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OBJECTIVE To provide reference for improving the dispensing accuracy of similar drugs and reducing dispensing error risk through exploring the dispensing mode of similar drugs. METHODS The effectiveness and feasibility of the similar drug dispensing management mode was explored through adjusting the traditional horizontal or vertical sorting method to a “Z” shaped cargo location sorting， implementing similar drug in different zones dispensed by different people， and combining measures such as adjusting the format of drug dispensing documents and improving inventory methods. The role of similar drug dispensing mode in drug dispensing management was evaluated comprehensively from two aspects： work quality and work efficiency. RESULTS After the implementation of similar drug dispensing mode， total number of monthly dispensing errors （18.42±8.79 vs. 28.50±6.87，P= 0.005） and the proportion of monthly dispensing errors of similar drugs （[ 4.17±5.71）% vs. （10.96±7.05）%，P＝0.017] were significantly lower than before the implementation； the monthly consistency rate between accounts and materials （[ 98.46±0.73）% vs. （97.61±0.57）%， P＝0.004] was significantly higher than before implementation； completion time of dispensing in each batch was not significantly affected， and daily work was carried out smoothly and orderly. CONCLUSIONS The similar drug dispensing mode has a significant effect in improving the accuracy of dispensing similar drugs， reducing the risk of dispensing errors， and does not affect the efficiency of dispensing work.
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【Objective】 To analyze the correlation between the expressions of ZEB1, androgen receptor (AR), E-cadherin (E-Ca), N-cadherin (N-Ca) and clinicopathological features of prostate cancer patients with different risk levels, and to explore their significance. 【Methods】 The clinical data of 47 patients with prostate cancer treated during Nov.2013 and Jun.2021 were retrospectively analzyed. The patients were divided into medium-low risk group and high-risk group. The expressions of ZEB1, AR, E-Ca and N-Ca in the prostate cancer tissues of the two groups were detected with immunohistochemical staining. The relationship between the expressions and Gleason grade, prostate-specific antigen (PSA) level and TNM stage was analyzed. 【Results】 The positive expression rate of ZEB1 increased with higher risk, Gleason score, and PSA level (P<0.01); the strong positive expression rate of AR decreased with higher risk and Gleason score (P<0.05); the positive expression rate of E-Ca decreased with increased risk, Gleason score, and PSA level (P<0.05); the positive expression rate of N-Ca increased with the increased risk and Gleason score (P<0.01); the positive expression rate of ZEB1 increased with higher tumor stage and TNM stage (all P<0.01); the strong positive expression rate of AR decreased only with increased TNM stage (P<0.05). Patients whose first surgical specimen showing a higher expression level of ZEB1 were more likely to develop into castration-resistant prostate cancer CRPC (P<0.05). 【Conclusion】 ZEB1 and N-Ca levels increase with increased tumor aggressiveness, while AR and E-Ca levels decrease. ZEB1, AR, E-Ca and N-Ca play important roles in prostate cancer progression. ZEB1 can not only affect prostate cancer through epithelial stromal transformation (EMT), but also through AR. ZEB1 may also be related to the development of CRPC.
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Objective:To evaluate the efficacy and safety of gold micrhenedle radiofrequency and other photoelectric methods in the treatment of facial acne depression scar by using a meta-analysis.Methods:From January 2015 to August 2022, gold microneedles and radio frequence for treatment of facial acne depression scar of randomized controlled trial were retrieved from CNKI, Wanfang Database, VIP, China Biomedical Literature Service System, PubMed database, Cochrane Library and Embase database, including 12 papers. There were 6 Chinese and 6 English literatures, with a sample size of 612 cases.Results:Gold microneedling radio-frequency showed better efficacy in the treatment of facial acne depression scar ( P<0.05). After subgroup analysis, the effective rate in the observation group was higher than that in the control group after 4 treatments, and the difference was statistically significant ( P<0.05). Clinical acne scarring assessment scale, pain score and recovery time had statistically significant difference ( P<0.05). Conclusions:Gold microneedling radiofrequency alone or in collaboration with other photoelectricity in the treatment of acne depression scar has short rest period, slight pain, and obvious improvement of scar effect. However, the improvement effect on icicle depression scar is limited.
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Objective:To investigate effect of miR-20b on the motor dysfunction after traumatic brain injury (TBI) in mice and the underlying mechanism.Methods:Sixty C57BL/6J mice were divided into sham group, TBI group and TBI+miR-20b Agomir (Agomir-20b) group according to the random number table, with 20 mice per group. A model of severe TBI was induced by controlled cortical impact. After injury, the mice in TBI group were subjected to tail-vein injection of 200 μl Agomir-negative control at dosage of 50 μmol/L and the mice in TBI+Agomir-20b group were subjected to tail-vein injection of 200 μl Agomir-20b at dosage of 50 μmol/L. At days 3 and 7 postinjury, the rate of neuronal apoptosis in the pericontusional region was detected by TUNEL assay, expression levels of apoptosis-related proteins in the pericontusional region were detected by Western blot analysis, including cleaved caspase-3, cleaved poly adenosine diphosphate-ribose polymerases (PARP), B-cell lymphoma-2 (Bcl-2) and Bcl-2-associated X protein (Bax), motor function was evaluated by beam walking test, and expression levels of cytokine mRNAs in the pericontusional region were detected by real-time quantitative PCR (RT-qPCR), including interleukin (IL)-1β, IL-6, IL-10, inducible nitric oxide synthase (iNOS), arginase (Arg) and macrophage mannose receptor 1 (CD206).Results:In TUNEL assay, the rate of neuronal apoptosis in sham group was significantly lower than that in TBI group and TBI+Agomir-20b group at days 3 and 7 postinjury (all P<0.01), and there was a significantly lower rate of neuronal apoptosis in TBI+Agomir-20b group as compared with TBI group (all P<0.01). In Western blot analysis, significantly increased levels of cleaved caspase-3, cleaved PARP and Bax proteins and lowered level of Bcl-2 protein were observed in TBI group at days 3 and 7 postinjury as compared with sham group (all P<0.01); similar levels of cleaved caspase-3, cleaved PARP and Bax proteins were found in TBI+Agomir-20b group at days 3 and 7 postinjury as compared with sham group (all P>0.05), and level of Bcl-2 protein in TBI+Agomir-20b group also showed no obvious variation at day 7 postinjury as compared with sham group ( P>0.05) in regardless of a significant reduction at day 3 postinjury ( P<0.01). Significantly increased levels of cleaved caspase-3, cleaved PARP and Bax proteins as well as a significantly reduced level of Bcl-2 protein were found in TBI group at days 3 and 7 postinjury as compared with TBI+Agomir-20b group (all P<0.05 or 0.01). In beam walking test, the latency and foot slip rate in TBI group were significantly higher than those in sham group and TBI+Agomir-20b group at days 3 and 7 postinjury (all P<0.01). In RT-qPCR analysis, levels of IL-1β, IL-6 and iNOS mRNA in TBI group were significantly higher than those in TBI+Agomir-20b group at days 3 and 7 postinjury (all P<0.01), but the two groups were similar in levels of IL-10, Arg and CD206 mRNA (all P>0.05). In comparison with sham group, levels of IL-1β, IL-6, iNOS and IL-10 mRNA in TBI+Agomir-20b group had no obvious change at days 3 and 7 postinjury (all P>0.05); level of Arg mRNA in TBI+Agomir-20b group was significantly increased at days 3 and 7 postinjury (all P<0.01); level of CD206 mRNA in TBI+Agomir-20b group did not change significantly at day 3 postinjury ( P>0.05), but was significantly increased at day 7 postinjury ( P<0.01). Conclusions:miR-20b can obviously inhibit neuronal apoptosis to improve motor function after TBI in mice, for which the underlying mechanism is related to Agomir-20b inhibiting the transformation of microglia to pro-inflammatory M1 type after TBI.
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OBJECTIVE To reevaluate the system atic evaluation of g emcitabine combined with cisplatin in the treatment of advanced non-small cell lung cancer （NSCLC），in order to provide evidence-based evidence for the treatment of NSCLC. METHODS Retrieved from Wanfang database ，CNKI，VIP，PubMed，Embase，systematic evaluation of gemcitabine combined with cisplatin versus pemetrexed/vinorelbine combined with cisplatin in the treatment of advanced NSCLC was included from the inception to Dec. 2021. RevMan 5.3 system evaluation software was used for meta-analysis of various outcome indicators ； AMSTAR2 scale was used for methodological quality evaluation ，and GRADE tool was used for evidence quality evaluation. RESULTS A total of 9 literatures were included. Meta-analysis showed that the effective rate of gemcitabine combined with cisplatin was significantly lower than pemetrexed combined with cisplatin ，but was similar to vinorelbine combined with cisplatin. The 1-year survival rate of gemcitabine combined with cisplatin was equivalent to that of pemetrexed combined with cisplatin ，but was superior to vinorelbine combined with cisplatin. There was no significant difference in the incidence of nausea and vomiting between gemcitabine combined with cisplatin and pemetrexed/vinorelbine combined with cisplatin. Gemcitabine combined with cisplatin had a higher incidence of thrombocytopenia than pemetrexed/vinorelbine combined with cisplatin. The incidence of neutropenia and leukopenia in gemcitabine combined with cisplatin were higher than pemetrexed combined with cisplatin ，but were significantly lower than vinorelbine combined with cisplatin. The evaluation results of AMSTAR 2 scale showed that 6 systematic evaluation were of low quality in methodology and 3 were of very low quality. The results of the GRADE tool showed that 31％ of the outcome indicators were of medium quality （14 items），27％ were of low quality （12 items），and 42％ were of very low quality（19 items）. Research limitations and publication bias were the most frequently downgraded factors. CONCLUSIONS Gemcitabine combined with cisplatin has advantages over 154854280@qq.com vinorelbine combined with cisplatin in the efficacy and safety of ad vanced NSCLC ，especially in the 1-year survival rate ，the incidence of neutropenia and leucopenia. The efficacy and safety of gemcitabine combined with cisplatin are inferior to those of pemetrexed combined with cisplatin. However ，the methodological quality and evidence level of systematic evaluation are not high on the whole ，and the overall quality of research needs to be improved.
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Objective:To study the correlation between non-contact anterior cruciate ligament (ACL) injury and functional ankle instability (FAI) in young patients.Methods:A retrospective analysis was conducted of the 102 patients with non-contact ACL injury[61 males and 41 females, with an age of (31.9±6.1) years and a Tegner activity score of (6.1±1.9) points] who had been treated at Department of Orthopedics, Sun Yat-sen Memorial Hospital from January 2017 to March 2020 (injury group). Another 102 citizens without ACL injury from Guangzhou [56 males and 46 females, with an age of (30.3±7.2) years and a Tegner activity score of (6.0±2.1) points] were recruited as a control group. The Cumberland ankle instability tool (CAIT) and the Ankle Joint Functional Assessment Tool (AJFAT) were used to assess whether the subjects had self-conscious FAI or not. A correlation analysis was conducted using the data collected.Results:The 2 groups were comparable because there were no significant differences between them in general data ( P>0.05). By the CAIT score, the incidence of FAI in the injury group [52.9% (54/102)] was significantly higher than that in the control group [32.4% (33/102)] ( P<0.05); by the AJFAT score, the incidence of FAI in the injury group [59.8% (61/102) ] was significantly higher than that in the control group [39.2% (40/102)] ( P<0.05). Pearson correlation analysis showed that diagnoses of FAI by CAIT and by AJFAT were respectively correlated with ACL injury ( r=-0.159, P=0.023; r=-0.215, P=0.002). Conclusions:The incidence of FAI may be high in patients with ACL injury and there is a correlation between FAI and ACL injury.
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Background and Objectives@#The immunomodulatory potential of mesenchymal stem cells (MSCs) can be regulated by a variety of molecules, especially cytokines. The inflammatory cytokine, TNF-like ligand 1A (TL1A), has been reported as an inflammation stimulator in-multiple autoimmune diseases. Here, we studied the effects of TL1A/TNF-receptor 2 (TNFR2) pathway on the therapeutic potency of bone marrow-derived MSCs (BMSCs). @*Methods@#and Results: BMSCs, fibroblast-like synoviocytes (FLSs), and H9 and jurkat human T lymphocytes were used in this study. BMSCs paracrine activities, differentiation, proliferation, and migration were investigated after stimulation with TL1A, and intervened with anti-TNFR2. Additionally, the effects of TL1A on BMSCs therapeutic potency were evaluated by treating RA-FLSs, and H9 and jurkat T cells with TL1A-stimulated BMSCs conditioned medium (CM). Indian hedgehog (IHH) involvement was determined by gene silencing and treatment by recombinant IHH (rIHH). TL1A induced BMSCs stemness-related genes, COX-2, IL-6, IDO, TGF-β and HGF through TNFR2. Also, TL1A corrected biased differentiation and increased proliferation, and migration through TNFR2. Meanwhile, CM of TL1A-stimulated BMSCs decreased the inflammatory markers of RA-FLSs and T cells. Moreover, TL1A-stimulated BMSCs experienced IHH up-regulation coupled with NF-κB and STAT3 signaling up-regulation, while p53 and oxidative stress were down-regulated. Furthermore, treatment of BMSCs by rIHH increased their anti-inflammatory effects.More importantly, knockdown of IHH decreased the ability of TL1A-stimulated BMSCs to alleviating the inflammation in RA-FLSs and T cells. @*Conclusions@#This study reports the effects of TL1A/TNFR2 pathway on the biological behaviors and therapeutic potency of BMSCs through IHH. These findings could introduce novel procedures to increase the stemness of MSCs in cellular therapy.
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Objective To compare the outcomes of bone marrow stimulation techniques-drilling by a Kirschner needle versus microfracturing technique in the treatment of small osteochondral lesions of the talus.Methods From February 2014 to June 2017,57 patients were treated at Department of Orthopaedics,Sun Yat-sen Memorial Hospital for small osteochondral lesions of the talus.Of them,26 were treated by arthroscopic drilling with a Kirschner needle.They were 15 males and 11 females,aged from 20 to 57 years.The areas of osteochondral lesion ranged from 0.6 to 1.4 cm2.By the Berndt & Harty classification of ankle osteochondral lesions based on X-ray films,there were 9 cases of stage Ⅰ,8 cases of stage Ⅱ,6 cases of stage Ⅲ and 3 cases of stage Ⅳ.The other 31 patients of them were treated by arthroscopic microfracturing technique.They were 17 males and 14 females,aged from 24 to 55 years.The areas of osteochondral lesion ranged from 0.5 to 1.5 cm2.By the Berndt & Harty classification of ankle osteochondral lesions based on X-ray films,there were 10 cases of stage Ⅰ,11 cases of stage Ⅱ,8 cases of stage Ⅲ and 2 cases of stage Ⅳ.The 2 groups were compared in terms of visual analogue scale (VAS),the American Orthopaedic Foot and Ankle Society (AOFAS) score,the ankle activity score (AAS) and the Berndt & Harty staging of osteochondral lesions based on ankle X-ray films at the final follow-up.Results All the 57 patients were followed up for 13 to 27 mouths.The VAS,AOFAS and AAS scores and Berndt & Harty stages at the final follow-up were significantly improved in all the patients compared with their preoperative values (P ＜ 0.05).There were no significant differences between the 2 groups in the VAS (2.2 ± 1.6 versus 2.1 ± 1.4),AOFAS (89.1 ±6.3versus 90.4±5.8) or AAS scores (6 versus 6) at the final follow-up (P ＞ 0.05).There was no significant difference between the 2 groups either in the excellent and good rate by the AOFAS ankle-hindfoot scoring [88.5％ (23/26) versus90.3％ (28/31)] at the final follow-up (x2 =0.052,P=0.820).Conclusion In the treatment of small osteochondral lesions of the talus,both arthroscopic drilling with a Kirschner needle and microfracturing technique can achieve satisfactory short-term curative effects,but the long-term effects need to be further studied.
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Objective:To explore the changes and clinical significance of inflammatory indices of urogenic sepsis with different severity.Methods:A retrospective case-control study was used to analyze the clinical data of 71 patients with urogenic sepsis admitted to 940th Hospital of PLA Joint Logistics Support Force from January 2010 to April 2018, including 34 males and 37 females, aged 39-96 years [(63.1±18.3)years]. The patients were divided into three groups according to the clinical diagnostic criteria for septic shock and sepsis according to the 2014 edition of the Chinese Urology Surgical Guidelines for Diagnosis and Treatment: 21 cases in sepsis group [sequential organ failure assessment (SOFA) score of 3.0 (2.0, 3.0)points], 21 cases in severe sepsis group [SOFA score of 9.0 (6.0, 11.0)points], and 29 cases in septic shock group [SOFA score of 15.0 (14.0, 16.0)points]. Spearman correlation analysis was used to analyze the correlation of inflammatory indicators with SOFA, including white blood cell count, percentage of neutrophils, C-reactive protein, interleukin-6, procalcitonin, fibrinogen, D-dimer, and platelet. Multiple linear regression analysis and stepwise regression weighted analysis were performed to analyze the relation between inflammatory indicators and sepsis severity. Levels of each inflammatory indicator was detected and compared among the groups.Results:① Spearman correlation analysis: percentage of neutrophils, D-dimer, interleukin-6, procalcitonin and SOFA scores were significantly positively correlated, with the r s value of 0.738, 0.712, 0.31, 0.795, respectively ( P<0.01); platelet and SOFA scores were significantly negatively correlated, with the r s value of -0.661 ( P<0.01). ② Multiple linear regression analysis: percentage of neutrophils, platelet, D-dimer, procalcitonin and SOFA score were significantly correlated ( P<0.01); Stepwise regression weighted analysis suggested that the model linear relationship and fit was good. ③ Inflammatory index comparison: percentage of neutrophils in sepsis group, severe sepsis group and septic shock group was 82.30 (76.25, 88.45), 90.50 (86.55, 93.85), 95.10 (92.05, 97.95), respectively; level of platelet was 183.01 (144.50, 246.50)×10 9/L, 149.11 (81.04, 207.00)×10 9/L, 81.26 (50.01, 93.50)×10 9/L, respectively; level of D-dimer was 0.98 (0.71, 1.74)mg/L, 3.45 (1.79, 5.56)mg/L, 7.19 (4.26, 11.63)mg/L, respectively; level of procalcitonin was 0.55 (0.21, 1.09)ng/ml, 5.45 (3.74, 11.80)ng/ml, 17.68 (13.97, 26.75)ng/ml, respectively. There were significant differences in above indicators among the groups ( P<0.05). Conclusions:The serum levels of procalcitonin, percentage of neutrophils, D-dimer and platelet are positively correlated with the severity of urogenic sepsis. While combined detection of those indicators can better predict the severity of the sepsis.
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Objective:To investigate the application value of magnetic resonance (MR) diffusion tensor imaging (DTI) automatic fiber quantification (AFQ) in the diagnosis and prediction of Alzheimer's disease (AD).Methods:Clinical and MR data of 21 patients with AD (AD group) and 33 normal controls (NC group) were collected.AFQ software was used to analyze DTI data, track 20 white matter fiber bundles in the brain, and compare the differences of fractional anisotropy (FA) and mean diffusivity (MD) value of each bundle between groups.Each fiber bundle was divided into 100 equal parts along the direction of travel, and the FA or MD value of each part was taken as a characteristic.Screening the characteristics with statistic differences between groups for classification of AD and NC by support vector machine (SVM) with leave one method for cross validation.Classification effectiveness was evaluated using the receiver operating characteristic (ROC) curve.Results:Eleven (left/right anterior thalamic radiation (ATR), left/right corticospinal tract (CST), genu of corpus callosum (CC Genu), right inferior longitudinal fasciculus (ILF), right superior longitudinal fasciculus (SLF), left/right uncinated fasciculus (UF), and left/right arcuate fasciculus (AF)) of the 20 fiber bundles were successfully tracked in all subjects.Compared with NC group, the FA values of 2 fiber bundles (left/right UF) in AD group were significantly decreased( t=-2.532, -2.391, both P<0.05), and the MD values of 7 fiber bundles (left ATR, left/right CST, right ILF, left/right UF, and left AF) were significantly increased ( t=2.569, 2.411, 2.108, 2.357, 3.773, 3.796, 3.492, all P<0.05). Among the 2 200 characteristics of 11 fiber bundles, 412 classification characteristics with inter-group differences were selected.Among which, 78 FA characteristics were distributed in 7 fiber bundles (left ATR, left/right CST, CC Genu, right ILF, left/right UF), and 334 MD characteristics were distributed in 9 fiber tracts (left/right ATR, left/right CST, CC Genu, right ILF, left/right UF, and left AF). The accuracy of SVM classification was 85.19%, sensitivity was 80.95%, specificity was 87.88%, and area under ROC curve was 0.894 7. Conclusion:AFQ analysis based on DTI has a high application value in the diagnosis and prediction of AD.
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OBJECTIVES@#To explore the improvement of neurological symptoms in patients with Type 2 diabetic peripheral neuropathy via resistance exercise.@*METHODS@#A total of 100 patients with Type 2 diabetic peripheral neuropathy were selected as the research objects, and they were randomly divided into an observation group who performed resistance exercise (@*RESULTS@#Compared with the control group, there was statistically difference in the TCSS scores in the observation group at 3 months (@*CONCLUSIONS@#After the intervention of resistance exercise, the blood glucose and DPN can be improved in a certain extent, and which can be popularized in Type 2 diabetes patients.
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Humans , Blood Glucose , Body Mass Index , Diabetes Mellitus, Type 2/complications , Diabetic Neuropathies , Resistance TrainingABSTRACT
OBJECTIVE：To understand the current management situation and problems of residual drugs in medical institutions in China ，evaluate the practice effect of corresponding control mode of our hospital and to explore the countermeasures to reduce the production of residual drugs and standardize its management. METHODS ：By random sampling ，30 third-level hospitals and 20 second-level hospitals in different regions were selected respectively during May 1st to 31st in 2019. For the pharmaceutical personnel，doctors，nurses and other non-pharmaceutical personnel ，a self-designed questionnaire on the status quo of residual drugs in medical institutions was issued. Excel 2010 software was used to count basic data of valid questionnaire ，and the causes ， management status ，disposal status and possible hazards of residual drugs in medical institutions were analyzed. A management mode of residual drugs was established and implemented （involving reducing the generation of sources ，implementing process management，and strictly implementing disposal ）. The effects of the model were evaluated ，then the countermeasures and suggestions were put forward . RESULTS & CONCLUSIONS：A total of 400 questionnaires were sent out ，and 311 valid questionnaires were collected with effective recovery rate of 77.75％. The causes of drug residual were complicated ，which included the“combination”of the same drugs ，the pre-order dispensing ，adverse drug reactions ，poor compliance of patients ，wrong order imput，sudden transfer ，discharge or death of patients ，wrong dispensing or nurse check error ，etc. The management status of residual drugs was chaotic ，the disposal methods lacked of standardization ，which may lead to harm such as deterioration ，illegal Δ 基金项目：重庆市技术预见与制度创新项目（No.cstc2018jsyj- recycling and pollution . The established whole-link residual zdcxX0093） drug management model in our hospital ，mainly included ＊主管药师 ，硕士。研究方向 ：药事管理 、抗肿瘤药理 。电话： measures of introducing Clinical Departments Residual Drug 023-68774769。E-mail：513293274@qq.com Safety Management Regulations to clarify the responsibilities # 通信作者：主任药师，博士生导师，博士。研究方向：药事管理、 of management group ， clinical department ， pharmacy 临床药学。电话：023-68755580。E-mail：zrcq73@163.com department； using rational medication control software to 中国药房 2020年第31卷第8期 China Pharmacy 2020Vol. 31 No. 8 ·897· reduce prescription error ；increasing the frequ ency of drug inventory ；introducing Drug Withdrawal and Refund Management to clear out drug withdrwal process ；independently researching and developing “Residual Drug Recovery Management System ”to standardize and simplify the recovery process ；bringing the residual drugs into special fund project management for medical assistance. According to the operation management practice from Jan. to Oct. 2018，a total of more than 1 million yuan worth of residual drugs were recovered. The residual drugs that did not meet the recovery conditions should be destroyed according to the specified process ，and the case number of non-standard notification of ward management would significantly reduced. The whole-link mode management established by our hospital can effectively reduce the production of residual drugs and standardize their management and disposal. It is suggested that the state or province should issue special regulations on the management of residual drugs in medical institutions ，and each medical institution should formulate specific management measures suitable for its own unit. Meanwhile ，the management of residual drugs in medical institutions should be further standardized systematically by actively exploring the ways to reduce residual drugs ，formulating the corresponding financial account processing standards ， supporting incentive mechanism and other measures.
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Objective@#To compare the clinical effects of autologous semitendinosus tendon and allogenic tendon arthroscopic anatomical reconstruction of anterior talofibular ligament (ATFL) combined with calcaneofibular ligament (CFL) in the treatment of chronic lateral ankle instability.@*Methods@#A retrospective analysis was made of 55 patients with chronic lateral ankle instability who underwent arthroscopic reconstruction of ATFL combined with CFL from January 2012 to June 2017. A total of 28 cases were treated with autologous semitendinosus tendon (autologous group), including 19 males and 9 females, with an average age of 28.5±8.03 years (range, 16-46 years). A total of 27 cases were treated with allogenic tendon (allogenic group), including 17 males and 10 females, with an average age of 27.48±7.89 years (range, 16-46 years). ATFL/CFL was reconstructed by the same method in both groups. The reconstruction methods were the same between the groups. The talus and calcaneus were fixed with absorbable compression nails.@*Results@#The operation duration in the autologous group was 94.07±7.83 min, which was longer than that in the allogeneic group 63.56±7.96 min (t=14.51, P<0.001). Fever days 5.26±0.90 days in allogeneic group were longer than 2.46±0.74 days in autologous group (t=-12.55, P<0.001). Wound healing duration in allogeneic group was 13.44±3.33 days longer than that in autologous group 10.32±2.34 days (t=-4.01, P<0.001). In the autologous group, 28 cases were followed up for 34.54±16.04 months, and 27 cases in the allograft group were followed up for 42.74±17.79 months. The mean AOFAS score improved from 63.64±11.20 before operation to 90.21±4.48 after operation in the autologous group, and that improved from 63.93±10.59 before operation to 89.56±5.15 after operation in the allogeneic group with no significant difference between the two groups after operation (t=0.506, P=0.615). The mean VAS score decreased from 5.79±1.79 before operation to 1.54±1.35 after operation in the autologous group, and from 5.89±1.78 before operation to 2.04±1.32 after operation in the allogeneic group. There was no significant difference between the two groups after operation (t=-1.396, P=0.168). Tegner score increased from 4.07±1.39 to 6.43±1.14 in the autologous group and from 3.85±1.06 to 6.52±0.85 in the allogeneic group with no significant difference between the two groups after operation (t=-0.333, P=0.740). Stress radiographic showed that the talar tilt angle decreased from 15.60°±3.86° to 6.01°±2.64° in the autologous group, 16.99°±3.78° to 7.14°±3.34° in the allogeneic group, and there was no significant difference between the two groups after operation (t=-1.382, P=0.171). Anterior talar displacement reduced from 10.82±3.12 mm to 4.03±1.69 mm in the autologous group, from 10.10±2.02 mm to 4.17±1.52 mm in the allogeneic group, and there was no significant difference between the two groups after operation (t=-0.326, P=0.746). No donor tendon dysfunction was found in the autologous group. At the end of follow-up, there was no difference in ankle dorsiflexion, plantar flexion and hind foot mobility between autologous group and allogeneic group.@*Conclusion@#Arthroscopic autologous tendon and allogeneic tendon reconstruction of AFTL combined with CFL can obtain satisfactory short-term results. The autologous tendon group was superior to the allogeneic group in terms of fever, wound healing time. However, there was no significant difference in clinical effects between the two groups.
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To evaluate the white-matter integrity and its correlation with cognitive function in patients with mild cognitive impairment (MCI) complicated with lacunar infarctions (LI) by diffusion tensor imaging (DTI) of magnetic resonance (MR). Methods: Twenty-six patients with MCI were selected including 14 patients with combined LI and 12 patients without combined LI, and 16 healthy volunteers were recruited as normal control. All subjects completed cognitive function assessment and DTI sequence of MR. Factional anisotropy (FA) and mean diffusivity (MD) values among the MCI with LI group (MCI-LI), the MCI without LI group (MCI-non LI), and the normal control group (NC) were compared, and the correlation between DTI parameters and cognition was determined by multiple linear stepwise regression. Results: Compared with the MCI-non LI group, the FA values were significantly decreased (P<0.05) and MD values were significantly increased (P<0.05) in the white matter fiber bundles (such as the left hippocampus of the cingulate tract, the frontal fascicle of the corpus callosum, the right inferior frontal occipital fascicle, and the right superior longitudinal fascicle) in the MCI-LI group. In the MCI-LI group, the FA value of right cingulate gyrus was significantly correlated with Activity of Daily Living Scale (ADL) score (B=-50.2, 95% CI -77.7 to -22.7, P=0.003); the FA value of left anterior thalamic radiation (B=443.8, 95% CI 222.9 to 664.8, P=0.001) and MD value of left inferior longitudinal tract (B=-318.5, 95% CI -534.7 to -102.3, P=0.009) were significantly correlated with Wechsler digit symbol substitution (WDSS) score; the FA value of left superior temporal lobe longitudinal tract was significantly correlated with Backward Digit Span (BDSP) score (B=12.5, 95% CI 1.5 to 23.4, P=0.030). Conclusion: The integrity of white matter is significantly destroyed in MCI patients with LI than that in MCI patients without LI, and there is a correlation between cognitive function and DTI parameters in some white matter tracts in MCI patients with LI.
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Humans , Anisotropy , Brain , Cognitive Dysfunction , Diagnostic Imaging , Diffusion Magnetic Resonance Imaging , Diffusion Tensor Imaging , Neuropsychological Tests , Stroke, Lacunar , White MatterABSTRACT
Objective To compare the clinical effects of autologous semitendinosus tendon and allogenic tendon arthroscopic anatomical reconstruction of anterior talofibular ligament (ATFL) combined with calcaneofibular ligament (CFL) in the treatment of chronic lateral ankle instability.Methods A retrospective analysis was made of 55 patients with chronic lateral ankle instability who underwent arthroscopic reconstruction of ATFL combined with CFL from January 2012 to June 2017.A total of 28 cases were treated with autologous semitendinosus tendon (autologous group),including 19 males and 9 females,with an average age of 28.5±8.03 years (range,16-46 years).A total of 27 cases were treated with allogenic tendon (allogenic group),including 17 males and 10 females,with an average age of 27.48±7.89 years (range,16-46 years).ATFL/CFL was reconstructed by the same method in both groups.The reconstruction methods were the same between the groups.The talus and calcaneus were fixed with absorbable compression nails.Results The operation duration in the autologous group was 94.07±7.83 min,which was longer than that in the allogeneic group 63.56±7.96 min (t=14.51,P＜0.001).Fever days 5.26±0.90 days in allogeneic group were longer than 2.46±0.74 days in autologous group (t=-12.55,P＜0.001).Wound healing duration in allogeneic group was 13.44±3.33 days longer than that in autologous group 10.32±2.34 days (t=-4.01,P＜0.001).In the autologous group,28 cases were followed up for 34.54± 16.04 months,and 27 cases in the allograft group were followed up for 42.74± 17.79 months.The mean AOFAS score improved from 63.64± 11.20 before operation to 90.21 ±4.48 after operation in the autologous group,and that improved from 63.93± 10.59 before operation to 89.56±5.15 after operation in the allogeneic group with no significant difference between the two groups after operation (t=0.506,P=0.615).The mean VAS score decreased from 5.79± 1.79 before operation to 1.54± 1.35 after operation in the autologous group,and from 5.89± 1.78 before operation to 2.04± 1.32 after operation in the allogeneic group.There was no significant difference between the two groups after operation (t=-1.396,P=0.168).Tegner score increased from 4.07± 1.39 to 6.43± 1.14 in the autologous group and from 3.85±1.06 to 6.52±0.85 in the allogeneic group with no significant difference between the two groups after operation (t=-0.333,P=0.740).Stress radiographic showed that the talar tilt angle decreased from 15.60°±3.86° to 6.01°±2.64° in the autologous group,16.99°±3.78° to 7.14°±3.34° in the allogeneic group,and there was no significant difference between the two groups after operation (t=-1.382,P=0.171).Anterior talar displacement reduced from 10.82±3.12 mm to 4.03±1.69 mm in the autologous group,from 10.10±2.02 mm to 4.17±1.52 mm in the allogeneic group,and there was no significant difference between the two groups after operation (t=-0.326,P=0.746).No donor tendon dysfunction was found in the autologous group.At the end of follow-up,there was no difference in ankle dorsiflexion,plantar flexion and hind foot mobility between autologous group and allogeneic group.Conclusion Arthroscopic autologous tendon and allogeneic tendon reconstruction of AFTL combined with CFL can obtain satisfactory short-term results.The autologous tendon group was superior to the allogeneic group in terms of fever,wound healing time.However,there was no significant difference in clinical effects between the two groups.
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Objective To evaluate systematically the efficacy of mirror therapy for improving the upper limb function, daily life and pain of stroke survivors. Methods The PubMed, EBSCO, Web of Science, Ovid, Co-chrane Library, Open Gray, China Biological Medicine, China National Knowledge Infrastructure, GoogleScholar, VIP and Wan Fang Data databases were searched for reports of randomized and controlled trials ( RCTs) of mirror therapy for improving the upper limb function of stroke survivors. Only papers published before December 2015 were surveyed. The relevant references of the primary studies were also searched. The literature screening, data extraction and assessments were conducted by two reviewers independently. The meta-analysis was performed using version 5.2 of the RevMan software. Results A total of 22 RCTs involving 823 patients were discovered, some not dealing with mirror therapy. Comparing the studies with and without visual feedback, there were significant differences in upper limb motor function as measured by the Fugl-Meyer, ARAT and Brunnstrom instruments. The average Barthel indexes and visual analogue scale were also significantly different. Conclusion Mirror therapy can improve upper limb function and ability in the activities of daily living, and also relieve pain among stroke survivors to some degree, though its long-term efficacy is still unclear. Large-sample, multi-center, high-quality RCTs are required to verify these conclusions.
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Objective To explore the association of serum cytokine levels with disease activity in patients with dermatomyositis (DM) and clinically amyopathic dermatomyositis (CADM),especially their association with skin lesions and interstitial lung disease (ILD).Methods Enzyme-linked immunosorbent assay (ELISA) and cytometric beads array (CBA)were performed to detect the serum levels of interleukin (IL)-2,IL-4,IL-6,IL-10,IL-17A,IL-18,tumor necrosis factor (TNF) and interferon (IFN)-γin 40 patients with DM or CADM,as well as in 16 health checkup examinees (healthy control group).Then,the association of serum cytokine levels with skin lesions,inflammatory biomarkers and severity of ILD was analyzed.Results The patients with DM/CADM showed significantly higher serum levels of IL-6 (37.8 ±45.8 pg/ml),IL-10 (16.1 ± 7.2 pg/ml) and IL-18 (492.0 ± 193.1 pg/ml) compared with the healthy controls (12.0 ± 2.7 pg/ml,7.7 ± 1.4 pg/ml,191.1 ± 39.2 pg/ml,respectively,all P ＜ 0.001),and there were no significant differences in the serum levels of the other 5 cytokines between the above 2 groups.The serum level of IL-6 was significantly higher in patients with elevated erythrocyte sedimentation rate (ESR) than in those with normal ESR (49.7 ± 46.8 pg/ml vs.29.1 ± 45.4 pg/ml,P =0.008).The patients with raised C-reactive protein (CRP) levels showed significantly higher serum levels of IL-6 (68.7 ± 59.7 pg/ml) and IL-18 (635.1 ± 232.8 pg/ml) compared with those with normal CRP levels (IL-6:30.6 ± 40.3 pg/ml,P =0.013;IL-18:440.2 ± 164.7 pg/ml,P =0.020).Moreover,the patients with elevated levels of lactate dehydrogenase (LDH) showed significantly higher serum levels of IL-10 (18.4 ± 6.9 pg/ml),IL-17A (19.6 ±6.7 pg/ml) and IL-18 (529.4 ± 197.2 pg/ml) compared with those with normal LDH levels (IL-10:10.7 ±4.8 pg/ml,P ＜ 0.001;IL-17A:11.4 ± 6.6 pg/ml,P =0.001;IL-18:404.9 ± 158.0 pg/ml,P =0.037).No significant difference in the cytokine levels was observed between the patients with elevated creatine kinase (CK) levels and those with normal CK levels.The patients with Gottron's papules/sign showed significantly higher serum levels of IL-18 (513.7 ± 187.2 pg/ml) compared with those without Gottron's papules/sign (297.1 ± 140.4 pg/ml,P ＜ 0.05).The serum levels of IL-10 and IL-18 were significantly higher in the patients with DM/CADM complicated by ILD (18.0 ± 6.7 pg/ml,552.3 ± 192.8 pg/ml,respectively) than in those without ILD (11.6 ± 6.5 pg/ml,351.4 ± 101.0 pg/ml,respectively,both P =0.001).Conclusion Serum levels of IL-6,IL-10 and IL-18 are highly associated with inflammatory biomarkers,skin lesions and ILD in patients with DM/CADM.
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Objective To evaluate the clinical results of arthroscopic anatomical reconstruction of anterior talofibular ligament and calcaneofibular ligament for treatment of chronic ankle instability. Methods From June 2012 to August 2016, 27 patients with chronic ankle instability (28 ankles) were treated with arthroscopic anatomical reconstruction of anterior talofibular ligament and calcaneofibular ligament. All the patients were evaluated preoperatively and at the last follow-up using visual analogue scale (VAS) and American Orthopaedic Foot and Ankle Society (AOFAS) score. The talar tilt angle and anterior translation were assessed radiographically in pre- and postoperative ankle stress views.Results The operations lasted for 75.8 minutes (from 72 to 104 minutes). The 27 patients received a mean follow-up of 14.8 months (range, from 12 to 25 months). All the wounds healed by the first intention. No neurovascular complications were observed and no patient reported ankle stiffness or pain in motion. On average, the anterior talar trans-lation was reduced from 10.82 ± 3.32 mm preoperatively to 4.03 ± 1.70 mm at the last follow-up, the talar tilt angle decreased from 15.60°± 3.86°to 6.01°± 2.64°, the VAS pain score decreased from 5.79 ± 1.79 to 1.54 ± 1.35, and the AOFAS ankle-hindfoot score improved from 63.64 ± 11.20 to 90.21 ± 4.48. All the above differences were statistically significant (P <0.01). Conclusion Arthroscopic anatomical re-construction of anterior talofibular ligament and calcaneofibular ligament can improve function and stability of the ankle joint effectively, providing a valid option for treatment of chronic ankle instability.
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Objective:Through the closed loop management mode,it realized the whole process of material information could be traced back,especially in the medical business level.Methods:Based on the requirement of management accounting,the integrated accounting and business information were in accordance with management accounting.Results and Conclusion:It set up different management nodes in the closed loop of the materials,such as medicine,sanitary materials and test reagents,so as to get the relevant information.The problems of the extensive management of materials could be solved to improve the efficiency of the management of hospital materials.
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Day care is described in the paper in terms of its meaning and management.As to areas deserving attention given the initial success,the authors proposed to priortize medical insurance compensation policy,medical resource deployment,patient safety and follow-up for discharged patients.These efforts may further quality of care and patient satisfaction.