Comparison of suture bridge and conventional double-row suture in repair of full-thickness rotator cuff tear / 中华创伤骨科杂志

Objective To compare the suture bridge (SB) and conventional double-row (DR) suture in the repair of full-thickness rotator cuff tear.Methods From May 2013 through July 2016,48 patients with full-thickness rotator cuff tear were randomly divided into 2 even groups (n =24).SB group was repaired using the SB technique while DR group using conventional DR technique.The 2 groups were compared in terms of operation time,postoperative shoulder function scoring and incidence of re-tear.Results All the patients were followed up for 8 to 24 months (average,15.3 months).In DR group,the visual analogue scale (VAS) scores decreased from preoperative 6.3 ± 2.3 to 1.0 ± 0.4 at the last follow-up,the America Shoulder and Elbow Surgeons (ASES) scores increased from preoperative 49.3 ± 8.5 to 90.0 ± 2.5 at the last follow-up,and the Constant scores increased from preoperative 58.7 ± 12.5 to 88.1 ± 4.0 at the last follow-up.In SB group,the VAS scores decreased from preoperative 6.0 ± 1.9 to 0.9 ± 0.8 at the last follow-up,the ASES scores increased from preoperative 50.2 ± 6.2 to 89.5 ± 3.4 at the last follow-up,and the Constant scores increased from preoperative 57.3 ± 7.5 to 90.0 ± 3.2 at the last follow-up.All the comparisons showed a significant difference between preoperation and the last follow-up (P ＜ 0.05),but an insignificant difference between the 2 groups (P ＞ 0.05).SB group used significantly less operation time (74.5 ± 19.0 min) than DR group (86.5 ± 21.0 min),and reported significantly lower incidence of re-tear (4.2％) than DR group (25.0％) (P ＜ 0.05).Conclusions In arthroscopic repair of full-thickness rotator cuff tear,SB technique shows few therapeutic advantages over conventional DR technique,but the former needs less operation time and leads to lower incidence of re-tear.

Comparison of suture bridge and conventional double-row suture in repair of full-thickness rotator cuff tear / 中华创伤骨科杂志

Objective To compare the suture bridge (SB) and conventional double-row (DR) suture in the repair of full-thickness rotator cuff tear.Methods From May 2013 through July 2016,48 patients with full-thickness rotator cuff tear were randomly divided into 2 even groups (n =24).SB group was repaired using the SB technique while DR group using conventional DR technique.The 2 groups were compared in terms of operation time,postoperative shoulder function scoring and incidence of re-tear.Results All the patients were followed up for 8 to 24 months (average,15.3 months).In DR group,the visual analogue scale (VAS) scores decreased from preoperative 6.3 ± 2.3 to 1.0 ± 0.4 at the last follow-up,the America Shoulder and Elbow Surgeons (ASES) scores increased from preoperative 49.3 ± 8.5 to 90.0 ± 2.5 at the last follow-up,and the Constant scores increased from preoperative 58.7 ± 12.5 to 88.1 ± 4.0 at the last follow-up.In SB group,the VAS scores decreased from preoperative 6.0 ± 1.9 to 0.9 ± 0.8 at the last follow-up,the ASES scores increased from preoperative 50.2 ± 6.2 to 89.5 ± 3.4 at the last follow-up,and the Constant scores increased from preoperative 57.3 ± 7.5 to 90.0 ± 3.2 at the last follow-up.All the comparisons showed a significant difference between preoperation and the last follow-up (P ＜ 0.05),but an insignificant difference between the 2 groups (P ＞ 0.05).SB group used significantly less operation time (74.5 ± 19.0 min) than DR group (86.5 ± 21.0 min),and reported significantly lower incidence of re-tear (4.2％) than DR group (25.0％) (P ＜ 0.05).Conclusions In arthroscopic repair of full-thickness rotator cuff tear,SB technique shows few therapeutic advantages over conventional DR technique,but the former needs less operation time and leads to lower incidence of re-tear.

Roles of CD4 + CD25 + regulatory T cells and T helper 17 cells in the pathogenesis of Kawasaki disease / 中华实用儿科临床杂志

Objective To observe the changes in CD4 + CD25 + regulatory T cells(Treg) and T helper 17 cells (Th17) cells' proportions in the peripheral blood in children with Kawasaki disease(KD) before and after the treatment,and to analyze the role of Treg/Th17 cell imbalance in the pathogenesis of KD.Methods Fifty-two children with acute KD(KD group) and 34 age-matched healthy children(healthy control group) were selected at Jiangxi Provincial Children's Hospital from April to December of 2014.Morning peripheral vein blood was collected from 2 groups:one before the treatment by Immunoglobulin and Aspirin,and the other 3 days after defervescence treatment.Flow cytometry was used to detect proportions of Treg cells and Th17 cells in the peripheral blood.The enzyme linked immunosorbent assay was used to detect the levels of interleukin(IL)-6,IL-10,IL-17,IL-23 and transforming growth factor(TGF)-β.Results Proportion of Treg cells in the acute KD group was remarkably lower than that in the healthy control group [(1.48 ± 0.21) ％ vs.(5.13-± 0.32) ％,t =28.41,P ＜ 0.05],but it was significantly increased after treatment,and there was a significant difference [(4.71 ± 0.36) ％ vs.(1.48 ± 0.21) ％,t =-23.32,P ＜ 0.05].Proportion of Th17 cells in the acute KD group was markedly higher than that in the healthy control group [(8.06 ± 0.48) ％ vs.(2.65 ± 0.50) ％,t =-23.47,P ＜ 0.05],which was significantly decreased after treatment [(3.04 ±0.35) ％ vs.(8.06 ± 0.48) ％,t =25.55,P ＜ 0.05].Compared with the healthy control group,the levels of serum IL-6,IL-17,IL-23 in the acute KD group were significantly increased before treatment,and there were significant differences [(34.53 ± 0.53) ng/L vs.(10.88 ± 0.83) ng/L,t =-72.36;(57.05 ± 0.78) ng/L vs.(14.29 ± 0.98)ng/L,t =-55.29;(45.18 ± 1.52) ng/L vs.(18.25 ± 1.08) ng/L,t =-43.27;all P ＜ 0.05],but after treatment the levels were significantly decreased [(14.94 ± 1.06) ng/L vs.(34.53 ± 0.53) ng/L,t =49.63;(27.64 ± 0.91)ng/Lvs.(57.05±0.78) ng/L,t =26.49;(24.50-±1.13) ng/L vs.(45.18-±1.52) ng/L,t =32.17;allP＜0.05].The levels of serum IL-10,TGF-β in the acute KD group significantly decreased than those of the healthy control group,and there were significant differences [(14.29-± 0.64) ng/L vs.(29.57 ± 0.87) ng/L,t =42.24;(16.88 ±-0.90) ng/L vs.(38.83 ±0.84) ng/L,t =53.51;all P ＜0.05],but after treatment the levels were significantly increased,and there were significant differences [(23.01-± 0.61) ng/L vs.(14.29-± 0.64) ng/L,t =-29.54;(33.47±-0.82) ng/Lvs.(16.88±-0.90) ng/L,t=-40.68;allP＜0.05].Conclusion Imbalance betweenTreg cells and Th17 cells may be an important cause for the immune disorder of KD,the changes in related cytokines are involved in the pathogenesis of KD.

Efficacy of Tocilizumab in the treatment of systemic juvenile idiopathic arthritis / 中华实用儿科临床杂志

Objective To explore the efficacy and safety of Tocilizumab in the treatment of systemic juvenile idiopathic arthritis (sJIA)in children.Methods Twenty-four sJIA patients were collected who were hospitalized at the Department of Rheumatology and Immunity,Jiangxi Provincial Children's Hospital from October 2015 to May 2016,and they received Tocilizumab combined with Methotrexate (MTX) treatment for 12 weeks.The clinical laboratory and physiological indices,including routine blood,liver and kidney function tests,number of joints with active arthritis,number of joints with limited range of motion,physicians and patients assessment of disease activity,childhood health questionnaire,erythrocyte sedimentation rate(ESR),C-reactive protein (CRP),and compliance rates of Pediatrics of American College of Rheumatology(ACR Ped) 30,50,70 were observed after 4,8 and 12 weeks of treatment,and the adverse reactions were recorded.Results After 4 weeks of treatment,the levels of white blood cells,platelet,ESR and CRP in 24 cases of sJIA significantly decreased compared with those of the patients before treatment [(15.1 ± 2.7) × 109/L vs.(24.2 ±3.5) × 109/L,(277 ±73) × 109/L vs.(368 ± 62) × 109/L,(25 ± 12) mm/1 h vs.(75 ± 15) mm/1 h,(20 ± 13) mg/L vs.(64 ± 1) mg/L],and the differences were statistically significant (t =10.08,4.65,70.71,26.78,all P ＜0.05);the hemoglobin was increased dramatically[(110 ± 12) g/L vs.(98 ± 10) g/L],and the difference was statistically significant(t =-3.76,P ＜ 0.05).The compliance rates of ACR Ped 30,50,70 after 4 weeks of treatment were 82％,74％,68％,and they were continuously improved after 8 weeks of treatment (90％,82％,78％)and 12 weeks of treatment (98％,93％,92％),and the differences were all statistically significant (F =7.11,7.29,8.86,all P ＜0.05).The levels of IL-6 after 12 weeks of treatment had no significant change compared with those of the patients pre-treatment [(10.8 ±2.5) ng/L vs.(12.7 ±3.0) ng/L,t =1.96,P ＞0.05].Conclusion Tocilizumab is effective and safe in the treatment of sJIA patients,which can improve the symptoms,signs and laboratory inflammatory activity indexes of sJIA in a short time.

Role of DNA methyltransferases in the pathogenesis of neuropathic pain in rats / 中南大学学报(医学版)

OBJECTIVE@#To explore the role of DNA methyltransferases (DNMTs) in the pathogenesis of neuropathic pain (NPP) in rats following sciatic nerve chronic constriction injury (CCI).
@*METHODS@#A total of 27 adult male Sprague-Dawley rats with successful implantation of lumbar intrathecal catheter were randomly divided into 3 groups: a sham + normal saline group (sham+NS group), a CCI+NS group, and a CCI+5-azacytidine group (CCI+5-AZA group) (n=9 in each group). The rats in the Sham+NS group and the CCI+NS group received NS, while the rats in the CCI+5-AZA group received 10 μmol/L of 5-AZA (a DNMTs inhibition) once a day through spinal injection from the 3th day to 14th day after CCI surgery. Mechanical withdrawal threshold (MWT) and thermal withdrawal latency (TWL) of ipsilateral hinds in the 3 groups were measured before or at the 3th, 5th, 7th, 10th or 14th day after CCI surgery. At the end of experiments, all rats were killed under deep anesthesia and their lumbar spinal cords were dissected to examine the DNMT1, DNMT3a and DNMT3b expression by RT-PCR, Western blot and immunohistochemistry, respectively.
@*RESULTS@#Compared with the sham+NS group, the MWT and TWL in the CCI+NS group were obviously reduced from the 3th day to the 14th day after surgery (both P<0.05). Compared with the CCI+NS group, the MWT and TWL in the CCI+5-AZA group were obviously increased from the 5th day to the 14th day after surgery (both P<0.05), but they were still reduced compared with the sham+NS group (both P<0.05). The DNMT1, DNMT3a and DNMT3b were highly expressed in the lumbar spinal dorsal horn in all rats, and the positive signals were mainly located in the nucleus. The DNMT1, DNMT3a and DNMT3b levels in the CCI+NS group were increased significantly compared with that in the sham+NS group on the 14th day after surgery (all P<0.05). The DNMT1, DNMT3a and DNMT3b expressions in the CCI+ 5-AZA group were decreased significantly compared with that in the CCI+NS group (all P<0.05), but they still increased compared with that in the sham+NS group (all P<0.05). 
@*CONCLUSION@#Up-regulation of DNMTs in the lumbar spinal may play an important role in the pathogenesis of NPP in CCI rats. DNMTs inhibitors (5-AZA) could reduce expression of DNMTs and attenuate CCI-induced NPP, which might be a potential therapeutic drug for NPP.

Activation of Wnt signaling pathway in the neuronal differentiation of bone marrow mesenchymal stem cells：a microarray analysis / 中国组织工程研究

BACKGROUND:It wil provide a new insight into the future application of bone marrow mesenchymal stem cels in the treatment of spinal cord injury and tissue engineering by studying the effect of activation of Wnt signaling pathway in the neuronal differentiation of bone marrow mesenchymal stem cels. OBJECTIVE: To detect the expression of related genes by gene chip technology during the neuronal differentiation of bone marrow mesenchymal stem cels. METHODS:Human bone marrow mesenchymal stem cels were isolated and purified, and passage 5 cels were obtained. GatewayTM technology was used to build lentiviral vectors that was used to transfect Wnt-1 into human bone marrow mesenchymal stem cels. Control, non-transduction and transduction groups were set in this study. Human bone marrow mesenchymal stem cels were then induced to differentiate into neurons. Cel morphology was observed under inverted phase contrast microscope. Gene chip was used to detect the regulation changes and the differential expression of related genes in the Wnt signaling pathway. RESULTS AND CONCLUSION: Under the scanning electron microscope, the transfected cels were found to have the similar morphology of neuron-like cels. Analysis by the gene chip hybridization technique showed that 3 287 genes were up-regulated and 4 215 genes were down-regulated in the signal pathway. In the Wnt signaling pathway, genes related to the nervous system development and differentiation were up- or down-regulated. It is verified that the Wnt signal pathway is activated via Wnt-1 transduction, and the downstream genes appear to have genetic transcription so as to promote the neuronal differentiation of human bone marrow mesenchymal stem cels.

Library space design / 中华医学图书情报杂志

After a description of the history, the opening, integrative, flexible and pluralistic trends, the principles and technological process of library space design, a case of library space design was analyzed with The Library of Zhejiang University as an example.

Investigation on Clonorchis sinensis infection and its risk factors in Futian District,Shenzhen City / 中国血吸虫病防治杂志

Objective To understand the status of Clonorchis sinensis infection and its risk factors in Futian District Shen?zhen City so as to provide the evidence for formulating the strategy of prevention and control. Methods Two monitoring points were randomly selected and the permanent population aged≥3 years were investigated and their stool samples were detected for the eggs of C. sinensis by using Kato?Katz technique. Meanwhile the risk factors of infection were also investigated. Results A total of 743 subjects were examined and 7 persons were infected with C. sinensis and the infection rate was 0.94%. Most of the infected cases were focused on 20?40 and 40?60 age groups. The risk factors were eating raw or semi?cooked fish and the protec?tive factor was the use of separated cutting board for cooked or uncooked food. Conclusion The infection rate of C. sinensis is low in the population of Futian District. However the health education especially for diet health education still should be strengthened.

Clinical observation of noninvasive ventilation in the treatment of patients with acute exacerbations of chronic obstructive pulmonary disease / 中国基层医药

Objective To investigate the therapeutic effect of non-invasive positi e pressure ventilation (NIPPV) in the treatment of patients with acute exacerbations of chronic obstructive pulmonary disease(AECOPD).Methods 68 AECOPD patients with type Ⅱ repiratory failure were randomly divided into control group and treatment group.The control group was treated by conventional therapy alone and the treatment group was given conventional therapy combined with NIPPV.The levels of power of hydrogen (pH),partial pressure of carbon dioxide in artery(PaCO2),arterial oxygen tension(PaO2),heart rate and repiratory rate were compared between the two groups.The mean length of patient stay,the frequency of tracheal intubation and the hospital mortality were analyzed after discharge from the hospital.Results Before treatment,the arterial blood gas analysis showed that the pH,PaCO2 and PaO2 had no significant differences between the two groups(all P ＞ 0.05).After treatment,compared with the control group,the levels of pH,PaCO2 and PaO2 were obviously improved(all P ＜0.05).The mean length of patients stay in the treatment group was significantly shorter than the control group(P ＜ 0.05).The frequency of tracheal intubation of the treatment group was significantly lower than the control group(P ＜ 0.05).The hospital mortality was lower in the treatment group,but the difference between the two groups was not significant (P ＞ 0.05).Conclusion NIPPV for treating the AECOPD can improve the arterial blood gas analysis,decrease the need of tracheal intubation and shorten hospitalization time.

Instant reimbursement practice under the NRCMS in Fujian Province / 中华医院管理杂志

The new rural cooperative medical system(NRCMS)is a significant breakthrough for people's wellbeiug as emphasized by the government in the new century.To better the system and further the social and economic development,the instant reimbursement practice came into being under the NCRMS.The article introduced the background and implementation of the practice at provincial and municipal level at designated medical institutions in Fujian province.It also analyzed the benefits and initial outcomes of the practice for peasants at large,and proposed remedies for setbacks found in the practice of NRCMS.

Research on risk factors and pathogens of ventilator associated pneumonia / 中国基层医药

ObjectiveTo study the risk factors and pathogenic characteristics of ventilator associated pneumonia(YAP). MethodsRisk factors of VAP,pathogens and drug resistance in 118 patients in ICU were analyzed retrospectively. ResultsThe incidence of VAP was 44.9％, and age, the mechanical ventilation time, state of consciousness,tracheotomy,the antibiotic combination are risk factors of incidence of VAP. 53cases of VAP(68.2％ )were infected by Gram negative bacilli,25.9％ were by Gram positive cocci,and 5.9％ were by fungi. Drug resistance was observed obviously. ConclusionThe occurrence of VAP was related with multiple factors. The gram negative bacteria are the major pathogens of VAP, and the rate of drug resistance was high. The occurrence of VAP could severely affect patients' prognosis.