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OBJECTIVE To provide reference for exploring alternative resources of Gentiana rigescens from the plants of Gentiana. METHODS The contents of four components （gentiopicroside， swertiamarin， swertioside and amarogentin） in the roots and rhizomes from 3 plants of Gentiana （G. rigescens， G. cephalantha， G. delavayi） were determined by high-performance liquid chromatography （HPLC）. The chemical compositions in the above roots and rhizomes were identified by ultra-performance liquid chromatography electrospray ionization quarter-time of flight mass spectrometry （UPLC-ESI-Q-TOF-MS）， and the differences were analyzed by principal component analysis （PCA）. RESULTS Four active components such as gentiopicroside， swertiamarin， swertioside and amarogentin were detected in the roots and rhizomes of G. rigescens and G. cephalantha， and the contents of the four components were similar in both. The contents of gentiopicroside in the root and rhizome of G. cephalantha and G.rigescens were more than four times of the limit standard of the Chinese Pharmacopoeia （Part Ⅰ） in 2020； However， only swertiamarin， swertioside and amarogentin were detected in the roots and rhizomes of G.delavayi， and the contents of swertioside and amarogentin were 34.12 and 8.81 times of those of G. rigescens， respectively. In addition， a total of 33 compounds 术。E-mail：515227235@qq.com were identified from the roots and rhizomes of 3 plants of Gentiana by UPLC-ESI-Q-TOF-MS， mainly iridoids. Additionally， G. rigescens and G. cephalantha contained xantones， G. delavayi contained flavonoids. PCA showed that there was a small difference between G. rigescens and G. cephalantha； however， there was a big difference between G. delavayi and G. rigescens. CONCLUSIONS The difference between the roots and rhizomes of G. cephalantha and G. rigescens from the same origin is small and there is substitutability； while the difference in the chemical components from roots and rhizomes between G. delavayi and G. rigescens is great and G. delavayi cannot be used as medicine instead of G. rigescens.
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OBJECTIVE@#To compare the short-term effectiveness of "SkyWalker" robot-assisted total knee arthroplasty (TKA) and traditional TKA.@*METHODS@#A clinical data of 54 patients (54 knees) with TKA who met the selection criteria between January 2022 and March 2022 was retrospectively analyzed. Among them, 27 cases underwent traditional TKA (traditional operation group) and 27 cases underwent "SkyWalker" robot-assisted TKA (robot-assisted operation group). There was no significant difference between the two groups ( P>0.05) in terms of gender, age, body mass index, osteoarthritis side, disease duration, and preoperative Knee Society Score (KSS), Western Ontario and McMaster University Osteoarthritis Index (WOMAC), visual analogue scale (VAS) score, hip-knee-ankle angle (HKA), lateral distal femoral angle (LDFA), medial proximal tibial angle (MPTA), and posterior proximal tibial angle (PPTA). The operative time, intraoperative bleeding volume, surgery-related complications, the KSS, WOMAC, and VAS scores before operation and at 6 months after operation, and Forgotten Joint Score (FJS) at 6 months after operation were recorded. X-ray films were taken to review the prosthesis position and measure HKA, LDFA, MPTA, and PPTA. The differences of the clinical and imaging indicators between before and after operation were calculated and statistically analyzed.@*RESULTS@#The operations were completed successfully in both groups. There was no significant difference in the operative time and intraoperative bleeding volume between the two groups ( P>0.05). After operation, 1 case of incision nonunion and 1 case of heart failure occurred in the traditional operation group, while no surgery-related complications occurred in the robotic-assisted operation group. The incidences of surgical complications were 7.4% (2/27) in the traditional operation group and 0 (0/27) in the robotic-assisted operation group, with no significant difference ( P=0.491). Patients in both groups were followed up 6 months. KSS score, WOMAC score, VAS score, and ROM significantly improved in both groups at 6 months after operation when compared with preoperative ones ( P<0.05). There was no significant difference between the two groups ( P>0.05) in the differences between the pre- and post-operative values of the clinical indicators and FJS scores at 6 months after operation. X-ray films showed that the lower extremity force lines of the patients improved and the knee prostheses were in good position. Except for LDFA in the robot-assisted operation group, HKA, LDFA, MPTA, and PPTA significantly improved in both groups at 6 months after operation when compared with the preoperative ones ( P<0.05). There was no significant difference between the two groups in the differences between the pre- and post-operative values of the radiological indicators ( P>0.05).@*CONCLUSION@#The "SkyWalker" robot-assisted TKA is one of the effective methods for the treatment of knee osteoarthritis and had good short-term effectiveness. But the long-term effectiveness needs to be further studied.
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Humans , Arthroplasty, Replacement, Knee/methods , Knee Joint/surgery , Knee Prosthesis , Osteoarthritis, Knee/surgery , Retrospective Studies , Robotics , Treatment OutcomeABSTRACT
Objective:To learn about the cognition of iodine deficiency disorders (IDD) prevention knowledge among key population in the IDD area of Jilin Province, and to evaluate the effect of health education.Methods:From 2015 to 2019, 10 counties (cities, districts, hereinafter referred to as counties) in Jilin Province were selected as project counties every year. Public health education covered the entire project county. In each project county, 3 project townships were selected, and students of grades 4-6 were selected from the central primary schools of each project township for school health education. In each project township, 3 project villages were selected to carry out community health education. Before and after health education, 30 fifth-grade students were selected from the central primary school of each project township, and 15 housewives were selected from the vicinity of each primary school to conduct a questionnaire survey on IDD prevention knowledge.Results:After health education, the overall awareness rate of IDD prevention knowledge among primary school students and housewives in Jilin Province was 96.26% (13 324/13 842) and 96.40% (6 819/7 074), which was significantly higher than that before the intervention [65.36% (9 032/13 818) and 71.26% (5 039/7 071)], and the differences were statistically significant (χ 2 = 4 258.34, 1 647.92, P < 0.001), and the awareness rates of primary school students and housewives increased by 30.90% and 25.14%, respectively. Conclusion:Health education has significantly increased the awareness rate of IDD prevention knowledge among key populations in Jilin Province, and is an important measure to ensure the continuous elimination of IDD.
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Objective:To explore the risk factors of seroma after laparoscopic totally extraperitoneal hernia repair.Methods:The clinical data of 236 patients underwent laparoscopic totally extraperitoneal hernia repair from July 2018 to June 2021 in Jiaozhou Central Hospital of Qingdao City were retrospectively analyzed. The related risk factors of seroma after laparoscopic totally extraperitoneal hernia repair were analyzed.Results:Among 236 patients, the seroma occurred in 36 cases (seroma group), the incidence of seroma was 15.25%; no seroma occurred in 200 cases (non-seroma group). There were statistical differences in the duration of disease ≥5 years, scrotal hernia, internal inguinal ring defect ≥3 cm, rupture of hernia sac, experience of operators <5 years between 2 groups ( P<0.01 or <0.05); there were no statistical difference in age, body mass, type of patch, preoperative complications (including diabetes, chronic obstructive pulmonary disease and cardiac cerebrovascular disease) and operative time between 2 groups ( P>0.05). Multivariate Logistic regression analysis result showed that the duration of disease ≥5 years, scrotal hernia, rupture of hernia sac and experience of operators<5 years were independent influencing factors of seroma after laparoscopic totally extraperitoneal hernia repair ( OR = 5.147, 5.006, 0.044 and 3.315; 95% CI 1.513 to 17.516, 1.845 to 13.583, 0.008 to 0.240 and 1.029 to 10.679; P<0.01 or<0.05). Conclusions:The duration of disease ≥5 years, scrotal hernia, rupture of hernia sac and experience of operators<5 years are independent influencing factors of seroma after laparoscopic totally extraperitoneal hernia repair, and preoperative assessment of risk factors is helpful to reduce the incidence of seroma.
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Objective:To investigate the preschool period neurodevelopmental status and analyze the perioperative data which associated with delayed neurodevelopment in patients underwent antergrade cerebral perfusion(ACP).Methods:To access the preschool period neurodevelopmental status in patients underwent ACP using Griffiths mental development scale-Chinese(GDS-C). Patients were classified as normal development group(ND) and low development group(LD) depending on the outcomes of assessment. Perioperative data including age, weight, CPB time, aortic cross-clamp time, mean arterial pressure, ACP time and flow were analyzed retrospectively.Results:62 children who met the inclusion criteria, of which 19 were accessed by GDS-C scale. Fourteen cases were lagged in general quotient(GQ) compared with normal children. The outcomes of assessment in six subscales of GDS-C scale indicated that 13 cases were delayed in language(C) and practical reasoning(F). Eight cases were delayed in locomotor(A) and personal-social(B). Eleven cases were delayed in eye-hand coordination(D). Ten cases were delayed in performance(E). The children in LD group had significant longer CPB time and aortic cross-clamp time than those in ND group. There were no differences between two groups in other perioperative data.Conclusion:The incidence of preschool period neurodevelopmental delay after ACP in infants is relatively high. In detailed analysis, their language and practical reasoning ability are lagged significantly. In addition, the longer time of CPB and aortic cross-clamp are associated with the neurodevelopmental delay.
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Objective:To explore the value of congenital muscular torticollis severity classification scores (CMT-SCSTs) in the diagnosis and prognosis of infants′ congenital muscular torticollis (CMT).Methods:A total of 89 CMT children were examined using ultrasound to determine the size of the affected side and the contralateral sternocleidomastoid mass or the abnormal area of the muscle fringe echo from the head and neck. They were also rated using CMT-SCST scoring. They were then given 15 minutes of massage once a day and 5 minutes postural correction twice a day for 3 to 6 months. They were reviewed using ultrasound and the CMT-SCST 3 and 6 months later.Results:The number of treatments was negatively correlated with the initial CMT-SCST score. For those with a baseline CMT-SCST score ≥7 it was effective after 3 and 6 months. Those with a baseline CMT-SCST score ≥9 were almost cured after 3 and 6 months. Gender, age, signs of hip dysplasia, and comorbid global developmental delay (GDD) were not consistently related to the severity and the outcome of CMT. The CMT-SCST was more sensitive in prognosis than the CMT-SCS published in 2013.Conclusions:CMT-SCST scoring provides a theoretical foundation for the diagnosis and treatment and evaluation of infants with CMT. It deserves wider popularity and application in clinical practice.
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Objective:To evaluate the development of children 2-4 years old with autism spectrum disorders (ASDs) using the Chinese version of the Griffiths Development Scales (GDS-C).Methods:Eighty-eight children with ASD, 80 children with developmental language disorder (DLD) and 82 healthy children aged 2-4 were evaluated using the GDS-C. They were compared and their development in sports, personal and social relationships, language, hand-eye coordination and other performance were analyzed. The personal-social and language results of the ASD and DLD children were compared.Results:No significant differences were found between the ASD and DLD children in their language development. The development quotient of the ASD children was significantly lower, on average, than those of the DLD and healthy children in all fields except language. However, the ASD children′s development was not balanced. Their average developmental quotients in the language and the personal-social fields were significantly lower than in the sports, performance and hand-eye coordination fields. In the field of language, the entry loss rates of the two structural modes of receptive language and non-verbal expression of the ASD children were significantly higher than the DLD children′s averages. In the personal-social field the entry loss rates of communication and housework skills and of self-care skill were significantly higher than the DLD children′s averages. The command structure model of the ASD children was also superior, on average.Conclusions:The GDS-C can effectively assess the development of ASD children aged 2-4, especially in terms of language and personal and social skills. It can provide clinical evidence useful for early diagnosis and intervention for children with ASD.
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Objective:To study the effect of microglia depletion combined with bone marrow mesenchymal stem cells (BMSC) transplantation for spinal cord injury (SCI) repair.Methods:GFP-BMSCs were cultured, identified and detected for expression levels of growth factors. The effects of BMSCs ondorsal root ganglion (DRG) axon outgrowth were observed by the co-culture of BMSCs with DRGs. Mice were depleted of microglia by administrating the colony stimulating factor 1 receptor (CSF1R) inhibitor PLX3397. The spinal cords of these microglia-depleted mice were subjected to crush injury. BMSCs were transplanted into SCI area after microglia depletion. Mice were randomly divided into control group (SCI+BMSCs) and experimental group (PLX3397+SCI+BMSCs). Mice were sacrificed at corresponding time points after transplantation for observing the survival of transplanted BMSCs and the repair of spinal cord. BMS score was used for evaluation of motor function recovery.Results:BMSCs secreted a large number of neurotrophic factors and promoted the growth of DRG axons when co-cultured with DRGs. Depletion of microglia significantly improved the survival of transplanted BMSCs. Compared with BMSCs transplantation alone, the combined treatments slightly but non-significantly reduced the area of the lesion ( t=2.141, P=0.065). Immunofluorescence staining showed that both BMSC transplantation alone and the combined treatments did not cause the corticospinalaxons across the lesion and into distal spinal cord. BMS scores were (1.20±0.45), (3.20±0.45), (3.80±0.45), (4.20±0.45), and (4.60±0.55) points in control group at 1, 7, 14, 21 and 28 d after injury. The experimental groups were(0.60±0.55), (3.00±0.71), (3.80±0.84), (4.20±0.84), and (4.40±0.89) points, respectively. Conclusion:Depletion of microglia improves the survival of transplanted cells, depletion of microglia combined with BMSC transplantation did not result in a significant reduction in lesion area. At the same time, the damaged CST axons were notregenerated. Thus, combining cell transplantation with axon-promoting strategy may be necessary for SCI repair.
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Objective:To investigate the advantages and disadvantages of percutaneous compression plate (PCCP) for femoral neck fractures in the elderly patients.Methods:A retrospective study was conducted of the 31 elderly patients with femoral neck fracture who had been treated with PCCP from January 2012 to December 2018 at Orthopaedic Department, The First People's Hospital of Yancheng, Orthopaedic Department, The Ninth People's Hospital of Wuxi and Department of Orthopaedics, The People's Hospital of Wuxi. They were 16 men and 15 women, aged from 65 to 80 years (average, 70.5 years). By the Garden classification, 7 cases were type Ⅱ, 15 cases type Ⅲ and 9 cases type Ⅳ; by the Singh index, 4 cases were level Ⅲ, 11 cases level Ⅳ, 10 cases level Ⅴ and 6 cases level Ⅵ. The time from injury to operation ranged from 3 to 14 days (average, 5.8 days). The operation time, intraoperative blood loss, fracture reduction, fracture union time, complications and functional recovery of the hip were observed.Results:The operation time averaged 73.4 min and intraoperative blood loss 116.4 mL. At one week after operation, the Garden alignment index was level Ⅰ in 25 cases and level Ⅱ in 6. Superficial incision infection was noted in one case intraoperatively. Follow-ups for the 31 patients ranged from 12 to 47 months (mean, 18.9 months). All the fractures united after 4.9 months on average (from 4 to 8 months). Delayed union occurred in 2 cases, neck shortening in 12 cases, and avascular necrosis of femoral head in 3 displaced subcranial fractures 2 of which were high shear ones. The necrosis of femoral head was treated by arthroplasty in 2 and by conservative treatment in one. The Harris hip scores at the last follow-up for the 31 patients averaged 90.9 (from 75 to 100), giving 15 excellent, 12 good and 4 fair cases and an excellent to good rate of 87.1% (27/31).Conclusions:In treatment of femoral neck fractures in the elderly patients, PCCP has advantages of allowing early weight-bearing after operation, a high rate of fracture union, limited complications and quick and fine functional recovery of the hip. However, it should be used with caution in patients with severe osteoporosis, displaced subcranial or high shear fracture.
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Objective:To investigate the effect and mechanism of exosomes derived from human umbilical cord mesenchymal stem cells (hUC-MSC) in repair of tendon injury in rats.Methods:The hUC-MSC were cultured and the surface markers were identified by flow cytometry. The cells were induced to differentiate into osteoblasts, chondroblasts and adipocytes using a specific media. Meanwhile, the exosomes were isolated from the cell supernatant using exosome separation columns, and were identified by transmission electron microscopy, PKH67 staining and Western blot. A total of 40 Wistar rats were used to establish the Achilles tendon injury model by surgical resection. The rats were divided into hUC-MSC group (Group A) (with 100 μg exosome injected at the injured site) and control group (Group B) (with 250 μl normal saline injected at the injured site) according to the random number table, with 20 rats per group. The expressions of transforming growth factor β (TGF-β), bone morphogenetic protein (BMP-2), vascular endothelial growth factor (VEGF), fibroblast growth factor (FGF-2), interleukin-1β (IL-1β) and tumor necrosis factor-α (TNF-α) in the tendon tissues of both groups were detected using q-PCR, Western blot and immunofluorescence assay at 4 weeks following injection. The expression of collagen III in the injured tissues of both groups was detected by immunohiestochemistry.Results:The isolated and cultured hUC-MSC presented fusiform under an inverted microscope. After osteogenic differentiation, the cells exhibited a cube nodular structure, and the Alizarin red staining was positive. After adipogenic differentiation, the fat was observed inside the cells, which was red by oil red O staining. After chondroblast differentiation, the cells secreted a large amount of glycosaminoglycans, and a strong positive was revealed by Alisin blue staining. The hUC-MSC-derived exosomes showed round disc shape with a depressed internal structure under a transmission electron microscope, which was verified via PKH67 staining. The Western blot analysis showed high expressions of motility-related protein-1 (CD9) and lysosomal associated membrane protein 3 (CD63). The q-PCR test revealed that the mRNA expressions of TGF-β (4.887±0.767), BMP-2 (3.079±0.150), VEGF (3.108±0.508) and FGF-2 (4.211±0.522) in Group A were markedly higher than those in Group B (1.000±0.062, 0.918±0.129, 1.004±0.103, 1.010±0.169, respectively) ( P<0.01), and that the mRNA expression of IL-1β (0.697±0.037) and TNF-α (0.793±0.021) in Group A was markedly lower than those in Group B (1.004±0.089 and 1.006±0.015, respectively) ( P<0.01). The Western blot analysis revealed that the protein expressions of TGF-β (1.434±0.041), BMP-2 (1.798±0.177), VEGF (1.552±0.113) and FGF-2 (1.357±0.039) in Group A were markedly higher than those in Group B (1.002±0.032, 0.992±0.068, 1.007±0.070, 0.994±0.051) ( P<0.01), and that the protein expressions of IL-1β (0.705±0.016) and TNF-α (0.840±0.045) in Group A was markedly lower than those in Group B (1.000±0.016, 1.003±0.040) ( P<0.01). The immunofluorescence revealed that the positive expression rates of TGF-β and VEGF in Group A were not significantly different from those in Group B ( P>0.05). However, the positive expression rates of BMP-2 (2.278±0.208) and FGF-2 (4.656±0.106) in Group A were markedly higher than those in Group B (0.315±0.101, 1.661±0.110) ( P<0.05 or 0.01), and the positive expression rates of IL-1β (1.677±0.947) and TNF-α (1.520±0.088) in Group A were greatly lower than those in Group B (4.296±0.291, 2.373±0.273, respectively) ( P<0.01). In Group A, the tendon collagen fibers were arranged regularly and tightly, with relatively significant expression of collagen III; while the tendon collagen fibers in Group B were distributed loosely, accompanying broken scarlike healing. Conclusion:The hUC-MSC-derived exosomes can prompt the repair of the injured tendon tissues, which may be associated with the function in up-regulating the expressions of growth factors including TGF-β, BMP-2, VEGF and FGF-2, enhancing the expression of collagen III and inhibiting the expression of the inflammatory cytokines including IL-1β and TNF-α.
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Objective:To analyze the cytopathologic and sonographic features of false-positive diagnosis in fine-needle aspiration (FNA) of thyroid nodules.Methods:The false-positive diagnosis of thyroid nodules FNA which was confirmed by histopathology in the Affiliated Hospital of Sun Yat-sen University from Jan 2016 to Sep 2020 were collected and analyzed.Results:A total of 2, 626 patients with 2, 971 thyroid nodules were performed ultrasonography (US)-guided FNA, and 1, 061 thyroid nodules (35.7%) were confirmed by histopathology.Among these 1, 061 nodules, 817 (77.0%) were histopathologic malignancy, and 748(70.5%) were cytopathologic malignancy (TBSRTC Ⅴ-Ⅵ). Twenty-one patients with 23 thyroid nodules were false-positive diagnosis, showing TBSRTC Ⅴ, with a false-positive rate of 9.4%. In these false-positive cases, 18 patients showed normal thyroid function and 13 showed negative thyroid antibodies. All the false-positive nodules showed part of cytopathologic features of papillary thyroid carcinoma, but were insufficient to diagnose TBSRTC Ⅵ. In sonographic features, 16 nodules (69.6%) were classified as ACR TI-RADS 2-4, 12 (52.2%) were classified as C-TIRADS 3-4A or sonographic benign, and none of the nodules were found suspicious cervical lymph nodes metastasis.Conclusions:The overlapping of cytopathologic features is the main cause of false-positive diagnosis in thyroid nodules FNA. Sonographic features may play a role in decreasing the false-positive diagnosis.
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Objective:To explore the clinical effectiveness of arthroscopic treatment of tibial eminence avulsion fracture by four-point fixation with suture anchors.Methods:A retrospective analysis was performed of the 58 patients with tibial eminence avulsion fracture who had been treated by the same group of surgeons using four-point fixation technique with suture anchors under arthroscopy at Department of Sports Medicine, The Affiliated Hospital to Qingdao University from January 2015 to December 2018. They were 33 males and 25 females, with an average age of 18.4 years (from 14 to 32 years). By the modified Meyers-McKeever classification, 15 fractures were type Ⅱ, 19 type Ⅲ and 24 type Ⅳ. Recorded and compared were knee Lysholm scores, International Knee Documentation Committee (IKDC) scores and tibial eminence height between preoperation and one year postoperation; recorded at the last follow-up were range of knee motion and results of Lachman and pivot-shift tests.Results:The 58 patients were followed up for a mean of 20.7 months (from 12 to 33 months). Bony union was achieved in all patients within 12 weeks after operation. In this cohort, the Lysholm score (85.2±4.9) and IKDC score (86.2±4.3) at one year postoperation were significantly higher than the preoperative values (43.2±5.2 and 51.2±4.9), and the post-operative tibial eminence height [(9.1±1.2) mm] was significantly lower than the preoperative value [(12.6±1.2) mm] (all P<0.05). The correlation coefficients between the tibial eminence height and the Lysholm & IKDC scores at one year postoperation were -0.16 and -0.17, respectively. The last follow-up showed a 132°±5° range of knee motion for all patients, a positive result of pivot-shift test (grade Ⅱ) for 3 and a positive result of Lachman test (grade Ⅰ) for 2. Conclusion:Arthroscopic treatment of tibial eminence avulsion fracture by four-point fixation with suture anchors can lead to satisfactory effectiveness, showing advantages of minimal invasion, anatomic reduction, reliable fixation, and little impact on the epiphysis plate.
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The drug formulation design of self-emulsifying drug delivery systems (SEDDS) often requires numerous experiments, which are time- and money-consuming. This research aimed to rationally design the SEDDS formulation by the integrated computational and experimental approaches. 4495 SEDDS formulation datasets were collected to predict the pseudo-ternary phase diagram by the machine learning methods. Random forest (RF) showed the best prediction performance with 91.3% for accuracy, 92.0% for sensitivity and 90.7% for specificity in 5-fold cross-validation. The pseudo-ternary phase diagrams of meloxicam SEDDS were experimentally developed to validate the RF prediction model and achieved an excellent prediction accuracy (89.51%). The central composite design (CCD) was used to screen the best ratio of oil-surfactant-cosurfactant. Finally, molecular dynamic (MD) simulation was used to investigate the molecular interaction between excipients and drugs, which revealed the diffusion behavior in water and the role of cosurfactants. In conclusion, this research combined machine learning, central composite design, molecular modeling and experimental approaches for rational SEDDS formulation design. The integrated computer methodology can decrease traditional drug formulation design works and bring new ideas for future drug formulation design.
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Objective@#To analyze the clinical characteristics of patients with asthma-chronic obstructive pulmonary overlap syndrome (ACOS).@*Methods@#From January 2015 to December 2017, 40 patients with ACOS, 40 patients with asthma and 40 patients with chronic obstructive pulmonary disease(COPD) in Zhoushan Hospital were collected.The general information, laboratory test indicators, lung function test indicators and FEV1 mutation after bronchodilator test were compared among the three groups.@*Results@#There were statistically significant differences in age[(45.36±5.27) vs. (54.45±4.69) vs. (67.57±5.18), F=9.334, P=0.004], the proportion of smoking patients (92.50% vs. 75.00% vs. 60.00%, χ2=11.550, P=0.003), and the proportion of family history of asthma (7.50% vs. 20.00% vs. 30.00%, χ2=6.562, P=0.038) among the patients with ACOS, asthma and COPD.The percentage of eosinophils in peripheral blood [(8.46±0.94)% vs. (6.13±0.78)% vs. (3.75±0.45)%, F=11.626, P=0.001] and the serum IgE levels [(353.41±45.74)IU/mL vs. (252.65±30.45)IU/mL vs. (155.26±22.77)IU/mL, F=7.605, P=0.001] were decreased in turn, the differences were statistically significant.The FEV1/FVC% and FEV1% pred in the ACOS group were lower than those in the asthma group [(54.26±6.86)% vs. (72.43±8.52)%, t=10.506, P=0.001 and (50.35±6.22)% vs. (62.60±7.52)%, t=7.939, P=0.001], however, there were no significant differences compared with the COPD group[(54.26±6.86)% vs. (53.88±7.25)%, t=0.241, P=0.810 and (50.35±6.22)% vs. (50.56±6.46)%, t=0.148, P=0.883]. The proportion of small airway dysfunction in the ACOS group was higher than that in the asthma group (82.50% vs. 57.50%, χ2=5.952, P=0.015), however, there was no statistically significant difference compared with COPD group(82.50% vs. 85.00%, χ2=0.092, P=0.762). The RV/TLC% in the ACOS group was higher than that in the asthma group [(46.71±5.31)% vs. (32.46±4.52)%, t=12.924, P=0.001], however, there was no statistically significant difference compared with the COPD group [(46.71±5.31)% vs. (46.92±5.75)%, t=0.170, P=0.866]. The DLCO% in the ACOS group was lower than that in the asthma group [(64.37±4.66)% vs (82.62±4.53)%, t=17.760, P=0.001], but higher than that of the COPD group [(64.37±4.66)% vs. (51.25±4.35)%, t=13.017, P=0.001]. After bronchodilator test, the FEV1 mutation rate of the ACOS group was higher than that of the COPD group [(20.86±2.05)% vs. (6.52±0.55)%, t=42.730, P=0.001], but there was no statistically significant difference compared with the asthma group [(20.86±2.05)% vs. (21.13±2.14)%, t=0.576, P=0.566].@*Conclusion@#Compared with asthma patients, the age of ACOS patients is older, the percentage of peripheral blood eosinophils and the level of serum IgE are lower, the pulmonary ventilation function is lower, the airway dysfunction is more significant, the residual volume is more significant, the lung diffuse function is lower, acidic granulocyte airway inflammation is mild.But compared with patients with COPD, the age of ACOS patients is younger, the percentage of peripheral blood eosinophils and serum IgE levels are higher, the lung diffuse function is higher, and acidic granulocyte airway inflammation is heavier.
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Objective@#To observe the effect of whole-body vibration therapy on the lower extremity the motor function of children with spastic diplegia.@*Methods@#Fifty-six children with spastic diplegia were randomly divided into a treatment group and a control group, each of 28. Both groups were given routine rehabilitation exercise training, while the treatment group was additionally provided with 15 minutes of whole-body vibration therapy every day, 5 days a week for 12 weeks. Their GMFM-88 D (standing) and E (walking and jumping) scores were recorded before and after the treatment along with the active and passive range of motion of the ankle in dorsiflexion, and the root mean square surface electromyogram signals from the tibialis anterior and gastrocnemius muscles. Berg balance scale scores were also assigned before and after the treatment for both groups.@*Results@#There were no significant differences between the two groups before the treatment. Afterward all of the evaluations except the signals from the tibialis anterior muscle in active ankle dorsiflexion had improved significantly. The improvements were all significantly better in the treatment group.@*Conclusion@#Whole-body vibration therapy can effectively improve the lower extremity motor function of children with spastic diplegia.
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Objective To observe the effect of whole-body vibration therapy on the lower extremity the mo-tor function of children with spastic diplegia. Methods Fifty-six children with spastic diplegia were randomly divid-ed into a treatment group and a control group, each of 28. Both groups were given routine rehabilitation exercise train-ing, while the treatment group was additionally provided with 15 minutes of whole-body vibration therapy every day, 5 days a week for 12 weeks. Their GMFM-88 D ( standing) and E ( walking and jumping) scores were recorded before and after the treatment along with the active and passive range of motion of the ankle in dorsiflexion, and the root mean square surface electromyogram signals from the tibialis anterior and gastrocnemius muscles. Berg balance scale scores were also assigned before and after the treatment for both groups. Results There were no significant differ-ences between the two groups before the treatment. Afterward all of the evaluations except the signals from the tibialis anterior muscle in active ankle dorsiflexion had improved significantly. The improvements were all significantly better in the treatment group. Conclusion Whole-body vibration therapy can effectively improve the lower extremity motor function of children with spastic diplegia.
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OBJECTIVE： To study the effects of exogenous methyl jasmonate on the contents of 4 kinds of secoiridoid substance （gentiopicrin， swertiamain， sweroside and amarogentin） and biochemical indexes in the leaves of Gentiana rigescens， and to provide scientific evidence for the application of methyl jasmonate in standardized planting of G. rigescens. METHODS： 2， 4， 6， 8， 10 d after spraying 10， 50， 100， 200 mg/L methyl jasmonate （spraying amount was 500 mL） for G. rigescens strain， the leaves of medicinal material were collected as sample， and the other leaves without spraying methyl jasmonate were collected as control. HPLC method was used to determine the contents of 4 kinds of secoiridoid substance in the leaves of G. rigescens after spraying 4 kinds of concentrations of methyl jasmonate for 10 d. The concentration of methyl jasmonate was optimized （the content of effective component was the highest）. HPLC method was adopted to determine the contents of 4 kinds of secoiridoid substance in the leaves of G. rigescens after spraying the optimal concentration of methyl jasmonate for different time. The levels of relevant biochemical indexes （SOD， POD， CAT， MDA） were determined. RESULTS： 10 d after spraying 10， 50， 100， 200 mg/L methyl jasmonate for G. rigescens strains， the contents of 4 kinds of secoiridoid substance in the leaves were increased to different extent. Compared with untreated leaves， 100 mg/L methyl jasmonate had the best effect after spraying， and the contents of gentiopicrin， swertiamain and sweroside in treated leaves were 1.88， 2.36 and 1.87 times of those in untreated leaves， respectively （P＜0.05）. 2， 4， 6， 8， 10 d after spraying 100 mg/L methyl jasmonate， the contents of 4 kinds of secoiridoid substance in treated leaves were higher than untreated leaves at corresponding stage； the content of secoiridoid had significant difference after spraying for 4 d （P＜0.05）. The contents of active components in general were relatively high after spraying for 6 d， and the contents of gentiopicrin， swertiamain， sweroside and amarogentin in treated leaves were 1.88， 1.88， 1.47， 1.82 times of those in untreated leaves， respectively （P＜0.05）. The levels of relevant biochemical indexes in treated leaves were increased significantly since 4 d of spraying， compared with untreated leaves （P＜0.05）. CONCLUSIONS： After spraying 100 mg/L methyl jasmonate for 6 d， the contents increase of 4 kinds of secoiridoid substance in the leaves of G. rigescens are most obvious， which may be associated with improving the levels of related biochemical indexes.
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Objective To investigate the clinical effects of treating traumatic lesions of the popliteal artery by staged stretching.Methods From July 2011 to March 2016,29 patients with traumatic lesion of the popliteal artery underwent staged stretching after direct end to end anastomosis at Department of Orthopaedics,The 9th People's Hospital of Wuxi.They were 19 males and 10 females,with a mean age of 38.3 years (range,from 16 to 61 years).The average length of popliteal artery lesions was 3.7 cm (range,from 2 to 5 cm).After the keen joint was immobilized at flexion by external fixation,direct end to end anastomosis was performed with a proper segmental vascular freedom.From 4 weeks after operation,the popliteal artery was stretched stage by stage to its original length by gradual adjustment of the external fixation till the knee joint was fully extended.The color,skin temperature,pulp tension and capillary reaction of the toes were closely observed after surgery.CT angiography (CTA) was performed 6 months after surgery.The active range of motion was assessed at 12 months after surgery for the knee and ankle joints on the injured limb.Results All the patients were available for an average follow-up of 2 years (range,from 1 to 3 years).Blood supply was good for all the affected limbs.The staged stretching of the popliteal artery resulted in no rupture of any anastomotic stoma or no thrombus.CTA at 6 months after surgery showed fine patency of the popliteal artery and no formation of false aneurysm or arteriovenous fistula.At 12 months after surgery,the knee function was excellent in 15 cases,good in 10 and fair in 4;the ankle function was excellent in 18 cases,good in 8 and fair in 3.Conclusion Staged stretching is a safe,convenient and effective treatment of traumatic lesions of the popliteal artery.
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Objective To analyze the clinical characteristics of patients with asthma-chronic obstructive pulmonary overlap syndrome (ACOS).Methods From January 2015 to December 2017,40 patients with ACOS,40 patients with asthma and 40 patients with chronic obstructive pulmonary disease (COPD) in Zhoushan Hospital were collected.The general information,laboratory test indicators,lung function test indicators and FEV1 mutation after bronchodilator test were compared among the three groups.Results There were statistically significant differences in age[(45.36 ±5.27) vs.(54.45 ±4.69) vs.(67.57 ±5.18),F=9.334,P=0.004],the proportion of smoking patients (92.50％ vs.75.00％ vs.60.00％,x2 =11.550,P =0.003),and the proportion of family history of asthma (7.50％ vs.20.00％ vs.30.00％,x2 =6.562,P =0.038) among the patients with ACOS,asthma and COPD.The percentage of eosinophils in peripheral blood [(8.46 ± 0.94) ％ vs.(6.13 ± 0.78) ％ vs.(3.75 ±0.45) ％,F =11.626,P =0.001] and the serum IgE levels [(353.41 ± 45.74) IU/mL vs.(252.65 ± 30.45) IU/ mL vs.(155.26 ± 22.77) IU/mL,F =7.605,P =0.001] were decreased in turn,the differences were statistically significant.The FEV1/FVC％ and FEV1％ pred in the ACOS group were lower than those in the asthma group [(54.26 ± 6.86) ％ vs.(72.43 ± 8.52) ％,t =10.506,P =0.001 and (50.35 ± 6.22) ％ vs.(62.60 ± 7.52) ％,t =7.939,P =0.001],however,there were no significant differences compared with the COPD group [(54.26 ± 6.86)％ vs.(53.88 ±7.25)％,t =0.241,P =0.810 and (50.35 ±6.22)％ vs.(50.56 ±6.46)％,t =0.148,P =0.883].The proportion of small airway dysfunction in the ACOS group was higher than that in the asthma group (82.50％ vs.57.50％,x2 =5.952,P =0.015),however,there was no statistically significant difference compared with COPD group(82.50％ vs.85.00％,x2 =0.092,P =0.762).The RV/TLC％ in the ACOS group was higher than that in the asthma group [(46.71 ± 5.31) ％ vs.(32.46 ± 4.52) ％,t =12.924,P =0.001],however,there was no statistically significant difference compared with the COPD group [(46.71 ± 5.31)％ vs.(46.92 ± 5.75)％,t =0.170,P =0.866].The DLCO％ in the ACOS group was lower than that in the asthma group [(64.37 ±4.66) ％ vs (82.62 ± 4.53) ％,t =17.760,P =0.001],but higher than that of the COPD group [(64.37 ± 4.66) ％ vs.(51.25 ± 4.35) ％,t =13.017,P =0.001].After bronchodilator test,the FEV1 mutation rate of the ACOS group was higher than that of the COPD group [(20.86 ± 2.05) ％ vs.(6.52 ± 0.55) ％,t =42.730,P =0.001],but there was no statistically significant difference compared with the asthma group [(20.86 ± 2.05)％ vs.(21.13 ±2.14)％,t =0.576,P=0.566].Conclusion Compared with asthma patients,the age of ACOS patients is older,the percentage of peripheral blood eosinophils and the level of serum IgE are lower,the pulmonary ventilation function is lower,the airway dysfunction is more significant,the residual volume is more significant,the lung diffuse function is lower,acidic granulocyte airway inflammation is mild.But compared with patients with COPD,the age of ACOS patients is younger,the percentage of peripheral blood eosinophils and serum IgE levels are higher,the lung diffuse function is higher,and acidic granulocyte airway inflammation is heavier.
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Objective: To investigate the association between the tip apex distance (TAD) and migration of helical blade in the femoral head of geriatric intertrochanteric fractures. Methods: A retrospective study of intertrochanteric fractures treated with the proximal femoral nail antirotation (PFNA) between June 2015 and June 2018 was performed. There were 32 males and 55 females with an average age of 84.7 years (range, 80-101 years). All of them were unilateral fresh closed intertrochanteric fractures caused by low energy injury. According to AO/Orthopaedic Trauma Association (AO/OTA) classification, 33 cases belonged to type 31-A1, 35 cases to type 31-A2, and 19 cases to type 31-A3. The time interval from injury to operation was 1-16 days (mean, 3.7 days). The TAD was measured according to immediate postoperative X-ray films. The cases were divided into two groups: group A with TAD less than 20 mm and group B with TAD greater than 20 mm. The difference of fracture healing and migration of helical blade between the two groups were observed. Results: According to the TAD value immediately after operation, 49 patients in group A had TAD of 8.9-19.7 mm, with an average of 18.6 mm; 38 patients in group B had TAD of 20.1-41.4 mm, with an average of 27.7 mm. The 87 patients were followed up for an average of 11.7 months, ranging from 4 to 28 months. Three cases (all in group B) underwent screw blade cutting and displacement, which resulted in internal fixation failure, including 1 case with femoral head cut upward and 2 cases with femoral head penetrated inward. The remaining 84 cases had bone healing without internal fixation related complications such as fracture of internal fixator and fracture of femoral shaft. There was significant difference in the incidence of internal fixation failure between group A and group B ( P=0.049). Conclusion: Reducing the TAD value of helical blade appropriately (15-20 mm) in PFNA internal fixation for intertrochanteric fracture patients over 80 years old can increase initial stability without increasing the risk of helical blade migration.