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ObjectiveTo explore the occupational needs of hand injury patients and the effects of activity-based analysis and occupation-based interventions. MethodsFrom January, 2021 to June, 2022, 212 patients who accepted occupational therapy for wrist-hand injury in Rehabilitation Center of the First Affiliated Hospital of Nanjing Medical University were interviewed using Canadian Occupational Performance Measure (COPM) to collect the activities that they wanted to do, needed to do, were expected to do, but unable to do. Two senior occupational therapists conducted the activity analysis of the summarized needs, identified occupational components, designed a purposeful occupation-based intervention program, and evaluated the performance and satisfaction using COPM. ResultsA cumulative total of 84 occupational needs were proposed, covering five major domains: work, basic activities of daily living, instrumental activities of daily living, leisure and sleep. The activities mostly impaired involved using computer (8.28%), using chopsticks (6.42%), wringing towels (6.25%), travelling on transport (4.90%) and lifting heavy objects (4.73%). The performance and satisfaction improved after treatment (t > 16.572, P < 0.001). ConclusionThe occupational needs are culturally specific for local hand injury patients; the use of an activity-based analysis and occupation-based intervention is effective on meeting the occupational needs.
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Objective To evaluate a new type of adult scapular anatomical locking plate which was designed for fixation of the major fracture fragment based on the characteristics of major fracture location and posterior surgical approach.Methods The Computed Tomography (CT) data of the scapula were collected for this studv of the 80 normal adults who had undergone CT scanning from January 2015 to January 2018 at Department of Orthopedics,Hanzhong Central Hospital.They were 43 males and 37 females.3D models of the scapula were reconstructed using the CT data by computer.After scapular neck (CD),scapular lateral border (D)E),angulus scapulae (EF),scapular spine (HJJ2 and HKK2),and angles of the scapula (∠ CD)E,∠ DEF,∠ HKK2 and ∠ HJJ2) were measured,our new type of adult scapular anatomical locking plate was designed to meet the requirements of operation and fixation.Results The main parameters of the scapula at the major fixation region were CD of 10.27 ±0.99 mm,DE of 73.03 ±6.27 mm,EF of 52.03 ±6.85mm,HJ of 36.27 ± 2.10 mm,HKof41.44±2.58mm,∠ CDE of128.61° ± 6.30°,∠DEF1of 167.11 °±3.83°,∠DEF2 of 173.01 °±4.45°,∠HJJ2 of 133.43°±7.47°,and ∠HKK2 of 123.55°± 7.84°.The new type of claw-shaped scapular locking plate we had designed conformed to the segmental lengths and the angles between the adjacent segments of the scapula.Conclusions Our new type of adult scapular anatomical locking plate mav be used to fix the major scapular fracture fragment,providing a new choice to solve the problem in fixation of complex scapular fractures.However,its clinical practicality and effectiveness needs further clinical research.
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Objective To investigate the clinical value of preset balloon in abdominal aorta in assisting cesarean section for patients with placenta previa complicated by placenta accreta.Methods Preset balloon in abdominal aorta was performed in 72 patients with placenta previa complicated by placenta accreta before cesarean section was carried out.Of the 72 patients,pernicious placenta previa (type A) was seen in 33,scar uterus,placenta previa with placenta accreta (type B) in 36 patients,and placenta previa complicated by placenta accreta with no cesarean section history (type C) in 3.The amount of blood loss during cesarean section,the course of uterine resection,the X-ray radiation dose in performing placement of balloon,and the procedure-related complications were recorded.Results The average amount of intraoperative blood loss in type A,B and C group was 1461 ml,947 ml and 533 ml,respectively.Subtotal hysterectomy was adopted in 9 patients and uterine repair in 32 patients.The average radiation doses in 17 patients who received preset balloon procedure in 2015 and in 55 patients who received preset balloon procedure in 2016 were (28.5±14.1) mGy and (3.7±2.5) mGy,respectively.During hospitalization period,one patient developed right superficial femoral artery thrombosis,one patient developed venous thrombosis of right lower extremity,and subcutaneous hematoma occurred in two patients.Conclusion Temporary occlusion of the abdominal aorta with preset balloon to assist the cesarean section for patients with placenta previa complicated by placenta accreta can effectively reduce the amount of intraoperative blood loss and markedly reduce hysterectomy rate.The procedure of preset balloon is simple,and the X-ray exposure time is short.Skilled and experienced manipulation can further reduce the incidence of complications.
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Objective To evaluate the role of interleukin?1β( IL?1β) in activation of N?methyl?D?aspartate ( NMDA) receptors in spinal dorsal horns of rats with neuropathic pain. Methods One hundred twenty?eight pathogen?free healthy adult male Sprague?Dawley rats, weighing 200-250 g, were divided into 4 groups (n=32 each) using a random number table: control group (group C), recombinant adenovirus vector group ( group rAd) , recombinant adenovirus vector shRNA group ( group rAd∕shRNA) , and recom?binant adenovirus vector shRNA plus recombinant adenovirus vector IL?1β group ( group rAd∕shRNA+rAd∕IL?1β) , receiving intrathecally injected equal volume of 0.9% sodium chloride solution, recombinant ade?novirus vector, recombinant adenovirus vector shRNA, and recombinant adenovirus vector shRNA plus re?combinant adenovirus vector IL?1β5 μl, respectively. Chronic compression of dorsal root ganglia was per?formed on 8th day after intrathecal injection. The thermal paw withdrawal latency ( TWL) was measured at 1 day before intrathecal injection ( T0 ) and at 1, 2, 3 and 5 weeks after intrathecal injection ( T1-4 ) . After measurement of the pain threshold at each time point, 8 rats selected randomly were anesthetized and sacri?ficed, and the lumbar enlargement segments of the spinal cord were harvested for determination of the ex?pression of IL?1β and phosphorylated NMDA receptor NR1 subunits at serine 896 ( pNR1S896) in spinal dorsal horns on the injured side by immunohistochemistry and Western blot. Results Compared with group C, the TWL was significantly prolonged, and the expression of IL?1βand pNR1S896 in spinal dorsal horns was significantly down?regulated at T2-4 in group rAd∕shRNA (P0.05) . Compared with group rAd, the TWL was significantly prolonged, and the expression of IL?1βand pNR1S896 in spinal dorsal horns was significantly down?regulated at T2-4 in group rAd∕shRNA ( P0.05). Compared with group rAd∕shRNA, the TWL was significantly short?ened, and the expression of IL?1β and pNR1S896 in spinal dorsal horns was significantly up?regulated at T2-4 in group rAd∕shRNA+rAd∕IL?1β ( P<0.05) . Conclusion IL?1β is involved in the activation of NM?DA receptors in spinal dorsal horns of rats with reuropathic pain.
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[Summary] Four patients with hyperthyroid-associated exophthalmos, myxedema, acropachy ( EMA ) syndrome, including three male patients and one female patient were diagnosed with Graves′diseases and treated by 131 I therapy. Complaints of thyrotoxicosis were presented at the onset. Tibia myxedema and acropathy appeared, and eye symptoms aggravated in two patients after anti-thyroid drug therapy and 131 I therapy. Four cases were all given clobetasol propionate, miconazole nitrate, neomycin sulfate and urea cream alone or in combination with compound betamethasone local injection treatment, and three cases were given low-dose oral prednisone treatment. Complaints of tibia myxedema and eye symptoms were significantly improved after the treatment. Therefore, we should be wary of the occurrence of hyperthyroid-associated EMA syndrome after 131 I therapy. Corticosteroid might be the effective therapy for myxedema and eye symptoms of EMA syndrome.
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BACKGROUND:Recent reports only concern vertebroplasty for mild to moderate vertebral compression fractures, but seldom address vertebroplasty for severe vertebral compression fractures such as vertebral colapse. OBJECTIVE:To evaluate the efficacy and imaging features of percutaneous vertebroplasty for severe vertebral compression fractures. METHODS:A total of 25 patients underwent single-level vertebroplasty for vertebral compression fractures. Imaging features were then analyzed including location, pattern of compression, extent of colapse, pre- and post kyphotic angle and adjacent disc height before and after vertebroplasty. RESULTS AND CONCLUSION:60% (16/25) patients involved the thoracolumbar junction. The height of colapsed vertebral body was 14%-30% of original vertebral body. The average height of colapse was 5.17 mm or 22% of original vertebral body. Kyphotic angle before vertebroplasty ranged from 0-33° (averagely 16°) with an average correction of 12° after vertebroplasty. Average disc height before vertebroplasty was 7.3 mm above and 7.7 mm below. Visual analogue scale score was significantly higher preoperatively than that postoperatively, showing significant difference in pain improvement (P< 0.015). These data suggest that percutaneous vertebroplasty is safe and effective in the treatment of single level severe vertebral compression fractures.
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BACKGROUND:Specific down-regulation of interleukin 1 beta (IL-1β) may al eviate the pain behaviors effectively after peripheral nervous injury. Compared with smal interference RNA (siRNA), short hairpin RNA (shRNA) could inhibit the expression of target gene more stably and efficiently. However, simple shRNA could not enter target cel s to down-regulate target gene efficiently. Adenovirus vectors have wide host range, high infection efficiency and stable expression in host cel s. OBJECTIVE:To construct recombinant adenovirus vector expressing shRNA targeting IL-1βgene and detect its effect on the expression of target gene. METHODS:Three siRNAs were designed on the basis of the nucleotide sequence of IL-1βobtained from NCBI and then three shRNAs (shRNA1, shRNA2 and shRNA3) were synthesized. The annealed shRNA product and adenovirus vector pHBAd/U6/GFP digested by BamH I and EcoR I were connected to construct the recombinant adenovirus vector shuttle plasmid expressing shRNA targeting IL-1β. After sequencing, HEK 293 cel s were co-transfected by the shuttle plasmid and skeleton vector, and three recombinant adenovirus vector expressing shRNA targeting IL-1β(rAd/shRNA1, rAd/shRNA2 and rAd/shRNA3) were packaged and amplified. Rats H9C2 cel s were infected by recombinant adenovirus vector expressing shRNA targeting IL-1βand fluorescence microscope was used to observe the infection efficiency. The effect of recombinant adenovirus vector expressing shRNA targeting IL-1βon the expression of target gene was detected by western blot assay. RESULTS AND CONCLUSION:The sequencing results showed that the sequences of three shRNAs adenovirus vector shuttle plasmid were consistent with the sequences of three designed shRNAs. rAd/shRNA1, rAd/shRNA2 and rAd/shRNA3 were constructed successful y. rAd/shRNA1, rAd/shRNA2 and rAd/shRNA3 could down-regulate the expression of IL-1βin rat H9C2 cel s and the down-regulation effect of rAd/shRNA2 was the most significant.
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Objective To investigate the changes in the phosphorylation of N-methyl-D-aspartate (NMDA) receptors in spinal dorsal horns in a rat model of neuropathic pain induced by chronic compression of dorsal root ganglion (CCD).Methods Ninety-six male Sprague-Dawley rats,weighing 200-250 g,were randomly divided into 3 groups (n =32 each) using a random number table:control group (group C),sham operation group (group S) and group CCD.In CCD group,a small stainless steel needle (4 mm in length and 0.8 mm in diameter) was inserted into the L4,5 intervertebral foramen in pentobarbital sodium-anesthetized rats,developing intervertebral foramen stenosis and hence producing a chronic steady compression of the dorsal root ganglion.In group S,the intervertebral foramen was only exposed without inserting the needle.The paw withdrawal latency (PWL) was measured at 1 day before operation and 1,2 and 4 weeks after operation.The rats were then sacrificed after measurement of PWL and the lumbar enlargement segments of the spinal cord were removed for determination of the expression of interleukin-1β (IL-1β) and phosphorylation of NMDA receptor NR1 subunits at serine 896 (pNR1S896) on the injured side by immunohistochemistry and Western blot.Results Compared with group C,the PWL was significantly shortened at each time point after operation,and the expression of IL-1β and pNR1S896 was up-regulated in group CCD,and the PWL was shortened at 1 week after operation,the expression of IL-1β and pNR1S896 was up-regulated,and no significant change was found in PWL and expression of IL-1β and pNR1S896 at the other time points in group S.Compared with group S,the PWL was significantly shortened at each time point after operation,and the expression of IL-1β and pNR1S896 was up-regulated in group CCD,Compared with the baseline value at 1 day before operation,the PWL was slowly shortened starting from 1 week after operation,and decreased to the lowest level at 2 weeks after operation and maintained at this level for 2 weeks,the expression of IL-1β and pNR1S896 was slowly up-regulated starting from 1 week after operation,and increased to the highest level at 2 weeks after operation and maintained at this level for 2 weeks in group CCD,and the PWL was shortened at 1 week after operation,and the expression of IL-1β and pNR1 S896 was up-regulated in group S.Conclusion The development and maintenance of neuropathic pain induced by CCD are related to phosphorylation of NMDA receptors in spinal dorsal horns of rats.
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<p><b>OBJECTIVE</b>To analyze the results of etiology and serology of plague among human and infected animals in Qinghai province from 2001 to 2010.</p><p><b>METHODS</b>Thirty-seven cases of human infected with plague, 53 541 different animal samples, 5 685 sets of vector insects flea and 49 039 different animal serum samples were obtained between 2001 and 2010. A total of 7 811 samples of serum from healthy farmers and herdsmen in 14 counties in Qinghai from 2005 to 2007 were collected. Yersinia pestis (Y. pestis) were detected in visceral and secretions from human, infected animals and vector insects, respectively. Plague antigen was detected by reverse indirect hemagglutination assay (RIHA) in those samples. Indirect hemagglutination assay (IHA) was used to test plague FI antibody in serum of human and infected animals.</p><p><b>RESULTS</b>37 human plague cases were confirmed, 21 strains of plague Y. pestis were isolated from human cases and 14 positive were detected out. 133 of 7 811 samples of human serum were IHA positive, with the positive rate at 1.7%. A total of 146 strains of plague were isolated from infected animals and vector insects, 99 out of which were from infected animals, with a ratio of Marmota himalayan at 72.7% (72/99) and the other 47 were from vector insects, with a ratio of callopsylla solaris at 68.1% (32/47). The number of IHA and PIHA positive were 300 and 10, respectively. A total of 3 animals and 3 insects species were identified as new epidemic hosts for plague. The natural plague focus of Microtus fuscus was discovered and confirmed and coexisted with natural focus of Marmota himalayan in Chengduo county, Yushu prefecture. The epidemic situation of plague is distributed mainly in Haixi, Yushu and Hainan prefectures.</p><p><b>CONCLUSION</b>From 2001 to 2010, animal infected with plague was detected in successive years and human plague was very common in Qinghai. New infected animals and vector insects species and new epidemic areas were confirmed, hence the trend of plague prevalence for humans and animals is very active in Qinghai province.</p>
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Animals , Humans , Antibodies, Bacterial , Blood , China , Epidemiology , Disease Vectors , Insect Vectors , Microbiology , Plague , Epidemiology , Yersinia pestis , ClassificationABSTRACT
Objective To study the effect of calorie restriction at early age of rats on their islet β cell mass in adulthood.Methods Sixteen 8-week-old male SD rats were randomized to control group (n=7) and calorie restricted group (n =9).The rats in control group took food freely,while the ones in calorie restricted group were given 70％ calorie of the control group.After 24 week calorie restriction,cholesterol (TC),triglyceride (TG),high density lipoprotein-cholesterol (HDL-C) and low density lipoprotein-cholesterol (LDL-C) were tested.The β cell mass was measured by immunohistochefistry and the activity of superoxide dismutase (SOD) as well as the level of malondialdehyde (MDA) in pancreas homogenate were determined by ELISA.Results The increase of the body weights(45 g vs.184 g)and the level of TG [(0.61±0.15)mmol/L vs.(0.78±0.14)mmol/ L]of the rats in the calorie restricted group were lower than those of the control group (P＜0.05),while the β cell mass [(43.6±9.8)mg vs.(31.9± 11.6)mg],β cell mass of every milligram pancreas tissue[(89.7 ± 7.4) μg/mg vs.(44.8g ± 14.1) μg/mg] and β cell mass per body weight[(11.5±2.5) × 10-5 vs.(6.3 ±2.3) × 10-5]of the rats in the calorie restricted group were higher than those of the control group (P＜0.05).There were no differences in the SOD activity [(0.91±0.30)nmol/ mg protein vs.(0.68±0.14)nmol/ mg protein]and MDA level [4.97± 0.65)U /mg protein vs.(6.05 ±2.14)U/mg protein] in pancreas homogenate between the two groups (P＞0.05).Conclusions Calorie restriction at early age of rats may increase the islet β cell mass in their adulthood.
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Objective To evaluate desmopressin stimulated inferior petrosal sinus sampling in diagnosing Cushing′s disease.Methods Sixteen ACTH-dependent Cushing′s disease patients underwent bilateral desmopressin stimulated inferior petrosal sinus ( IPS ) sampling because of negative or equivocal magnetic resonance imaging.Cortisol response to high-dose dexamethasone suppression test was also evaluated.ACTH sampling was taken from a peripheral vein and bilateral IPS before and both 5 and 10 min after injection of desmopressin.Diagnosis was based on the ratio of ACTH level in between IPS to peripheral vein by desmopressin test.Diagnosis was confirmed after surgery.Results High-dose dexamethasone suppression test showed suppressible in 9 of 16 patients with Cushing′s disease.An IPS gradient ＞2 was found in 14 of the 16 cases (87.5％ )with Cushing′s disease after desmopressin injection,while before injection the respective figure was 12 of 16 (75.0％).No severe adverse effects were observed during or after the procedure.Conclusion Desmopressin test during bilateral IPS sampling is a safe and effective diagnostic procedure in Cushing′s disease.
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Eleven-week-old SD rats were randomized into control and calorie restriction group. The pancreatic β cell function and oxidative stress indexes in the two groups were compared after 24-week intervention. The results showed that calorie restriction, which started from young age, improved the early insulin secretion after glucose loading and alleviated the oxidative stress in adult rats, which wag related to the reduction of body weight.
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[Objective]To evaluate surgical treatment and curative effect of intercondylar humeral comminuted fractures.[Method]Twenty-one cases of intercondylar humeral comminuted fractures were collected from February 2001 to December 2005. The fractures were classified to 5 cases of C1,9 cases of C2 and 7 cases of C3 according to the AO classification.Seventeen fractures were internal fixed by open-reduction, and 4 fractures were treated by total elbow replacement. After olecranon osteotomy, capitate eminence and trochlea humerus were reducted and fixed with bone screw,while shaft of humerus and the distal end of humerus were fixed with AO double plate or Y-shaped plate in internal fixed group. Early physiotherapy were started as soon as possible. The elbow replacement group were replaced by semi-restriction elbow prosthesis and fixed with cemente following physiotherapy after 4 to 7 days.[Result]forteen of 17 cases were postoperatively followed-up in internal fixed group from 12 to 44 months, and all cases had been visited for 14 to 36 months in elbow replacement group. According to modified Cassebaum scoring system, 71.4% were good in internal fixed group and 100% in elbow replacement group.[Conclusion]It has good curative effect in intercondylar humeral comminuted fractures with olecranon osteotomy, the AO double plate or Y-shaped plate internal fixation and early physiotherapy. With severe injury of the distal end of humerus, obviously osteoporosis and older than 50 years, the total elbow arthroplasty and replacement are preferred.
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OBJECTIVE:To discuss the general pattern and features of adverse drug reactions(ADRs) of defibrase.MET-HODS:The cases of ADRs of defibrase reported in the national medical journals during 1999 and 2003 were collected and analyzed.RESULTS:ADRs of defibrase mainly included bleeding,urticaria,high fever,positive cutantest,liver function injury,ecchymoma,purpura haemorrhagica,incision hemorrhea,and arterial embolism.CONCLUSION:Great importance should be attached to ADRs of defribrase in clinic in order to ensure the safety of drug use.