate was greater than 50%in 75%patients. The visual acuity of 33.3%patients increased by more than three lines,and 66.6%cases had complications. The main factors affecting the prognosis are:The degree of corneal and corneal limbal burns,complication and corneal epithelial repair rate.[Conclusion]1 g/L tacrolimus eye drops can reduce the inflammatory reaction of ocular alkali burns ,reduce the incidence of glaucoma,promote corneal ulcer healing and corneal epithelial repair,and reduce complications caused by corneal lim-bal burns.
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Objective To screen the active components of Bushen Huoxue Decoction ( BSHXD) involved in promoting the proliferation of bone marrow mesenchymal stem cells ( MSCs). Methods BSHXD and its subdivisions were extracted with petroleum ether, ethyl acetate, water-free ethanol and water respectively. MSCs were isolated and cultured by the bone marrow adherent method. At the third passage, MSCs were identified by the specific surface markers with immunofluorescence, and their osteogenic and adipogenic differentiation were tested by alizarin red staining and oil red “O” staining. After treated with the extracts of BSHXD and its subdivisions at gradient concentrations for 24 hours, cell viability was detected by methyl thiazolyl tetrazolium (MTT) assay for the screening of active components and optimal concentration. MTT assay was used to describe the growth curve of MSCs treated with the most effective components, and cell cycle was analyzed by flow cytometry. Results Compared with the blank control group, the extracts of BSHXD and its subdivisions could protect MSCs from death to various degrees. Of all the extracts, the ethyl acetate extract of Bushen Division ( BSD) , ethyl acetate extract of BSHXD, ethyl acetate extract of Huoxue Division ( HXD) had the strongest effect, and the effect was dose-dependent, 100 μg/mL being the optimal active concentration while having no any cytotoxic reaction. The results of MTT assay revealed that BSD extracts promoted the proliferation of MSCs significantly and was the most effective component, and then came BSHXD. The results of flow cytometry indicated that BSD extract had the most strongest effect on increasing the amount of MSCs at proliferative phase, and then came BSHXD. Conclusion BSD ethyl acetate extract is the active component of BSHXD for promoting the proliferation of MSCs, showing an effect on increasing the proportion of MSCs at proliferative phase.
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Objective To investigate the changes of serum thyroid hormone in elder patients with type 2 diabetes mellitus and its chnical significance.Methods A total of 436 elder patients with type 2 diabetes mellitus (elder diabetes mellitus group) and 312 cases without diabetes mellitus (control group)were underwent thyroid ultrasound.For all of the patients,clinical data including fasting plasma glucose (FPG),hemoglobin A1c (HbA1c),serum lipid were tested.Serum thyroid hormone such as total triio dothyronine (TT3),total thyroxine (TT4),free triio dothyronine (FT3),free thyroxine (FT4),thyrotrophin (TSH),antithyroglobulin antibody (TGAb) and anti-thyroid peroxidase antibody (TPOAb) were measured simultaneously.The patients were divided into 3 groups according to the level of HbA1c:HbA1c ＜ 7.5％ group(132 cases),HbA1c 7.5％-9.0％ group(211 cases) and HbA1c ＞ 9.0％ group(93 cases).And they were also divided into 4 groups according to the level of duration:duration ≤ 1 year group (65 cases),1 year ＜ duration ≤ 5 years group(133 cases),5 years ＜ duration≤ 10 years group(195 cases) and duration ＞ 10 years group (43 cases).The levels of thyroid function and thyroid ultrasound were compared among different groups.Results The incidence of abnormal structure of thyroid was 19.7％ (86/436) and the incidence of hypothyroidism and sub-clinical hypothyroidism was higher than the incidence of hyperthyroidism and sub-clinical hyperthyroidism [14.4％ (63/436) vs.5.3％ (23/436)] in elder diabetes mellitus group,and there was significant difference(P＜ 0.05).Compared with that in control group,TT3,FT3 was decreased [(1.27 ± 0.20) nmol/L vs.(1.60 ± 0.34) nmol/L,(3.71 ± 0.49) pmol/L vs.(4.45 ± 0.62)pmol/L],TGAb,TPOAb and thyroid gland volume was increased [(74.73 ±41.25) kU/L vs.(40.05 ± 18.28) kU/L,(87.46 ± 36.81) kU/L vs.(42.39 ± 20.84) kU/L,(17.1 ± 3.0) ml vs.(13.7 ± 2.5) ml],the ratio of thyroid swelling and thyroid nodule was increased [17.66％(77/436) vs.4.17％(13/312),59.86％ (261/436) vs.29.49％ (92/312)],and there was significant difference (P ＜ 0.05).While the levels of HbA 1c increased,the levels of TT3 and TSH decreased simultaneously.The level of FT3 in HbA1c ＞ 9.0％ group was lower than that in HbA1c ＜ 7.5 ％ group and HbA1c 7.5 ％-9.0％ group [(3.46 ± 0.39) pmol/L vs.(3.73 ± 0.47),(3.75 ± 0.49) pmol/L] (P ＜ 0.05),the ratio of thyroid swelling,thyroid nodule and abnormal thyroid echo in HbA1c ＞ 9.0％ group was higher than that in HbA1c ＜ 7.5％ group and HbA1c 7.5％-9.0％ group [36.6％ (34/93) vs.11.4％ (15/132),13.3％ (28/211);90.3％ (84/93) vs.50.0％ (66/132),52.6％ (111/211) ;45.2％(42/93) vs.12.9％(17/132),15.2％(32/211)],and there was significant difference (P ＜0.05).When the duration of diabetes increased,the levels of TT3,FT3 decreased and the levels of TSH,TGAb increased simultaneously.Conclusions It is common that elder patients with type 2 diabetes mellitus always follow with thyroid dysfunction,which should be checked out and followed up.The levels of thyroid function are important for assessing the glucose metabolism in elder patients with type 2 diabetes mellitus.
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@#ObjectiveTo evaluate the effects of exercise training on bone histomorphometry of ovariectomized rats.Methods46 SD rats were randomly divided into the normal control group (group A), ovariectomized group (group B) , estrogen supplement group (group C) and exercise training group (group D). The rats of group A had a sham operation, while that of other groups was ovariectomized. 3 months after operation, the rats had been treated for 3 months. The rats of group C were given estradiol, and the rats of group D were trained by exercise. The tibia sections were studied by histomorphometric analysis.ResultsThe values of the trabeclar area, trabeclar area%, trabeclar perimeter and trabeclar number of group D were significantly higher than that of group B. The values of the trabeclar separation, osteoclast number/mm2 and osteoclast number/mm of group D were the least in all groups, which had been ovariectomized. The values of the labeled perimeter % mineral apposition rate, bone formation rate of group D were superior to that of all groups.ConclusionThe exercise training can increase bone mass of ovariectomized rats, which had double effects of promoting bone formation and restraining bone absorption.