Case-control study on Scarf and double metatarsal osteotomy of the first metatarsal for the treatment of hallux valgus deformity / 中国骨伤

OBJECTIVE@#To compare clinical efficacy of scarf osteotomy and double metatarsal osteotomy(DMO) in treating moderate to severe hallux valgus.@*METHODS@#Fifty patients (81 feet) with moderate to severe hallux valgus deformity were treated from January 2017 to December 2019, and were divided into Scarf osteotomy (SO) group or DMO group according to different osteotomy methods. There were 26 patients (44 feet) in SO group, including 1 male and 25 females, aged from 48 to 65 years old with an average of (55.5±4.67) years old;18 patients (30 feet) with moderate and 8 patients (14 feet) with severe. There were 24 patients(37 feet) in DMO group, including 1 male and 23 females, aged from 45 to 62 years old with an average of (52.1±6.8) years old;there were 14 patients (24 feet) with moderate and 10 patients (13 feet) with severe. Hallux valgus angle (HVA), intermetatarsal angle (IMA), distal metatarsal articular angle (DMAA) and relative length of the first metatarsal(RLFM) on weight-bearing anteroposterior radiographs before and after operation were compared. American Orthopaedic Foot and Ankle Society (AOFAS) hallux, metatarsal, and interphalangeal joint scores was used for evaluate clinical effects. Weight bearing time and complications were observed.@*RESULTS@#Fivty patients were followed up. The follow-up time in SO group ranged from 12 to 36 months with an average of(20.50±6.22) months and from 16 to 28 months with an avaerge of(19.80±2.44) months in DMO group while there was no significant difference between two groups(P>0.05). All incision healed at stage I, and osteotomy healed at (20.31±3.17) months after operation. One patient occurred hallux adduction deformity, without transferred metatarsalgia;2 patients occurred metastatic metatarsalgia in DMO group. There were no significant difference in HVA, IMA, DMAA, and AOFAS scores between two groups(P>0.05) before and after operation. There was no significant difference in RLFM between two groups(P>0.05), while had significant difference in RLFM between two groups at final follow-up (P<0.05). Partial weight-bearing time and full weight-bearing time in SO group were significantly earlier than those in DMO group (P<0.05).@*CONCLUSION@#Both of Scarf osteotomy and the first metatarsal biplane osteotomy could effectively treat moderate to severe hallux valgus deformity, with similar imaging and clinical evaluation. However, the relative length of the first metatarsal bone in SO group was longer than that in DMO group after operation, and the time of weight bearing in Scarf osteotomy is earlier than that of double metatarsal osteotomy of the first metatarsal.

Clinical results of modified medial approach in the treatment of Pilon fracture with medial column compression / 中国骨伤

OBJECTIVE@#To explore the clinical results of modified medial incision in the treatment o f Pilon fracture with medial column compression and evaluate its safety.@*METHODS@#Thirty-one patients of Pilon fracture with medial column compressiom accepted surgical treatments in the Department of Foot and Ankle at Honghui Hospital of Xi'an Jiaotong University from January 2015 to January 2019. According to the imaging data at admission, 31 cases were diagnosed as closed Pilon fractures, and both preoperative X-ray and 3D CT scan were shown as medial column compressive fractures. All patients underwent modified medial incision with complete data, including 23 males and 8 females;ranging in age from 22 to 65 years old, with an average of (39.5±16.2) years old. All patients underwent modified medial approach combined with other approaches to expose the broken end of fracture. The time from trauma to operation ranging from 7 to 20 days, with a mean of(9.5±5.5) days. The incision and fracture healing were followed up regularly after operation.@*RESULTS@#All patients were followed up with an average of(15.7±5.5) months(ranged, 13 to 25 months). Preoperative and postoperative routine X-ray and 3D CT examination showed anatomical reduction in 8 cases, and the anatomical reduction rate was 25.81%. Up to the latest follow-up, all 31 fractures had achieved bone healing, and the healing time ranged from 11 to 22 weeks, with a mean of (14.3±4.7) weeks. At the latest follow-up, the American Orthopaedic Foot and Ankle Society (AOFAS) ankle and hindfoot scores ranged from 75 to 89, with a mean of 80.5±4.9, 24 patients got a good result, 7 fair.@*CONCLUSION@#The improved medial approach for Pilon fracture can directly expose the posterior medial, medial and anterior medial of the distal tibia. After reduction under direct vision, the medial compressed and collapsed articular surface are fixed. The clinical curative effect is satisfactory and the wound complications are less. It is recommended for Pilon fracture where compression of the medial articular surface is predominant.

Clinical Observation of Acupuncture plus Hyperbaric Oxygen for Depression After Cerebral Stroke / 上海针灸杂志

Objective To observe the clinical efficacy of acupuncture plus hyperbaric oxygen in treating depression after cerebral stroke.Method A total of 120 patients with depression after cerebral stroke were randomized into a treatment group of 60 cases and a control group of 60 cases. The treatment group was intervened by acupuncture plus hyperbaric oxygen, while the control group was intervened by Fluoxetine. Before the treatment, and respectively after 14-d and 28-d treatments, the patients were evaluated by Hamilton Depression Scale (HAMD) and National Institute of Health Stroke Scale (NIHSS), and the therapeutic efficacies were compared between the two groups. Result The treatment group was significantly superior to the control group in comparing therapeutic efficacy (P<0.01). After 1 course of treatment, the HAMD and NIHSS scores dropped significantly in the treatment group (P<0.01); the scores in the control group showed a declining tendency but without statistical significances (P>0.05). After 2 treatment courses, the HAMD and NIHSS scores were significantly different from those before the treatment in both groups (P<0.01), and the differences were more significant in the treatment group (P<0.01).Conclusion Acupuncture plus hyperbaric oxygen is effective in treating depression after cerebral stroke, and it can obviously improve the neural function.

Clinical Observation of Acupuncture plus Hyperbaric Oxygen for Depression After Cerebral Stroke / 上海针灸杂志

Objective To observe the clinical efficacy of acupuncture plus hyperbaric oxygen in treating depression after cerebral stroke.Method A total of 120 patients with depression after cerebral stroke were randomized into a treatment group of 60 cases and a control group of 60 cases. The treatment group was intervened by acupuncture plus hyperbaric oxygen, while the control group was intervened by Fluoxetine. Before the treatment, and respectively after 14-d and 28-d treatments, the patients were evaluated by Hamilton Depression Scale (HAMD) and National Institute of Health Stroke Scale (NIHSS), and the therapeutic efficacies were compared between the two groups. Result The treatment group was significantly superior to the control group in comparing therapeutic efficacy (P<0.01). After 1 course of treatment, the HAMD and NIHSS scores dropped significantly in the treatment group (P<0.01); the scores in the control group showed a declining tendency but without statistical significances (P>0.05). After 2 treatment courses, the HAMD and NIHSS scores were significantly different from those before the treatment in both groups (P<0.01), and the differences were more significant in the treatment group (P<0.01).Conclusion Acupuncture plus hyperbaric oxygen is effective in treating depression after cerebral stroke, and it can obviously improve the neural function.

The anti-HIV-1 activities of benzophenones non-nucleoside reverse transcriptase inhibitors in vitro / 药学学报

To evaluate the anti-HIV-1 activities of 5 benzophenones non-nucleoside reverse transcriptase inhibitors (NNRTIs) such as DY1203, DY1204, DY1119, DY1208 and DY1209 in vitro, the cytotoxicity of 5 compounds were tested on C8166, MT-4, H9 and PBMC with the MTT assay. The anti-HIV-1 activities of compounds were evaluated on laboratory-adapted strain, drug-resistant strains and primary isolated strains by p24 antigen expression ELISA. The inhibition of HIV-1 recombinant reverse transcriptase activity was assessed by ELISA assay. Among 5 compounds, DY1203 and DY1204 showed low cytotoxicities with CC50 greater than 200 μg·mL-1. DY1119, DY1208 and DY1209 showed strong anti-HIV-1 activities against HIV-1IIIB, HIV-174V, HIV-1RF/V82F/184V, HIV-1NL4-3 gp41(36G) N42S, HIV-1KM018, HIV-1TC-1 and HIV-1Wan. However, NNRTIs drug-resistant strain HIV-1A17 showed different resistance to these compounds. The 5 compounds proved active against HIV-1 recombinant reverse transcriptase. DY1208 is expected to become a new lead compound for its high therapeutic index. The results can provide new information for HIV-1 drug research and promote the development of new HIV-1 drugs.

An empirical study on the willingness to engage in elderly care among nursing students in junior college based on the theory of planned behavior / 预防医学

Objective To learn the willingness to engage in elderly care among nursing students in junior college in order to provide the basis for the training of geriatric nursing staff.Methods Totally 1 1 76 junior college nursing students in Ningbo were selected by stratified sampling method and were investigated with a questionnaire based on the theory of planned behavior.The willingness and plan to engage in elderly care among the students were analyzed.Results Fifty six percent of the nursing students would like to work in geriatric nursing.The average score of behavioral attitude,subjective norm,and perceived behavior control were (52.1 2 ±9.52),(1 6.42 ±6.21 ),and (31 .54 ±7.94).The regression analysis showed that the score of behavior attitude (β=0.1 8),subjective norm (β=0.35 ),and perceived behavior control (β=0.25 )were the factors influencing the willingness to work in geriatric nursing.Different major,grade, experience in elderly care and knowledge had different attitude and behavior in the willingness to engage in elderly care work(P <0.05).There were positive correlations among behavioral attitude,subjective norm,perceived behavior control and behavior intention (P <0.01 )Conclusion The investigation suggested that training nursing staff achievements previews in this area.Nursing students in higher vocational colleges have good professional intention in the work of geriatric nursing work.

Application of 3D-printing kidney and stones for PCNL planning and teaching: a preliminary research / 中华泌尿外科杂志

Objective To explore the possibility of three-dimensional (3D) kidney replications for clinical and teaching of percutaneous nephrolithotomy (PCNL).Methods The CT urography (CTU) DICOM format data from 5 patients with kidney calculi were selected from March 1st to June 1st,2015.Thresholding technique,region growing technique,edit mask technique and multiple slice edit technique were used in sequence by Mimics software.And five 3D replications were printed by Object 500 3D printer.The sizes of the replications were measured and the replications were punctured.Results The 3D replications of the kidneys were successfully designed and printed.The average difference of the long axes between 3D replications and patients' kidneys was 0.283cm,the average difference of the diameters was 0.212cm,and the average difference of the diameter of the stones was 0.244cm.The sizes of the 3D replications were basically consistent with those of patients' kidneys.The simulative puncturing was successful.Conclusions After comparing the 3D replications with their original 2D CT images,the anatomical details are found basically the same.The 3D replications could provide 3D visual observations of organ anatomy for surgeons.

Dry eye analysis of diabetes with cataract patients after phacoemulsification / 中华实验眼科杂志

Background Cataract phacoemulsification combined with intraocular lens (IOL) implantation is a primary treatment for cataract.However,tear film stability and ocular surface structure are affected after surgery,especially some cataract patients with diabetes.Researches determined that tear film dysfunction is an important causative factor of dry eye.Objective This study was to investigate the change of tear film after phacoemulsification in cataract patient with diabetes.Methods A non-randomized cases-controlled study was designed.Thirty-six cataract patients with diabetes (54 eyes)and matched 32 patients (40 eyes)with age-related cataract were included in this study in Tianjin First Center Hospital from October,2010 to May,2011.Phacoemulsification and IOL implantation was performed on the all patients with the same topical eyedrops in both groups.Dry eye-related symptom was surveyed and scored by questionnaire,and tear film break-up time (BUT),Schirmer Ⅰ test(S Ⅰ t)and corneal fluorescein(FL) were examined 3 days before operation and 1 day,1 week,1month,3 months after operation.Written informed consent was obtained from each patient before entering this trial.Results The percentage with preoperative symptoms of dry eye was 36.2％ and postoperative dry eye symptoms accounted for 75.8％.Significant differences were seen in dry eye symptom score,FL score,BUT value and S Ⅰ t value between the diabetic cataract group and only cataract group as well as among 4 time points(dry eye symptom score:Fgroup =139.347,P =0.000 ; Ftime =342.741,P =0.000 ; FL score: Fgroup =14.073,P =0.000 ; Ftime =332.697,P =0.000 ; BUT value: Fgroup =28.198,P =0.000 ; Ftime =868.364,P =0.000 ; S Ⅰ t value: Fgroup =2.848,P =0.095 ; Ftime =564.017,P=0.000).FL scores of 2 groups were significantly higher in postoperation than those in preoperation (P＜0.05),and those of diabetic cataract group were significantly higher than only cataract group(P＜0.05),but no significant difference was found between postoperation 3 months and preoperation (P＞0.05).BUT was shorter in postoperation than that in preoperation in the diabetic cataract group(P＜0.05).S Ⅰ t values in postoperative 1 day and 1 week were significantly lower than in preoperation in both groups(P＜0.05).However,S Ⅰ t values returned to normal from 1 month through 3 months in both groups(P＞0.05).Conclusions Tear film dysfunction occurs after operationin cataract patient with type 2 diabetes.It is thought that cataract patient with diabetes is susceptible population of dry eye.Dry eye appears more early and severer in diabetes patients after phacoemulsification combined with IOL implantation.

Protective effect of ciliary neurotrophic factor on retinal ganglion cell in acute ocular hypertension rat / 中华实验眼科杂志

BackgroundGlaucoma associates with apoptosis of retinal ganglion cells ( RGCs).Research showed that ciliary neurotrophic factor (CNTF) can repair optic nerve trauma,but it has not reported whether CNTF has a protective effect on glaucomatous optic neuropathy.ObjectiveThis experimental study was to explore the protective effect of CNTF on RGCs in rat eyes with acute ocular hypertension.MethodsOcular acute hypertension models were induced in bilateral eyes of 24 clean Wistar rats by forced perfusion of a balanced salt solution into the anterior chamber.Two days before molding,0.5 μg recombinant human CNTF (5 μl) was injected intravitreously in the left eyes,and 5 mmol/L sodium phosphate solution (5 μl) was injected in the same way as the control group.Three other Wistar rats were used as the normal control group.The animals were sacrificed by excessive anesthesia and the retinal sections were prepared 1,3,7,14 days after molding.The morphology of the retina was examined and RGCs counting was performed by hematoxylin & eosin staining and observed under a light microscope.The expression of glutamic acid in RGCs was assessed by immunochemistry.ResultsRegular retinal structure with clearly defined cell layers were observed in normal control rats.Changes in vacuoles in RGCs were seen in the model control group.The number of degenerative RGCs decreased in the CNTF group.Compared with the model control group,number of normal RGCs increased from 1 day to 14 days after molding with a significant difference between the two groups (all P=0.000).Immunochemistry assay showed that the numbers of positive cells for glutamic acid were 5.50±1.04 and 6.00±1.41 for the average of 3 fields at 3 days or 7 days in the CNTF group,and those in the model control group were 9.00±2.91 and 10.83 ± 1.94,respectively,showing significant differences between them ( all P =0.000 ).However,no comparable differences were found in the numbers of positive cells for glutamic acid at 1 day and 14 days between the two groups( P=0.578,0.180).ConclusionsCNTF down-regulates the expression of glutamic acid in RGCs and offers neuroprotection for RGCs in an acute glaucoma rat model.