ObjectiveTo compare the effectiveness of locking compression plate and elastic intramedullary nail for the treatment of benign long bone pathological fractures in children, so as to provide the evidence for clinical treatment. MethodsSeventy-two children with long bone pathological fractures who accorded with the inclusion criteria between January 2005 and July 2013 were randomly divided into 2 groups. Fracture was fixed with elastic intramedullary nail in 33 cases (group A) and with locking compression plate in 39 cases (group B). There was no significant difference in sex, age, body mass index, primary lesion, location of fracture, side of fracture, and interval between injury and operation between 2 groups (P>0.05). ResultsGroup A had shorter operation time, less intraoperative blood loss, and less overall costs than group B, showing significant differences (P<0.05). Primary healing of incision was obtained. All the patients were followed up 1-7 years (mean, 3.4 years). Tumor lesions disappeared and the pathological fracture healed after operation by X-ray film observation, and group A had faster fracture healing time than group B (P<0.05). There was no loosening and displacement of internal fixation, bone resorption, and bone defect nonunion in 2 groups. Recurrence was found in 2 cases (6.1%) of group A and 3 cases (7.7%) of group B, showing no significant difference (χ2=0.074, P=0.580). Re-fracture was found in 1 patient with tibial bone cyst of group B after 3 months of operation, and healed after 1 year of open reduction and internal fixation. According to X-ray film and comprehensive function evaluation of shoulder, elbow, hip, knee, and ankle, the results were all excellent in 2 groups at last follow-up. ConclusionElastic intramedullary nail fixation should be the first choice, and locking compression plate should be the second choice for children with benign long bone pathological fractures.
ObjectiveTo establish a forecasting model for inpatient cases of pediatric limb fractures and predict the trend of its variation.MethodsAccording to inpatient cases of pediatric limb fractures from January 2013 to December 2018, this paper analyzed its characteristics and established the seasonal auto-regressive integrated moving average (SARIMA) model to make a short-term quantitative forecast.ResultsA total of 4 451 patients, involving 2 861 males and 1 590 females were included. The ratio of males to females was 1.8 to 1, and the average age was 5.655. There was a significant difference in age distribution between males and females (χ2=44.363, P<0.001). The inpatient cases of pediatric limb fractures were recorded monthly, with predominant peak annually, from April to June and September to October, respectively. Using the data of the training set from January 2013 to May 2018, a SARIMA model of SARIMA (0,1,1)(0,1,1)12 model (white noise test, P>0.05) was identified to make short-term forecast for the prediction set from June 2018 to November 2018, with RMSE=8.110, MAPE=9.386, and the relative error between the predicted value and the actual value ranged from 1.61% to 8.06%.ConclusionsCompared with the actual cases, the SARIMA model fits well with good short-term prediction accuracy, and it can help provide reliable data support for a scientific forecast for the inpatient cases of pediatric limb fractures.
ObjectiveTo observe the effects of Th9 cell relative factors, including PU.1, interferon regulatory factor 4 (IRF4) and interleukin 4 (IL-4), in rats with pulmonary fibrosis. MethodsNinety SD rats were randomly divided into 3 groups, ie. a normal group, a pulmonary fibrosis group, and a dexamethasone treatment group, with 30 rats in each group. Ten rats in each group were sacrificed respectively on 7th, 14th, 28th days. Model rats were induced by injecting bleomycin into trachea. Real-time PCR was applied to detect mRNA expression of PU.1 and IRF4 in bronchoalveolar lavage fluid. IL-4 in the peripheral blood was measured by ELISA. ResultsIn the normal group, the lung tissue was normal without inflammatory reaction and fibrosis at any time points. In the pulmonary fibrosis group, at the early stage the lung tissue showed alveolar inflammation with a large number of macrophages and other inflammatory cells infiltratation in the pulmonary interstitial and alveolar cavity; on 14th day, part of the alveolar structure disappeared, inflammatory cells infiltrated slightly, while the alveolar septum was mildly widened and fibroblasts proliferated; on 28th day, alveolar structure was destructed, partial alveolar walls were collapsed, alveolar septuml was significantly widened, extracellular matrix was hyperplastic, a wide range of fibrosis occured. In the dexamethasone treatment group, the alveolar structure exsisted completely, and the inflammatory cell infiltration, widened alveolar septum and fibrosis were significantly lighter than those in the pulmonary fibrosis group. PU.1 mRNA was significantly lower in the pulmonary fibrosis group compared with the normal group. Compared with the pulmonary fibrosis group, PU.1 mRNA were lower on 14th day and 28th day in the dexamethasone treatment group (P < 0.05). PU.1 mRNA increased from 7th day, reached peak on 14th day, and declined on 28th day. IRF4 mRNA was significantly lower in the pulmonary fibrosis group compared with the normal group. Compared with the pulmonary fibrosis group, IRF4 mRNA was lower on 28th day in the dexamethasone treatment group (P < 0.05). There was a positive correlation between the content of IRF4 mRNA and IL-4 on 14th day in the pulmonary fibrosis group (r=0.044, P < 0.05). ConclusionPU.1 and IRF4 play a role in inflammation leading to pulmonary interstitial fibrosis, and IL-4 may regulate Th9 cells through activating IRF4.
Objective To investigate the effect of ultrasonic irradiation time on enhanced green fluorescent protein (EGFP) gene transfection efficiency and local tissue in bone defects using ultrasound-mediated microbubble destruction. Methods Thirty 3-month-old New Zealand rabbits (2.5-3.0 kg in weight) were randomly divided into 5 groups (n=6) and bone defect models were made on the right ulna. At 10 days after modeling, suspension of microbubbles and EGFP plasmids were locally injected (0.3 mL/kg) and then ultrasound was performed on defect at a frequency of 1 MHz, a intensity of 0.5 W/cm2, and a duty ratio of 20% for 1, 2, 3, 4, and 5 minutes respectively (in 1, 2, 3, 4, and 5 minutes groups respectively). The survival condition was observed. Rabbits were sacrificed for gross observation at 7 days after transfer. The gene expression was observed by fluorescence staining. HE staining and transmission electron microscopy were used to observe the local tissue damage. Results The animals all survived. New soft tissue formed in bone defects area at 1 week after transfer, the surrounding muscle tissue was partly filled in it. Green fluorescence expression was observed in all rabbits. The expression was the strongest in 2 minutes group, and was the weakest in 1 minute group. The absorbance (A) value showed significant differences when compared 1 minute and 2 minutes groups with other groups (P<0.05), but no significant difference was found between 3, 4, and 5 minutes groups (P>0.05). Tissue damage was observed in all groups and it was aggravated with the increase of irradiation time. Conclusion EGFP transfection efficiency in bone defect by ultrasound-mediated microbubble destruction is related to irradiation time. EGFP gene can be efficiently transfected without obvious toxicity at 1 MHz, 0.5W/cm2, and duty ratio of 20% for 2 minutes in bone defects of rabbits.
Objective To study the expression of interleukin (IL)-37 and related factors in lung tissue of rats with acute lung injury, and explore the role and significance of IL-37 in acute lung injury so as to understand the pathogenesis of acute lung injury. Methods Forty-five clean-grade Wistar rats were randomly divided into a healthy control group, a bleomycin group and a dexamethasone treatment group, with 15 rats in each group. The rats in the bleomycin group and the dexamethasone group were treated with bleomycin at a dose of 4 mg/kg by intratracheal administration. The healthy control group was given the same volume of saline as control. The dexamethasone treatment group was injected with dexamethasone 3 mg/kg intraperitoneally twice a day on the basis of acute lung injury. The healthy control group and the bleomycin group were injected intraperitoneally with normal saline as control. The rats in each group were sacrificed at 7, 14 and 28 days after modeling. The histopathological changes of lung tissue were evaluated by HE staining. The levels of IL-37 in lung homogenate and tumor necrosis factor (TNF)-α in serum were measured. The expression of IL-18 mRNA in lung tissue was detected by RT-PCR. Results Pathological morphology showed that the lung tissue of the healthy control group was complete, no inflammatory and fibrotic changes at all time points. The lung tissues of the bleomycin group and the dexamethasone group manifested with acute alveolitis firstly and thus developed fibrosis changes lately, and the changes in the dexamethasone group were more slightly than those in the bleomycin group. The contents of IL-37 and TNF-α and the expression of IL-18 mRNA in the bleomycin group and the dexamethasone group reached to the highest point on the 7th day, and then decreased, but were significantly higher than those of the healthy control group on the 28th day (all P<0.05). Conclusions IL-37 plays an important role in the pathogenesis of acute lung injury in rats. This effect may be related to the regulation of IL-18 and TNF-α transduction.
Objective To investigate the application of gluteus maximus transplantation for fecal incontinence after surgery of high anal atresia. Methods Between December 2002 and November 2010, 25 patients with fecal incontinence were treated with gluteus maximus transplantation, which was caused by surgery of high anal atresia. There were 11 malesand 14 females with an average age of 10.2 years (range, 3-22 years). Preoperative radiography, anorectal manometer, and electromyogram showed abnormality or deficiency of anal sphincter function. Wexner score, Fecal Incontinence Quality of Life (FIQL) questionnaire, and Self-rated Health Measurement Scale Version 1.0 (SRHMS) score were used to evaluate l ife qual ity of the patients. The anorectal manometer, intra-rectal ultrasound examination, and defecation radiography were performed. Results Healing of incision by first intention was achieved in 23 cases and rectal-wound fistula occurred in 2 cases. The follow-up time was 1 to 9 years (mean, 6.3 years). Defecation frequency was decreased from more than 10 times to 4-6 times every day. Wexner score and SRHMS were significantly improved at 1 or 2 years after surgery when compared with preoperative socres (P lt; 0.05). FIQL was also significantly improved after 2 years (P lt; 0.05). At 2 years after surgery, the anal maximum systol ic pressure, contraction duration, and maximum systol ic volume were improved, showing significant differences when compared with those at preoperation and 1 year after surgery (P lt; 0.05). Conclusion Gluteus maximus transplantation can improve defecation controls in the patients with fecal incontinence after surgery of high anal atresia.
ObjectiveTo investigate the therapeutic effects of different doses of tanshinone ⅡA microemulsion on radioactive lung injury. MethodsSeventy-two Wistar rats were randomly divided into a healthy control group,a model group,a liposome microemulsion treatment group,a tanshinone ⅡA microemulsion high-dose group,a tanshinone ⅡA microemulsion middle-dose group,and a tanshinone ⅡA microemulsion low-dose group.Radiation-induced lung injury model was established by irradiation of radiotherapy instrument.In addition to the control group,other groups received 6MV X radiation with one dosage of 22Gy.Four rats in each group were sacrificed on 7th,14th,and 28th day,respectively.Lung tissues were sampled to analyze the pathological changes by HE staining and the Smad7 mRNA expression by RT-PCR.The level of glutathione(GSH)in peripheral blood was determined by ultraviolet spectrophotometric method. ResultsIn the model group and four treatment groups,lung tissue biopsy showed the pathological changes gradually from pulmonary alveolitis to fibrosis.The level of Smad7 mRNA in lung tissue and GSH in peripheral blood were higher in the high-dose group,the middle-dose group and the low-dose group than those in the model group at all time points(P<0.05),and were highest in the high-dose group.There was no significant differences in the level of Smad7 mRNA in lung tissue and GSH in peripheral blood between the liposome microemulsion treatment group and the middle-dose group. ConclusionTanshinone ⅡA microemulsion has treatment effect on lung injury in a dose dependent manner.