Tibial transverse bone transport assisted by nose ring drainage for treatment of foot and ankle chronic osteomyelitis / 中华创伤骨科杂志

Objective:To investigate the clinical effects of tibial transverse bone transport assisted by nose ring drainage (NRD) in the treatment of foot and ankle chronic osteomyelitis.Methods:A retrospective study was conducted to analyze the data of 32 patients with foot and ankle chronic osteomyelitis who had been treated at Department of Orthopedics, Beijing Rehabilitation Hospital from March 2013 to February 2022. The patients were assigned into a study group and a control group. In the control group, there were 12 males and 3 females, aged (39.5±8.8) years. The osteomyelitis was located at the distal tibia in 4 cases, at the talus in 1 case, at the calcaneus in 2 cases, at the midfoot in 4 cases and at the forefoot in 4 cases. According to the Crerny-Mader classification, there were 5 cases of type Ⅰ and 10 cases of type Ⅱ. The control group was treated with Ilizarov transverse tibial bone transport in combination with thorough debridement and anti-infection therapy. In the study group, there were 12 males and 5 females, aged (42.3±13.4) years. The osteomyelitis was located at the distal tibia in 4 cases, at the talus in 1 case, at the calcaneus in 3 cases, at the midfoot in 5 cases and at the forefoot in 4 cases. According to the Crerny-Mader classification, there were 7 cases of type Ⅰ and 10 cases of type Ⅱ. The study group was treated with NRD drainage in addition to the procedures in the control group. The curative effects were evaluated by comparing the cure, recurrence, amputation (toe amputation), antibiotic use time, wound healing time, relevant inflammatory indicators [WBC, neutrophil percentage (NEU), erythrocyte sedimentation rate (ESR), procalcitonin, interleukin-6 (IL-6), C-reactive protein (CRP)], and postoperative functional recovery between the 2 groups.Results:The 2 groups were comparable because there was no statistically significant difference in the general data between them ( P>0.05). The follow-up period was (36.0±9.8) months. There was no significant difference between the 2 groups in the cure or amputation (toe amputation) ( P>0.05), but the recurrence rate in the study group was significantly lower than that in the control group ( P<0.05). The antibiotic use time [(20.7±3.6) d] and wound healing time [(88.3±17.1) d] in the study group were significantly shorter than those [(37.9±6.5) d and (102.2±22.6) d] in the control group ( P<0.05). The ESR, IL-6 and CRP at 1 week after operation in the study group were significantly lower than those in the control group ( P<0.05), but there was no significant difference between the 2 groups in the WBC, NEU or PCT at 1 week after operation ( P>0.05). There was no significant difference either in the inflammatory indicators between the 2 groups at 1 month after operation ( P>0.05). In all patients, the inflammatory indicators like WBC, NEU, ESR, PCT, IL-6 and CRP at 1 week and 1 month after operation were significantly better than those before operation, and the Maryland foot functional score at 12 months after operation was significantly higher than the preoperative one ( P<0.05). There was no significant difference between the 2 groups in the Maryland foot functional score at 12 months after operation ( P>0.05). Conclusion:In the treatment of foot and ankle chronic osteomyelitis, compared with the Ilizarov transverse tibial bone transport, our tibial transverse bone transport assisted by NRD can achieve satisfactory therapeutic effects, shorten antibiotic use time and treatment cycle, and reduce recurrence rate.

Clinical effect of periacetabular osteotomy in the treatment of hip dysplasia / 中国综合临床

Object:To explore the clinical effect of periacetabular osteotomy (PAO) in the treatment of developmental dysplasia of hip (DDH).Methods:The clinical data of 305 patients with DDH admitted to Tangshan Second Hospital from January 2012 to June 2018 were analyzed retrospectively. All patients were treated with PAO alone. There were 123 cases of left hip dysplasia, 131 cases of right hip dysplasia and 51 cases of double hip dysplasia (356 hips in total). The patients underwent X-ray examination before and on the second day after operation to compare the acetabular index and the lateral center edge angle (LCEA) and the anterior center edge angle (ACEA) of the acetabulum before and after operation. The ability of daily living and hip joint function were evaluated before and 6 months after operation, and Barthel index and Harris score of hip joint were compared before and after treatment. The measurement data with normal distribution are expressed in xˉ± s, and the paired t test was used for comparison before and after operation. The measurement data of non-normal distribution is expressed by M( Q1, Q3), and the comparison before and after surgery is performed by the rank sum test. Results:On the second day after operation, the LCEA and ACEA of 356 hip joints in 305 patients were greater than those before operation (32.5(20.0,47.5)° vs 8.5(-18.5 23.0)°, 29.0(18.5,52.3)° vs 2.5(-20.8, 24.5)°), while the acetabulum index was lower than that before operation (6.7(-8.4,12.5)° vs 26.8(10.0, 62.3)°), and the differences were statistically significant ( Z values were 51.50, 45.37, 32.22, all P<0.001). After 6 months of follow-up, the Barthel score and Harris score of the hip joint were higher than those before the operation (92.5±1.3) scores vs (65.6±1.5) scores, (96.4±2.5) scores vs (85.1±1.3) scores, and the difference was statistically significant ( t values were 335.56 and 89.70, both P<0.001). Conclusions:PAO can make the acetabulum cover the femoral head well through acetabular transposition, improve the ability of daily living and hip joint function of DDH patients, reduce pain, increase joint range of motion, and correct limb deformities. It is an effective means to treat DDH.

Efficacy of Shugan Lidan Decoction in Treating Acute Calculous Cholecystitis and Analysis of Its Mechanism Based on Network Pharmacology / 中国实验方剂学杂志

Objective:To explore the clinical efficacy of Shugan Lidan decoction（SLD） combined with laparoscopic cholecystectomy on acute calculous cholecystitis（ACC），and explore its mechanism based on network pharmacology. Method:In a retrospective analysis， 121 patients with ACC were divided into laparoscopic cholecystectomy+SLD group （observation group， 68 cases） and laparoscopic cholecystectomy group（control group，53 cases）. The postoperative recovery of the patients （time to first exhaust，time to temperature recovery，antibiotic use time and hospitalization time），serum inflammatory factor levels ［white blood cell count（WBC），C-reactive protein（CRP），interleukin-6（IL-6）］，immune index levels［claster of differentiation（CD）3⁺，CD4⁺/CD8⁺，immunoglobulin M（IgM）］ and safety were compared between these two groups. The TCMSP，BATMAN-TCM and TCMIP databases were used to collect all chemical components and targets of SLD. GeneCard and OMIM databases were combined to search ACC-related targets，and then the intersection ones of SLD-related targets and ACC-related targets were extracted to obtain the potential action targets of SLD for treatment of ACC. The STRING database platform was used to establish and analyze the protein-protein interaction （PPI） network，and Bioconductor software package was used for Kyoto encyclopedia of genes and genomes（KEGG） pathway enrichment of the targets. Result:The time to first exhaust，antibiotic use time and hospitalization time of observation group were shorter than those of control group，and the differences were statistically significant（<italic>P</italic><0.05）. After treatment，the postoperative WBC，CRP，IL-6，CD4⁺/CD8⁺ and IgM in the two groups of patients were lower than those before treatment，and the postoperative CD3⁺ was higher than that before treatment，with statistically significant differences（<italic>P</italic><0.05）. The postoperative WBC，CRP，IL-6，CD4⁺/CD8⁺ and IgM in the observation group were lower than those in control group，and the CD3⁺ was higher than that of control group，with statistically significant differences（<italic>P</italic><0.05）. There was no statistical difference in adverse reactions between the two groups. Totally 159 components in SLD were screened，which acted synergistically on key targets such as IL-6，vascular endothelial growth factor A（VEGFA），insulin（INS），and epidermal growth factor receptor（EGFR），and participated in the regulation of HIF-1 signaling pathway，EGFR tyrosine kinase inhibitor resistance and PI3K-Akt signaling pathway in the treatment of ACC. Conclusion:SLD may regulate HIF-1 pathway and other signaling pathways by acting on IL-6，VEGFA，INS，EGFR and other targets，thereby reducing postoperative inflammatory factors，improving immune function，and promoting postoperative recovery in patients with ACC.

Short term effect of PM2.5 on cardiovascular mortality in residents in Changping district, Beijing / 中华流行病学杂志

Objective@#To make a quantitative evaluation on the short term effect of particulate matter with aerodynamic diameter no more than 2.5 μm (PM2.5) on cumulative excess mortality rate (CER) and years of life lost (YLL) in residents in Changping district of Beijing.@*Methods@#The death data in local residents, daily mortality, meteorology data and air pollution data (PM2.5, SO2 and NO2 concentrations) in Changping from 2014 to 2017 were collected. Distributed lag non-linear model was used to assess the age and gender specific cumulative lag effects of PM2.5 on cardiovascular CER and daily YLL in Changping.@*Results@#The effects of PM2.5 on cardiovascular CER and YLL were obvious on lag 7 days and lag 9 days, respectively, peaking on day 14, and lasting for 21 days. On lag0-21 days, for a 10 μg/m3 increase in PM2.5, the population based CER of cardiovascular disease death was 0.021% (95%CI: 0.004%-0.038%), and the YLL was 1.47 (95%CI: 0.23-2.70) years. Greater PM2.5 effect were observed in males and the elderly.@*Conclusion@#PM2.5 increased the risk of cardiovascular disease death and YLL.

Study on the mechanism of electroacupuncture scalp point penetration therapy in action on apoptosis in the Parkinson's disease rat model / 中国针灸

<p><b>OBJECTIVE</b>To explore the mechanism of electroacupuncture scalp point penetration therapy in treatment of the Parkinson's disease (PD).</p><p><b>METHODS</b>Forty Wistar rats were randomly divided into a normal group, a sham-operation group, a model group and an electroacupuncture (EA) group. 6-OHDA was injected into the left striatum to make lateralization PD rat model. Acupuncture at "Baihui" (GV 20)-through-"Taiyang" (EX-HN 5), once each day, 6 days constituting one course. Immunohistochemical method was used to observe the facio-density and the integral optical density of brain-derived neurotrophic factor (BDNF) in the left substantia nigra, and TUNEL method was used to observe the apoptotic amount, and high performance liquid chromatography was used to observe DA contents of the left striatum in each group.</p><p><b>RESULTS</b>As compared with the model group, in the acupuncture group, the facio-density and the integral optical density in the left substantia nigra increased significantly (P < 0.05), the amount of apoptosis decreased significantly (P < 0.05), and the content of striatum DA increased significantly (P < 0.05).</p><p><b>CONCLUSION</b>EA scalp point-through-point therapy may enhance BDNF protein expression level in the substantia nigra to decrease the amount of apoptosis in the PD model rat.</p>

Study on the effect of bone-cement interface with bone cement oscillator / 中华外科杂志

<p><b>OBJECTIVE</b>To evaluate the effect on increasing bone cement-bone interface micro-gomphosis intensity with bone cement oscillator.</p><p><b>METHODS</b>One hundred femoral bones of adult pig were randomly divided into 6 groups: oscillating group (A1) and control group (A2) of anti-tensile force, oscillating group (B1) and control group (B2) of anti-pressure (n = 20 in each group), oscillating group (C1) and control group (C2) of imaging (n = 10 in each group). Mechanics and CT test was performed, micro-gomphosis intensity of bone cement-bone interface between oscillating group and control group was compared.</p><p><b>RESULTS</b>Mechanics and CT test showed bone cement-bone interface micro-gomphosis intensity in oscillating group was significantly stronger than control group (P < 0.01).</p><p><b>CONCLUSION</b>Bone cement oscillator can significantly increase micro-gomphosis intensity of bone-cement interface, and reduce long-term aseptic loosening of artificial prostheses.</p>

Bone marrow mesenchymal stem cell transplantation aggravates postangioplasty aortic restenosis in rats / 中华心血管病杂志

<p><b>OBJECTIVE</b>To observe the effect of bone marrow mesenchymal stem cell transplantation on postangioplasty aortic restenosis in rats.</p><p><b>METHODS</b>48 SD rats were randomly divided into normal control group, balloon injury group, balloon injury and MSCs transplantation group. MSCs were pre-labeled by DAPI (25 microg/ml) and then infused into aorta through the balloon catheter (MSCs 2 x 10(6)/animal). Thoracic aorta were taken for histological examination (frozen and paraffin sections) at 1, 2, 6 weeks post angioplasty, respectively. DAPI labeled MSCs were detected under immunofluorescence microscopy. Expressions of c-kit, proliferating cell nuclear antigen (PCNA), smooth muscle alpha-actin (alpha-SMA) in aorta were determined by immunocytochemistry using related antibodies.</p><p><b>RESULTS</b>The DAPI-labeled MSCs could be detected on impaired intimae and alpha-SMA expression was seen in these cells 1 weeks after MSCs transplantation. Similar weak c-kit expression in neointima was found in both injury and transplantation group at 2 weeks (P > 0.05). Expressions of PCNA and alpha-SMA in the neointima were significantly higher in transplantation group than in injury group at 2 weeks. Intima/tunica media area ratio and luminal stenosis ratio were significantly increased in transplantation group than injury group at 6 weeks (all P < 0.05).</p><p><b>CONCLUSION</b>Bone marrow MSCs transplanted post aortic angioplasty could home to serious wounded aortic intima, differentiate into smooth muscle like cells, promote neointima cellular proliferation and aggravate postangioplasty aortic restenosis in rats.</p>

Periampullary carcinoma with situs inversus totalis: case report and review of the literature / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To explore the diagnosis and surgical treatment of patients with periampullary carcinoma and situs inversus totalis.</p><p><b>METHODS</b>The data of a patient with periampullary carcinoma and complete situs inversus totalis, a rare disease treated in our hospital on Mar. 2006, was reported, and relative articles were reviewed.</p><p><b>RESULTS</b>This patient was diagnosed with stage I to II of periampullary carcinoma. Bilirubin was recovered one week postoperatively. Incomplete adhesive ileus at gastroenteral anastomosis appeared 2 weeks after the operation and was healed by nutritional support, acupuncture, endoscopic drainage and enteral nutrition. From 1936 to 2006, 15 malignant tumors with situs viscerum inversus totalis were reported, only 5 periampullary carcinomas with situs viscerum inversus totalis were reported.</p><p><b>CONCLUSIONS</b>Surgical operation should be considered for malignant tumor patients with situs inversus totalis without contraindication. Attention should be paid to the opposite anatomical structure in this kind of situation.</p>

Effect of Aspirin on Thromboembolism in Hypertensive Patients Associated with Paroxysmal Atrial Fibrillation / 中华高血压杂志

Objective To investigate the effect of aspirin on the incidence of thromboembolism in hypertensive patients associated with paroxysmal atrial fibrillation.MethodsFour hundred hypertensive patients with paroxysmal atrial fibrillation (mean age 59 years) free of thromboembolic events were randomized assigned to receive aspirin (0.3 g/d) or placebo. Cerebral thromboembolism,including transient ischemic attack and embolism of peripheral arteries were defined as primary outcomes. Event-free survival curves were estimated by Kaplan-Meier curve. Results During 3.6 years follow-up,primary outcomes occurred in 61 patients (4.3% per year). Aspirin significantly reduced the incidence of primary outcome as compared with placebo group( 9.0% vs 21.5%,P

Application of distraction osteogenesis in correction of deformity of spine during development / 中国矫形外科杂志

[Objective]To evaluate the value of distraction osteogenesis for treatment of deformity of spine during development.Distraction osteogenesis could be used for patients with campylorrhachia,dwarfism eccyliosis of spine or those combined with thoracocyllosis and obliquity pelvis.[Method]According to the principle of Halo-pelvic distraction apparatus which was divided into two parts of halo and pelvic,the halo was 4-nail fixation and the pelvic was 2-nail fixation.The halo and pelvic were connected by 4 standing pillar.Through the daily extending of 4 standing pillar the curved spine was extended and stretched gradually.As a result,action of 3D correction of deformity of spine was achieved.[Result]Ten patients of this group were treated by this methods.The action of 3D correction and automatic correction of deformity were showed in 70~120 days distraction that the wedge-shaped vertebra changed into squareness,curved spine was stretched and rotatory vertebra was reduced.[Conclusion]Distraction osteogenesis is a minimally invasive surgery instead of internal fixation of spine for the treatment of deformity of spine during development.