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1.
Chinese Journal of Orthopaedics ; (12): 280-288, 2021.
Article in Chinese | WPRIM | ID: wpr-884713

ABSTRACT

Objective:To assess if metagenomic next-generation sequencing (mNGS) of periprosthetic joint tissue can provide an alternative rapid and sensitive tool for the diagnosis of prosthetic joint infection (PJI), especially compared to microbiological culture.Methods:A total of 33 eligible patients who underwent revision arthroplasty from June 2019 to June 2020 in orthopedic surgery department of the first affiliated hospital of Zhengzhou University were retrospectively analyzed. Twenty-one patients were included in PJI group according to the American Academy of Musculoskeletal Infection diagnostic criteria, with 17 cases of knee and 4 cases of hip, including 9 cases of male and 12 cases of female, with an average age of 59.14±14.55 years old (range from 28 to 84), and an average BMI of 23.7±2.8 kg/m 2 (range from 17.7 to 29.4 kg/m 2). Twelve patients were included in aseptic loosening group (control group), with 4 cases of knee and 8 cases of hip, including 4 cases of male and 8 cases of female, with an average age of 53.08±10.05 years old (range from 39 to 70), and an average BMI of 25.2±2.9 kg/m 2 (range from 18.3 to 31.2 kg/m 2 ). Microbiological culture results of synovial fluid and periprosthetic joint tissue and mNGS results of periprosthetic joint tissue were collected. The sensitivity and specificity of mNGS and microbiological culture were calculated and compared. The species of pathogenic microorganismsdetected by the two techniques were summarized. In addition, the impact of antibiotic use on the efficacy of both techniques were compared. Results:mNGS detected 13 positive cases and microbiological culture detected 6 positive cases in the PJI group. In the aseptic loosening group, 1 case was determined positive by mNGS, and all the microbiological culture results were negative. In the diagnosis of PJI, mNGS showed significantly higher sensitivity than that of culture (61.9% vs 28.6%, χ2=4.71, P=0.03), while no statistical difference was observed in terms of specificity (91.7% vs 100%, χ2=1.04, P=0.31). In the PJI cases with prior exposure to antibiotics within two weeks, the sensitivity of mNGS was significantly higher than that of culture (53.8% vs 15.4%, χ2=4.25, P=0.04). However, there was no significant difference in the sensitivity between mNGS and culture in patients without antibioticsexposure (66.7% vs 44.4%, χ2=0.90, P=0.34). In the detection of pathogenic microorganism, mNGS detected 9 kinds of bacteria (Staphylococcus aureus, Staphylococcus family, Moraxella Oslo, Propionibacterium acnes, Streptococcus acnes, Staphylococcus epidermidis, Mycobacterium tuberculosis, Staphylococcus Lyons, Bacteroides fragilis) and 2 kinds of fungi (Aspergillus fumigatus, Candida parapsilosis), while microbiological culture detected 3 kinds of bacteria (Staphylococcus aureus, Moraxella catarrhalis, Mycobacterium tuberculosis) and one kind of fungi (Candida parapsilosis). mNGS and microbiological culture were both positive in 5 cases, among which 3 cases had completely matched results (Staphylococcus aureus, Mycobacterium tuberculosis, Candida parapsilosis), one case had partly matched results (mNGS detected more bacteria than culture) and one case had totally mismatched results. Additionally, in the diagnosis of the 3 included tuberculous PJI, mNGS showed 100% specificity and sensitivity. Conclusion:mNGS of periprosthetic joint tissue is a more powerful tool for diagnosis and pathogen detection of PJI compared to microbiological culture, especially in the diagnosis of tuberculosis PJI. Besides, mNGS is more resistant to antibiotic exposure than culture.

2.
Article in Chinese | WPRIM | ID: wpr-884269

ABSTRACT

Objective:To investigate the feasibility of replacing the femoral prosthesis and implanting antibiotic calcium sulfate carriers in a two-stage revision for periprosthetic infection following total knee arthroplasty (TKA).Methods:Between May 2017 and January 2020, 35 patients were admitted to Department of Orthopaedic Surgery, The First Affiliated Hospital to Zhengzhou University for periprosthetic infection after TKA. They were 12 males and 23 females, aged from 49 to 84 years (average, 67.9 years). The two-stage revision for periprosthetic infection was performed for all of them and replacement of femoral prosthesis and implantation of antibiotic calcium sulfate carriers were carried out in stage-one revision. Recorded were postoperative culture of micro-organisms, white blood cell count (WBC), erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) before stage-one and stage-two revisions; the Hospital for Special Surgery (HSS) knee score, range of motion (ROM) and American Knee Society Score (KSS) were compared between preoperation and the last follow-up.Results:Postoperative negative culture was found in 22 cases (62.9%), and positive one in 13 cases (37.1%) of which 4 were caused by Staphylococcus aureus, 2 by Staphylococcus epidermidis, 2 by Candida glabrata, 2 by Candida parapsilosis, one by Candida albicans, one by Mycobacterium tuberculosis and one by Escherichia coli. WBC, ESR and CRP decreased on average from 13.67×10 9/L, 49.71 mm/h and 45.13 mg/L before stage-one revision to 6.44×10 9/L, 18.79 mm/h and 7.82 mg/L before stage-two revision. All patients were followed up for an average of 22.4 months (from 8 to 41 months). At the last follow-up, ROM, HSS and KSS were significantly increased from preoperative 73.2°±15.9°, 59.5±14.6 and 36.1±6.0 to 105.6°±13.2°, 84.3±10.0 and 86.1±5.6, respectively ( P<0.05). None of the patients showed any sign of re-infection at the last follow-up. Conclusion:For patients with periprosthetic infection following total knee arthroplasty, replacing femoral prosthesis and implantation of antibiotic calcium sulfate carriers can well control infection, facilitating recovery of range of motion and function after surgery.

3.
Article in Chinese | WPRIM | ID: wpr-883992

ABSTRACT

Objective:To observe the changes of plasma oxytocin (OT), arginine vasopressin (AVP) and anxiety after exercise intervention in male opioids-dependent patients.Methods:Forty-five male opioids addicts who met the inclusion criteria and voluntarily participated in exercise rehabilitation were enrolled.According to stratified random sampling, all subjects were divided into exercise group ( n=22) and control group( n=23). Exercise group attended aerobic exercise combined with resistance training intervention, 5 times per week for 8 weeks.Aerobic exercise was mainly treadmill and elliptical, while resistance training was based on strength and endurance training.Subjects completed self-rating anxiety scale (SAS) and Chinese perceived stress perception scale (CPSS) before and after intervention, as well as physical fitness tests. Besides, plasma OT and AVP levels were detected.Independent sample t-test, paired sample t-test, and Chi-square test were conducted by using SPSS 20.0 software. Results:Before the intervention, there were no significant differences between the two groups in demography, drug history, SAS, CPSS, plasma OT and AVP(all P>0.05). The overall anxiety detection rate was 66.67%, the scores of SAS and CPSS were both higher than the Chinese norm, and the difference was significant(both P<0.01) . After the intervention, the levels of plasma AVP, the scores of SAS and CPSS in the exercise group (AVP(19.57±2.23)pg/ml, SAS(50.17±10.09), CPSS(36.59±6.36)) were significantly lower than those in the control group (AVP(22.53±2.56)pg/ml, SAS(57.12±12.00), CPSS(43.09±5.57), all P<0.05), and plasma OT((61.98±5.27) pg/ml) was significantly higher than that in the control group ((54.64±7.62) pg/ml)( P<0.01). Compared with baseline, maximal oxygen uptake(VO 2max), 1 min push-ups and sitting body flexion increased significantly in the exercise group (all P<0.05). Conclusion:Opioids drug addicts were prone to excessive stress and anxiety and other negative emotions in the process of drug withdrawal. Eight-week aerobic combined with resistance exercise changed the plasma OT and AVP levels of opioids addicts, effectively alleviated the perceived stress, improved the anxiety state and their health related fitness level.

4.
Article in English | WPRIM | ID: wpr-880576

ABSTRACT

OBJECTIVE@#To evaluate the safety and effectiveness of Qishe Pill () on neck pain in real-world clinical practice.@*METHODS@#A multi-center, prospective, observational surveillance in 8 hospitals across Shanghai was conducted. During patients receiving 4-week Qishe Pill medication, Visual Analogue Scale (VAS) and Neck Disability Index (NDI) assessments have been used to assess their pain and function, while safety monitoring have been observed after 2 and 4 weeks.@*RESULTS@#Results from 2,023 patients (mean age 54.5 years) suggest that the drug exposure per unit of body mass was estimated at 3.41 ± 0.62 g/kg. About 8.5% (172/2,023) of all participants experienced adverse events (AEs), while 3.8% (78/2,023) of all participants experienced adverse reaction. The most common AEs were gastrointestinal events and respiratory events. The VAS score (pain) and NDI score (function) significantly decreased after 4-week treatment. An effect-quantitative analysis was also conducted to show that the normal clinical dosage may be consider as 3-4 g/kg, at which dosage the satisfactory pain-relief effect may achieve by 40-mm reduction in VAS.@*CONCLUSION@#These findings showed that patients with cervical radiculopathy who received Qishe Pill experienced significant improvement on pain and function. (Registration No. NCT01875562).

5.
Article in Chinese | WPRIM | ID: wpr-878882

ABSTRACT

The natural forest and artificial shed are the main cropping modes of Coptis chinensis. This study is aimed to reveal the rhizosphere soil bacterial community structure difference between under tow C. chinensis cropping modes-natural forest and artificial shed, and to assist us to completely understand soil quality condition,and provide theoretical guidance for soil improvement and C. chinensis planting. The rhizosphere soil samples of 1-5-year-old C. chinensis under tow cropping modes-natural forest and artificial shed were collected. Illumina high-throughput sequencing technology was used to analyze the alpha diversity, community composition, community structure of soil bacteria under the tow cropping modes,and the effects of soil nutriment indices on soil bacterial community structure. Through the analysis of species number, Shannon, Chao1 index and ACE index of bacterial community, it was found that the bacterial diversity of 1-year-old C. chinensis soil under natural forest cropping mode was significantly lower than that under artificial shed cropping mode, and the diversity of bacterial communities in soil of 2-5-years old C. chinensis were not significant different between two cropping modes. A total of 53 phyla,60 classes,140 orders and 266 families were detected in the rhizosphere soil of C. chinensis under the cropping modes of natural forest, respectively. The rhizosphere soil of C. chinensis under the cropping modes of artificial shed included 54 phyla,65 classes,140 orders and 264 families, respectively. Under the two cropping modes, the top 10 dominant species of bacterial community abundance are the same, they are Proteobacteria, Acidobacteria, Actinobacteria,Bacteroidetes, Planctomycetes, Chloroflexi, Verrucomicrobia, Gemmatimonadetes, Firmicutes and Cyanobacteria, but there are differences in the abundance sequence. The top 10 dominant species of bacterial community abundance accounted for 74.36% to 74.30% of the total bacteria, and 3.15% to 3.92% of the bacteria are unclassified. The results of Metastat analysis showed that the abundance of Gemmatimonadetes in the rhizosphere soil of C. chinensis under the cropping modes the artificial shed was significantly higher than that under the natural forest cropping mode(P<0.05). MRPP analysis of community structure differences showed that under tow cropping modes, there were significant differences in the bacterial community structure of 1-4-year-old soil bacteria, among which the difference between 1-year-old soil samples was the largest. With the increase of cropping years, the difference gradually decreases, and there is no significant difference in the bacterial community structure between 5-year-old soil samples. RDA analysis and correlation analysis of bacterial community structure and soil physical and chemical properties showed that the order of environmental factors on the rhizosphere soil bacteria of Coptis chinensis was: pH>available P> total P> total K>bulk density>total N>available N>organic matter. The results are helpful to understand the soil health of C. chinensis and provide scientific basis and theoretical guidance for soil improvement and C. chinensis planting.


Subject(s)
Child, Preschool , Coptis , Forests , Humans , Infant , Rhizosphere , Soil , Soil Microbiology
6.
Article in Chinese | WPRIM | ID: wpr-879045

ABSTRACT

To investigate the effects of six common drying methods on the quality of different specifications of Sophorae Flos, in order to select their suitable drying methods. According to appearance and morphology, Sophorae Flos was divided into the following three specifications: flower bud type(HL), half-open type(BK) and blooming type(SK). All specifications of samples were treated with shade-drying method(25 ℃, natural temperature), sun-drying method, hot-air-drying method(60, 105 ℃), and drying method(60 ℃) after steaming. The contents of total flavonoids, rutin, narcissus, quercetin, isorhamnetin, and Fe~(3+) reducing ability, DPPH free radical scavenging ability, ABTS free radical scavenging ability and fluorescence recovery after photobleaching(FRAP) were detected by UV, HPLC and colorimetry, respectively. Principal component analysis(PCA), cluster analysis(CA) and correlation analysis were used to comprehensively evaluate the quality of samples. According to the results, there were significant differences in the effect of drying methods on different specifications of samples. The drying method(60 ℃) after steaming was suitable for HL and BK, while the hot-air-drying method(60 ℃) was suitable for SK. When the fresh medicinal materials could not be treated in time, they should be spread out in a cool and ventilated place. Under high and low temperature conditions, the quality of three specifications of Sophorae Flos would be reduced. The hot-air-drying method(105 ℃) and shade-drying method(25 ℃) were not suitable for the treatment of fresh flowers and flower buds of Sophora japonicus. There were obviously differences of chemical compositions and antioxidant activities among the three specifications of samples. Therefore, the specifications of medicinal materials should be controlled to ensure the uniform quality. The study provided the abundant data reference for the selection of appropriate drying methods for the three specifications of Sophorae Flos, and useful exploration for the classification and processing of medicinal materials of flowers.


Subject(s)
Chromatography, High Pressure Liquid , Flavonoids/analysis , Flowers/chemistry , Rutin , Sophora
7.
Article in Chinese | WPRIM | ID: wpr-828011

ABSTRACT

Forty-three annual Citrus aurantium grafted seedlings from Chongqing, Sichuan, Hunan, Jiangxi and other main producing areas were collected, and the plant height, rootstock diameter, scion diameter, root length, root diameter, lateral root number, root breadth, branch number, branch length, green leaf number, leaf length, leaf width, thorns and other indicators were measured. Through the K-cluster analysis of SPSS 19.0 software, the classification standards were obtained. Combined with the production practice, plant height, scion diameter and branch number were taken as the quality classification indexes of C. aurantium seedlings(annual grafted seedlings), and three classification standards were established. If it does not meet the three-level standard, it is unqualified seedling and cannot be used as seedling. It is suggested to use the first and second level seedlings in production.


Subject(s)
Citrus , Plant Leaves , Plant Roots , Seedlings
8.
Article in Chinese | WPRIM | ID: wpr-878801

ABSTRACT

This study is aimed to reveal the rhizosphere soil fungal community structure difference of Coptis chinensis cropping between natural forest and artificial shed modes, and provide theoretical guidance for soil improvement and C. chinensis planting. The rhizosphere soil samples of 1-5-year-old C. chinensis under natural forest and artificial shed modes were collected. Illumina high-throughput sequencing technology was used to analyze the community structure and diversity of soil fungi under the tow cropping modes,and the effects of soil nutriment indices on soil fungal community structure. The results suggested that the abundance and diversity of fungal communities in soil of 2-5-year-old C. chinensis were not significant different in both two cropping modes, but it was significantly higher than that in the 1-year-old C. chinensis. Comparing soil samples from the same year-old C. chinensis under the two cropping modes, it was found that there was no significant difference in the abundance and diversity of fungal communities. The fungal community of the rhizosphere soil was different in composition and abundance between tow cropping modes, and between different planting years. The 17 phyla,59 classes and 155 orders,and 17 phyla,59 classes and 157 orders were detected in the rhizosphere soil of C. chinensis under the cropping modes of natural forest and the artificial shed, respectively. Ascomycota, Basidiomycota and Mortierellomycota were dominant phyla in rhizosphere soil, and the average abundance of the 3 phyla accounted for 74.36% and 74.30% of the total fungi. The results of analysis of similarities showed that there were significant differences in the fungal community structure of 1-year-old and 2-year-old C. chinensis soil fungi, and there was no significant difference in the community structure of 3-5-year-old samples. Under the natural forest cropping mode, there were significant differences among the samples of different years. Under the artificial shed cropping, there were significant differences in fungal community structure between 1-year-old and 3-5-year-old C. chinensis soil, and between 2-year-old and 3-5-year-old C. chinensis soil. The results of canonical correlation analysis showed that soil pH and soil organic matter content were the main factors affecting the soil fungal community structure. Soil organic matter content was positively correlated with Basidiomycota and Cryptomycota, pH was negatively correlated with Basidiomycota and C. ryptomycota. The planting of C. chinensis has promoted the diversity and abundance of rhizosphere fungal community significantly. For the same year-old C. chinensis soil, abundance of fungal community was no significant difference between two cropping modes. There are significant differences in the rhizosphere soil fungal community structure between tow cropping modes in the first two years of planting. Through the interaction between the rhizosphere and the soil and the continuous selection of the rhizosphere to the fungal community, the fungal community structure tended to be the same between the two cropping modes in rhizosphere soil of 3-5-year old C. chinensis. The soil pH and orga-nic matter content were the main factors affecting the change of fungal community structure.


Subject(s)
Coptis , Forests , Fungi , Mycobiome , Plant Roots , Rhizosphere , Soil , Soil Microbiology
9.
Article in Chinese | WPRIM | ID: wpr-872183

ABSTRACT

Objective:To present a new treatment method using orbital septum for mild blepharoptosis.Methods:Patients with mild blepharoptosis from December 2015 to October 2017 were included in this study. We incised the orbital septum horizontally. The adhesion between the levator aponeurosis and orbital fat was released. The lower part of the dissected orbital septum was turned downward and then sutured to the upper border of the lower orbicularis oculi muscle and posterior pretarsal fascia. The efficacy of this surgical procedure was analyzed.Results:Fourty-four eyes of 31 patients were included in the final analysis. Stitches were removed 7 days after surgery. The double eyelid lines were well formed. The eyelid closed well. The 6-month follow-up revealed that blepharoptosis was corrected in all analyzed eyes. No upper eyelid retraction or incomplete eye closure was observed. Before the operation and 6 months after the operation, the height of upper eyelid covering the cornea were 3.03±0.32, 1.55±0.19, respectively ( P<0.01). 25 patients were fully satisfied with the surgical results and 6 were basically satisfied with the surgical results. Conclusions:Turning the orbital septum downward and fixing it to the upper border of the lower orbicularis oculi muscle and pretarsal fascia is a promising method for correcting mild blepharoptosis.

10.
Article in Chinese | WPRIM | ID: wpr-805402

ABSTRACT

Objective@#To investigate a new approach for double-eyelid blepharoplasty.@*Methods@#Double-eyelid blepharoplasty was performed by turning the orbital septum downward and fixing it to the upper border of the lower orbicularis oculi muscle and posterior pretarsal fascia, which is imitating physiological mechanical conduction. During double-eyelid blepharoplasty, the orbital septum was cut horizontally. Using the fusion of the levator aponeurosis with septum as a pedicle, the lower part of the orbital septum was turned downward and then sutured to the upper border of the lower orbicularis oculi muscle and posterior pretarsal fascia. We evaluated the outcomes of this double-eyelid surgical procedure in patients undergoing the procedure from December 2015 to February 2018.@*Results@#622 eyes of 311 patients were included in the final analysis. Sutures were removed 7 days after surgery. All double-eyelid lines were well-formed, and the eyelids closed well. Three-to twelve-month follow-up results revealed that the double-eyelid shape was natural, no patients experienced upper eyelid retraction or incomplete eye closure. Notched scars did not occur, and patient satisfaction was achieved in all cases. 281 patients were fully satisfied with the surgical results and 30 were basically satisfied with the surgical results.@*Conclusions@#Turning the orbital septum downward is a good approach for double-eyelid blepharoplasty.

11.
Article in Chinese | WPRIM | ID: wpr-805401

ABSTRACT

Objective@#To investigate a new approach for double-eyelid blepharoplasty.@*Methods@#Double-eyelid blepharoplasty was performed by turning the orbital septum downward and fixing it to the upper border of the lower orbicularis oculi muscle and posterior pretarsal fascia, which is imitating physiological mechanical conduction. During double-eyelid blepharoplasty, the orbital septum was cut horizontally. Using the fusion of the levator aponeurosis with septum as a pedicle, the lower part of the orbital septum was turned downward and then sutured to the upper border of the lower orbicularis oculi muscle and posterior pretarsal fascia. We evaluated the outcomes of this double-eyelid surgical procedure in patients undergoing the procedure from December 2015 to February 2018.@*Results@#622 eyes of 311 patients were included in the final analysis. Sutures were removed 7 days after surgery. All double-eyelid lines were well-formed, and the eyelids closed well. Three-to twelve-month follow-up results revealed that the double-eyelid shape was natural, no patients experienced upper eyelid retraction or incomplete eye closure. Notched scars did not occur, and patient satisfaction was achieved in all cases. 281 patients were fully satisfied with the surgical results and 30 were basically satisfied with the surgical results.@*Conclusions@#Turning the orbital septum downward is a good approach for double-eyelid blepharoplasty.

12.
Article in Chinese | WPRIM | ID: wpr-734204

ABSTRACT

Objective To compare the biomechanical stabilities among different combinations of anterior and medial cortical supports after intramedullary nailing for unstable intertrochanteric fractures.Methods Twenty-seven synthesized femur specimens were used to create models of unstable intertrochanteric fracture of type 31A2.1 according to AO/ASIF classification.They were divided into 9 groups (n =3) according to 9 combinations of anterior and medial cortical supports on the anteroposterior and lateral X-ray films:positive-positive,positive-neutral,positive-negative,neutral-positive,neutral-neutral,neutral-negative,negative-positive,negative-neutral,negative-negative groups.After all the fractures were fixated with the newly adapted femoral intertrochanteric nails (FITN),static loadings were applied for tests of fatigue and destruction to investigate the relative displacements and yield loads of the head-neck fragments.Results For the positive-positive,positive-neutral,positive-negative,neutral-positive,neutral-neutral,neutral-negative,negative-positive,negative-neutral,negative-negative groups,the vertical displacements of the head-neck fragments under fatigue loading were respectively 5.33 ±0.58 mm,7.83 ±0.29mm,7.73 ±0.15 mm,8.17 ± 0.29 mm,8.33±1.15 mm,8.83±0.29 mm,9.33±0.58 mm,9.67±1.15 mm and 12.0±1.0 mm,showing significant differences (P < 0.05).The smallest displacement was observed in the positive-positive group,significantly smaller than that in any other groups (P < 0.05).For the above 9 groups,the yield loads were respectively 4,967 ± 153 N,4,467 ± 58 N,3,717 ± 76 N,2,767 ± 58 N,2,533 ± 58 N,2,267 ± 58 N,1,833 ± 58 N,1,667 ± 58 N and 1,333 ± 58 N,showing significant differences between any 2 groups (P < 0.05).In the destruction test,bone interface loosening in the femoral head happened in 2 cases,bone interface loosening in the intertrochanteric zone in 15 cases,split fracture at the zone of distal locking nail in 2 cases,and loosening and breakage of the internal fixator in the distal femur in 8 cases.Conclusions The medial cortical support plays a major role and the anterior cortical support plays a secondary role in the stability of unstable intertrochanteric fracture.In the surgical procedure,surgeons should avoid the medial cortical negative support as much as possible.

13.
Article in Chinese | WPRIM | ID: wpr-751768

ABSTRACT

Objective To evaluate the efficacy of traditional herbal enema combined with vacuum sealing drainage in the treatment of perianal abscess.Methods A total of 87 patients who met the inclusion criteria were randomly divided into control group (43 cases) and study group (44 cases) by random number table method.The control group was treated with vacuum sealing drainage.The study group was given traditional herbal enema on the basis of the control group.Both groups were treated for 20 days and followed up for 6 months.The WBC,neutrophil count (NEU) and neutrophil percentage (NEU%) was measured by automatic blood cell analyzer,and the hospitalization and wound healing time was recorded.The recurrence rate of abscess and secondary anal fistula was observed during the follow-up period.Results The total effective rate was 97.7% (43/44) in the study group and 88.4% (38/43) in the control group.There was significant differences between the two groups (x2=4.010,P=0.045).The hospitalization time (14.2 ± 0.6 d vs.17.0 ± 1.2 d,t=13.970) and wound healing time (45.6 ± 0.7 d vs.48.7 ± 1.2 d,t=15.216) in the study group was significantly shorter than those in the control group (P<0.01).After treatment,the WBC,NEU and NEU% level in the study group was significantly lower than those in the control group (t=23.318,12.827,46.630,all Ps<0.01).After 6 months of follow-up,the recurrence rate of abscess and the secondary anal fistula rate in the study group was significantly lower than those in the control group(x2=12.813,4.225,respectively,P<0.01 or P<0.05).Conclusions Traditional herbal enema combined with vacuum sealing drainage can significantly shorten the hospitalization and wound healing time,reduce the recurrence of abscess and secondary anal fistula,and improve the clinical efficacy.

14.
Article in English | WPRIM | ID: wpr-719300

ABSTRACT

BACKGROUND AND PURPOSE: This study investigated the contribution of white-matter hyperintensities (WMH) and lacunar infarcts (LI) to the risk of Alzheimer's disease (AD) in an elderly cohort in China. METHODS: Older adults who were initially cognitively normal were examined with MRI at baseline, and followed for 5 years. WMH were classified as mild, moderate, or severe, and LI were classified into a few LI (1 to 3) or many LI (≥4). Cognitive function was assessed using the Mini Mental State Examination and the Activities of Daily Living scale. RESULTS: Among the 2,626 subjects, 357 developed AD by the end of the 5-year follow-up period. After adjusting for age and other potential confounders, having only WMH, having only LI, and having both WMH and LI were associated with an increased risk of developing AD compared with having neither WMH nor LI. Moderate and severe WMH were associated with an increased risk of developing AD compared with no WMH. Furthermore, patients with many LI had an increased risk of developing AD compared with no LI. CONCLUSIONS: Having moderate or severe WMH and many LI were associated with an increased risk of developing AD, with this being particularly striking when both WMH and LI were present.


Subject(s)
Activities of Daily Living , Adult , Aged , Alzheimer Disease , China , Cognition , Cohort Studies , Follow-Up Studies , Humans , Magnetic Resonance Imaging , Strikes, Employee , Stroke, Lacunar
15.
Journal of Chinese Physician ; (12): 503-506, 2019.
Article in Chinese | WPRIM | ID: wpr-744899

ABSTRACT

Objective To investigate the clinical effect of 595 nm tunable pulsed dye laser (PDL) in treating fresh trauma scars.Methods 85 patients had been selected,of which,117 sites were treated with a 595 nm tunable PDL one time or two times at a fluence of 7-15 J/cm2 and pulse widths of 1.5-3 ms,7 mm spot size.Nursing skill of burn wound was also used on treatment area after laser treatment.Scars were evaluated for melanin,height,vascularity and pliability using the Vancouver Scar Scale (VSS) before treatment and after the last treatment 8weeks.Results Total score of 117 sites decreased from (8.30 ± 2.63) to (2.70 ± 1.25),melanin decreased from (1.60 ± 0.84) to (0.60 ± 0.97),height decreased from (1.30 ± 0.82) to (0.40 ± 0.51),vascularity decreased from (2.40 ± 0.52) to (0.40 ±0.52),pliability decreased from (2.80 ± 1.32) to (1.30 ±0.48),with statistical significance between before treatment and after treatment (P < 0.05).Conclusions 595 nm tunable pulsed dye laser appears to have a beneficial clinical effect on patient's fresh trauma scar.

16.
Article in Chinese | WPRIM | ID: wpr-773869

ABSTRACT

OBJECTIVE@#To compare the clinical efficacy of pneumatic reduction combined with bone-filled mesh bag implantation and pneumatic reduction combined with kyphoplasty in the treatment of thoracolumbar burst fracture without spinal cord injury.@*METHODS@#The clinical data of 160 patients with thoracolumbar osteoporotic burst fracture without spinal cord injury treated from January 2014 to July 2017 were retrospectively analyzed. There were 66 males and 94 females, aged from 72 to 84 years old with an average of 76.4 years old. The patients were divided into two groups according to different surgical methods, including 80 cases of pneumatic reduction combined with bone-filled mesh bag implantation(treatment group) and 80 cases of pneumatic reduction combined with kyphoplasty(control group). The intraoperative bone cement leakage rate was compared between two groups. The height of the injured vertebrae was measured by X-rays preoperatively and 6-month postoperatively in order to assess height loss of injured vertebrae. VAS score and ODI score were used for follow-up to assess lumbar back pain and autonomic dysfunction before surgery and 2 weeks, 6 months, 1 year after surgery.@*RESULTS@#In treatment group, 3 cases occurred bone cement leakage during operation and leakage rate was 3.75%(3/80); In control group, 14 cases had cement leakage with leakage rate of 17.5%; The difference between two groups was statistically significant(<0.05). All patients were followed up for 13 to 24 months with an average of 14.6 months. Among them, 2 cases occurred postoperative infections which were superficial infections. After oral antibiotics and outpatient treatment infections were controlled. At 6 months after surgery, the height of the injured vertebra was measured by X-ray. Treatment group recovered (5.12±1.31) % and control group recovered (14.11±1.17) %. The difference between two groups was statistically significant (<0.05). At 1 year after surgery, ODI score was 4.03±1.62 in treatment group and 10.03±1.54 in control group. The difference between two groups was statistically significant(<0.05). VAS score was 1.03±0.62 in treatment group and 2.67±0.55 in control group. The difference between groups was statistically significant(<0.05).@*CONCLUSIONS@#Extracorporeal pneumatic reduction combined with bone-filled mesh bag implantation technique can significantly reduce the occurrence of intraoperative cement leakage in the treatment of thoracolumbar osteoporotic burst fractures, effectively improve reposition of the injured vertebrae, relieve the pain and recover the function of lower back. However, high price of bone-filled mesh bags obstructs its clinical popularization.


Subject(s)
Aged , Aged, 80 and over , Female , Humans , Lumbar Vertebrae , Male , Osteoporotic Fractures , Retrospective Studies , Spinal Cord Injuries , Spinal Fractures , Surgical Mesh , Thoracic Vertebrae , Treatment Outcome
17.
Article in Chinese | WPRIM | ID: wpr-816427

ABSTRACT

Nutrition support is an important part of the therapy for critical patients with intra-abdominal infections.How to perform optimal nutrition support is crucial to improve the success rate of treatment for critical patients with intraabdominal infection.In general,proper energy and nutrient substrates and right timing and approach should be providedto maximize the benefits of nutrition support for critical patients with intra-abdominal infection according to the metabolic characteristics,gastrointestinal function and nutritional status.

18.
Article in Chinese | WPRIM | ID: wpr-699479

ABSTRACT

Objective To explore the effect of adenosine preconditioning on vascular endothelial growth factor(VEGF)and angiopoietin-1 (Ang-1) in oxygen-glucose deprivation and reoxygenation astrocytes.Methods Astrocytes of pallium in Sprague Dawley rats were cultured in vitro,and the third generation of astrocytes were passaged to 96 pore plate.The astrocytes were divided into normal control group,oxygen-glucose deprivation group and adenosine preconditioning group randomly when the astrocytes adhered to the wall and grew the evection.The cells in the normal control group did not received oxygen glucose deprivation;the cells in the oxygen-glucose deprivation group received oxygen-glucose deprivation 8 h and reoxygenation 24 h;the cells in the adenosine preconditioning group were given adenosine 100 μmol · L-1 at 24 hours before received oxygen-glucose deprivation 8 h and reoxygenation 24 h.The shape of astrocytes were observed after reoxygenation 24 h.The cytoactivity of astrocytes in each group was detected by methyl thiazolyl tetrazolium assay;the concentration of VEGF and Ang-1 in supernatant of astrocytes in each group was detected by enzyme linked immunosorbent assay.Results The astrocytes in the normal control group grew well.The edema of astrocytes in the oxygen-glucose deprivation group was obvious,and the cell body became round;the cell morphology changed from irregular to spindle shape;and the neurites became shorter or even disappeared.Compared with the oxygen-glucose deprivation group,the astrocytes in the adenosine preconditioning group had a mildly edema,and the cells were arranged orderly.The vitality of astrocytes in the normal control group,oxygen-glucose deprivation group and adenosine preconditioning group was 0.698 ± 0.059,0.196 ± 0.062,0.412 ± 0.009 respectively;the vitality of astrocytes in the oxygen-glucose deprivation group was obviously lower than that in the normal control group(q =3.561,P <0.05);the vitality of astrocytes in the adenosine preconditioning group was obviously higher than that in the oxygen-glucose deprivation group (q =2.102,P < 0.05).The concentration of VEGF in supemate in the normal control group,oxygen-glucose deprivation group and adenosine preconditioning group was (0.038 ± 0.005),(0.053 ± 0.007),(0.084 ± 0.006) μg · L-1 respectively;the concentration of Ang-1 in supemate in the normal control group,oxygen-glucose deprivation group and adenosine preconditioning group was (0.030 ± 0.007),(0.049 ± 0.008),(0.080 ± 0.004) μg · L-1 respectively.The concentration of VEGF and Ang-1 in the oxygen-glucose deprivation group were obviously higher than those in the normal control group(q =1.394,1.633;P < 0.05);the concentration of VEGF and Ang-1 in the adenosine preconditioning group were obviously higher than those in the oxygen-glucose deprivation group (q =1.584,1.632;P < 0.05).Conclusion The adenosine preconditioning can increase the expression of VEGF and Ang-1 in astrocytes after oxygen-glucose deprivation.It can enhance the tolerance of brain to ischemia-reperfusion injury and produce neural protection effect.

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Article in Chinese | WPRIM | ID: wpr-698476

ABSTRACT

BACKGROUND:The research and application of platelet-rich plasma in tissue regeneration and restoration have always been an issue of concern in the medicine and bioengineering fields.OBJECTIVE:To analyze the effects of platelet-rich plasma in combination with tendon stem cells on histomorphology change and matrix metalloproteinase 1 expression of the tendon tissues in a rabbit model of Achilles tendinopathy.METHODS:Forty New Zealand white rabbits were randomly divided into model group (n=32) and blank control group (n=8).In the model group,the animals were injected about 2 cm distant to the attachment point of the left calcaneus with prostaglandin E2 (once a week,for totally 4 weeks) to make the animal model of tendinopathy.The rabbits in the blank control group were injected the equal amount of normal saline.After 4 weeks,model rabbits were randomly divided into four subgroups:combination group,tendon stem cell group,platelet-rich plasma group and model control group,with eight rabbits in each group.Platelet-rich plasma and tendon stem cells,alone or in combination,and normal saline were injected into the corresponding group,twice with an interval of 3 weeks.At 6 weeks after injection,the tendon tissue was collected and stained for histological examination and detection of matrix metalloproteinasa 1 expression.RESULTS AND CONCLUSION:(1) Hematoxylin-eosin staining:the tendon fibers in the combinationgroup were intact and arranged orderly;in the tendon stem cell group,the tendon fibers were almost arranged orderly despite some fractured fibers;in the platelet-rich plasma group,fiber breakage and loose fiber structure were observed;in the model control group,there were no intact tendon fibers,with the presence of inflammatory cell filtration.(2) Masson staining:The tendon fibers in the combination group had slight wave-shaped changes but the fibers were not cut off;in the tendon stem cell group,the tendon fibers were slightly in disorder,but with the intact structure,and obvious inflammatory cell filtration was observed;in the platelet-rich plasma group,fiber breakage,reduced collagen fibers and inflammatory cell filtration were obviously observed;in the model control group,there were no intact tendon fibers,and inflammatory cell filtration was clearly visible.(3) The expression of matrix metalloproteinase 1:Compared with the blank control group,the expression of matrix metalloproteinase 1 was significantly higher in the other groups except the combination group (P < 0.05).There was no significant difference in the expression of matrix metalloproteinase 1 between the combination group and blank control group (P > 0.05).To conclude,the combination of platelet-rich plasma and tendon stem cells can inhibit the vicious cycle of degeneration of collagen and extracellular matrix,reduce the expression of matrix metalloproteinase 1 in tenocytes,and delay inflammation responses and degeneration due to tendinopathy.

20.
China Pharmacy ; (12): 534-537, 2018.
Article in Chinese | WPRIM | ID: wpr-704622

ABSTRACT

OBJECTIVE: To investigate the effects of memantine hydrochloride on cognitive function, cerebral hemodynamics and oxidative stress level in patients with vascular dementia (VD). METHODS: A total of 70 VD patients in the Third Affiliated Hospital of Xinxiang Medical College from Feb. 2013 to Feb. 2015 were divided into control group (36 cases) and observation group (34 cases) aoccording to random number table. Observation group was given Memantine hydrochloride tablets orally with initial dose of 5 mg/d, qd, increasing by 5 mg/week gradually, maintaining at 20 mg/d, qd, at 4th week. Control group was given Piracetam tablets 0. 8 g orally, tid. A treatment course of 2 groups lasted for 4 weeks, and both were treated for 6 courses. Clinical efficacies as well as MoCA scores, ADL scores, systolic peak velocity (Vmax),diastolic peak velocity (Vmin),pulsatility index (PI), resistance index (RI) and breath holding index (BHI) of middle cerebral artery, the levels of MDA, SOD and Hcy were observed in 2 groups. The occurrence of ADR was recorded. RESULTS: Four, two patients withdrew from the study in control and observation group, respectively, and 32 patients in each group completed the study. The total response rate of observation group was 87. 50%, which was significantly higher than 65. 63% of control group, with statistical significance (P<0. 05). Before treatment, there was no statistical significance in above indexes between 2 groups (P>0. 05). After treatment, MoCA, ADL scores and SOD levels of 2 groups were increased significantly, while MDA and Hcy levels were decreased significantly; Vmax and BHI of observation group were increased significantly, and above indexes of observation group was significantly better than those of control group, with statistical significance (P<0. 05). There was no statistical significance in Vmin, PI or RI between 2 groups before and after treatment, and Vmax or BHI of control group before and after treatment (P>0. 05). ADRs of 2 groups were mild, and there was no statistical significance in the incidence of ADR between 2 groups (P>0. 05). CONCLUSIONS: Memantine hydrochloride in the treatment of VD patients can improve the cerebral hemodynamics, reduce oxidative stress and improve cognitive function with good safety.

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