Baicalein demonstrated a well curative capability on rats with SAP. The mechanism may be alleviateing pancreatic injury and inhibiting pro-inflammatory cytokines expression.

Abstract. This study aimed to gain a better understanding of the molecular circuitry of Schmid-type metaphyseal chondrodysplasia (SMCD), and to identify more potential genes associated with the pathogenesis of SMCD. Microarray data from GSE72261 were downloaded from the NCBI GEO database, including collagen X p.Asn617Lys knock-in mutation (ColX N617K), ablated XBP1 activity (Xbp1 CartΔEx2), compound mutant (C/X), and wild-type (WT) specimens. Differentially expressed genes (DEGs) were screened in Xbp1 vs. WT, Col vs. WT and CX vs. WT, respectively. Pathway enrichment analysis of these DEGs was performed. Transcription factors (TFs) of the overlapping DEGs were identified. Weighted correlation network analysis (WGCNA) was performed to find modules of DEGs with high correlations, followed by gene function analysis and a protein-protein interaction network construction. In total, 481, 1,530 and 1,214 DEGs were identified in Xbp1 vs. WT, Col vs. WT and CX vs. WT, respectively. These DEGs were enriched in different pathways, such as extracellular matrix (ECM)-receptor interaction and metabolism-related pathways. A total of 7 TFs were found to regulate 19 common upregulated genes, and 4 TFs were identified to regulate 21 common downregulated genes. Two significant gene co-expression modules were enriched and DEGs in the 2 modules were mainly enriched in different biological processes, such as ribosome biogenesis. Moreover, Kras (downregulated), Col5a1 (upregulated) and Furin (upregulated) were both identified in the regulatory networks and protein-protein interaction (PPI) network. On the whole, our findings indicate that the Kras, Col5a1 and Furin genes may play essential roles in the molecular mechanisms of SMCD, which warrants further investigation.

Cubitus varus deformity is common in children. The purpose of this study was to assess the usefulness of computer simulation based on three-dimensional computed tomography (3D-CT) reconstruction with regard to preoperative planning and surgical treatment in children with traumatic cubitus varus deformity.The study included 13 patients with traumatic cubitus varus deformity between January 2012 and January 2015. The original 3D-CT data were transferred to Mimics 10.01 software. Special tools were used for simulation of supracondylar lateral wedge osteotomy of the humerus. Intraoperative elbow arthrography was used to identify the articular surface of the elbow joint for assisting the judgment of the osteotomy site. Kirschner wires were used to determine the osteotomy plane and angle. The osteotomy site was fixed by crossing Kirschner wires and steel wire tension band.Of the 13 patients, 11 were male and 2 were female. The left side was affected in 8 patients, and the right side was affected in 5 patients. The patient age ranged from 2 years to 14 years (mean age, 6 years and 7 months). The varus angle ranged from 12° to 35° (mean angle, 20°). The carrying angle on the contralateral side ranged from 5° to 18° (mean angle, 10°). The varus deformities showed good correction. The 13 patients were followed up for 24 to 60 months (mean follow-up, 38 months). According to the Flynn score of elbow joint function after surgery: 10 patients had excellent function, 2 had good function, and 1 had fair function. The excellent rate was 92.3%. At the final follow-up, the ipsilateral carrying angle ranged from 4° to 15° (mean angle, 11°).Computer simulation based on 3D-CT reconstruction can provide good information on the right humeral osteotomy position and osteotomy angle. It can guide the actual operation and provide better results after surgery. Intraoperative elbow arthrography is useful to determine the level of elbow joint osteotomy, and it can assist in the operation.Level of evidence: Level IV-retrospective case, treatment study.

Pediatric radial neck fractures are uncommon. Severely displaced and angulated fractures usually require treatment. Our goals for treatment are to avoid incision, reduce the fracture adequately with no reduction loss, and achieve good postoperative function. We aimed to observe the clinical outcomes of closed reduction with the percutaneous leverage technique and internal fixation with Kirschner-wires (K-wires) to treat angulated radial neck fractures in children.From January 2011 to April 2013, we treated 16 cases of angulated radial neck fracture in 12 boys and 4 girls. Five fractures were type II and 11 fractures were type III using the O’Brien classification. One K-wire was percutaneously introduced into the fracture site using the leverage technique to attain good reduction. Two K-wires were introduced from the proximal to the distal areas of the fracture site. The elbow was immobilized by cast in 90° of flexion and the forearm in supination for 3 to 4 weeks. The K-wires were removed at 3 to 4 weeks postoperatively. All cases were followed up for a mean duration of 3 years 6 months.According to the Metaizeau reduction classification, 12 cases were excellent, and 4 cases were good. According to the Metaizeau clinical classification, 14 cases were excellent, and 2 cases were good. There was no necrosis of the radial head. There was no infection, radioulnar synostosis, and damage of the radial nerve deep branch. There was no limitation in the pronation and supination functions of the forearm.Closed reduction using the percutaneous leverage technique and internal fixation using K-wires is easy to perform. It is encouraged to use this approach as the clinical outcome is good.Level of evidence: level IV-retrospective case, treatment study.

Valgus osteotomy of the proximal humerus using a plate-screw fixation method can correct the deformity and provide strong fixation in children. The postoperative improvement of shoulder motion and radiologic changes were satisfactory. However, we need to do second operation to remove the plate. Meanwhile, the patients would require a second operation to elongate the affected limb.

Background:The divergent dislocation of the elbow is not common in children, and the imaging is difficult and challenging. This often leads to misdiagnosis or inappropriate treatment. The literature has reported a total of 19 cases currently.Methods:A 10-year-old girl with divergent dislocation of the elbow was admitted in our department in November 2013. When playing basketball, her right elbow was injured on the concrete floor. After injury, her right elbow joint became severely swollen, with obvious deformity. The anteroposterior X-ray of elbow showed right olecranon and coronoid fractures, the proximal radioulnar separation, and displacement; the lateral X-ray showed the posterior dislocation of right elbow.Results:Under local anesthesia, right elbow manual reduction was performed, and after reduction, 3-dimensional computed tomography reconstruction displayed good reduction of the elbow dislocation. The fracture of coronoid displaced minimally, but the olecranon fracture showed great displacement which underwent the open reduction and internal fixation. Postoperatively, a plaster splint was applied for protection, with regular outpatient follow-ups. At the end of the normal follow-up, the active ROM of the right elbow joint was 5° to 130° and with normal rotation.Conclusion:Therefore, through the treatment of this case and the literature review, we believe that for children, most divergent dislocations of the elbow may achieve a better clinical result with closed reduction, and we also believe that after surgery or closed reduction, in the follow-up, proper function exercise is an important condition for the rehabilitation of children. For such patients, correct diagnosis and timely treatment can help to avoid joint dysfunction of elbow.

ObjectiveThe aim of this study was to retrospectively evaluate the effects of our double osteotomy technique in the treatment of congenital radial head dislocation (CRHD).MethodsA total 14 children (14 elbows; 71.42% male; mean age: 9.31 ± 3.06 years) with CRHD who underwent double osteotomy of the proximal ulna between April 2010 and June 2015 were included in the study. The patients with CRHD were identified according to medical history, plain radiographs or magnetic resonance imagings. The outcomes were evaluated through comparison of the preoperative and postoperative motion range of elbow and Mayo Elbow Performance Score (MEPS).ResultsAfter a follow-up of 13–35 months (22.29 ± 5.80), compared with pre-operation, the flexion (132.14 ± 3.23° vs 123.21 ± 7.75°, P = 0.003), extension (8.21 ± 4.21° vs 1.07 ± 3.50°, P = 0.003), and pronation of elbow (83.21 ± 4.21° vs 80.36 ± 4.14°, P = 0.011) improved significantly in all patients. Furthermore, the carrying angle was recovered to the normal level (5–15°) in all of these patients (18.57 ± 5.69° vs 8.21 ± 2.49°, P = 0.001). MEPS score was significantly increased postoperatively (96.79 ± 2.49 vs. 90.71 ± 1.82, P = 0.000), with the good outcome in CRHD patients.ConclusionThe results of our study suggested that this double osteotomy on the proximal ulna might be an effective method for the treatment of CRHD.Level of EvidenceLevel IV, Therapeutic Study.

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