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ObjectiveTo observe the clinical efficacy of compound Huangbai liquid fomentation on diabetic foot ulcer of Wagner grade 1-2. MethodPatients were classified into the observation group and control group， with 41 cases in either group. The observation group received routine therapy and compound Huangbai liquid fomentation， while the control group was treated by routine therapy and medical silver nanoparticles-containing dressing. Ulcer area， ulcer depth， traditional Chinese medicine （TCM） syndrome score， ankle-brachial index， transcutaneous oxygen pressure， vascular endothelial growth factor， epidermal growth factor， advanced glycation end product， high-sensitivity C-reactive protein， interleukin-6， erythrocyte sedimentation rate， and adverse events were observed before and after treatment in two groups. ResultAfter treatment， the ulcer area， ulcer depth， TCM syndrome score， vascular endothelial growth factor， epidermal growth factor， advanced glycation end product， high-sensitivity C-reactive protein， interleukin-6（IL-6）， and erythrocyte sedimentation rate were lower than those before treatment in two groups （P<0.05）， and ankle-brachial index， transcutaneous oxygen pressure， vascular endothelial growth factor， and epidermal growth factor were higher than those before treatment in two groups （P<0.05）. After treatment， the ulcer area， ulcer depth， TCM syndrome score， advanced glycation end product， high-sensitivity C-reactive protein， IL-6， and erythrocyte sedimentation rate were lower in the observation group than in the control group （P<0.05）， and ankle-brachial index， transcutaneous oxygen pressure， vascular endothelial growth factor， and epidermal growth factor were higher in the observation group than in the control group （P<0.05）. The clinical efficacy of observation group was better than that of the control group （P<0.05）. There was no significant difference in the incidence of adverse events and endpoint events between two groups. ConclusionCompound Huangbai liquid fomentation is effective for diabetic foot ulcer of Wagner grade 1-2， as it is beneficial to the healing of the ulcer. This study provides clinical evidence for the further promotion of Chinese medicine fomentation.
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ObjectiveTo observe the clinical efficacy and safety of traditional Chinese medicine （TCM） external therapeutic protocol of enriching pus for tissue growth （EPTG） in the treatment of Wagner 2-3 diabetic foot ulcer. MethodThe randomized controlled trial （RCT） design was adopted. Patients receiving basic treatment were divided into the EPTG group and the control group （debridement and change of nano-silver medical antibacterial dressing）. Ulcer healing rate， ulcer area， ulcer depth， TCM symptom score， visual analogue scale（VAS）， transcutaneous partial pressure of oxygen， wound blood flow， inflammatory factors ［C-reactive protein （CRP）， interleukin-6 （IL-6）， and tumor necrosis factor-α （TNF-α）］， growth factors ［vascular endothelial growth factor （VEGF）， transforming growth factor-β1 （TGF-β1）， and fibroblast growth factor-β （FGF-β）］， adverse events， and outcome events of the two groups before and after treatment were observed. ResultCompared with the conditions before treatment， the ulcer healing rate， ulcer area， ulcer depth， TCM symptom score， VAS score， transcutaneous partial pressure of oxygen， wound blood flow， CRP， IL-6， TNF-α， VEGF， TGF-β1， and FGF-β were significantly improved （P<0.01）. In terms of the improvement in the ulcer healing rate， ulcer area， ulcer depth， VAS score， transcutaneous partial pressure of oxygen， wound blood flow， CRP， IL-6， TNF-α， VEGF， TGF-β1， and FGF-β， the EPTG group was superior to the control group （P<0.01）. There were no statistically significant differences in adverse events and outcome events between the two groups. ConclusionThe TCM external therapeutic protocol of EPTG is safe and effective in the treatment of Wagner 2-3 diabetic foot ulcer. It can greatly reduce the area and depth of diabetic foot ulcer， improve the ulcer healing rate and TCM symptom score， relieve the pain of patients， and improve the microcirculatory blood supply in the local ulcer. Its mechanism of action may be related to the reduction of the local inflammatory response of the wound and the improvement of the proliferation of fibroblasts and vascular endothelial cells.
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Objective@#To investigate the microhardness distribution of cancellous bone in the proximal tibia and its clinical significance.@*Methods@#Three fresh tibias were obtained and examined by X-ray and CT to exclude skeletal pathologies, such as osteoporosis, osteoarthritis. According to the Heim's square, the proximal tibias were cut off. Each of the proximal tibias was divided into three parts, the medial condyle, the intercondylar area and the lateral condyle. Each part was divided into three sections, proximal, middle and distal sections. Each of the proximal tibias was divided into 9 regions. Bone specimens with a thickness of 3 mm were taken from each region using a high precision low-speed saw and fixed on flat sheets. The microhardness of the bone tissue was measured using a Vickers microhardness tester after polish. Ten effective micro-indentation tests were conducted in each region. After measurement the diagonal length of the indentations, the microhardness values were calculated via software provided by the hardness tester. Analysis of variance and Tukey method were used to compare the microhardness values of different parts, sections and regions of cancellous bone. The microhardness distribution of the proximal tibia was analyzed.@*Results@#A total of 270 effective indentations were made in the specimens, and the microhardness values were obtained. The average microhardness of the three proximal tibias was 40.98±3.44, 34.92±4.64 and 39.49±3.86 HV, respectively. There was a significant difference among the groups (F=55.87, P=0.000). The microhardness distribution of bone tissue in the three proximal tibias was similar. In the comparison of different parts, the microhardness of medial condyle was greater than that of the lateral condyle, which was larger than that of the intercondylar area. The difference between the parts was statistically significant (F=18.42, 8.236, 10.877; P=0.000, 0.001, 0.000). In the comparison of different sections, the microhardness of the distal section was greater than that of the proximal section, which was larger than that of the middle section. The difference between the sections was statistically significant (F=8.720, 17.140, 6.142; P=0.000, 0.000, 0.003). The microhardness distribution was similar among different regions. The region with the highest microhardness is the medial condyle of the distal section with microhardness of 44.87±3.25 HV (range 39.2-49.7 HV). The lowest microhardness was in the intercondylar area of the middle section with hardness of 29.41±4.53 HV (range 24.8-36.2 HV).@*Conclusion@#The microhardness value of cancellous bone near the articular surface at the proximal tibia was smaller, which could disperse the load and protect the fragile of articular cartilage. Furthermore, the microhardness of the transition zone is larger. The microhardness value of the cancellous bone in medial tibia condyle is the greatest, which is related to load-bearing.
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Objective@#To investigate the distribution characteristics and significance of bone hardness in different segments and layers of clavicle.@*Methods@#The right clavicles of three fresh Chinese corpses were taken and then divided into proximal, middle and distal segments according to Allman's classification. The clavicles were cut with diamond saw in the vertical of long axis equidistant exactly into 15 layers (proximal: 3 layers; midshaft: 7 layers; distal: 5 layers), and each layer was divided into four directions: superior, inferior, anterior, and posterior. The bone hardness were measured by Vickers microindentation, HV(kgf/mm2). The distribution of bone hardness was recorded and analyzed.@*Results@#A total of 180 parts of cortical bone were measured, generating 900 measurements. Meanwhile, a total of 45 parts of cancellous bone were measured, generating 225 measurements. We found that: (1)The average hardness of cortical bone was (35.9±8.1)HV, and the midshaft segment [(41.3±6.8)HV] was harder than the proximal segment [(33.8±6.1)HV] and the distal segment [(29.7±5.4)HV](P<0.05); (2)The average hardness of cancellous bone was (30.7±6.2)HV, and there were significant differences among the midshaft segment [(34.5±5.5)HV], the proximal segment [(29.2±2.9)HV] and the distal segment [(26.3±5.1)HV](P<0.05); (3)for cortical bone, the hardest segment was the fifth layer of the midshaft segment [(44.8±8.6)HV] while the most soft segment was the fourth layer of the distal segment [(28.0±3.5)HV](P<0.05); (4)for cancellous bone, the hardest segment was the fifth layer of the midshaft segmnet [(36.8±5.1)HV] while the most soft was the fifth layer of the distal segment [(23.0±4.4)HV](P<0.05); (5)There were no statistically significant differences among four directions of segments(P>0.05).@*Conclusion@#The microindentation hardness varies greatly among different segments and layers of the clavicles. The cortical bone and cancellous bone have consistent hardness changes, which shows that the middle segment is obviously harder than the proximal and distal segments with a gradually gradient decreasing trend from the middle to both ends. The data can be used to guide the design of 3D printing implants that conform to the stress conduction characteristics of the clavicle under physiological conditions, and provide good data support for the modeling and finite element analysis of the clavicle under simulated physiological conditions.
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Objective To investigate the distribution characteristics and significance of bone hardness in different segments and layers of clavicle. Methods The right clavicles of three fresh Chinese corpses were taken and then divided into proximal, middle and distal segments according to Allman's classification. The clavicles were cut with diamond saw in the vertical of long axis equidistant exactly into 15 layers ( proximal:3 layers; midshaft:7 layers; distal:5 layers ) , and each layer was divided into four directions:superior, inferior, anterior, and posterior. The bone hardness were measured by Vickers microindentation, HV ( kgf/mm2 ) . The distribution of bone hardness was recorded and analyzed. Results A total of 180 parts of cortical bone were measured, generating 900 measurements. Meanwhile, a total of 45 parts of cancellous bone were measured, generating 225 measurements. We found that:(1)The average hardness of cortical bone was (35.9 ±8.1)HV, and the midshaft segment[(41.3 ±6.8)HV] was harder than the proximal segment [(33.8 ±6.1)HV] and the distal segment [(29.7±5.4)HV](P<0.05);(2)Theaveragehardnessofcancellousbonewas(30.7±6.2)HV, and there were significant differences among the midshaft segment [(34. 5 ± 5. 5)HV], the proximal segment [(29.2±2.9)HV] and the distal segment [(26.3 ±5.1)HV](P<0.05);(3)for cortical bone, the hardest segment was the fifth layer of the midshaft segment [(44. 8 ± 8. 6)HV] while the most soft segment was the fourth layer of the distal segment [(28. 0 ± 3. 5)HV](P<0. 05);(4)for cancellous bone, the hardest segment was the fifth layer of the midshaft segmnet [(36. 8 ± 5. 1)HV] while the most soft was the fifth layer of the distal segment [(23. 0 ± 4. 4) HV] (P<0. 05);(5) There were no statistically significant differences among four directions of segments(P >0. 05). Conclusion The microindentation hardness varies greatly among different segments and layers of the clavicles. The cortical bone and cancellous bone have consistent hardness changes, which shows that the middle segment is obviously harder than the proximal and distal segments with a gradually gradient decreasing trend from the middle to both ends. The data can be used to guide the design of 3D printing implants that conform to the stress conduction characteristics of the clavicle under physiological conditions, and provide good data support for the modeling and finite element analysis of the clavicle under simulated physiological conditions.
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Objective To study the micro-hardness distribution of ulna and explore its correlation with surgical procedures of ulnar fractures,internal fixator,total elbow arthroplasty and the epidemiology of ulna fracture.Methods The ulna wasdivided into proximal metaphysis,diaphysis,and distal metaphysis.The proximal metaphysis was divided into the olecranon and the metaphysis olecranon of ulna.Thedistal epiphysis included the head of ulna.The shaft of the ulna was divided equally into nine segments.Each ulna was sawed by a band saw into twelve parts,which were prepared for the micro-indention testing.The micro-indention testing samples precision cuts were conductedwith a Buehler Isomet 11-1280-250 low speed diamond saw.Each micro-indention sample was cut 3mm thickness and fixed on glass sheet with epoxy resin.The samples surface was polished with progressive grades of sandpaper.Micro-indentation was pedormed on each bone sample sudace using a vicker micro-hardness tester,and the hardness value were measured as Hardness value (HV,HV=kgf/mm2).Twenty indentions were randomly selected on each sample,which were equally divided into four quadrants (anterior,medial,posterior and lateral).Hence,a total of 720 micro-indentations were pedormed on the three ulna.Before indention,each sample was controlled under the optical microscope where the bone surface was intact and not damaged.The micro-indentations were performed on each sample with a load of 50 g.The indentation time was set to 12 s.Hardness value (HV/0.05) was computed for each indentation.The lengths of the diagonals were measured under reflected light microscopy,and the Vickers hardness value was calculated.Indentations in which one diagonal was 10％ longer or more than the other were ignored.The indention was repeated.These preliminary data were used to determine the appropriate sample size of micro =indentation to be performed on each bone segment.SPSS 19.0 statistical software was used for statisticalanalysis.The one =way ANOVA analysis was used to compare the difference of bone micro-hardness values in different parts,and P ＜ 0.05 was statistically significant.Results The hardest part of the ulna is the lower ulnaand the value of micro-hardness was 47.77 HV.The least hard part was the head of ulna and the value of micro-hardness was 29.64 HV.The proximal metaphysis hardness value was 34.39 HV.The shaft hardness value was 43.47 HV.Thedistal metaphysis hardness value was 29.64 HV.The hardness was higher in diaphysis than metaphysis in the ulna with statistical significance.There was no statistically significant difference in the hardness of ulna anterior,medial,posterior and lateral quadrant.Conclusion It is demonstrated that the micro-hardnessof ulna shaft is significant higher than other two parts of ulna.The micro-hardness value difference was not significant among the anterior,medial,posterior and lateral quadrant.This study revealed the distribution rule of ulna micro-hardness and provided data support for the total elbow arthroplasty with human physiological characteristics through 3D printing.
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BACKGROUND:The ankle joint is capable of flexion and extension, including plantar flexion and dorsiflexion, to act as a support and a lever. An ankle injury, often accompanied by fracture and ligament injury, seriously threatens the ankle joint function. Previous diagnosis of ankle injury mainly relied on clinical signs and X-ray examination. However, X-ray examination is not accurate enough for ankle injury diagnosis because it cannot clearly diagnose damage to the surrounding ligaments, tendons and other soft tissues except for obvious fractures. Mutlisequence and multiplanar MRI is currently the optimal noninvasive method for high-resolution determination of soft tissue deformations, but little has been reported on the diagnostic accuracy of ankle ligament and tendon injury. OBJECTIVE:To observe the diagnostic value of MRI for ligament and tendon injury of the ankle in its normal position, and during complete plantar flexion and dorsiflexion. METHODS:It is a single-center, prospective, diagnostic trial that wil be completed at the First Hospital of Hebei Medical University, China. Sixty cases were recruited, including 30 cases of normal ankle joint and 30 cases of ankle ligament and tendon injury. MRI scans of the ankle joint in normal position, complete plantar flexion and complete dorsiflexion were performed in al the cases, and the multi-position MRI results were compared. The primary outcome measure is the sensitivity of MRI to ligament and tendon injury of the ankle during complete plantar flexion. The secondary outcomes include the specificity, positive predictive value, negative predictive value, positive likelihood ratio, and negative likelihood ratio of MRI to ligament and tendon injury of the ankle during the complete plantar position as wel as rate of correct diagnosis;specificity and sensitivity, positive predictive value, negative predictive value, positive likelihood ratio, and negative likelihood ratio in normal position or during the complete dorsiflexion as wel as rate of correct diagnosis;the morphology of the ankle on the multi-position MRI. This study design was registered at ClinicalTrial.gov (03049423) on February 8, 2017. This study protocol has been approved by the Medical Ethics Committee of Qinghai University Affiliated Hospital of China (approval No. 2015076) and wil be performed in accordance with the guidelines of the Declaration of Helsinki, formulated by the World Medical Association. Signed informed consent regarding trial procedure and treatment was obtained from each volunteer. DISCUSSION:This study aims to determine the rate of correct diagnosis of ankle ligament and tendon injury using the MRI, to clarify the diagnostic value of MRI for ankle ligament and tendon injury, and to provide a quantitative MRI diagnostic standard for developing a reasonable surgical treatment.
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Objective To establish a method for quality control of Arnebia euchroma inZizhu Ointment.Methods The TLC was used to make qualitative identification to Arnebia euchroma in Zizhu Ointment. The content of shikonin was targeted as the evaluation index and the method of orthogonal design was used to optimize the extraction of shikonin. UV-visible spectrophotometry was used for the determination of shikonin.Results Main spots of TLC were clear, and negative control had no interference. The optimum extraction of shikonin was extracted for three times, 30 min for each time, NaOH volume fraction of 1%, NaOH amount of 50 mL. The absorbance of shikonin showed a good linear relationship in the range of 0.010 2-0.035 7 mg (r2=0.999 7), and the average recovery was 103.27%, RSD=4.17%.Conclusion This method was simple and feasible, and can be used for the quality control and the evaluation ofZizhu Ointment.
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Objective To establish an HPLC method to simultaneously determine the contents of shikonin andβ,β'-dimethylacrylshikonin inZizhu Ointment.Methods The contents of shikonin andβ,β'-dimethylacrylshikonin inZizhu Ointment were determined by HPLC. The chromatographic conditions were Welch Materials XB-C18 Column (4.6 mm × 250 mm, 18.5μm), with mobile phase of acetonitrile-water-formic acid (75:25:0.05), detection wavelength of 516 nm, temperature of 30℃, flow rate of 1.0 mL/min and the load of 20μL.Results Shikonin showed a good linearity in the range of 0.025 6-0.256μg (r2=0.999 5), and the average recovery rate was 98.12% (RSD=1.92%).β,β'-dimethylacrylshikonin showed a good linearity in the range of 0.174 4-2.616μg (r2=0.999 2), and the average recovery rate was 100.46% (RSD=1.17%).Conclusion This method is simple and accurate, which can be used for the quality control and evaluation of Zizhu Ointment.
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OBJECTIVE@#To investigate the allergens in patients with allergic rhinitis in Yichang, so that to find common allergens of Yichang and to provide statistic basis for a reasonable prevention and treatment to allergic rhinitis.@*METHOD@#1,979 patients with allergic rhinitis in Yichang were detected for allergens by skin prick test and the distribution of positive rates to inhaled allergens was compared between different genders and ages.@*RESULT@#1,545 (78.1%) of 1,979 suspected allergic rhinitis patients presented positive reaction. The positive rate in male was significantly higher than in female, and that in juvenile group was significantly higher than in adults. Among positive cases in inhalation group, the most common allergen was flour mite (80.4%), followed by house dust mite (64.9%), cockroach (13.3%) and artemisia pollen (8.2%).@*CONCLUSION@#The study shows that the flour mite and house dust mite are the most common inhaled allergens causing allergic rhinitis in Yichang. We should pay more attention to the prevention and treatment for the juvenile patients.
Subject(s)
Adolescent , Adult , Aged , Child , Child, Preschool , Female , Humans , Male , Middle Aged , Young Adult , Allergens , Allergy and Immunology , China , Epidemiology , Rhinitis, Allergic , Diagnosis , Epidemiology , Allergy and Immunology , Skin TestsABSTRACT
Objective To establish the quality standards of Zizhu ointment. Methods The TLC was applied to identify Radix arnebiae and borneol of Zizhu ointment, and the content of borneol was determined by gas chromatography. Results The TLC spots were clear, well-separated and easy to identify. The good linear range of borneol reference substance on calibration curve was 0.048 4-1.210 0 μg, and the recovery was 90%-110%, the relative standard deviation was less than 5%. Conclusion The method is simple and feasible, can be used as the quality control method of Zizhu ointment.
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Objective To evaluate the effect of atrioventricular nodal ablation and permanent pacing(AVNAP) or atrioventricular nodal modification(AVNM) in the treatment of atrial fibrillation(AF).Methods 32 patients with drug refractory AF were divided into AVNAP group(18) and AVNM group(14).The patients were measured the left ventricular ejection fraction(LVEF) by the echocardiogram,tested by the 6 minu te walking test(6-MWT),assessed by NYHA function classification and the Mos 36~item short from health surrey(SF~36) before or after the treatments respectively.Results Mean follow up is 14 months.In AVNAP group,LVEF was increased from(47?9)% to(57?6)%(P