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ObjectiveTo evaluate the intervention effect of meteorological risk forecasting service on acute onset and medical expenses of chronic obstructive pulmonary disease（COPD） patients， and to provide scientific basis for the establishment of health management model for chronic obstructive pulmonary disease（COPD） patients. MethodsStudy subjects were recruited from chronic obstructive pulmonary patients aged ≥40 in Pudong New Area. Propensity score matching method was used to determine the intervention group and the control group. The control group received regular health education and follow-up management， and the intervention group was provided with meteorological and environmental risk forecasting services through WeChat， mobile phone short message service（SMS）and telephone. Finally， a total of2 589 subjects were included in the analysis， including 1 300 in the intervention group and 1 289 in the control group. General demographic data， past medical history and family history of COPD， COPD related knowledge and practice survey， COPD related symptom assessment， acute onset， health service utilization and medical expenses before and after intervention were collected through questionnaire survey. The differences of acute attack， health service utilization and related medical expenses between the two groups before and after intervention were compared to evaluate the intervention effect. ResultsIn terms of acute attacks， after intervention， the incidence of acute attacks in the intervention group was lower than that before intervention（χ2=52.901， P<0.001）， and the incidence of acute attacks in the groups with different intervention methods was lower than that before intervention （P<0.001）. WeChat had the best effect， decreasing the incidence by 14.4%， followed by mobile phone SMS SMS decreasing by 12.3%. In terms of utilization of health services， the outpatient rate due to acute attack was lower in the intervention group after intervention than that before intervention （χ2=7.129， P=0.008）， and the outpatient rate due to acute attack was lower in the subjects who received the forecast service through mobile phone SMS than that before intervention （χ2=4.675， P<0.001）. In terms of medical expenses， there was no significant difference between control group and intervention group with different intervention methods before intervention （P>0.05）. After intervention， the difference between the control group and the intervention group with different intervention methods was statistically significant （H=11.864， P<0.05）. The results of multiple comparisons showed that compared with the control group， the average annual medical expenses of patients receiving mobile phone SMS and telephone forecasting services after intervention were lower than those of the control group， and the difference was statistically significant （P<0.05）. ConclusionMeteorological risk forecasting service can reduce the acute onset of COPD， reduce the rate of consultation and medical expenses due to acute onset， and provide scientific basis for the basic COPD health management model.
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A total of 6 patients were treated with surface knee joint prosthesis combined with 3D-printed customized bionic tibial block for reconstruction of bone defect after giant cell tumor (GCT) in proximal tibia (1 male and 5 females, aged 50, 40, 68, 53, 35, 42, respectively). 3 patients with primary and 3 patients with recurrence of GCT. After resection of the tumor, the bone defect was filled with 3D-printed block combined with surface knee prosthesis, the surrounding ligaments were reconstructed with microporous structure and artificial mesh. All cases were followed up for 60, 90, 60, 60, 75, and 50 months, respectively. During the follow-up, there was no local recurrence, no radiolucent lines around prosthesis, and no signs of loosening. The clinical scores of the American Knee Society Score (KSS) were 87, 92, 85, 90, 95 and 78. The functional scores were 70, 100, 70, 100, 100 and 80 respectively. Musculoskeletal Tumor Society Score (MSTS) were 27, 28, 26, 26, 26, 27, respectively. Surface knee prosthesis combined with bionic block can effectively fill the bone defect after resection of GCT in proximal tibia, achieve anatomical and functional reconstruction of knee joint.
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@#In order to explore the therapeutic effects and preliminary mechanism of gypenosides (GP) on hypercholesterolemia, as well as the protective effect on liver injury induced by high-dose simvastatin and high cholesterol diet (HCD), the hypercholesterolemia model of golden hamster was established by high cholesterol diet. The experimental animals were divided into blank group, model group, GP low and high dose groups (60 mg/kg, 120 mg/kg), simvastatin group (10 mg/kg), and GP high dose combined with simvastatin group (120 mg/kg + 10 mg/kg).The efficacy was investigated through dynamic monitoring serum cholesterol and liver function related indexes after drug treatment of 14 and 23 days. The results showed that GP could significantly reduce the levels of serum low density lipoprotein cholesterol (LDL-C), total cholesterol (TC), triglyceride (TG), alanine aminotransferase (ALT), aspartate aminotransferase (AST), and alkaline phosphatase (ALP), increase the level of serum high density lipoprotein cholesterol (HDL-C), and reduce the secretion of PCSK9. It is suggested that GP has a good therapeutic effect on HCD diet-induced hypercholesterolemia hamsters, which may be related to its inhibition of PCSK9 secretion. In addition, GP can significantly ameliorate liver damage caused by HCD diet and high-dose simvastatin. These findings provide a scientific basis and useful reference for the combination of GP and statins to reduce toxicity and increase efficacy.
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Objective:To investigate the feasibility and early clinical effect of lumbar lateral anterior interbody fusion in the treatment of degenerative lumbar scoliosis.Methods:Forty patients with degenerative lumbar scoliosis who underwent lumbar lateral anterior interbody fusion combined with posterior percutaneous pedicle screw and rod internal fixation from January 2018 to January 2020 were selected. There were 17 males and 23 females; The age was 65.4±7.2 years (range 51-84 years). All patients had obvious low back pain, of which 22 patients (55.0%) had lower limb pain, numbness or intermittent claudication. 16 patients (40.0%) had scoliosis and the main curve protruded to the right, and 24 patients (60.0%) had scoliosis and the main curve protruded to the left. The operation time and intraoperative bleeding were recorded. The main outcome measures were visual analogue scale (VAS), Oswestry disability index (ODI), the MOS item short from health survey (SF-36), deformity correction, bone graft fusion time and complications.Results:The left approach was used in 16 cases of scoliosis with the main curve protruding to the right; In 24 cases, the main curve of scoliosis protruded to the left, of which 6 cases showed osteophyte on the concave side (right side) of coronal CT and the right approach was adopted, while the rest were adopted the left approach. Single segment fusion was performed in 8 cases (20.0%), double segment fusion in 12 cases (30.0%), three segment fusion in 16 cases (40.0%), and four segment fusion in 4 cases (10%). Among the 22 patients with symptoms of lower limb nerve damage, 6 needed secondary unilateral laminectomy. All 40 patients completed the operation successfully, the operation time was 255±37 min (range 130-345 min) and the amount of intraoperative bleeding was 100±16.2 ml (range 10-505 ml). All patients were followed up for 12.8±4.5 months (range 6-24 months). The preoperative VAS score was 5.7±1.0, improved to 3.5±0.7 on the first day after operation, and 1.4±0.3 at the last follow-up. The difference was statistically significant ( F=2322.229, P <0.001). The preoperative ODI was 79.9%±9.3%, the first day after operation was 51.6%±8.9%, and the last follow-up was 11.7%±2.2%. The difference was statistically significant ( F=3770.411, P <0.001). SF-36 was 68.6±5.3 before operation and 78.4±5.5 on the first day after operation, which increased to 109.9 ± 4.9 at the last follow-up. The difference was statistically significant ( F=21736.486, P <0.001). The Cobb angle of lumbar scoliosis was 27.8°±14.1° before operation and 7.5°±3.5° on the first day after operation, the difference was statistically significant ( t=3.551, P <0.001); The height of intervertebral space was 10.9±2.1 mm before operation and 15.3±3.4 mm on the first day after operation, the difference was statistically significant ( t=2.106, P <0.001). 24 patients (60.0%) had pain or numbness in the front of the thigh, and 4 patients (10.0%) had quadriceps femoris weakness; These symptoms disappeared within 3 months after operation in 26 patients, except that the numbness in the front of the thigh was only reduced in 2 patients 3 months after operation. All patients achieved satisfactory fusion in all segments at the last follow-up, and there was no non-fusion. Conclusion:Lumbar lateral anterior interbody fusion is a safe and feasible method for the treatment of degenerative lumbar scoliosis.
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The mentor system has been applied in the standardized residency training, currently the "one to one" ortwo mentors′ system are more common applied. However, the clinical training of general practitioners needs joint effort of mentors from the general practice department and specialists in hospital, as well as of mentors from primary health institutes. Thus, we proposed a "three-in-one" tutorial system, which consisted of one GP mentor, one specialists in the hospital and one primary physician for residency training of general practice. The implementation of the "three-in-one" system has motivated the enthusiasm of specialists and community instructors, and enhanced their responsibility. The mentors from different department can learn from each other and complement each other, so the overall teaching level can be raised and the quality of standardized training of general practitioners can be improved.
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The effects and practicability of in situ simulation and standardized patient (SP) in residency training of general practice was evaluated in Hangzhou First People′s Hospital. From September 2017 to December 2019, typical cases were collected in accordance with the teaching objectives, the teaching plans of in situ simulation were established and simulation scenarios were set up; the SPs were recruited from nursing staff and retirees in the community. Forty general practice residents were randomly divided into two groups with 20 in each group. The traditional teaching group was given theoretical teaching, while the combined teaching group was taught by in-situ simulation combined with SP teaching. The satisfaction of residents, the scores of theory and skill were observed and compared between two groups.Results showed that the satisfaction of teaching method( t=-2.11, P<0.05), teaching effect( t=-4.25, P<0.01) and scores of history collection( t=-3.21, P<0.01) in the combination teaching group were significantly higher than those in the traditional teaching group. It is suggested that in situ simulation combined with SP teaching method can improve the satisfaction and teaching effect of the general practice residents.
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The mentor system has been applied in the standardized residency training, currently the "one to one" ortwo mentors′ system are more common applied. However, the clinical training of general practitioners needs joint effort of mentors from the general practice department and specialists in hospital, as well as of mentors from primary health institutes. Thus, we proposed a "three-in-one" tutorial system, which consisted of one GP mentor, one specialists in the hospital and one primary physician for residency training of general practice. The implementation of the "three-in-one" system has motivated the enthusiasm of specialists and community instructors, and enhanced their responsibility. The mentors from different department can learn from each other and complement each other, so the overall teaching level can be raised and the quality of standardized training of general practitioners can be improved.
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0bjective@#To explore the feasibility and clinical efficacy of cervical vertebral dome expansion laminoplasty..@*Methods@#Our hospital from February 2017 to 2018 Sep 16 cases with cervical spinal canal dome of cervical spinal stenosis angioplasty in treatment of cervical spinal cord due to the medical records of patients, including 14 males and 2 females; Aged 49- 76 years old, average age 57.3±1.7 years old. The course of disease was 7-48 months, with an average disease duration 17.75±1.90 months. Of the 16 patients, 5 had multi-segment cervical disc herniation and 11 had long segmental ossification of the posterior longitudinal ligament. All the 16 patients underwent cervical C3-7 dome-type spinal canal enlargement; the position, stability and spinal cord compression of the internal fixation were evaluated according to the patient's imaging data (X-ray, CT and MRI). The neck and upper extremity pain was evaluated by visual analogue scale (VAS) before and after operation. The cervical spinal cord function was evaluated by the Japanese Orthopaedic Association (JOA) spinal cord function score, and the rate of improvement of neurological function was calculated. The Frankel grading was used to evaluate the neurological function of patients before and after surgery.@*Results@#Cervical X-ray, CT and MRI were performed in all patients before and after surgery. Operation time 55-110 min, mean 65±12 min, bleeding 100-220 ml, mean 110±20 ml. The cross-sectional area of the spinal canal and the median sagittal diameter of the spinal canal were significantly increased compared with the preoperative. All patients were followed up for an average of 10.9±1.4 months (3-20 months). Imaging examination showed that 16 patients had no loosening and fracture after internal fixation, and no re-closure occurred. MRI T2WI images showed continuous recovery of cerebrospinal fluid signal in the spinal cord of C3-7 range. The preoperative VAS score was 7.3±0.9 points, the average VAS score at the last follow-up was 1.6±0.4 points, the preoperative JOA score was 6.9±1.1 points, and the last follow-up JOA score was 13.4±1.3 points. The improvement rate was 87.23%±3.81%; Frankel grade D before surgery, and Frankel grade E after surgery.@*Conclusion@#Cervical spinal canal domed simple angioplasty operation, spinal canal full, satisfactory clinical efficacy, and can effectively reduce the incidence of related complications, it is a safe and feasible method for the treatment of cervical spinal stenosis.
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Objective@#To develop a new type of triple-leaf-enhanced cervical spine plate system, to study its biomechanical properties, perform clinical preliminary applications, and observe clinical effects.@*Methods@#Twelve fresh goat specimens were used, and the high-precision digital display grating displacement sensor system was used to compare the stability, fatigue strength and tensile strength of the fixation of the anterior nailing of the new type of triple-leaf-enhanced cervical spine plate system. All of 92 patients with cervical spondylosis who underwent cervical anterior decompression, cage or titanium mesh fusion, with new PRUNUS spine plate system or Atlantis spine plate system internal fixation were selected from January 2015 to January 2018. Comparative study recorded intraoperative blood loss, operative time, preoperative cervical Cobb angle, pain visual analogue scale (VAS), and Japanese Orthopaedic Association (JOA) spinal function score, and neurological improvement ratewas calculated. Frankel grading was used to evaluate pre and postoperative functional status of the anterior and posterior nerves, so as to comprehensively evaluate the initial clinical efficacy of the new PRUNUS spine plate system.@*Results@#The biomechanical tests showed that: 1) The flexion, extension, left bending, right bending, left rotation and right rotation ROM after fixing with the new PRUNUS spine plate system were 1.02°±0.13°, 1.32°±0.11°, 0.96°±0.23°, 1.03°±0.19°, 1.37°±0.17° and 1.05°±0.08°. ROM after fixation of Atlantis spine plate system were 0.99°±0.11°, 1.08°±0.23°, 0.83°±0.21°, 0.82°±0.13°, 1.18°±0.43°, 1.17°±0.17°, respectively. There was no significant statistical difference between the two groups; 2) The fatigue life of the new PRUNUS spine plate system and Atlantis spine plate system were 6.3×105 and 6.1×105, and the fatigue strengths were 512.12 Mpa and 502.85 Mpa respectively. There was no statistical difference between the two groups. 3) The maximum pull-out force of the new PRUNUS spine plate system was 483.62±39.14 N, and the maximum pull-out force of the Atlantis spine plate system was 396.55±22.79 N. The difference between the two groups was statistically significant. In the clinical application, the new PRUNUS spine plate system was used, the average operation time was 102.8±13.6 min, and the average blood loss was 56.8±14.1 ml. Using the Atlantis spine plate system, the average operation time was 132.8±15.7 min, and the average blood loss was 76.8±19.1 ml. The difference between the two groups was statistically significant; Using the new PRUNUS spine plate system, the VAS score was reduced from 5.42±1.17 before surgery to 1.58±0.44, the preoperative JOA score was 8.13±1.26, and the JOA score was 14.71±1.16 at the last follow-up. Using the Atlantis spine plate system, the VAS score was 6.94±1.06 before surgery. dropped to 1.75±0.35, the preoperative JOA score was 9.26±1.32, and the JOA score was 14.96±1.56 at the last follow-up. There was no significant difference between the two groups.@*Conclusion@#The new PRUNUS spine plate system has good biomechanical properties and has a good effect on the stability of the cervical vertebra, especially for the postoperative renovations and osteoporosis patients. The operation is simple and convenient, safe and effective, and worthy of clinical promotion.
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Objective@#To analyze the mid-term clinical efficacy of extended to C1, 2 posterior single-door laminoplasty for the treatment of ossification of the posterior longitudinal ligament combined the upper cervical spine.@*Methods@#From February 2013 to December 2015, 32 patients with cervical OPLL who were extended to C1, 2 posterior open-door laminoplasty were enrolled in our hospital (complete follow-up of 25 patients). There were 19 males and 6 females, aged 48-76 years (mean 60.1±7.0 years). Cervical spinal cord function was assessed using the Japanese Orthopaedic Association (JOA) spinal cord function score, and the rate of improvement in neurological function was calculated. The quality of life of patients was assessed using the neck disability index (NDI). Axial symptoms were assessed and indexed using the visual analog scale (VAS). The C0-2 angle of the cervical spine was measured by X-ray preoperative and at the last follow-up. The cervical curvature was evaluated by the C2-7 angle, and the cervical vertebra activity was observed by the dynamic X-ray of the cervical spine.@*Results@#25 patients were followed up for a period of 26-64 months (mean 35.9±8.1 months). At the last follow-up, the JOA score was 14.32±3.24, the NDI score was 7.61±1.23, and the VAS score was 1.42±0.78. The differences between the three scores were statistically significant compared with the preoperative scores. The neurological improvement rate at the last follow-up was 79.61%±13.23%. The preoperative C0-2 angle was 26.04°±6.28°, and the last follow-up was 24.92°±5.51°; the C2-7 angle was 19.55°±9.42° before surgery, and the C2-7 angle at last follow-up was 17.97°±8.80°. The C2-7 angle at last follow-up was slightly reduced compared with that preoperative, but the difference was not statistically significant. The preoperative cervical vertebra ROM was 35.31°±12.24°, and at the last follow-up it was 32.23°±9.65°. The ROM of cervical vertebrae at the last follow-up was slightly lower than that before surgery, but the difference was not statistically significant. Among them, the reduction of the ROM of overflexion was greater than that of the over-extension, which was the main reason for the decrease of ROM. The OPLL bone mass continued to grow at the last follow-up of 11 patients.@*Conclusion@#The extended to C1, 2 posterior single-door laminoplasty for the treatment of ossification of the posterior longitudinal ligament combined the upper cervical spine can achieve adequate spinal cord decompression, satisfactory neurological improvement, and improve the postoperative cervical curvature and activity. There was no obvious change in the curvature and activity of the cervical spine, and the axial symptoms did not increase significantly, and the clinical efficacy was positive.
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Objective@#To explore the relationship between the compression depth and compressive stress of the anterior and posterior cervical spinal cord in different sports positions.@*Methods@#Specimens of ten intact fresh cervical spine (C1-T1) from adult cadaver were collected. In order to simulate cervical disc degeneration and abnormal ligamentum flavum, we placed two hemispherical steel balls into the anterior and posterior side of the cervical spinal cord through the bone window of the C4, 5. The measurement was conducted in 10%, 20%, 30%, 40%, 50%, and 60% of the sagittal diameter for the compressive stress of the anterior and posterior cervical spinal cord under different compression depths of flexion, neutral, and posterior extension.@*Results@#The anterior depth of a certain pressure with the posterior pressure depth was increasing in neutral position, the stress on the anterior of the cervical cord-meningeal complex (CCMC) had no significant change, while the stress on the posterior of the CCMC increased greatly with the increasing of the degree of canal occlusion. The stress on the posterior of the CCMC varied insignificantly between 10% and 20% depth of canal occlusion (P>0.05). However, there was remarkable significance among 30% and 60% (P<0.05). In extension or flexion position, the stress on the anterior of the CCMC had no significant change, while the stress on the posterior of the CCMC increased greatly with the increasing of the degree of canal occlusion. The stress on the posterior of the CCMC varied insignificantly between neighboring depths of canal occlusion from 10% (P>0.05). However, there was remarkable significance among 20% and 60% (P<0.05). The posterior depth of a certain pressure with the anterior pressure depth was increasing in neutral position. The stress on the anterior of the CCMC increased greatly with the increasing of the degree of canal occlusion. The stress on the anterior of the CCMC varied insignificantly between 10% and 20% depth of canal occlusion(P>0.05). However, there was remarkable significance among 30% and 60% (P<0.05). The stress on the posterior of the CCMC had no significant change. In extension or flexion position, the stress on the anterior of the CCMC increased greatly with the increasing of the degree of canal occlusion. The stress on the anterior of the CCMC varied insignificantly between neighboring depths of canal occlusion from 10% (P>0.05). However, there was remarkable significance among 20% and 60% (P<0.05). The stress on the posterior of the CCMC had no significant change. Compared with the neutral position, the anterior flexion position and the posterior extension position had different trends in the compressive stress in the anterior and posterior aspect of the cervical spinal cord.@*Conclusion@#The stress on the anterior and the posterior of the CCMC has a closely nonlinear relationship with the depth of canal occlusion. With the increase of the depth of canal occlusion, the stress is increasing, especially running over the 30% depress of canal occlusion under neutral position. However, the stress is increased, especially running over the 20% depress of canal occlusion under the flexion and extension position.
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Objective To explore the feasibility and clinical efficacy of cervical vertebral dome expansion laminoplasty..Methods Our hospital from February 2017 to 2018 Sep 16 cases with cervical spinal canal dome of cervical spinal stenosis angioplasty in treatment of cervical spinal cord due to the medical records of patients,including 14 males and 2 females;Aged 49-76 years old,average age 57.3± 1.7 years old.The course of disease was 7-48 months,with an average disease duration 17.75± 1.90 months.Of the 16 patients,5 had multi-segment cervical disc herniation and 11 had long segmental ossification of the posterior longitudinal ligament.All the 16 patients underwent cervical C3-7 dome-type spinal canal enlargement;the position,stability and spinal cord compression of the internal fixation were evaluated according to the patient's imaging data (X-ray,CT and MRI).The neck and upper extremity pain was evaluated by visual analogue scale (VAS) before and after operation.The cervical spinal cord function was evaluated by the Japanese Orthopaedic Association (JOA) spinal cord function score,and the rate of improvement of neurological function was calculated.The Frankel grading was used to evaluate the neurological function of patients before and after surgery.Results Cervical X-ray,CT and MRI were performed in all patients before and after surgery.Operation time 55-110 min,mean 65±12 min,bleeding 100-220 ml,mean 110±20 ml.The cross-sectional area of the spinal canal and the median sagittal diameter of the spinal canal were significantly increased compared with the preoperative.All patients were followed up for an average of 10.9±1.4 months (3-20 months).Imaging examination showed that 16 patients had no loosening and fracture after internal fixation,and no re-closure occurred.MRI T2WI images showed continuous recovery of cerebrospinal fluid signal in the spinal cord of C3-7 range.The preoperative VAS score was 7.3±0.9 points,the average VAS score at the last follow-up was 1.6±0.4 points,the preoperative JOA score was 6.9± 1.1 points,and the last follow-up JOA score was 13.4± 1.3 points.The improvement rate was 87.23％±3.81％;Frankel grade D before surgery,and Frankel grade E after surgery.Conclusion Cervical spinal canal domed simple angioplasty operation,spinal canal full,satisfactory clinical efficacy,and caneffectively reduce the incidence of related complications,it is a safe and feasible method for the treatment of cervical spinal stenosis.
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Objective To develop a new type of triple-leaf-enhanced cervical spine plate system,to study its biomechanical properties,perform clinical preliminary applications,and observe clinical effects.Methods Twelve fresh goat specimens were used,and the high-precision digital display grating displacement sensor system was used to compare the stability,fatigue strength and tensile strength of the fixation of the anterior nailing of the new type of triple-leaf-enhanced cervical spine plate system.All of 92 patients with cervical spondylosis who underwent cervical anterior decompression,cage or titanium mesh fusion,with new PRUNUS spine plate system or Atlantis spine plate system internal fixation were selected from January 2015 to January 2018.Comparative study recorded intraoperative blood loss,operative time,preoperative cervical Cobb angle,pain visual analogue scale (VAS),and Japanese Orthopaedic Association (JOA) spinal function score,and neurological improvement ratewas calculated.Frankel grading was used to evaluate pre and postoperative functional status of the anterior and posterior nerves,so as to comprehensively evaluate the initial clinical efficacy of the new PRUNUS spine plate system.Results The biomechanical tests showed that:1) The flexion,extension,left bending,right bending,left rotation and right rotation ROM after fixing with the new PRUNUS spine plate system were 1.02°±0.13°,1.32°±0.11 °,0.96°±0.23°,1.03°±0.19°,1.37°±0.17° and 1.05°±0.08°.ROM after fixation of Atlantis spine plate system were 0.99°±0.11°,1.08°±0.23°,0.83°±0.21°,0.82°±0.13°,1.18°±0.43°,1.17°±0.17°,respectively.There was no significant statistical difference between the two groups;2) The fatigue life of the new PRUNUS spine plate system and Atlantis spine plate system were 6.3×105 and 6.1×105,and the fatigue strengths were 512.12 Mpa and 502.85 Mpa respectively.There was no statistical difference between the two groups.3) The maximum pull-out force of the new PRUNUS spine plate system was 483.62±39.14 N,and the maximum pull-out force of the Atlantis spine plate system was 396.55±22.79 N.The difference between the two groups was statistically significant.In the clinical application,the new PRUNUS spine plate system was used,the average operation time was 102.8±13.6 min,and the average blood loss was 56.8±14.1 ml.Using the Atlantis spine plate system,the average operation time was 132.8±15.7 min,and the average blood loss was 76.8±19.1 ml.The difference between the two groups was statistically significant;Using the new PRUNUS spine plate system,the VAS score was reduced from 5.42±1.17 before surgery to 1.58±0.44,the preoperative JOA score was 8.13±1.26,and the JOA score was 14.71±1.16 at the last follow-up.Using the Atlantis spine plate system,the VAS score was 6.94±1.06 before surgery.dropped to 1.75±0.35,the preoperative JOA score was 9.26± 1.32,and the JOA score was 14.96±1.56 at the last follow-up.There was no significant difference between the two groups.Conclusion The new PRUNUS spine plate system has good biomechanical properties and has a good effect on the stability of the cervical vertebra,especially for the postoperative renovations and osteoporosis patients.The operation is simple and convenient,safe and effective,and worthy of clinical promotion.
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Objective To analyze the effect of air quality index (AQI) on the incidence of tuberculosis (TB) in Beijing,and to provide evidence for setting up a better program regarding prevention and control of tuberculosis.Methods Generalized additive model (GAM) was used to analyze the association between AQI and the incidence of tuberculosis in Beijing,from January 1,2014 to November 9,2016.Confounding factors as meteorological conditions and time trends were under control.Results In Beijing,a total of 14 533 TB cases with definite dates of onset were collected during the study period,with 36 children excluded from the study.Finally,14 497 cases were included in the study,including 9 513 men and 4 984 women,with 11 290 adults (15-59 years old) and 3 207 elderly (≥60 years old).Data from the optimal single-day lag effect of GAM showed that,with every 1 0 increase of AQI,the percent of increase on the onsets of overall,male,female and adult;tuberculosis cases were 0.85％ (95％CI:0.26％-1.44％),0.83％ (95％CI:0.24％-1.42％),0.93％ (95％CI:0.24％-1.62％) and 0.88％ (95％CI:0.29％-1.46％),respectively.The optimal lag time of the single-day effects were 15 days (lagl5),but 16 days (lag16) for male.The optimal cumulative lag effect showed that with every 10 AQI increase,the percent of increase on the onsets of overall,male,female and adult tuberculosis cases were 1.92％ (95％CI:0.23％-3.16％),1.94％ (95％CI:0.15％-3.72％),2.04％ (95％CI:0.10％-3.97％) and 2.00％ (95％CI:0.30％-3.69％),respectively,with the optimal lag time of cumulative delayed effects as 17 days (lag0_17),18 days (lag0_18),16 days (lag0_16) and 17 days (lag0_17),respectively.However,there were no statistical significances noticed in the elderly cases.Conclusion There was a positive correlation between AQI and the number of TB cases in Beijing,and the effects of AQI on the number of TB cases in different genders and age groups were different.
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Objective To analyze the effect of air quality index (AQI) on the incidence of tuberculosis (TB) in Beijing,and to provide evidence for setting up a better program regarding prevention and control of tuberculosis.Methods Generalized additive model (GAM) was used to analyze the association between AQI and the incidence of tuberculosis in Beijing,from January 1,2014 to November 9,2016.Confounding factors as meteorological conditions and time trends were under control.Results In Beijing,a total of 14 533 TB cases with definite dates of onset were collected during the study period,with 36 children excluded from the study.Finally,14 497 cases were included in the study,including 9 513 men and 4 984 women,with 11 290 adults (15-59 years old) and 3 207 elderly (≥60 years old).Data from the optimal single-day lag effect of GAM showed that,with every 1 0 increase of AQI,the percent of increase on the onsets of overall,male,female and adult;tuberculosis cases were 0.85％ (95％CI:0.26％-1.44％),0.83％ (95％CI:0.24％-1.42％),0.93％ (95％CI:0.24％-1.62％) and 0.88％ (95％CI:0.29％-1.46％),respectively.The optimal lag time of the single-day effects were 15 days (lagl5),but 16 days (lag16) for male.The optimal cumulative lag effect showed that with every 10 AQI increase,the percent of increase on the onsets of overall,male,female and adult tuberculosis cases were 1.92％ (95％CI:0.23％-3.16％),1.94％ (95％CI:0.15％-3.72％),2.04％ (95％CI:0.10％-3.97％) and 2.00％ (95％CI:0.30％-3.69％),respectively,with the optimal lag time of cumulative delayed effects as 17 days (lag0_17),18 days (lag0_18),16 days (lag0_16) and 17 days (lag0_17),respectively.However,there were no statistical significances noticed in the elderly cases.Conclusion There was a positive correlation between AQI and the number of TB cases in Beijing,and the effects of AQI on the number of TB cases in different genders and age groups were different.
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Objective To investigate the risk of atopic disease in infants with a atopic mothers. Methods The level of CCL22 and total IgE in the cord blood were measured using ELISA for 33 newborns with atopic mothers and for 44 newborns with non-atopic mothers. Correlation between the two factors was examined. Periodic follow-ups were conducted on the newborns to observe the risk of atopic diseases. Results The atopic group showed a higher level of CCL22 than that in non-atopic group, and the difference was statistically significant (Z=5.20, P=0.000). When 0.9 kU/L was taken as the threshold of an elevated IgE level in cord blood, the positive rates of the atopic group (11/33) was much higher than that of the non-atopic group (4/44) (χ2=7.07, P=0.008). Furthermore, the level of CCL22 and the level of IgE were significantly positively correlated (r=0.808, P=0.000; r=0.348, P=0.021) in the atopic group and the non-atopic group, respectively. During the 12 months of follow-up, the number of atopic diseases occurred in the infants in the atopic group (24/33) was much higher than that in the non-atopic group (10/44) (χ2=19.12, P<0.001).Significant correlation exists between levels CCL22 and total IgE in cord blood and infant atopic diseases (Z=5.36, P=0.000; Z=4.44, P=0.000). Conclusions At birth, the infants with an atopic mother are already in a sensitization state and have a tendency to develop potential atopic diseases. There is a correlation between the history of atopic diseases in the mothers and the elevated level of CCL22 in the cord blood of the newborns, and the probability of developing atopic diseases for the newborns is significantly higher when the level of CCL22 is elevated. The combined detection of CCL22 and IgE levels impact significantly on the prediction of the risk of atopic diseases clinically.
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Objective To explore the effect of Exosomes isolated from the A549 lung cancer cells on the proliferation of these cells and their ho?mologous tumor cells,HCC827,and the role of the PI3K/Akt and SRC signaling pathways in this process. Methods Exosomes were isolated from the supernatant after density gradient centrifugation of A549 cells. The Exosomes morphology was observed by transmission electron microscopy. The expression of the Exosome?specific proteins was analyzed using Western blotting. Cell proliferation was investigated using the MTT assay. Re?sults The A549?derived Exosomes were 30?100 nm in diameter and had a bilayer membrane.Western blotting showed that CD9 was detected in these Exosomes. The isolated Exosomes promoted the proliferation of the A549 and the HCC827 cells in a dose?and time?dependent manner,ac?companied by the activation of Akt and SRC. Conclusion Exosomes isolated from A549 cells promote the proliferation of the secreting cells and the homologous tumor cells in a dose?and time?dependent manner. The mechanism may be related to the activation of Akt and SRC.
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Objective To investigate the effect of Exosomes derived from lung cancer cells on the migration of secretory cells and homologous tumor cells and to explore the role of PI3K/Akt and SRC signaling pathways in this process.Methods Exosomes were isolated from the supematant post density gradient centrifugation of A549,lung cancer cells.Morphology of the Exosomes was studied using transmission electron microscopy.Protein expression was analyzed using Western blotting.Cell migration was analyzed by a transwell assay.Results The double-membrane-bound Exosomes appeared as discal-shaped structures,30-100 nm in diameter.Western blotting showed that CD9 was abundant in the Exosomes.The Exosomes promoted the migration of A549 cells and their homologous tumor cells,HCC827 in a dose-dependent manner,accompanied by the activation of Akt and SRC.Conclusion The Exosomes derived from A549 (lung cancer) cells promote the migration of the secreting cells and the homologous tumor cells.The mechanism may be correlated with the activation of Akt and SRC.
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Objective:The effect of naltrexone on function of murine peritoneal macrophage in vitro was studied in order to illuminate its immune activity futher. Methods:Peritoneal macrophages were divided in three groups:RPMI1640 blank control group, LPS positive control group and NTX treated group. Various phenotypic and functional indices were tested by MTS, flow cytometry technology,phagocytosis experiment and ELISA. Results: Compared with RPMI1640 group,at a LDN exhibits paradoxical properties;the expression of CD64 on surface increased while the expression of CD206 decreased in NTX group;the expression of tumour necrosis factor-α(TNF-α),interleukin-6(IL-6),interleukin-1β(IL-1β)were increased. Conclusion:The results of experiment had proved that LDN could influence macrophage polarzation, regulate the inflamatory mediators production and affect the phagocytosis function of peritoneal macrophage.
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Objective To explore the influence of trimetazidine on left cardiac systolic function and plasma brain natriuretic peptide(BNP)in alcoholic cardiomyopathy.Methods 60 cases of alcoholic cardiomyopathy in our hospital from December 2014 to December 2015 were chosen to research,and they were divided into observation group and control group by random number table,30 patients in each group.The control group was treated with bisoprolol combined with strengthening heart,diuretic and other treatment,the observation group was treated with trimetazidine on the basis of routine treatment.Left ventricular ejection fraction(LVEF),left ventricular end diastolic diameter (LVEDD),each sub output(CO)after 6 months'treatment were compared.Results LVEF of the observation group was from pre -treatment (34.8 ±5.4)% up to (47.4 ±5.5)%,LVEDD value (49.1 ±6.5)min and CO values (5.6 ±0.7)L/min were significantly better than the control group[(53.4 ±7.5)min,(4.9 ±0.7)L/min],the differences were statistically significant(t =2.373,3.873,all P <0.05).BNP level of the observation group after treatment was significantly lower than control group[(455.8 ±133.2)fmoL/mL vs (542.7 ±128.3)fmoL/mL,t =2.574,P <0.05)].The total effective rate of the observation group (96.67%)was higher than that of the control group (80%),and the difference between the two groups was significant (χ2 =13.09,P <0.05 ).Conclusion Alcoholic cardiomyopathy should pay attention to the daily scientific daily routine,take measure to quit smoking and alcohol.Trimetazidine could effectively improve the left ventricular systolic function,decrease the level of BNP,thus is worthy of clinical application.