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OBJECTIVE@#To compare the mid-term clinical effect of arthroscopic surgery versus conservative treatment on the middle aged early knee osteoarthritis (EKOA) patients, with the hope to provide clinical evidence for their individual therapy.@*METHODS@#A total of 145 middle aged EKOA patients(182 knees) who received arthroscopic surgery or conservative treatment from January 2015 to December 2016 were retrospectively enrolled, including 35 males and 110 females, aged from 47 to 79 years old with an average of (57.6±6.9) years old, and the duration of disease ranged from 6 to 48 months with an average of(14.6±8.9) months. According to treatment method, patients were divided into arthroscopic surgery group (47 patients, 58 knees) and conservative treatment group(98 patients, 124 knees). Before treatment, patients presented with symptoms of knee joint, such as pain, swelling, locking, limited flexion and extension, and weakness, as well as abnormal findings in knee X-ray (without or suspicious joint space narrow, and a few of osteophyte formation) or in knee MRI (injury or degeneration of articular cartilage or meniscus, loose body in the joint cavity and synovial hyperemia edema, etc). Related data were collected, including duration of knee symptoms, presence of meniscus injury, loose body in the joint cavity or mechanical symptoms such as locking, and visual analogue scale (VAS) and Lysholm knee function score before treatment and at the latest follow-up. Statistical analysis was performed to compare the differences in VAS or Lyshilm score before or after treatment between the low groups and within each group.@*RESULTS@#Patients in the two groups were followed up from 60 to 76 months. In the arthroscopic surgery group, the incision healing was good and no surgical complications occurred. There were no significant differences in age, gender, BMI and follow-up time between the two groups(P>0.05). Before treatment, compared with conservative group, duration of symptoms in the arthroscopic group was longer (P<0.001), comorbidity rates of meniscus injury (P<0.001), free body (P=0.001) and mechanical symptoms (P<0.001) were higher, VAS (P<0.001) and Lysholm score (P<0.001) were worse. At the final follow-up, VAS and Lysholm score in either the conservative group or the arthroscopic group were significantly better than before treatment (P<0.05), while no significant differences between the two groups were found. The VAS was (1.5±1.2) scores in the arthroscopic group and (1.6±1.0)scores in the conservative group(P=0.549), and the Lysholm score was (84.9±12.5) scores in the arthroscopic group and (84.2±9.9) scores in the conservative group (P=0.676).@*CONCLUSION@#Both arthroscopic surgery and conservative treatment have satisfactory intermediate clinical effect middle- aged patients with EKOA, without statistically differences. However, most of the patients before surgery in the arthroscopic treatment group had mechanical locking symptoms caused by meniscus injury or loose body. Therefore, for the middle-aged EKOA patients with mechanical locking symptoms or without obtaining satisfactory outcome after conservative treatment, arthroscopic surgery may be considered.
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Male , Middle Aged , Female , Humans , Aged , Osteoarthritis, Knee/surgery , Retrospective Studies , Arthroscopy/methods , Treatment Outcome , Knee Joint/surgeryABSTRACT
Objective Laparoscopic splenectomy has become an effective method to treat the hypersplenism and splenomegaly caused by various diseases.Although laparoscopic technology is very mature at present,laparoscopic splenectomy is still associated with many complications.This study was based on the comparison of different processes and operation techniques of laparoscopic splenectomy,to summarize a more effective operation process and operation technique which can reduce the related complications of laparoscopic splenectomy.Methods The study reviewed the clinical data of 130 patients'who underwent laparoscopic splenectomy in our department from September 2015 to December 2017.According to different operation mode and operation technique these patients were divided into 6 groups.Operation process groups:group Ⅰ for arterial priority group (open the gastrocolic ligament and expose splenic artery,then dissociate ligament around the spleen,and finally divide from the spleen pedicel) had 73 cases;group 2 with the way of building a tunnel beneath spleen pedicel and dissecting spleen in situ had 57 cases.With regard to the way of breaking spleen pedicel:group 3 using stapler to break spleen's pedicel included 101 cases;group 4 using dissecting the secondary spleen pedicel included 29 cases.Whether blocking the splenic vein:group 5 whose splenic vein was not ligated had 95 cases;group 6 whose splenic vein was ligated coverd 35 cases.Analysis and comparison between groups about intraoperative and postoperative complications related to different groups were made.Measurement date were expressed as (-x ± s),t test was used for comparison between groups.Count data was expressed as rate(％),and chi-square test was used for comparison between groups.Results Group 2 has less blood loss [group 1:(356.0 ± 96.2) ml versus group 2:(220.9 ± 57.3) ml,P =0.016],shorter operation time [group 1:(156.0 ± 36) min versus group 2:(120.9 ± 55.4) min;P =0.038] and fewer complications [group 1:9.6％ (7/73) versus group 2:5.3％ (3/57);P =0.035].When compared with group 4,group 3 have more advantages in the intraoperative blood loss [group 3:(256.0 ± 85.1) ml versus group 4:(380.9 ± 107.3) ml;P=0.019],the operation time [group 3:(131.0±30.9) min versus group 4:(171.9 ±61.2) min;P=0.024],and the postoperative complications [group 3:6.95 ％ (7/101) versus group 4:10.3 ％ (3/29);P =0.048].When compared with group 5,group 6 has more advantages in the intraoperative blood loss [group 5:(250.0 ± 56.2) ml versus group 6:(320.9 ± 87.3) ml;P =0.012],the operation time [group 5:(136.0 ± 36.2) min versus group 6:(180.9 ± 57.3) min;P =0.013],and the postoperative complications [group 5:6.3％ (6/95) versus group 6:11.4％ (4/35);P=0.013].Conclusion Both the procedure of tunnel procedure in situ cutting spleen and the application of stapler can reduce the amount of bleeding,shorten the operation time,and reduce the occurrence of postoperative complications.The ligation of the splenic vein is not necessary because it increases the operation time,the risk of bleeding,and the occurrence of postoperative complications.
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Objective To investigate effect of Salvia miltiorrhiza Ligustrazine on peripheral lymphocyte neutrophil proportion, neurological function score and prognosis in patients with acute cerebral infarction. Methods 125 cases of acute cerebral infarction in our hospital from June 2015 to June 2016 were selected as the research object, randomly divided into two groups, the control group was treated with conventional treatment of acute cerebral infarction, patients in the observation group in the control group patients on the basis of Salviae Miltiorrhizae and Ligustrazine Hydrochloride Injection, all patients were detected in the blood leukocyte classification, and the NIHSS evaluation of patients with neurological function and prognosis of the two groups of patients. Results After treatment, the observation group of white blood cells in patients with (×109/L), neutrophil (%), neutrophil / lymphocyte was significantly lower than the control group patients, two groups of patients before treatment, after treatment of 1 day and 7 days, two groups of NIHSS score comparison showed no significant difference, after the treatment of 14d patients in the observation group the NIHSS score was (11.1±3.3), which was obviously lower than the control group, the patients in the observation group were six cases death and disability in three cases, 53 cases of independent life, significantly better than the control group, the difference was statistical significance(P<0.05). Conclusion Salvia miltiorrhiza Ligustrazine can help to reduce the ratio of neutrophil / lymphocyte, improve neurological function and improve the prognosis of patients with acute cerebral infarction, and it is worthy of clinical application.
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Objective:To observe the curative effect of vinpocetine combined with Danhong injections in the treatment of posterior circulation ischemia syndrome. Methods:Totally 120 patients with posterior circulation ischemia syndrome were selected and randomly divided into the treatment group and the control group with 60 cases in each. Both groups were treated by the conventional therapy, meanwhile, the treatment group was given vinpocetine and Danhong injections, and the control group was given vinpocetine alone. The treatment course was 14 days. The curative effect was observed, blood rheology and hemodynamics were also studied. Results:The to-tal effective rate of the treatment group was 95. 0%, which was significantly higher than that of the control group (75. 0%) with statis-tically significant difference(P<0. 05). After the treatment, the blood rheology (viscosity, low shear viscosity, plasma viscosity and reduced viscosity) and TCD ( LVA, RVA, BA and PI) in the two groups were significantly improved, and the treatment group showed more significant improvement(P<0. 05). Conclusion:Vinpocetine combined with Danhong injections in the treatment of posterior cir-culation ischemia syndrome has significant effect in the effective improvement of blood rheology and hemodynamics, which is worthy of clinical promotion and application.
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OBJECTIVE: This study was performed to evaluate the clinical performance of APTIMA human papillomavirus (AHPV) assay and Hybrid Capture 2 (HC2) assay in screening for cervical disease, especially in women with atypical squamous cell of undetermined significance (ASC-US) and low-grade squamous intraepithelial lesion (LSIL). METHODS: A total of 411 women diagnosed with ASC-US or LSIL were referred and further triaged by HC2 test. Prior to colposcopy, liquid-based cytology specimens were collected for the AHPV assay. Sensitivity and specificity were established based on the histological findings of cervical intraepithelial neoplasia (CIN). RESULTS: In all 411 subjects, the positive detection rate of AHPV assay was 70.8% (95% confidence interval [CI], 66.4 to 75.2), which was significantly lower than the positive detection rate of 94.9% obtained using HC2 test (95% CI, 92.3 to 96.8). Only one CIN 3-positive case was detected among the 120 AHPV-negative women, which was then confirmed by Pap smear test to be LSIL. The sensitivities of AHPV and HC2 for CIN 3 were similar (94.1% and 100%, respectively). However, AHPV showed a significantly higher specificity than HC2 test (30.2% and 5.3%, respectively; p<0.001). CONCLUSION: AHPV assay is effective in identifying CIN 3-positive cases because of its high specificity and lower false-negative rate. The use of AHPV for the triage of ASC-US and LSIL might help to reduce the referral rate of colposcopy during cervical cancer screening.
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Adult , Aged , Female , Humans , Middle Aged , Young Adult , Uterine Cervical Dysplasia/diagnosis , China/epidemiology , Colposcopy/methods , Early Detection of Cancer/methods , False Negative Reactions , Human Papillomavirus DNA Tests/methods , Papillomavirus Infections/complications , Prevalence , Sensitivity and Specificity , Triage , Uterine Cervical Neoplasms/diagnosisABSTRACT
Objective To investigate the diagnosis and therapy of vaginal intraepithelial neoplasia (VAIN) and correlation to cervical intraepithelial neoplasia (CIN). Methods The clinical and pathological data about age, liquid-based cytology, human papillomavirus (HPV) DNA test, colposcopy,histology types and treatment in 35 patients with VAIN were reviewed to investigate the diagnosis and therapy of VAIN and correlation to CIN. Results Mean age at presentation was 43.9 years. The percentage of VAIN I, VAINⅡ and VAINⅢ were 52% (18/35), 34% (12/35) and 14% (5/35), respectively. 8% (1/13) of patients were younger than 40 years developed VAIN Ⅲ, while 18% (4/22) patients were eider than 40 years. There were 83% (29/35) cases were diagnosed from 2007 to June 2008. 69% (24/35) or 17% (6/35) cases had the history of CIN or cervical cancer, respectively. VAIN Ⅱ - Ⅲ accounted for 3/9, 53% (8/15) and 4/6 of CIN I , CIN Ⅱ - Ⅲ and cervical cancer, respectively. There were 87% (13/15) positive high risk HPV infection in VAIN Ⅰ , while 100% in VAIN Ⅱ and VAINⅢ. There were 97% (33/34) cases with abnormality for liquid-based cytology and 86% (30/35) cases of lesions were located in the upper 1/3 vagina. Among 19 cases received therapy, 14 eases (74%) were treated by surgery, 2 eases (11%) by brachytherapy, 3 cases (16%) used drug on the surface of vagina and the lesions were shown recovery in 9 cases followed up. Conclusion The clinical characteristics of VAIN are similar to CIN and the principles of diagnosis and treatment are also the same as that of CIN.
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Objective To evaluate the role of high-risk human papillomavirus (HR-HPV) testing in diagnosis of high-grade cervical intraepithelial neoplasia (CIN2/3+) and cervical cancer.Methods Total 3426 women with known cytologic abnormality tests were subjected to detect high-risk HPV DNA by hybrid capture II and to have established diagnoses by cervical coloposcopy-directed biopsy test.Results Among 3426 women,45 were cervical cancer,670 were CIN 2/3,and 2711 were CIN 1 or other benign lesions based on the cervical histologic results. Compared with the women with CIN 1 or other benign lesions,the women with CIN 2/3+ had higher positive rates of HR-HPV. Higher load of HR-HPV was more common among women with cervical lesions than those without. Fifty-seven women who were transiently HR-HPV positive did not develop CIN2/3+ during follow-up.Conclusions Our data suggest that a high viral load could be used as a short-term marker of CIN 2/3+,and women repeatedly tested positive for HR-HPV are at risk of developing CIN2/3+. Detecting HR-HPV and follow up the positive women would be useful in diagnosis of CIN2/3+.
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0.05).In the 35 patient who had unitary incontinence before the operation,the symptom disappeared in 6(17.1%) patients,and deteriorated in 2(5.7%).While in the 38 patients without urinary incontinence before the operation,9(23.7%) showed the symptom postoperation.Totally,urinary incontinence was developed in 11 patients after the operation.Conclusions The patients with moderate-to-severe pelvic organ prolapse treated by traditional surgical procedures have a low rate of objective cure and a high rate of recurrent cystocele.It is important to repair the anterior pelvic floor during the operation.And the surgeons should be alert to the possibility of urinary incontinence.
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Objective To explore the role of high-risk human papillomavirus(Hr-HPV) DNA testing in the detection of cervical intraepithelial lesions(CIN) Ⅱ and Ⅲ,or cervical cancers for patients with abnormal cervical cytology.Methods A total of 2197 patients with abnormal cervical liquid-based cytology,who had received Hr-HPV detection and colposcopy,were enrolled into this study.The data were analyzed using ?2-test and Logistic regression.Among the patients,1013(46.5%) had atypical squamous cells undetermined significance(ASC-US),89(4.1%) had atypical squamous cell which cannot exclude high grade squamous intraepithelial lesion(ASC-H),757(34.7%) low squamous intraepithelial lesion(LSIL),253(11.6%) high-grade squamous intraepithelial lesion(HSIL),and 67(3.1%) atypical gland cells(AGC).Results Pathological examination showed CINⅡ in 224 patients(10.3%),CIN Ⅲ in 140(6.4%),cervical cancer in 27(1.2%),and adenocarcinoma in 9(0.4%).The other patients(1779/2179,81.6%) had CINⅠ,condyloma,or chronic cervicitis.The detection rate of CIN Ⅱ and Ⅲ,and cervical cancer was increased in the patients with Hr-HPV.The differences in the rate among ASC-US,ASC-H,LSIL,and HSIL patients were significant.The incidence rate of CINⅡ and Ⅲ,or cervical cancer was 2.2%(13/588),9.7%(21/216),24.9%(97/389),29.8%(182/611),and 23.2%(87/375) for the patients with a Hr-HPV load of 0-0.9,1.0-9.9,10.0-99.9,100.0-999.9,and ≥1000.0.Logistic regression showed that the risk of CINⅡ and Ⅲ,and cervical cancer increased by 1.325 folds with the log of the HPV load.Conclusions Hr-HPV DNA test is helpful for the detection of CIN Ⅱ and Ⅲ or cervical cancer in patients with abnormal cervical cytology.
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<p><b>OBJECTIVE</b>To evaluate the clinical significance of breast duct endoscope for plasma cell mastitis.</p><p><b>METHODS</b>Breast duct endoscope was performed on 250 patients with nipple discharge. The characters of 95 cases of plasma cell mastitis under the breast duct endoscope were analyzed and studied.</p><p><b>RESULTS</b>Among the 95 cases with plasma cell mastitis, 21 were in type I, 43 in type II, 18 in type III and 13 in type IV. Eighty-three cases were treated with no-operation treatment, and 45 completely released, 38 partly released. There were 5 cases with middle to serious atypical hyperplasia in 12 cases treated with operation, that were all confirmed by pathological examination.</p><p><b>CONCLUSION</b>In patients with plasma cell mastitis, clear diagnosis can be made through breast duct endoscope, and the breast duct with lesions could be positioned. It is a necessary assistant method for patients to avoid biopsy or decrease the biopsy range.</p>
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Adolescent , Adult , Aged , Female , Humans , Middle Aged , Breast , Pathology , Endoscopy , Mastitis , Pathology , Plasma Cells , PathologyABSTRACT
Objective:To detect the clinical features of vulvar and vaginal intraepithelial neoplasias(VIN and VAIN,respectively).Methods:Total 148 women were performed vulvar or vaginal coloposcopy-directed biopsy pathology tests,from Sep.2004 to Dec.2007.Results:Among 148 women,vulvar or vaginal histologic results were vulvar cancer for 1,VIN or VAIN 2,3 for 23,VIN or VAIN for 16,condyloma for 61,vulvitis and vaginitis for 47.Eighty-five percent(33/39) women with VIN or VAIN 2,3 were more than 30 years old.Compared to women with cervical intraepithelial neoplasia(CIN),women with VIN or VAIN were older.The rate of high-risk HPV DNA in women with vulvar or vaginal lesions was 84%(84/100).VAIN occurred mainly in the upper vagina(90%,69/75).VIN or VAIN often accompanied or followed CIN or cervical cancer(79%,31/39),and VIN or VAIN 2,3 often accompanied or followed CIN 2,3 or cervical cancer(70%,16/23).Conclusion:Our data suggest that women with high-risk HPV infection are at risk of developing VIN or VAIN 2,3.The vulva and vagina should be carefully inspected by colposcopic examination at the time of colposcopy for any abnormal findings.
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<p><b>OBJECTIVE</b>Effects of red palm oil on major plasma carotenoids, tocopherol, retinol and serum lipids were evaluated when used in Chinese diet.</p><p><b>METHODS</b>Red palm oil group (RPO) composed of 20 male subjects(aged 18-32) and soybean oil group (SBO) composed of 22 male subjects (aged 18-32). Dietary fat provided about 28% of total calories, and the test oil accounted for about 60% of total dietary fat. In the 3 weeks of pretest period, diets were prepared with soybean oil, and then in the next 6 weeks subjects in each group consumed the diet prepared by test oil.</p><p><b>RESULTS</b>Plasma alpha-carotene, beta-carotene and lycopene concentration of RPO group significantly increased at the time of interim (21 days) and of the end (42 days) (P < 0.05), and alpha-tocopherol concentration significantly increased at the time of the end (42 days) in this study. Though Chinese plasma retinol level was relatively low when compared with that of Westerners, red palm oil diet showed no significant effect on adult Chinese plasma retinol level. Serum concentration of total cholesterol, triglyceride, high density lipoprotein cholesterol, apolipoprotein AI and apolipoprotein B of all subjects showed no significant changes in RPO group during the study.</p><p><b>CONCLUSIONS</b>The data in our study suggest that red palm oil is a good source of carotenoids and vitamin E when used in Chinese diet preparation, and it can significantly increase plasma concentration of alpha-carotene, beta-carotene, lycopene and alpha-tocopherol.</p>
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Adolescent , Adult , Humans , Male , Administration, Oral , Carotenoids , Blood , China , Diet , Lipids , Blood , Palm Oil , Plant Oils , Pharmacology , Tocopherols , Blood , Vitamin A , BloodABSTRACT
<p><b>OBJECTIVES</b>To investigate the effects of calcium and vitamin D supplementation in fortified milk on physical development in Chinese school girls aged 10 - 12 years.</p><p><b>METHODS</b>A non-randomized, double-blind intervention trial was carried out at nine primary schools of Beijing for two years. Seven hundred and fifty-seven girls (with an average age of 10.1 years) were recruited from nine primary schools in Beijing, China. They were divided into three trial groups, a control group (n = 259) having regular diet without milk supplementation, Group 1 (n = 238) having regular diet supplemented with 144 ml/d of calcium-fortified milk, and Group 2 (n = 260) having regular diet supplemented with 144 ml/d of calcium and vitamin D-fortified milk. Data of dietary intake and physical activities were collected by questionnaire, and height, weight, sitting height and knee height were measured before, during and after intervention.</p><p><b>RESULTS</b>Two years after intervention, the percentage increases in height and weight were significantly greater in Groups 1 and 2 than those in control group (9.52%, 9.26% and 8.59% in height, and 34.53%, 35.38% and 30.91% in weight, respectively). The percentage increase of sitting height was greater in Group 1 than those in Group 2, and then than that in control group (9.21%, 8.58% and 7.87%, respectively). The percentage increase of knee height was significantly greater in Group 1 than that in Group 2 and control group (9.00%, 8.37% and 8.44%, respectively).</p><p><b>CONCLUSION</b>Calcium and vitamin D-fortified milk supplementation could promote their physical development in girls aged 10 - 12 years.</p>
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Animals , Child , Female , Humans , Body Height , Body Weight , Calcium, Dietary , Pharmacology , Dietary Supplements , Food, Fortified , Human Development , Milk , Metabolism , Vitamin D , PharmacologyABSTRACT
To observe therapeutic effects of Lishengsu (recombinant human granulocyte colony stimulating factor, rhG-CSF) on leukopenia induced by chemotherapy, 40 patients with malignant tumor included in the clinical observation were randomly divided into group A and B (20 patients each). Each patient was received two cycles of chemotherapy. In group A Lishengsu was administered in the first cycle and none in the second cycle, while in group B Lishengsu was given in the second cycle, but not in the first cycle. Lishengsu was subcutaneoasly injected for 5 - 7 days at dosage of 75 micro g or 150 micro g per day 24 - 48 hours after completion of chemotherapy. The results showed that Lishengsu remarkably alleviated the degree of leukopenia and neutropenia, and lower the incidence of infection. The curative effect of Lishengsu is reliable with slight side-effects, and it might assist to completion of chemotherapy in tumor patiants.