Bone and soft tissue combined with surgery for the treatment soft flatfoot combined with painful navicular bone / 中国骨伤

OBJECTIVE@#To explore short-term clinical effects of bone and soft tissue combined with surgery for the treatment of soft flatfoot accompanied with painful navicular bone.@*METHODS@#From May 2015 to August 2017, 16 patients (16 feet) with navicular bone soft flatfoot accompanied with painful navicular bone were treated with bone and soft tissues operation (gastrocnemius release, medial displacement calcaneal osteotomy, and excision of accessory navicular with reconstruction of posterior tibial tendon). Among them, there were 9 males (9 feet) and 7 females (7 feet), aged from 22 to 48 years old with an average of (32.0±3.4) years old. The duration of diseases ranged from 6 months to 5 years with an average of (2.4±1.7) years. The postoperative complications were observed, talocalcaneal angle, the first metatarsal horn of the talus, arch height, angle of inclination and calcaneal valgus before and after operation at 12 months were compared. VAS score and AOFAS score after operation at 12 months were applied to evaluate pain relief and function.@*RESULTS@#All patients were followed up for an average of (18.4±3.5) months(13~25 months). The incisions of patients were healed at grade A without wound infection, nonunion or delayed union, internal fixation fracture or loosening and other complications. Medial pain of foot was disappeared and motor ability was restored at 12 months after operation. Arch height, angle of inclination and the first metatarsal horn of the talus of lateral X-ray before operation and after operation at 12 months on weight-bearing foot were(21.51±1.20)°vs(31.01±1.62)°, (10.71±1.52)°vs(22.12±2.11)°, (15.61±1.41)°vs(5.10±1.20)°; talocalcaneal angle, the first metatarsal horn of the talus of AP X-ray before operation and after operation at 12 months on weight-bearing foot were (36.12±2.21) ° vs (22.12±2.61)°, (13.41±1.51)°vs(4.30±0.91)°; calcaneal valgus of axial X-ray before operation and after operation at 12 months on weight-bearing foot were (10.80±1.21)°vs(3.92±1.81)°; there were statistical difference in imaging indicators between preoperation and 12 months after operation. VAS score was significantly decreased from (6.21±2.31) before operation to (1.82±0.56) at 12 months after operation (=2.64, <0.05). AOFAS score was obviously increased from (51.2±5.6)before operation to (87.1±4.7)at 12 months after operation (=3.43, <0.05).@*CONCLUSIONS@#Bone and soft tissue operation (namely, gastrocnemius release, medial displacement calcaneal osteotomy, and excision of accessory navicular with reconstruction of posterior tibial tendon) could obviously relieve foot pain, improve foot appearance and function in patients with navicular bone soft flatfoot complicated with painful navicular bone, and has certain clinical efficacy.

A Prospective Randomized Multicenter Controlled Trial on Salvianolate for Treatment of Unstable Angina Pectoris in A Chinese Elderly Population / 中国结合医学杂志

OBJECTIVE@#To evaluate the efficacy and safety of salvianolate in elderly patients with unstable angina pectoris (UAP).@*METHODS@#A prospective double-blind randomized placebo-controlled multicenter trial in elderly patients with UAP from 13 third-grade class-A hospitals in China was performed. A total of 318 patients were randomly allocated in a 1:1 ratio to an experimental group (160 patients) and a control group (158 patients). The experimental group was treated with salvianolate for 14 days on the basis of conventional medicine, and the control group was given a placebo for 14 days with the same criteria. Follow-up was lasted 28 days in both groups. The primary endpoint was biweekly frequency of angina pectoris attacks. The secondary endpoints included biweekly dosage of nitroglycerin, the Seattle Angina Questionnaire, angina pectoris severity and duration, myocardial injury markers, high-sensitivity C-reactive protein (hs-CRP) and N-terminal pro-B-type natriuretic peptide (NT-proBNP), as well as major adverse cardiovascular events (MACEs). Safety was assessed according to adverse events and serious adverse events.@*RESULTS@#Baseline characteristics were similar between treatment groups. Compared with those in the control group, the frequency of biweekly angina attacks (2.92 vs . 4.08, P=0.025), the biweekly dosage of nitroglycerin, as well as the severity and duration of angina attacks (P<0.01) were reduced by salvianolate. The Seattle Angina Questionnaire score was also significantly improved in the experimental group than in the control group (P<0.05). No significant differences were observed between the two groups with respect to the incidence of MACEs. Salvianolate was well tolerated.@*CONCLUSIONS@#Salvianolate appear to have efficacy and well tolerated for elderly patients with UAP. [ClinicalTrials.gov identifier: NCT03037047].

Treatment of distal radius fracture with manual reduction and external fixation with small splint steel support external fixation / 中国骨伤

<p><b>OBJECTIVE</b>To evaluate the short-term result for the treatment of distal radius fracture with manual resetting and fixing with small splint.</p><p><b>METHODS</b>From January 2015 to December 2016, 60 cases of distal radial fractures were treated by manual resetting and small splint fixation including 39 males and 21 females with an average age of (43.50±10.56) years old ranging from 18 to 65 years old. According to AO classification, 38 cases were type A, 19 cases were type B, 3 cases were type C. The anteroposterior and lateral X-ray of the wrist joint was performed before reduction, 1, 2, 4 weeks after reduction, and the removal of the small splint, the palm inclination angle, ulnar deviation angle and radius height were measured. At 8, 24 and 48 weeks after reduction, the wrist extensor, palmar flexion, pronation, supination, ulnar deviation and radial deviation were measured. Wrist strength was measured at 4, 8, 24 and 48 weeks after fracture reduction. After the distal radius fracture healed, the splint support was removed. After dismantling small splint steel support, Mayo score of wrist joint was performed.</p><p><b>RESULTS</b>All cases of distal radius fractures were followed up, the healing time of fracture was 6 to 8 (7.1±0.9) weeks. The difference of palmar obliquity, ulnar deviation angle and radius shortening between before reduction and 2 weeks after reduction was statistically significant. There was no significant difference in palmar inclination, ulnar deviation and radius shortening between 2 and 4 weeks after reduction. After 24 weeks and 8 weeks, 48 weeks and 24 weeks after reduction, there was significant difference in wrist extensor, palmar flexion, pronation, supination, ulnar deviation and radial deviation. The grip strength was statistically significant between after reduction and 4 weeks after reduction, 8 weeks and 4 weeks after reduction, 16 weeks and 8 weeks after reduction, 24 and 16 weeks after reduction. There was no significant difference in grip strength between 48 weeks and 24 weeks after reduction. The Mayo wrist function scoring system was used to evaluate the curative effect, the results were excellent in 50 cases, good in 8 cases, fair in 1 case and poor in 1 case.</p><p><b>CONCLUSIONS</b>The treatment of distal radius fracture with the method of manual resetting and fixing with plywood is simple and the clinical efficacy is accurate.</p>

Effect of selected fungi on the reduction of gossypol levels and nutritional value during solid substrate fermentation of cottonseed meal / 浙江大学学报（英文版）（B辑：生物医学和生物技术）

The objective of this work was to investigate the effect of six individual strains of fungi on the reduction of gossypol levels and nutritional value during solid substrate fermentation of cottonseed meal (CSM). Six groups of disinfected CSM substrate were incubated for 48 h after inoculation with either of the fungi C. capsuligena ZD-1, C. tropicalis ZD-3, S. cerevisae ZD-5, A. terricola ZD-6, A. oryzae ZD-7, or A. niger ZD-8. One not inoculated group (substrate) was used as a control. Levels of initial and final free gossypol (FG), crude protein (CP), amino acids (AA) and in vitro digestibility were assayed. The experiment was done in triplicate. The experimental results indicated that microbial fermentation could greatly decrease (P<0.05) FG levels in CSM. The detoxification efficiency differed between the species of microorganisms applied. From the perspective of reducing CSM potential toxicity, C. tropicalis ZD-3 was most successful followed by S. cerevisae ZD-5 and A. niger ZD8. They could reduce FG levels of CSM to 29.8, 63.07 and 81.50 mg/kg based on DM (dry matter), respectively, and their detoxification rate were 94.57%, 88.51% and 85.16%, respectively. If crude protein, amino acids content and their in vitro digestibility were also taken into account, A. niger ZD-8 may be the best choice. The CP content of CSM substrate fermented by C. tropicalis ZD-3 and A. niger ZD-8 were improved by 10.76% and 22.24%; the TAA (total amino acids) contents were increased by 7.06% and 11.46%, and the EAA (essential amino acids) were raised by 7.77% and 12.64%, respectively. Especially, the levels of methionine, lysine and threonine were improved greatly (P<0.05). The in vitro CP digestibility of CSM fermented by C. tropicalis ZD-3 and A. niger ZD-8 was improved by 13.42% and 18.22%, the TAA were increased by 17.75% and 22.88%, and the EAA by 16.61% and 21.01%, respectively. In addition, the in vitro digestibility of methionine, lysine and threonine was also improved greatly (P<0.05).

Prevalence and risk factors of urinary incontinence in Fuzhou Chinese women / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>We randomly sampled a healthy community to evaluate the prevalence and associated risk factors of urinary incontinence.</p><p><b>METHODS</b>The survey was performed in Fuzhou, China. Of women over twenty years of age in the city, 3.0% were randomly selected and 4684 evaluated by Bristol Female Urinary Tract Symptoms Questionnaire.</p><p><b>RESULTS</b>Of the women in Fuzhou, 19.0% had urinary incontinence. The prevalence of stress incontinence, urge incontinence and mixed incontinence was 16.6% (n = 777), 10.0% (n = 468), 7.7% (n = 360) respectively. The prevalence of the three types of urinary incontinence increased significantly with age (P < 0.01). In multiple logistic models, age (OR, 1.3, 95% CI, 1.1-1.4), vaginal delivery (3.0, 1.9-4.7), parity > 2 (2.1, 1.5-2.9), hypertension (2.7, 1.4-5.6), constipation (2.6, 1.8-3.8), alcohol consumption (4.7, 1.1-20.2), episiotomy (1.7, 1.4-2.0), higher body mass index (BMI, 1.8, 1.5-2.2) and unskilled worker (0.7, 0.5-0.8) were potential risk factors for stress incontinence. Urge incontinence was associated with age (OR, 1.3, 95% CI, 0.9-1.3), menopause (1.6, 1.1-2.4), Caesarean delivery (0.2, 0.1-0.5), parity > 2 (2.6, 1.8-3.8), constipation (2.3, 1.4-3.7), foetal birthweight (1.7, 1.1-2.4), episiotomy (1.4, 1.1-1.8), higher BMI (1.5, 1.2-2.0) and unskilled worker (0.7, 0.5-0.9).</p><p><b>CONCLUSIONS</b>The prevalence of urinary incontinence and its subtypes in Chinese women is lower than that of occidental women. In China, age, vaginal delivery, parity, hypertension, constipation, alcohol consumption, episiotomy, higher BMI are potential risk factors for stress incontinence. Urge incontinence is associated with age, menopause, Caesarean delivery, parity, constipation, foetal birthweight, episiotomy, higher body mass index.</p>