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OBJECTIVE@#To analyze the femoral head collapse and the operation of osteonecrosis of the femoral head (ONFH) in different Japanese Investigation Commitee (JIC) types, in order to summarize the prognostic rules of each type of ONFH, and explore the clinical significance of CT lateral subtypes based on reconstruction of necrotic area of C1 type and verify their clinical effect.@*METHODS@#A total of 119 patients (155 hips) with ONFH between May 2004 and December 2016 were enrolled in the study. The total hips consisted of 34 hips in type A, 33 in type B, 57 in type C1, and 31 in type C2, respectively. There was no significant difference in age, gender, affected side, or type of ONFH of the patients with differenct JIC types ( P>0.05). The 1-, 2-, and 5-year femoral head collapse and operation of different JIC types were analyzed, as well as the survival rate (with femoral head collapse as the end point) of hip joint between different JIC types, hormonal/non-hormonal ONFH, asymptomatic and symptomatic (pain duration >6 months or ≤6 months), and combined preserved angle (CPA) ≥118.725° and CPA<118.725°. JIC types with significant differences in subgroup surgery and collapse and with research value were selected. According to the location of the necrotic area on the surface of the femoral head, the JIC classification was divided into 5 subtypes in the lateral CT reconstruction, and the contour line of the necrotic area was extracted and matched to the standard femoral head model, and the necrosis of the five subtypes was presented by thermography. The 1-, 2-, and 5-year outcomes of femoral head collapse and operation in different lateral subtypes were analyzed, and the survival rates (with collapse of the femoral head as the end point) between CPA≥118.725° and CPA<118.725° hip in patients with this subtype were compared, as well as the survival rates of different lateral subtypes (with collapse and surgery as the end points, respectively).@*RESULTS@#The femoral head collapse rate and operation rate in the 1-, 2-, and 5-year were significantly higher in patients with JIC C2 type than in patients with other hip types ( P<0.05), while in patients with JIC C1 type than in patients with JIC types A and B ( P<0.05). The survival rate of patients with different JIC types was significantly different ( P<0.05), and the survival rate of patients with JIC types A, B, C1, and C2 decreased gradually. The survival rate of asymptomatic hip was significantly higher than that of symptomatic hip, and the survival rate of CPA≥118.725° was significantly higher than that of CPA<118.725° ( P<0.05). The lateral CT reconstruction of type C1 hip necrosis area was selected for further classification, including type 1 in 12 hips, type 2 in 20 hips, type 3 in 9 hips, type 4 in 9 hips, and type 5 in 7 hips. There were significant differences in the femoral head collapse rate and the operation rate among the subtypes after 5 years of follow-up ( P<0.05). The collapse rate and operation rate of types 4 and 5 were 0; the collapse rate and operation rate of type 3 were the highest; the collapse rate of type 2 was high, but the operation rate was lower than that of type 3; the collapse rate of type 1 was high, but the operation rate was 0. In JIC type C1 patients, the survival rate of the hip joint with CPA≥118.725° was significantly higher than that with CPA<118.725° ( P<0.05). In the follow-up with femoral head collapse as the end point, the survival rates of types 4 and 5 were all 100%, while the survival rates of types 1, 2, and 3 were all 0, and the difference was significant ( P<0.05). The survival rate of types 1, 4, and 5 was 100%, of type 3 was 0, and of type 2 was 60%, showing significant difference ( P<0.05).@*CONCLUSION@#JIC types A and B can be treated by non-surgical treatment, while type C2 can be treated by surgical treatment with hip preservation. Type C1 was classified into 5 subtypes by CT lateral classification, type 3 has the highest risk of femoral head collapse, types 4 and 5 have low risk of femoral head collapse and operation, type 1 has high femoral head collapse rate but low risk of operation; type 2 has high collapse rate, but the operation rate is close to the average of JIC type C1, which still needs to be further studied.
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Humans , Femur Head/surgery , Femur Head Necrosis/surgery , Retrospective Studies , Hip Joint , Tomography, X-Ray ComputedABSTRACT
Sclerostin, a protein secreted from osteocytes, negatively regulates the WNT signaling pathway by binding to the LRP5/6 co-receptors and further inhibits bone formation and promotes bone resorption. Sclerostin contributes to musculoskeletal system-related diseases, making it a promising therapeutic target for the treatment of WNT-related bone diseases. Additionally, emerging evidence indicates that sclerostin contributes to the development of cancers, obesity, and diabetes, suggesting that it may be a promising therapeutic target for these diseases. Notably, cardiovascular diseases are related to the protective role of sclerostin. In this review, we summarize three distinct types of inhibitors targeting sclerostin, monoclonal antibodies, aptamers, and small-molecule inhibitors, from which monoclonal antibodies have been developed. As the first-in-class sclerostin inhibitor approved by the U.S. FDA, the monoclonal antibody romosozumab has demonstrated excellent effectiveness in the treatment of postmenopausal osteoporosis; however, it conferred high cardiovascular risk in clinical trials. Furthermore, romosozumab could only be administered by injection, which may cause compliance issues for patients who prefer oral therapy. Considering these above safety and compliance concerns, we therefore present relevant discussion and offer perspectives on the development of next-generation sclerostin inhibitors by following several ways, such as concomitant medication, artificial intelligence-based strategy, druggable modification, and bispecific inhibitors strategy.
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Objective@#To explore the effect of long term aerobic exercise on microcirculation function and VO 2max of college students, and to explore the relationship between microcirculation function and VO 2max .@*Methods@#Seventy sports major college students were selected as the exercise group, 70 sedentary non sports major students were selected as the control group. PF6000 dual channel laser Doppler blood flow detector was used to assess the skin microcirculation function on the quadriceps femoris muscle of the subjects right lower limbs.The PFT Ergo cardiopulmonary function test system and the equipped power bicycle were used to measure the VO 2max of the subjects.@*Results@#The baseline value of MBP in the exercise group was significantly lower than that in the control group (6.5±1.8 vs. 8.1±2.5), but the microvascular reactivity(1 666.3±588.6 vs. 1 165.2±407.1) was significantly higher than that in the control group(t =-3.42，4.46， P <0.01). The absolute value of VO 2max (2 684.8±451.1 vs. 2 474.4±423.5) and relative value (42.7±4.3 vs. 35.1±4.8) in exercise group were significantly higher than those in control group( t =2.16，3.25， P < 0.01 ). Multiple regression showed that there was a positive correlation between microvascular reactivity and VO 2max (relative value) ( β = 0.40 , P =0.03), but no significant correlation between percutaneous oxygen partial pressure and VO 2max (relative value) ( β= 0.23 , P =0.19).@*Conclusion@#Long term physical exercise can decrease microcirculation perfusion volume, improve microvascular reactivity, percutaneous oxygen partial pressure among college students. Improvement of the microvascular reactivity may be a sport improving VO 2max (relative) one of the most important peripheral physiological mechanism.
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Ganoderma lucidum is a traditional folk common rare medicinal herb, which plays an important role in maintaining human health. Among them, G. lucidum polysaccharide is one of the main bioactive components of G. lucidum, which has various pharmacological effects such as anti-cancer, immunomodulatory, antibacterial, antioxidant, and scavenging free radicals. Due to the complex etiology and pathogenesis of central nervous system diseases, the clinical manifestations are diverse, and the individual response to treatment varies widely, which brings great challenges to clinical treatment. The characteristics and mechanism of the central neuroprotective effect of G. lucidum polysaccharide are reviewed in this paper from the aspects of Alzheimer's disease, anti-epileptic, modulating microglia inflammatory response, etc., in order to provide relevant evidence for its clinical application.
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Objective:To evaluate the effect of general practice service based on network platform in health management of patients with multiple chronic conditions (MCC).Methods:Based on network platform, the general practitioners provided health management service for 626 MCC patients in a petrochemical company in Panjin city of Liaoning province from June 2015 to June 2016. The individualized health management plan included health counseling, diet and exercise guidance, health information delivery, health file establishment, and rational medication guidance. After intervention the patient activeness, quality of life, clinical variables were evaluated.Results:Ninety participants dropped out of study (14.38%, 90/626), the questionnaire survey was conducted in rest 536 participants. After 1-year intervention, the scores of physical functioning, role-physical, general health, vitality, social functioning, role-emotional, mental health, and total scores in SF-36 were significantly increased ( F=12.350, 13.215, 10.515, 29.114, 42.972, 10.951, 89.783 and 33.311, respectively, all P<0.05); the values of BMI, waist, systolic and diastolic blood pressure, total cholesterol, triglycerides, low density lipoprotein cholesterol, fasting blood glucose were significantly decreased( F= 30.039, 33.849, 7.152, 27.453, 59.938, 214.270, 73.488 and 62.014, respectively, all P<0.05); the values of high density lipoprotein cholesterol were markedly increased ( F=16.491, P<0.01); the overall scores of activation were increased ( F=9.471, P<0.01), the level of activation was changed (χ 2=16.183, P<0.05); but there was no change in body pain ( F=1.486, P=0.227). There was a weak correlation between patient activation and the general health ( r=0.099, P=0.013), vitality ( r=0.101, P=0.011), mental health ( r=0.099, P=0.013). Conclusion:General practice service based on network platform is feasible and effective for patients with multiple chronic conditions, after the implementation, the activation and the health outcomes are improved significantly.
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Objective:To investigate the compliance of statins and influencing factors in population with cardiovascular risks in the community.Methods:One hundred and eighty-six residents with cardiovascular disease risks in a community of Tianjin were recruited from June 2017 to October 2017. The Chinese revised version of the compliance Morisky scale was used to assess the compliance, and the influencing factors were analyzed.Results:Among all subjects 119 were prescribed with statins (64.0%,119/186) , of whom 7.6% (9/119) did not take the drug. According to the risk assessment of arteriosclerotic cardiovascular disease (ASCVD) in the next 10 years, among the 110 subjects taking the medicine, there were 18 subjects with intermediate risk and 92 with high risk. The subjects with good compliance accounted for 30.0% (33/110), and those with poor compliance accounted for 70.0% (77/110). Univariate analysis showed that education level, occupation, and drug types were significantly associated with statin compliance ( P<0.05). Multivariate logistic regression analysis showed that higher education level and fewer total drug users were correlated with better compliance ( OR=3.530 and 0.388, P<0.05) . The reasons for subjects not taking medicine were fearing of adverse reactions ( n=6, 6/9) , and thinking no symptoms and no need to have medication ( n=3, 3/9).The reasons of poor medication adherence were thinking no symptoms and no need to have medication ( n=31, 40.2%), thinking ineffectiveness of medication ( n=28, 36.4%), fearing of adverse reactions ( n=16, 20.8%), and economic pressure ( n=2, 2.6%). Conclusions:The proportion of residents with poor compliance of statins is high in the community. It is suggested that targeted interventions and standardized management for subjects with cardiovascular risks should be conducted based on the related factors found in the study.
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Purpose To evaluate the clinical guiding value of 99Tcm-methoxyisobutylisonitrile gated myocardial perfusion imaging (99Tcm-MIBI G-MPI) in diagnosing the coronary microangiopathy in patients with diabetic mellitus.Materials and Methods Sixty patients with clinical confirmed coronary microvascular angina were selected and assigned into two groups,with 26 patients (with diabetes mellitus) in group A and 34 patients in group B (without diabetes mellitus).The region,extent and range of coronary microangiopathy was detected by 99Tcm-MIBI G-MPI,and the difference of myocardial ischemia between the two groups was statistically analyzed.Results The ratio of abnormal myocardial perfusion in group A was significantly higher than that in group B (96.15％ vs.73.53％,x2=5.43,P＜0.05);the total number of abnormal coronary branches in group A was significantly larger than that in group B (82.67％ vs.62.67％,P＜0.05);the total number abnormal perfusion segments in group A was significantly larger than that in group B (P＜0.05),and the abnormal perfusion segments number of anterior wall,septum,apical region and inferior wall in group A was significantly larger than that ingroup B (P＜0.05);the rate of abnormal perfusion at single coronary supplying region in group A was significantly lower than that in group B (P＜0.05).Conclusion 99Tcm-MIBI G-MPI is of great clinical significance for diagnosing coronary microangiopathy and evaluating myocardial ischemia in patients with diabetes mellitus.
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Objective To investigate characteristics of abnormal eating behaviors in patients with Alzheimer's disease and explore the potential needs of the patients.Methods Based on the model of Need-driven Dementiacompromised Behavior (NDB),we used the list of eating behaviors in patients with Alzheimer's disease to observe and record the behaviors of 120 patients and extracted the characteristics of abnormal eating behaviors.Twelve caregivers were selected to participate in the individual in-depth interview using semi-structured interview method,and then 5 of them were involved in the focus group interview for richness and accuracy.Content analysis was used to analyze data.Results Abnormal eating behaviors were identified in 47.5％(57/120) of the patients with Alzheimer's disease.The most common abnormal eating behavior was verbal refusal to eat or stating "No more","Not hungry","I'm fu11"(64.9％),the second was spiting food out(63.2％),the simultaneous items were impatient behaviors prior to or during meal time(38.6％),being distracted from eating(38.6％),resisting help with meal(38.6％),refusal to open mouth (38.6％).Four potential needs were extracted,including desire for family,desire for companion,desire for eating dignity,and eagerness for a sense of inner security.Conclusion It is common for patients with Alzheimer's disease to show abnormal eating behaviors,which demonstrate their potential needs.Caregivers need to be trained to identify the abnormal behaviors of patients and reflected potential needs.Those needs should be met to improve patients' quality of care,and reduce burdens of caregivers.
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Objective To make the scale for the compliance of patients with chronic obstructive pulmonary disease (COPD) during home oxygen therapy.Methods By literature searching,semi-structured interview,expert consultation,as well as pre test,the tentative scale was formed at first.Then the investigation was conducted among 324 patients with COPD selected.Finally the scale was formed by testing the reliability and validity.Results The scale was made up of two dimensions with 16 items in total.It showed that Cronbach α coefficient was 0.984,split-half reliability was 0.976,and content validity index was 0.98.The exploratory factor analysis combined with AMOS 7.0 confirmatory factor analysis was used for construct validity of the home oxygen therapy compliance scale.Conclusions The self-management behavior scale for patients with COPD shows good reliability and validity,which can be used to evaluate the compliance during home oxygen therapy and provide reference tool for COPD patients' family intervention.
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The methylcytosine dioxygenases TET proteins (TET1, TET2, and TET3) play important regulatory roles in neural function. In this study, we investigated the role of TET proteins in neuronal differentiation using Neuro2a cells as a model. We observed that knockdown of TET1, TET2 or TET3 promoted neuronal differentiation of Neuro2a cells, and their overexpression inhibited VPA (valproic acid)-induced neuronal differentiation, suggesting all three TET proteins negatively regulate neuronal differentiation of Neuro2a cells. Interestingly, the inducing activity of TET protein is independent of its enzymatic activity. Our previous studies have demonstrated that srGAP3 can negatively regulate neuronal differentiation of Neuro2a cells. Furthermore, we revealed that TET1 could positively regulate srGAP3 expression independent of its catalytic activity, and srGAP3 is required for TET-mediated neuronal differentiation of Neuro2a cells. The results presented here may facilitate better understanding of the role of TET proteins in neuronal differentiation, and provide a possible therapy target for neuroblastoma.
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Animals , Mice , Catalytic Domain , Cell Differentiation , Physiology , Cell Line, Tumor , DNA-Binding Proteins , Genetics , Metabolism , Enzyme Inhibitors , Pharmacology , GTPase-Activating Proteins , Genetics , Metabolism , Immunohistochemistry , Microscopy, Fluorescence , Neuroblastoma , Metabolism , Pathology , Protein Isoforms , Genetics , Metabolism , Proto-Oncogene Proteins , Genetics , Metabolism , RNA Interference , RNA, Messenger , Metabolism , RNA, Small Interfering , Metabolism , Valproic Acid , PharmacologyABSTRACT
<p><b>OBJECTIVE</b>To Evaluate four kits for screening HIV antibody by comparing and analyzing the HIV antibody screening positive results and Western Blot (WB) test results.</p><p><b>METHODS</b>From January 2004 to June 2009, three ELISA kits (Zhongshan, Biomérieux and Livzon) were used for initial screening HIV antibody. The reactive positive samples were reexamed by initial ELISA kit and a rapid kit (Abbot Determine HIV-1/2). All repeatedly reactive positive screening results were followed by WB test.</p><p><b>RESULTS</b>A total of 193 (0.094%) WB confirmed positive results were obtained from 206 151 specimens. The sensitivities and predictive values of negative test result (PVN) of three ELISA kits were all 100% and those of Abbot Determine HIV-1/2 were 93.93%, and 91.67% respectively. All false negative results from Abbot were WB indeterminate. The specificities of Zhongshan, Biomérieux, Livzon and Abbot were 99.88%, 99.89%, 99.96% and 89.38%; the study predictive values of a positive test result (PVP) were 35.58%, 46.46%, 76.61% and 92.20%; the efficiencies were 99.88%, 99.89%, 99.96% and 91.98%; the areas under ROC curve of the three ELISA kits were 0.93, 0.99, and 0.95 respectively. PVP of Livzon was obviously higher than those of Zhongshan (chi(2) = 45.804, P = 0.000), Biomérieux (chi(2) = 25.231, P = 0.000) and Biomérieux was higher than Zhongshan (chi(2) = 2.488, P = 0.115). PVP of Abbot was highest (chi(2) = 18.633, P = 0.000, vs Livzon). There were some specimens with S/CO (optical density of sample/cut off) ratio < 6 or > or = 6 in all three groups with positive, indeterminate and negative WB results. The S/CO ratio from Zhongshan in confirmed positive group (14.29 + or - 2.63) was higher than in positive-negative group (2.80 + or - 3.25) (t = 17.652, P = 0.000). The S/CO ratio from Biomérieux in confirmed positive group(16.09 + or - 2.35) was higher than in positive-negative group (2.14 + or - 1.91) (t = 31.622, P = 0.000). The S/CO ratio from Livzon in confirmed positive group (11.54 + or - 1.95) was higher than in positive-indeterminate group (5.54 + or - 3.57) (t = 6.386, P = 0.000), positive-negative group (3.25 + or - 2.41) (t = 21.772, P = 0.000) and positive-indeterminate group was higher than positive-negative group (t = 2.301, P = 0.033).</p><p><b>CONCLUSION</b>The performances of four HIV antibody screening kits are good but estimating WB confirming result in line with S/CO ratio is not available. All repeated screening positive results should be followed by confirmatory tests.</p>
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Humans , AIDS Serodiagnosis , Methods , Blotting, Western , Methods , Enzyme-Linked Immunosorbent Assay , Methods , HIV Antibodies , Blood , HIV Seropositivity , Diagnosis , Indicators and Reagents , Mass Screening , Reagent Kits, Diagnostic , Sensitivity and SpecificityABSTRACT
OBJECTIVE: To investigate the clinical efficacy of self-made 32P applicator for treating different kinds of keloid. others were treated with surgical excision combined with self-made 32P applicator. The 32P applicator was shaped according to the size and shape of the diseased region and the application time was calculated according to the dose rate and the decay correction. 4.0-5.0 Gy was applied in every diseased region in each of the four days (one course), and 4-6 courses in total was required, with 4 weeks of intervals following each course. For children, dose was reduced to 4 Gy or less once a day in every diseased region. Patients in the operation combined with application group were performed keloids excision first. Then 32P applicators were applied to the wound without any exudation in the same way as above. RESULTS: Of all the 39 patients (lesion thickness≤0.3 cm, 32P applicator therapy only), 32 ones was cured (82.1%), with the total effective rate of 98%. For patients with lesion thickness > 0.3 cm, the total effective rate of 32P applicator therapy and surgical excision combined with self-made 32P applicator were 55.6% and 93.3% respectively, and the difference was ofsignificance (P < 0.01 ). Among these patients, those with disease course less than 9 months had the effective rates of 25.0% and75.0% corresponding to 32P applicator therapy only and surgical excision combined with self-made 32p applicator respectively.For those with long course of disease, the effective rates were 13% and 77% respectively. A total of 26 patients experienced local buming and slight pain during the 32P applicator treatment, and all the symptoms were relieved by using calamine lotion; 5 patients and 2 patients expedencad grade Ⅰ and Ⅱ radio dermatitis respectively, which were relieved by using Mupirocin Ointment. No radio dermatitis of grade Ⅲ or above occurred to any patient. In addition, pigmentation or color changing occurred at local skins of cured patients.CONCLUSION: 32P applicator therapy is safe and effective for treating keloid. For patients with short disease course and lesion thickness ≤0.3 cm, 32P applicator therapy only is enough. Otherwise, patients are suggested to use 32P applicator after operation.
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Objective To investigate the clinical value of 99m Tc-HL91 hypoxia imaging in the diagnosis and treatment of lung cancer. Methods 99m Tc-HL91 hypoxia imaging was performed in 72 patients with primary lung cancer. The qualitative analysis and semi-quantitative analysis of the early and delayed images were also performed. 65 patients underwent chemotherapy were divided into 2 groups by the T/N value of delayed images, and the curative efficacy in both the two groups was compared. Results The sensitivity of 99m Tc-HL91 hypoxia imaging for diagnosing lung cancer was 86 1% in early imaging and 98 6% in delayed imaging. The results of semi-quantitative analysis in different pathological types of lung cancer hadn’t obvious difference. The curative efficacy of the patients with low uptake was better than that of the patients with high uptake in 65 patients underwent chemotherapy, difference of which had significant(P
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Objective To analyze the curative effects in hyperthyroidism radioiodine treatment which using different methods to measure thyroid weight in order to calculate therapeutic dose.Methods 265 hyperthyroidism underwent radioiodine treatment,then they were divided into 4 groups.Calculating therapeutic dose was done according to SPECT tomography,nuclear plane imaging,ultrasonography and palpation to measure thyroid weight.We Compared and analyzed the curative effects after 6 months.Results The curative effects of 4 groups had obviously difference(P
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Objective To investigate the value of ~(99m)Tc-HL91 hypoxia imaging,~(99m)Tc-MIBI tumoraffin and computered tomography(CT) in the diagnosis of lung cancer.Methods The ~(99m)Tc-HL91 hypoxia imaging,~(99m)Tc-MIBI tumoraffin and CT were performed in 50 patients with lung neoplasm confirmed by pathology.Results There was not significant difference in the sensitivity of three imaging examination methods.The specificity of ~(99m)Tc-HL91 hypoxia imaging was obviously higher than that of ~(99m)Tc-MIBI tumoraffin and CT.The accuracy of ~(99m)Tc-HL91 hypoxia imaging was higher than that of ~(99m)Tc-MIBI tumoraffin,and had not significance difference with that of CT.The sensitivity,specificity and accuracy of the combination of three imaging examination methods in the diagnosis of lung cancer were 96.9%,100% and 98%,respectively.Conclusion The ~(99m)Tc-HL91 hypoxia imaging is valuable in diagnosing lung cancer and the diagnostic accuracy may be further improved with the combination of ~(99m)Tc-MIBI tumoraffin and CT.