Relationship between rotator cuff muscle function and shoulder abduction function in patients with posterior superior rotator cuff tear: a dynamic biomechanical study / 中华创伤杂志

Objective:To evaluate the relationship of rotator cuff muscle function with shoulder abduction function after posterior superior rotator cuff tear via dynamic biomechanical study.Methods:By using the customized dynamic shoulder biomechanical testing system, seven freshly frozen cadaveric shoulders were used to stimulate shoulder abduction at 90° under four statuses: (1) intact rotator cuff with activation (normal rotator cuff group); (2) posterior superior rotator cuff tear with activation (posterior superior rotator cuff tear with activation group); (3) posterior superior rotator cuff tear with posterior superior rotator cuff deactivation (posterior superior rotator cuff tear with deactivation group); (4) none rotator cuff tissue above the geometric rotation center of the humeral head with deactivation (global tear group). The peak and stable value of middle deltoid force were used to evaluate biomechanical status in different rotator cuff tear conditions during shoulder abduction procedure. The peak subacromial pressure, average subacromial pressure, subacromial contact area, and subacromial force were used to evaluate subacromial pressed conditions under different rotator cuff tear conditions. The peak and stable ratio of glenohumeral contact force/middle deltoid force were used to evaluate shoulder stability under different rotator cuff tear conditions.Results:During dynamic abduction at 90°, the peak and stable value of middle deltoid force were (42.1±8.7)N and (29.9±7.4)N in normal rotator cuff group, (45.7±10.3)N and (30.5±7.2)N in posterior superior rotator cuff tear with activation group, and (48.4±13.4)N and (29.9±4.8)N in posterior superior rotator cuff tear with deactivation group (all P>0.05). But the peak and stable value of middle deltoid force were (69.7±9.7)N and (53.7±8.9)N in global tear group, significantly increased compared with other three groups (all P<0.05). The elevated middle deltoid force increased the subacromial contact pressure between glenohumeral head and acromion. The peak subacromial pressure, average subacromial pressure, subacromial contact area, and subacromial force were (0.40±0.05)MPa, (0.22±0.03)MPa, (7.71±5.09)mm 2, and (1.66±1.06)N respectively in normal rotator cuff group, (0.41±0.05)MPa, (0.26±0.07)MPa, (12.71±11.35)mm 2, and (2.93±2.46)N respectively in posterior superior rotator cuff tear with activation group, and (0.50±0.12)MPa, (0.26±0.07)MPa, (17.29±9.11)mm 2, and (4.09±1.46)N respectively in posterior superior rotator cuff tear with deactivation group (all P>0.05). However, the peak subacromial pressure, average subacromial pressure, subacromial contact area, and subacromial force were (3.64±1.70)MPa, (0.98±0.49)MPa, (47.63±11.91)mm 2, and (45.48±23.86)N respectively in global tear group, significantly higher than those in other three groups (all P<0.05). The peak and stable ratio of glenohumeral contact force/middle deltoid force were 2.24±0.30 and 2.46±0.13 in normal rotator cuff group, 2.21±0.19 and 2.52±0.08 in posterior superior rotator cuff tear with activation group, and 2.03±0.14 and 2.42±0.16 in posterior superior rotator cuff tear with deactivation group (all P>0.05). However, the peak and stable ratio of glenohumeral contact force/middle deltoid force were 1.40±0.14 and 1.52±0.41 in global tear group, significantly higher than those in other three groups (all P<0.05). No significant differences of the above parameters were observed in posterior superior rotator cuff tear with activation group, posterior superior rotator cuff tear with deactivation group and global tear group (all P>0.05). Conclusions:After posterior superior rotator cuff tear, rotator cuff muscle function does not affect the whole abduction function of shoulder. When the size of rotator cuff tear involves the whole superior humeral head rotation center, the normal abduction function of shoulder will be significantly impaired.

Neglect and associated factors among preschool children in two-child families in southwest Shandong Province / 中国学校卫生

Objective@#To investigate neglect among preschool children in two-child families in southwest Shandong Province, and to provide reference is for improving nursing parenting quality of two-child families.@*Methods@#A questionnaire survey was conducted among 2 646 parents of two-child families and 2 074 parents of one-child families from 16 kindergartens in southwest Shandong Province.@*Results@#The total neglect rate of two-child family preschool children in southwest Shandong Province was 27.37%, and the degree score of neglect was(40.15±5.51). The physical neglect rate(10.39%), emotional neglect rate(40.15±5.51), total neglect (38.15±4.88) and emotional neglect (46.12±6.91) of boys were higher than those of girls, and the difference was statistically significant(χ2/t=4.57, 6.65, 4.58, 4.72, P<0.05); No significant frequencies were found in total neglect rate, total neglect, neglect rate and neglect at all levels among all age groups(P>0.05); Among preschool children with siblings aged 7-<13, ≥13, total neglect rate(30.44%, 32.77%), emotional neglect rate(10.20%,12.00%), total neglect degree (44.71±5.98, 45.33±5.20) and emotional neglect degree (45.95±7.12, 48.86±4.97) of preschool children in two-child families have higher than those in onechild families, and the differences were of statistical significance(χ2/t=31.10, 4.55, 27.92, 24.13, 19.83, P<0.05); the total neglect rate(27.37%), emotional neglect rate(23.47%), emotional neglect (43.68±6.83) of twochild families and the total neglect (40.15±5.51) were higher than those of one-child families, and the differences were of statistical significance(χ2/t=4.98, 4.96, 3.76, 8.53, P<0.05). The age of siblings(OR=0.58), the education level of mothers(OR=0.64), and the main executor of family education (OR=1.54) were main factors to influence the child neglect of preschool children in two-child families(P<0.05).@*Conclusion@#Neglect of preschool children in two-child families is higher than that in one-child families in southwest Shandong, especially among those preschool boys and preschool children whose siblings were of school age.

Sevoflurane effect on cognitive function and the expression of oxidative stress response proteins in elderly patients undergoing radical surgery for lung cancer

Objective: To investigate the effects of sustained inhalation of sevoflurane on cognitive function and the expression of oxidative stress response proteins such as NADPH oxidase subunits NOX2 and NOX4 in elderly patients undergoing radical surgery for lung cancer

Study Design: An experimental study

Place And Duration Of Study: Department of Anesthesiology, Suzhou Kowloon Hospital, Shanghai Jiao Tong University School of Medicine, China, from February 2016 to October 2017

Methodology: Elderly patients who underwent radical surgery for lung cancer were divided into the sevoflurane group and the propofol group, with 52 cases in each group. Sustained inhalation of sevoflurane and propofol was administered to maintain anesthesia in the respective groups. Cognitive function and lung function parameters were compared between the two groups. Serum S100 beta levels and expression of NOX2 and NOX4 proteins in peripheral blood mononuclear cells of the two groups were determined

Results: At 24 hours after surgery, the lung function indices of the sevoflurane group such as FEV1, FVC and VC were higher than those of the propofol group [p<0.001, p=0.008 and p=0.002, respectively]. At the end of the surgery and at 24 hours after surgery, the MMSE scores of the sevoflurane group were higher than the propofol group [all p< levels were lower than the propofol group [p=0.003 and p?0.001]. S100<0.001, respectively]. Levels of NADPH oxidase subunits NOX2 and NOX4 proteins in peripheral blood mononuclear cells of the sevoflurane group were lower than the propofol group [p=0.033, p<0.001, p<0.001and p<0.001, respectively]

Conclusion: Compared with intravenous anesthesia with propofol, general anesthesia with sevoflurane inhalation has little effect on the short-term cognitive function in elderly patients undergoing radical surgery for lung cancer, and can effectively improve lung function. The mechanism may be related to the reduction of the expression of NOX2 and NOX4 proteins

Correction to: Increasing targeting scope of adenosine base editors in mouse and rat embryos through fusion of TadA deaminase with Cas9 variants

In the original publication the grant number is incorrectly published. The correct grant number should be read as "17140901600". The corrected contents are provided in this correction article. This work was partially supported by grants from the National Natural Science Foundation of China (Nos. 81670470 and 81600149), a grant from the Shanghai Municipal Commission for Science and Technology (17140901600, 18411953500 and 15JC1400201) and a grant from National Key Research and Development Program (2016YFC0905100).

Application of peripherally inserted central venous catheter and central venous catheter in the surgical nutrition / 中华临床营养杂志

ObjectiveTo explore the application of peripherally inserted central venous catheter (PICC)and central venous catheter (CVC) in the surgical parenteral nutrition.MethodThe operation time,success rate,indwelling duration,abnormal biopsy,and adverse reactions of PICC and CVC were retrospectively compared.ResultsCVC had significantly shorter operation time than PICC groups [ (28.67 ±5.13) min vs.(45.20 ±6.89)min,P =0.035 ).The mean indwelling duration was significantly longer in PICC group than in CVC group [ ( 114.85 ± 10.29) d vs.(24.78 ± 8.42) d,P =0.033 ].PICC group was superior to CVC group in terms of five complication items,while only phlebitis was more frequent/severe in CVC group.ConclusionsPICC may be more suitable for long-term ( ＞4 weeks) catheter-based nutrition.CVC has short operation time and fast flow rate,and therefore is most suitable for rescue treatment for critically ill patients.