Associations of distribution of time spent in physical activity and sedentary behavior with obesity / 北京大学学报(医学版)

OBJECTIVE@#To explore associations of distribution of time spent in physical activity (PA) and sedentary behavior (SB) with obesity with taking account that time is finite during the day of adult residents in Wuhai City.@*METHODS@#A cross-sectional study was undertaken in Wuhai City, and we carried out a sampling of local residents aged 18-79 by using multiple stratified cluster sampling method. Data about social demographic characteristics, time spent in PA and SB, diet intake, controlling situation of chronic disease and other covariates were obtained by qualified investigators for face-to-face questionnaire survey. Data about height, weight, and waist circumstance, were obtained by doctors in a secondary hospital or above for body measurements. The statistical method used in our study was known as compositional data analysis, which had been used to process compositional data in many fields. Liner regression analysis with compositional data was used to synthetically analyze the associations of distribution of time spent in PA and SB with obesity,and to investigate the effect of re-allocating time from one behavior to another one whilst the remaining one was kept stable.@*RESULTS@#The investigation revealed the special advantage of compositional data analysis in processing time-use data. The result of liner regression analysis with the compositional data showed that after controlling the potential confounding factors, the associations of distribution of time spent in PA and SB was significantly associated with body mass index (BMI, P<0.001) and the negative natural logarithm of waist to height ratio (-lnWHtR, P<0.001). Among them, in professional population, the proportion of time spent in moderate-to-vigorous physical activity (MVPA) was negatively correlated with -lnWHtR (β=-0.008, P=0.022), while the proportion of time spent in SB was positively correlated with BMI and -lnWHtR (β=0.117, P=0.003; β=0.007, P=0.005). However, in nonprofessional population, the proportion of time spent in MVPA was only negatively correlated with BMI (β=-0.079, P=0.041). Nevertheless, the proportion of time spent in low-intensity physical activity (LIPA) was not significantly associated with BMI and -lnWHtR in both professional and nonprofessional population. In addition, the effects of MVPA replacing another behavior and of MVPA being displaced by another behavior were not symmetrical, and 10 minutes of MVPA replacing LIPA or SB had a greater influence on intervention and prevention of obesity than 10 minutes MVPA being replaced by LIPA or SB.@*CONCLUSION@#The research has resulted in a solution of the associations of the distribution of time spent in PA, SB with health risk. Our results suggest that public health messages should target the health effects of the distribution of time of PA and SB synergistically in developing PA guidelines and health management practice, rather than simply increasing or decreasing the absolute time of PA or SB, so that we can provide scientific suggestions to make people get a profounder healthy effect.

Mechanism of Duhuo Jisheng decotion in delaying degeneration of nucleus pulposus cells in human intervertebral disc / 中国中药杂志

This paper aimed to investigate the role of Duhuo Jisheng decotion (DHJSD) in delaying human disc degeneration and its possible molecular mechanism. The intervertebral disc specimens were divided into normal and degenerated groups according to Pfirrmann classfication. The expressions of TNF-α, IL-1β, MMP-3 and MMP-13 in intervertebral disc tissue were detected by Western blot and PCR. Then degenerated human primary NPCs were cultured in vitro, the viability of NPCs treated with stromal cell-derived factor-1 (SDF-1，10 μg·L⁻¹)and various concentrations of DHJSD was assessed by the CCK-8 assay, and the appropriate concentration was screened. The experiment was divided into three groups, control group, SDF-1 group and DHJSD plus SDF-1 group. The levels of TNF-α, IL-1β, Agg, coIⅡ, MMP-3 and MMP-13 were detected. The levels of CXCR4, NF-κB major groups P65 phosphorylation (p-P65) and nuclear translocation, after treated with CXCR4 siRNA and NF-κB inhibitor (BAY11-7082) were measured by Western blot and immunofluorescence. At the same time, the expression of cell inflammatory factors and extracellular matrix were also measured. The expressions of TNF-α, IL-1β, MMP-3 and MMP-13 in the degenerated intervertebral disc tissue were significantly increased. In vitro study, the results of CCK-8 indicated that the viability of NPCs was significantly increased when DHJSD concentration was 300 mg·L⁻¹. After the experiment was divided into three groups, compared with SDF-1 group, the expressions of TNF-α, IL-1β, MMP-3 and MMP-13 in DHJSD group were significantly decreased, but the expressions of Agg, coIⅡ were significantly increased. When CXCR4-siRNA was transfected into NPCs, SDF-1 increased expressions of CXCR4 and p-P65 and inhibited nuclear translocation of P65, whose effect was suppressed by CXCR4-siRNA and DHJSD. In addition, when BAY11-7082 was used to treat NPCs, the expression of TNF-α, IL-1β, MMP-3 and MMP-13 were significantly decreased. DHJSD could inhibit the production of inflammatory factors and promote the synthesis of extracellular matrix. The potential mechanism may be related to the SDF-1/CXCR4/NF-κB signaling pathway.

A case report of atypical placental site nodule / 天津医药

Placental site nodule as a kind of benign trophoblastic disease is rare.The features of placental site nodule are known very little. Pathological diagnosis is the gold standard, while the pathological features of atypical placental site nodule are known very little. Here we report a case of mass in uterus with atypical placental site nodule, which can supplement our knowledge of this disease.

Factors affecting asymmetrical lower extremity loading after unilateral total knee arthroplasty / 医用生物力学

Total knee arthroplasty (TKA) is the most common surgery for treating late-stage knee osteoarthritis. Previous studies have shown that after unilateral TKA, the load-carrying on lower limbs is asymmetrical and the contralateral knee have to bear even greater loads. Therefore, the osteoarthritis side is susceptible to become even worse and under the risk of subsequent replacement. In this review, factors affecting asymmetrical loading on lower limbs, including changes in alignment, pain, muscle weakness, loss of proprioception, and psychological factors are reviewed. The overall effects of these affecting factors on human body, compensation of asymmetrical loading on the body segments and clinical interventions are also discussed. Specific clinical interventions can be introduced to reduce the risk of osteoarthritis or replacement of contralateral knee by analyzing the above factors affecting asymmetrical loading on lower limbs after unilateral TKA.

Neurobehavioral Assessment of Rats Exposed to Yttrium Nitrate during Development / 生物医学与环境科学（英文）

<p><b>OBJECTIVE</b>The aim of this study was to assess the effects of yttrium nitrate on neurobehavioral development in Sprague-Dawley rats.</p><p><b>METHODS</b>Dams were orally exposed to 0, 5, 15, or 45 mg/kg daily of yttrium nitrate from gestation day (GD) 6 to postnatal day (PND) 21. Body weight and food consumption were monitored weekly. Neurobehavior was assessed by developmental landmarks and reflexes, motor activity, hot plate, Rota-rod and cognitive tests. Additionally, brain weights were measured on PND 21 and 70.</p><p><b>RESULTS</b>No significant difference was noted among all groups for maternal body weight and food consumption. All yttrium-exposed offspring showed an increase in body weight on PND 21; however, no significant difference in body weight for exposed pups versus controls was observed 2 weeks or more after the yttrium solution was discontinued. The groups given 5 mg/kg daily decreased significantly in the duration of female forelime grip strength and ambulation on PND 13. There was no significant difference between yttrium-exposed offspring and controls with respect to other behavioral ontogeny parameters and postnatal behavioral test results.</p><p><b>CONCLUSION</b>Exposure of rats to yttrium nitrate in concentrations up to 45 mg/kg daily had no adverse effects on their neurobehavioral development.</p>

Observation of clinical effects of surgery for trailing edge fracture of tibial plateau medial condyle and posterior cruciate ligament avulsion fracture / 中国骨伤

<p><b>OBJECTIVE</b>To investigate the clinical effects of enblock distal radius T-plate fixation in treating trailing edge fracture of tibial plateau medial condyle and posterior cruciate ligament (PCL) avulsion fracture.</p><p><b>METHODS</b>From September 2008 to November 2011, 5 patients with trailing edge fracture of tibial plateau medial condyle and PCL avulsion fracture caused by knee joint hyperextension,were treated with surgery. There were 3 males and 2 females with an average age of 35 years old (25 to 42). Left knee injury was in 3 cases and right knee had in 2 cases; 2 cases caused by sports injury and 3 cases caused by road accident. All patients were undergone emergency treatment. Fractures were anatomically reduced and fixed with T-plate through poples approach. Complications were observed after operation. Bone healing and clinical effects were respectively evaluated by X-rays and HSS system.</p><p><b>RESULTS</b>Five patients were followed up for 1 to 4 years with a mean of 2 years. All incisions obtained healing of I stage. All knee joints recovered well and were stable with inflexion more than 120 degrees, no complications such as knee joint pain, injuries of nerve and blood vessel, infection, internal fixation failure were found. The mean score of HSS system was 94.40 +/- 6.09 and all patients got excellent result.</p><p><b>CONCLUSION</b>For the treatment of trailing edge fracture of tibial plateau medial condyle and PCL avulsion fracture caused by knee joint hyperextension, enblock distal radius T-plate fixation had advantages of good stability,higher success rate, and knee joint function can recover well.</p>

Clinical effects of steel plate fixation for the failure of arthrodesis of ankle by screw fixation / 中国骨伤

<p><b>OBJECTIVE</b>To observe the therapeutic effects of steel plate fixation after the failure of arthrodesis of ankle by screw fixation.</p><p><b>METHODS</b>From August 2001 to October 2011, 15 patients were with steel plate fixation after failure of arthrodesis of ankle by screw fixation. Among patients, 9 cases were males and 6 cases were females,ranging age from 40 to 65 years old with the average of 56 years old. Ten cases were in left and 5 cases were in right. Screws were removed and steel plate was fixed intraoperatively, and plaster external fixation for postoperation. Clincal effect were evaluated according to AOFAS scoring system from pain, waliking ability and aligment before and after operation, and X-ray was used to evaluate joint fusion after operation.</p><p><b>RESULTS</b>All patients were followed up, and the duration ranged from 4 months to 4 years with an average of 2 years. The incison were healed in stage I. No ankle pain,injury of blood vessel and nerve,infection and farilure of internal fixation occuerred. The AOFAS score increased from 36.86 +/- 8.32 preoperatively to 85.09 +/- 4.65 (t = -26.366, P = 0.000).</p><p><b>CONCLUSION</b>Steel plate fixation after the failure of ankle arthrodesis of screw fixation has the advantages of rigid stability, simple manipulation and high success rate, less pain, perfect recovery.</p>

Experimental study on invigorating kidney and activating blood on preventing and curing SD rats with knee osteoarthritis / 中国骨伤

<p><b>OBJECTIVE</b>To explore the effects and mechanism of invigorating kidney and activating blood, invigorating kidney and expelling wind on hemorheology, IL-1β and TNF-α of SD rats with knee osteoarthritis, then definite the evolution of muscle certified turning into heumatism and compare the effect of Chinese herbal.</p><p><b>METHODS</b>One hundred and eighty SD rats with 3-month-old (each weight was 185 to 215 g) received intra-articular injection of papain solution for establishing knee OA models. All rats were randomly divided into activating blood group, preventing group, expelling wind group, invigorating kidney group, invigorating kidney and activating blood group and model group. Laboratory indexes were obtained at the 30th, 60th, 90th days after gastric perfusion, which including state of mind, activity, fur, weight, joint swelling, largely image, hemorheology, inflammation and HE pathological appearance.</p><p><b>RESULTS</b>After operation, rats appeared blood stasis and swelling and difficulty crawling. There was significant difference of hemorheology in invigorating kidney and activating blood group the content of IL-1β and TNF-α was obviously lower than model group (P < 0.05 ). While the content of IL-1β and TNF-α on the early stage was obviously higher than late stage (P < 0.05).</p><p><b>CONCLUSION</b>Knee osteoarthritis mainly show synovial inflammation at the early stage, inflammation at early stage is more severe than late; invigorating kidney and activating blood decoction can inhibit the knee cartilage injury, improve blood circulation and prevent local inflammatory reaction. Activating blood decoction and invigorating kidney and activating blood Decoction have certain curative effect in early time, but the effects of invigorating kidney and activating blood Decoction is more effective than other on the late stage.</p>

Analysis of concurrent intravertebral vacuum sign in thoracolumbar fractures after posterior internal fixation / 中国骨伤

<p><b>OBJECTIVE</b>To investigate the importance of TLICS classification to surgical options of thoracolumbar fractures by analyzing the cause of intravertebral vacuum sign, vertebral collapse and vertebral pseudarthrosis.</p><p><b>METHODS</b>From January 2006 to December 2010, the clinical data about 15 patients with postoperative complications by thoracolumbar fracture after posterior internal fixation were retrospectively analyzed. There were 9 males and 6 females, ranging in age from 18 to 75 years, with an average of 54.6 years. Of them, fracture site in T12 was 7 cases, L1 was 5 cases, L2 was 3 cases; compression fractures was in 12 cases and burst fracture was in 3 cases; according to classification of TLICS, 12 cases were of type I ,3 cases of type III. And the causes of complications after posterior fixation were analyzed according clinical manifestation and imaging finding combined with review literatures.</p><p><b>RESULTS</b>After 10 to 20 months following-up (with average of 15 months), loss of vertebral height found in 9 cases (4 cases existed vertebral collapse, as well as 3 cases occurred screw loosening) and Intravertebral Vacuum Sign appeared in 6 cases.</p><p><b>CONCLUSION</b>In order to avoid the vertebral vacuum and fixation failure, the clinical data of patients should be roundly and carefully evaluated, surgical indications should be strictly controlled and the surgical approach should be selected according to correct classification. Particularly, the reconstruction of the stability of former spinal column shoud be paid more attention.</p>

The effects of high-protein, low-carbohydrate diet on body weight and the expression of gastrointestinal hormones in diet-induced obesity rat / 中华预防医学杂志

<p><b>OBJECTIVE</b>To investigate the effects of long-term high-protein, low-carbohydrate diet on body weight and the expression of gastrointestinal hormones in diet-induced obesity rats.</p><p><b>METHODS</b>Twenty-four diet-induced obesity rat models were established by feeding fat-enriched diet, then were randomly divided into two groups by stratified sampling method by weight: the high-protein diet group (HP, 36.7% of energy from protein), and the normal chow group (NC, 22.4% of energy from protein), 12 rats in each group. The total calorie intake of each rat per day was similar and was maintained for 24 weeks, then body weight, visceral fat mass, fasting plasma ghrelin and glucagon-like peptide-1 (GLP-1) were determined, as well as protein expression of ghrelin in stomach, GLP-1 in ileum were detected by immunohistochemistry.</p><p><b>RESULTS</b>After 24 weeks, body weight of HP, NC groups were (490.92 ± 39.47) g and (545.55 ± 31.08) g, respectively (t = -3.664, P < 0.01); visceral fat mass were (22.42 ± 7.04) g and (32.33 ± 9.27) g, respectively (t = -2.503, P < 0.05); plasma ghrelin level were (2.36 ± 0.82) and (1.95 ± 0.64) ng/ml, respectively (t = 1.337, P > 0.05), and plasma ghrelin level was negatively correlated to body weight (r = -0.370, t = -1.899, P < 0.05), visceral fat mass (r = -0.454, t = -2.52, P < 0.01); plasma GLP-1 concentration were (0.52 ± 0.13) and (0.71 ± 0.19) ng/ml, respectively(t = -2.758, P < 0.05); ghrelin protein expression in stomach were 25 473 ± 8701 and 10 526 ± 6194, respectively (t = 2.501, P < 0.05); GLP-1 protein expression in ileum were 27 431 ± 5813 and 36 601 ± 5083, respectively (t = -1.833, P = 0.081).</p><p><b>CONCLUSION</b>Long-term isocaloric high-protein, low-carbohydrate diet can reduce body weight and visceral fat, increase the expression of ghrelin, and decline GLP-1 expression in diet-induced obesity rats.</p>

Application and effect of auricular acupoint pressing for analgesia in perioperative period of total knee joint replacement / 中国中西医结合杂志

<p><b>OBJECTIVE</b>To observe the effect of auricular acupoint pressing (AAP) for analgesia during perioperative period of total knee joint replacement.</p><p><b>METHODS</b>Sixty patients with osteoarthritis of ASA grade I - III scheduled to receive unilateral total knee joint replacement were equally randomized into the AAP group and the control group, 30 in each group. The general anesthesia on all patients was implemented by physicians of an identical group through endotracheal intubation. To the patients in the AAP group, AAP with Vaccaria seed was applied before operation, and the local analgesia on affected limb with acupoint pasting was used after operation. Besides, administering of celecoxib 400 mg on the day before operation, and celecoxib 200 mg twice daily post-operation was given to all patients. When the visual analogue scales (VAS) reached more than 7 points, 0.1 g of bucinnazine hydrochloride was given for supplement. Meantime, same post-operative training methods were adopted in both groups. The resting VAS pain scores, contentment of sedation, incidence of adverse event, postoperative range of motion (ROM) of knee joint and Hospital for Special Surgery (HSS) score were recorded.</p><p><b>RESULTS</b>The resting VAS pain scores at 6 h and 24 h after operation was 5.99 +/- 0.67 scores and 4.26 +/- 0.59 scores in the AAP group respectively, which was significantly lower than that in the control group at the corresponding time (7.02 +/- 0.85 scores and 4.92 +/- 0.43 scores, P < 0.01); but it showed insignificant difference between the two groups at 1 h and 48 h after operation (P > 0.05); sedation contentment in the two groups was similar; incidence of adverse event in the AAP groups seemed lower (4 cases vs. 11 cases), but the intergroup difference was statistically insignificant (P > 0.05). ROM before surgery were 75.63 degrees +/- 5.74 degrees and 75.43 degrees +/- 5.63 degrees in the two groups respectively, showing no significant difference (P > 0.05), two weeks after operation, the initiative ROM raised to 96.50 degrees +/- 3.79 degrees and 93.50 degrees +/- 3.50 degrees, and the passive ROM reached 107.8 degrees +/- 3.37 degrees and 105.27 degrees +/- 3.25 degrees in the two groups respectively, with statistical significance between them (P < 0.05). HSS score was similar between groups before operation (60.23 +/- 3.44 scores vs. 61.70 +/- 2.83 scores, P > 0.05); while it became 86.97 +/- 2.33 scores and 85.37 +/- 2.30 scores after operation, showing significant difference between groups (P < 0.05).</p><p><b>CONCLUSION</b>Applying auricular acupoint pressing in perioperative period of knee joint replacement is favorable for alleviating postoperative pain, decreasing narcotic consumption, and promoting early rehabilitation, and it has the advantages of low cost, less complication, simple manipulation and high safety.</p>

Relationship between post-traumatic stress disorder and perceived social support among middle school students in Wenchuan earthquake-stricken / 中华流行病学杂志

Objective To explore the relationship between post-traumatic stress disorder (PTSD) and perceived social support (PSS)ability among middle school students in earthquake-stricken areas after the Wenchuan earthquake accident. Methods A total of 1966 students from three secondary schools of Wenchuan earthquake-stricken areas were evaluated by PTSD Checklist-Civilian Version (PCL-C) and Perceived Social Support Scale (PSSS). Results The overall incidence rate of PTSD was 78.3%, with severe PTSD as 24.38%. Significant differences on the incidence rates of PTSD were found among the students who were in different PSS levels (P<0.05) and significant negative correlation existed between the levels of severity on PTSD and PSS (γ=-0.226, P<0.05). Significant differences on PTSD incidence rates were found among those students who were from different families or out-family PSS levels (P=0.009, P<0.05). Significant negative correlation existed between the severity of PTSD and family or out-family PSS level (γ=-0.176, P<0.05, γ=-0.214, P<0.05). Conclusion Relationships between the incidence rate, severity of PTSD and PSS levels existed among the middle school students in Wenchuan earthquake-stricken areas, with higher PSS, lower incidence rate and lighter severity of PTSD. Psychological intervention for earthquake-stricken students should be carried out.

The selection of responsible veterbal body in PKP (percutaneous kyphosis plasty) for aged osteoporotic spinal multiple fracture / 中国骨伤

<p><b>OBJECTIVE</b>Through an analysis of the effect of PKP (percutaneous kyphosis plasty) for aged osteoporotic spinal multiple fracture to demonstrate the importance of the selection of responsible veterbal body.</p><p><b>METHODS</b>Twenty-four consecutive procedures were performed in 19 aged patients with osteoporotic spinal compression fractures from May 2004 to October 2007. The 24 responsible veterbal bodies were confirmed by the manifestations of MRI, X-ray, physical examination before the procedures. Established work path through hibateral vertebral arch, put into saccule, poured in bone cement under X-ray perspective. To observe the condition about symptom improving, fractured reduction and complications after operation.</p><p><b>RESULTS</b>The operations were successfully completed and the pain released obviously at 2 days after operation. The patients can walk next day after operation and no complication found. The mean loss percent of the anterior and middle vertebal heights were respectively (34.22 +/- 11.51)% and (26.53 +/- 11.61)% before operation,postoperative were respectively (13.21 +/- 11.43)% and (15.10 +/- 6.50)%. The mean kyphosis corrected from (24.50 +/- 3.10) degrees to (8.70 +/- 4.30) degrees; the VAS scores decreased from 83.00 +/- 6.00 to 27.00 +/- 5.00. There was significant difference between before and after operation (P < 0.01).</p><p><b>CONCLUSIONS</b>PKP for aged osteoporotic spinal multiple fractures by selecting true veterbal body has satisfactory clinical efficacy. We should emphasize the importance of the selectivity of responsible veterbal body in the procedures. It needs three essential elements: (1) Obviously spinous process tenderness and rap pain. (2) X-rays showed veterbal body compression fracture; MR showed low signal in veterbal body by T1WI, and high signal by T2WI, STIR. (3) The manifestation of radiology can be explained clearly by clinical symptomes arid signs.</p>

Three-tunnels core decompression with implantation of bone marrow stromal cells (bMSCs) and decalcified bone matrix (DBM) for the treatment of early femoral head necrosis / 中国骨伤

<p><b>OBJECTIVE</b>To analyse retrospectively 3-tunnels core decompression with implantation of bone marrow stromal cells(bMSCs) and decalcified bone matrix (DBM) for treatment of femoral head necrosis in early stages, and to study its therapeutic results and indications.</p><p><b>METHODS</b>According to the University of Pennsyvania system of classification and staging,to treat the patients with 3-tunnels core decompression with implantation of bone marrow stromal cells (bMSCs) and decalcified bone matrix (DBM) for treatment of early femoral head necrosis. Among the total 87 patients (103 hips), the male was 71 (86 hips) and the female 16 (17 hips) with the average age of 47 years old. The average course of disease was 1.3 year. The effect was evaluated by the clinical symptoms, the Harris' scores and the manifestations of radiology before and after operation.</p><p><b>RESULTS</b>All the patients were followed up more than 2 years (average 26 months). The average Harris' scores increased from preoperation 47.3 to postoperation 74.0. The average rate of excellent and good results was 75.7%. The rate of excellent and good was 88% (22/25) in type I, 78.7% (37/47) in type II and 61.3% (19/31) in type III. No severe complications were observed.</p><p><b>CONCLUSION</b>Three-tunnels core decompression with implantation of bMSCs and DBM not only removal the focus of disease, but also use DBM the induction of bone and autologous hone marrow stem cells to differentiate the functions of the femoral head can be resumed loading structure, eliminate pain,improve joint function. It is an effective method for early femoral head necrosis.</p>