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Objective:To evaluate the effects of peroneal osteotomy combined with arthroscopic knee debridement on perioperative indexes, X-ray indexes, Japanese Orthopaedic Association Assessment score (JOA score), American Hospital for Special Surgery knee score (HSS score) and complication rate of patients with knee osteoarthritis.Methods:A prospective research method was adopted. A total of 110 patients with knee osteoarthritis who were admitted to Chengde Central Hospital from April 2016 to April 2021 were selected as the research objects and divided into the control group (55 cases), the combined group (55 cases) by random number table method. The control group underwent arthroscopic debridement of the knee joint. On the basis of the control group, the combined group was combined with fibula osteotomy. The control group and the combined group were followed up for 6 months after operation. The perioperative indicators, score of JOA before and after 1 month of treatment, X-ray indicators, score of HSS before and after 6 months of treatment, and the incidence of complications during the follow-up period were compared between the control group and the combined group.Results:The operation time of the combined group was longer than that of the control group: (84.36 ± 14.64) min vs. (75.88 ± 12.86) min; compared with before operation, 1 month after operation, the scores of swelling, pain while up and down stairs, walking pain, joint range of motion were increased in the control group and the combined group, and the combined group was higher than the control group: (8.35 ± 0.73) points vs. (6.74 ± 0.67) points, (15.05 ± 1.74) points vs. (13.96±1.66) points, (21.75 ± 2.07) points vs. (18.58 ± 1.73) points, (27.59 ± 3.25) points vs. (25.74 ± 2.83) points; the femoral tibial angle and the range of motion of the knee joint in the control group and the combined group were increased, and the combined group was greater than the control group: (1.94 ± 0.60)° vs. (3.02 ± 0.67)°; the scores of stability, flexion deformity, muscle strength, range of motion, function, and pain in the control group and the combined group increased, and the combined group was higher than the control group: (8.62 ± 0.86) points vs. (6.89 ± 0.78) points, (7.86 ± 0.96) points vs. (6.27 ± 0.68) points, (7.79 ± 0.62) points vs. (6.95 ± 0.57) points, (14.95 ± 2.60) points vs. (12.48 ± 2.33) points, (17.46 ± 2.21) points vs. (14.59 ± 1.76) points, (24.83 ± 3.25) points vs. (18.59 ± 2.57) points, the difference was statistically significant ( P<0.05). During the following up period, there were no significant differences in the incidences of osteofascial compartment syndrome, neurovascular injury, intraarticular adhesion and incision infection between the two groups ( P>0.05). Conclusions:The operation time of fibular osteotomy combined with arthroscopic debridement of knee joint in patients with knee osteoarthritis was longer, but fibular osteotomy combined with arthroscopic debridement of the knee joint can reduce the valgus of the patient and improve the range of motion of the joint. It could effectively reduce the degree of pain and improve the function of knee joint, and the safety was good, with good therapeutic effect.
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Objective:To investigate the clinical, imaging and gene variation characteristics of hereditary spastic paraplegia type 74 caused by mutations in IBA57 gene. Methods:A retrospective analysis was performed on 2 cases of autosomal recessive spastic paraplegia caused by mutations in IBA57 gene who visited the Department of Neurology, the Affiliated Wuxi Children′s Hospital of Nanjing Medical University in 2010 and 2021, and the patients′ clinical data were collected. Results:The 2 patients were siblings with onset age of 4 years and 7 months, 1 year and 3 months, respectively. The same compound heterozygous mutations in IBA57 gene were found in the sibling patients [c.473G>C (p.R158P) and c.697C>T (p.R233X)]. Both patients were diagnosed as spastic paraplegia type 74. They had mild to moderate gait abnormalities, optic atrophy, decreased vision, and leukodystrophy with periventricular white matter abnormality, but no obvious growth and mental retardation in developmental assessment. Conclusions:Cases of spastic paraplegia type 74 caused by compound heterozygous mutations in IBA57 gene mainly manifested as childhood onset and slowly progressive inferior spasmodic weakness. The patients did not display significant cognitive impairment, and imaging examinations showed obvious leukodystrophy.
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Objective:To compare the efficacy and safety of standard treatment with or without adjuvant chemotherapy in patients with highly malignant non-metastatic prostate cancer.Methods:In this prospective non-randomized controlled study, consecutive non-metastatic prostate cancer patients with pathologically proven Gleason score of 9-10 or Gleason score of 5 admitted to Peking University First Hospital were enrolled. Four to six cycles of chemotherapy using docetaxel ± carboplatin regimen were added or not after standard radical therapy. The primary end point was 5-year event-free survival (EFS), and the secondary end points were distant metastasis-free survival (MFS), overall survival (OS), and treatment-related adverse events. The survival curve was drawn by Kaplan-Meier method. The differences between two groups were analyzed by log-rank test.Results:A total of 176 patients were consecutively enrolled from November 2019 to January 2022 of which 138 patients received only standard radical therapy (control group), and 38 patients received adjuvant chemotherapy after standard radical therapy (chemotherapy group). The median follow-up time was 13.4 (2.0-34.0) months. All patients survived. The 30-month EFS rates in the chemotherapy and control groups were 100% and 85.6%, respectively ( P=0.064). There were no events in the chemotherapy group, while there were 12 cases of events in the control group, including 6 cases of biochemical recurrence and 6 cases of imaging progression. The 30-month MFS rates in two groups were 100% and 91.9%, respectively ( P=0.205). After the 1 vs. 2 propensity score matching, the EFS and MFS rates in two groups were 100% vs. 85.7% ( P=0.056), and 100% vs. 92.2% ( P=0.209), respectively. The incidence rates of grade 2 and above urinary toxicity in the chemotherapy and control groups were 2.6% and 7.2% ( P=0.354), respectively. The incidence rates of grade 2 and above rectal toxicity were 5.3% and 5.1% ( P=0.711), respectively. Grade 3 and above chemotherapy-related toxicity in the chemotherapy group were leukopenia (31.6%), thrombocytopenia (2.6%) and alopecia (13.2%). Conclusion:The addition of adjuvant chemotherapy after standard radical therapy tends to improve the overall EFS of patients with highly malignant prostate cancer, and the adverse effects are tolerable, which should be confirmed by long-term follow-up results.
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Objective To analyze the results of acceptance testing of 60 extraoral dental X-ray equipment in Beijing, China from 2021 to 2022, and understand the main types and performance parameters of newly installed extraoral dental X-ray machines in the clinical market of Beijing, as well as the level of installation and trial run of the whole machine by various manufacturers, and to summarize the problems found in acceptance testing for improving equipment testing. Methods Field acceptance testing and evaluation were carried out according to the Specification for Testing of Quality Control in Medical X-Ray Diagnostic Equipment (WS 76—2020). Results The overall qualified rate of 60 extraoral dental X-ray equipment was 98.33%. Under the same condition of the same tube voltage for one dental equipment, the maximum deviation of the tube voltage indicated by the two modes (panorama and skull) is 5.5%, and the maximum difference of the half-value layer of the useful beam is 1.22 mm Al. There is also a certain difference between the exposure time indicating deviation from the panorama and the skull, with a maximum difference of 75.51%. Conclusion Strengthening ex-factory quality control, installing, and debugging of equipment can basically guarantee the performance of newly installed equipment. In the testing process, it is critical to ensure the effective point of measurement of the dose detector located on the central axis of the primary beam.
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Objective:To observe the effect of methylphenidate hydrochloride (MPH) combined with mentalization-based family therapy (MBFT) on clinical efficacy and social function in children with attention deficit hyperactivity disorder (ADHD).Methods:Sixty-four children with ADHD diagnosed in Wuxi Children's Hospital and Affiliated Hospital of Jiangnan University from June 2019 to May 2021 were selected and divided into observation group ( n=32) and control group ( n=32) according to the random number table.Children in both groups received methylphenidate hydrochloride extended-release tablets, while those in the observation group were given additional MBFT.The duration of treatment was 12 weeks in both groups.The parent symptom questionnaire (PSQ), swanson nolan and pelham-version Ⅳ (SNAP-Ⅳ) parent Al scale, and Weiss impairment functional scale (WFIRS-P) were used to evaluate the effectiveness of treatment.Statistical analysis was performed by SPSS 25.0 statistical software.In particular, the χ2 test was used for counting data and the paired sample t test was used for comparison of measurement data between the two groups before and after treatment. Results:(1) All the PSQ dimension scores of patients in the observation group and the control group after treatment were significantly lower than those before treatment (all P<0.01). Compared with the control group after treatment, the PSQ dimension scores of personality and behavior problems ((1.25±0.15), (0.94±0.18), t=7.484, P<0.001), learning problems ((1.57±0.16), (1.32±0.20), t=5.522, P<0.001), psychosomatic disorders ((0.56±0.11), (0.44±0.13), t=3.986, P<0.001), impulse hyperactivity ((1.76±0.23), (1.54±0.25), t=3.663, P<0.001), anxiety ((0.94±0.12), (0.76±0.11), t=6.255, P<0.001) and hyperactivity index ((1.74±0.19), (1.51±0.16), t=5.238, P<0.001) decreased significantly in the observation group after treatment.(2) Compared with the pre-treatment period, the SNAP-Ⅳ scale scores of attention deficit, impulsivity-hyperactivity and oppositional defiance were significantly lower in both groups after treatment (all P<0.01); and compared with the control group, the SNAP-Ⅳ scale scores of the above three dimensions were significantly lower in the observation group (all P<0.01). (3) All six dimensions (family, learning and school, life skills, self-management, social activities, and risk-taking activities)of the WFIRS-P scale were significantly lower in the children in the observation group after treatment compared with those before treatment (all P<0.01), and all the six dimensions of the WFIRS-P scale were significantly lower in the observation group compared with those in the control group (all P<0.01). Conclusion:Methylphenidate hydrochloride extended-release tablets combined with MBFT can significantly improve the clinical symptoms and social function of children with ADHD.
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Objective:To compare MRI findings of uveal melanomas and other intraocular masses in adults and to evaluate the optimal MRI features for the differential diagnosis.Methods:The MRI data of 254 patients with intraocular masses confirmed by histopathologic or clinical follow-up results from March 2005 to December 2015 in Beijing Tongren Hospital, Capital Medical University was analyzed retrospectively. A total of 128 patients with uveal melanoma and 126 patients with other intraocular masses were enrolled. MRI findings of the masses including the location, shape, margin, signal intensity on T 1WI and T 2WI compared to the gray matter and vitreous body, homogeneity and degree of enhancement of the mass, secondary retinal detachment, height, and ratio of basal diameter to height were compared between uveal melanoma and other intraocular masses by χ 2 test or independent t test. The logistic regression analysis was performed to identify the most discriminating MRI features. The diagnostic performance of different predictive models was analyzed by receiver operating characteristic (ROC) curve. The model of multiple parameters was established by logistic analysis, and the diagnostic efficacy was evaluated. Results:The location, shape, margin, signal intensity on T 1WI and T 2WI compared to the gray matter and vitreous body, homogeneity and degree of enhancement of the mass, secondary retinal detachment, height and ratio of basal diameter to height were significantly different between the uveal melanoma and other intraocular masses (all P<0.05). The results of logistic regression analysis showed that the signal intensity on T 1WI and T 2WI compared to the gray matter, height, shape, location, degree of enhancement of the mass, and secondary retinal detachment were associated with higher likelihood of uveal melanoma. The mass with hypointense on T 2WI (compared with gray matter) was the best MRI feature in the differential diagnosis of uveal melanoma and other intraocular masses (odds ratio 12.237), with the accuracy of 86.2%. The diagnostic accuracy of low signal on T 2WI and high signal on T 1WI (compared with gray matter) was significantly higher than those of vitreous (Delong test, P<0.001). The sensitivity, specificity and accuracy of the combination of height, degree of enhancement, T 1WI and T 2WI signal compared to the gray matter were 90.6%, 92.1% and 96.1%, respectively. The diagnostic performance of combination features was higher than that of each single sign ( P<0.001). Conclusion:MRI features including the signal intensity on T 1WI and T 2WI compared to the gray matter, height, shape, degree of enhancement of the mass, and secondary retinal detachment are helpful in the differential diagnosis between uveal melanoma and other intraocular masses. In addition, the gray matter as the reference is superior to the vitreous body in the evaluation of the signal intensity of intraocular masses.
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<p><b>OBJECTIVE</b>To assess the association of cytochrome P450 gene single nucleotide polymorphisms (SNPs) with susceptibility to gout in ethnic Han males from coastal regions of Shandong province.</p><p><b>METHODS</b>Four hundred and eighty male patients with gout and 480 healthy male controls were included. Genotyping was carried out with a custom Illumina GoldenGate Genotyping assay to detect SNP rs2275620 of CYP2C8 gene, SNP rs2070676 of CYP2E1 gene, SNP rs837395 of CYP4B1 gene, and SNP rs194150 of TBXAS1 gene. The association was assessed with chi-square test.</p><p><b>RESULTS</b>No significant difference has been found between the two groups in regard to the genotypic and allelic frequencies of the TT, AT, AA genotypes and A, T alleles of the SNP rs2275620 of the CYP2C8 gene (P=0.88; P=0.97), the CC, CG, GG genotypes and C,G alleles of SNP rs2070676 of the CYP2E1 gene (P=0.24; P=0.09), the TT, AT, AA genotypes and A, T alleles of SNP rs837395 of the CYP4B1 (P=0.88; P=0.97), and TT, AT, AA genotypes and the A,T alleles of SNP rs194150 of TBXAS1 gene (P=0.15; P=0.06).</p><p><b>CONCLUSION</b>This study has identified no association of SNP loci rs2275620(A/T) of CYP2C8, rs2070676(C/G) of CYP2E1, rs837395(A/T) of CYP4B1 and rs194150(A/T) of TBXAS1 with gout in ethnic Han males from coastal regions in Shandong province. However, our result needs to be replicated in larger sets of patients collected from other regions and populations.</p>
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Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Hidrocarboneto de Aril Hidroxilases , Genética , Povo Asiático , Etnologia , Genética , China , Etnologia , Citocromo P-450 CYP2C8 , Genética , Citocromo P-450 CYP2E1 , Genética , Suscetibilidade a Doenças , Gota , Etnologia , Genética , Polimorfismo de Nucleotídeo Único , Tromboxano-A Sintase , GenéticaRESUMO
Objective The study aimed to explore the application of fast track surgery in nursing of patients with colon cancer in a primary hospital.Methods The 60 colon cancer patients were identified with numbers to indicate randomization into the fast tract surgery group (group A) and the conventional treatment group (group B) with 30 cases in each group.Group A used the concept of fast track surgery (FST) perioperative nursing care,whereas traditional perioperative nursing care for colon cancer was used in group B.Patients in both groups were observed for postoperative time for passage of gas by anus,time for first food intake,length of stay in hospital,fee for hospitalization as well as incidence of postoperative complications,and comparative analysis was carried out.Results Time for passage of gas by anus(t value was 3.571),time for first food intake (t value was 8.944),length of stay in hospital (t value was 3.397),fee for hospitalization (t value was 3.950) as well as incidence of postoperative complication in group A were lower than those of group B.The satisfaction degree of group A was 96.67％(29/30) while 83.33％(25/30) in group B and the satisfaction degree between the two groups was statistically significant.Conclusions In the primary hospital,the fast track surgery care used in colon cancer can not only speed up the recovery process of the patients,shorten hospital stay,reduce hospital cost and the incidence of postoperative complications,but also can reduce the workload of nurses and improve the satisfaction degree of patients.
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Objective To explore the significance of changes of matrix metalloproteinase-9 (MMP-9),interleukin-6 (IL-6),and tumor necrosis factor-alpha (TNF-oα) protein level in the cerebrospinal fluid (CSF) of children with viral encephalitis (VE).Methods The concentration of neuron-specific enolase (NSE),structural proteins 100B (S100B),and MMP-9,IL-6,TNF-α in the CSF of VE children were detected by an enzyme linked immunosorbent assay,and the correlations of them were analyzed.Results NSE,S100B,MMP-9,IL-6,TNF-α protein expression could be found significantly higher than those in the control group,and there were significant differences according to statistics expression trends(all P ＜0.05).The NSE protein expression was significantly positive related with S100B in the VE group (r =0.467,P =0.009),and the concentration was markedly negative related with the duration of viral encephalitis (r =-0.472,P =0.008).MMP-9,IL-6 protein expression were significantly positive related with NSE,S100B respectively (r =0.698,P =0.00 ; r =0.559,P =0.00 ; r =0.812,P =0.00 ; r =0.664,P =0.00).TNF-α protein expression was positive related with CSF S100B(r =0.363,P =0.049),but there was no correlation between TNF-α and NSE (r =0.245,P =0.193).Conclusions The neurons and the neuroglial cells are damaged in the viral encephalitis children.MMP-9,IL-6,TNF-α protein may participate in the pathological damage process of nerve cells in VE children in different degrees.
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Objective To evaluate the accuracy and reliability of cone-beam computed tomography (CBCT) in the diagnosis of periodontal bone defects in the elderly.Methods The 38 teeth of 27 cases were collected and scanned both with CBCT technology and periapical radiography (PA).Periodontal bony defects were identified and linear measurements were made for all defects.All cases were treated with periodontal flap surgery with the bony defects and their linear measurements detected during operation as the gold standard.Results All periodontal bony defects were identified with CBCT with its accuracy rate of 100.0％ (72/72),but the buccal and lingual defects could not be measured by PA with its accuracy rate of 62.5％ (45/72).Linear measurements for all defects revealed no statistical differences between CBCT and direct measurement [(5.516 ± 0.393) mm vs.(5.385± 0.415) mm,t=1.948,P＞0.05],but there was a significant difference in linear measurement between PA and direct measurement [(6.311±0.439) mm vs.(5.411±0.418) mm,t=9.956,P＜0.05].Conclusions CBCT can offer the diagnostic information for periodontal bone defect from three dimensional direction in the elderly,provide objective and accurate assessment of alveolar bone resorption,and has higher accuracy and reliability.
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Objective To investigate the clinical efficacy of purging fu-organs traditional Chinese medicine (TCM)therapy for treatment of patients with severe pneumonia and sthenia-heat. Methods According to random number table method,71 patients with sthenia-heat of severe pneumonia were divided into a treatment group (35 cases)and a control group(36 cases). Conventional basic treatment was given to both groups,and additionally, small chengqi decoction was applied nasogastrically for the therapy in treatment group for 2 weeks. The clinical pulmonary infection score(CPIS),Marshall score,integration score of TCM syndromes and the mortalities in 28 days and 60 days were used to compare the clinical efficacy of the two groups. Results With the prolongation of treatment,the CPIS,Marshall score and integration score of syndromes in the two groups were gradually decreased. In treatment group,CPIS and Marshall scores were lower than those of control group on the 4th day ,and there were statistically significant differences(CPIS score:5.8±1.7 vs. 6.8±1.9,Marshall score:5.3±2.3 vs. 6.6±2.7,both P0.05). In addition,the integration scores of syndromes were significantly decreased on the 4th, 7th and 14th day in the treatment group significantly lower than those in the control group(4th day:7.6±2.3 vs. 10.6±2.7,7th day:7.4±2.5 vs. 9.2±2.1,14th day:6.1±1.9 vs. 8.3±2.4,all P0.05). Conclusion Purging fu-organs therapy not only can decrease the CPIS and Marshall scores of patients with sthenia-heat of severe pneumonia,but also can improve their syndromes.
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Objective To learn the effect of different combination model between irradiation and cisplatin or lobaplatin on the radiosensitization of xenographt tumor in mice.Methods Seventy C57BL/6 mice with Lewis lung carcinoma were randomly divided into fourteen groups.Then a single intravenous bolus injection of 10 mg/kg either cisplatin or lobaplatin was given.Tumor tissues were collected at the indicated times of 0.5 h, 2.0 h, 4.0 h, 24.0 h, 48.0 h, 72.0 h, and 96.0 h.The platinum levels were determined by inductively coupled plasma-mass spectrometry.Eighty tumor-bearing mice were randomly divided into 10 groups, including a blank control group, a irradiation group, two drug treatment groups and 6 combined treatment groups.The tumors were irradiated at 1 h, 24 h or 72 h after either cisplatin or lobaplatin injection.The tumor size of the groups was compared.Results The concentrations of cisplatin and lobaplatin in tumors rapidly reached 4.78 μg/g and 2.79 μg/g (t=3.82,P=0.005), respectively, then declined rapidly to 3.39 μg/g and 0.99 μg/g (t=9.10,P=0.000) at 4 h, 1.41 μg/g and 0.23 μg/g (t=3.70,P=0.006) at 96 h, respectively.The tumor growth among the three groups of irradiation at 1 h, 24 h or 72 h after cisplatin was similar, which was slower than the blank control group, the irradiation group and the cisplatin treatment group.At the 15th day, the relative volume of tumor in the three combined treatment groups were 4.73, 5.52 and 2.15(F=0.84,P=0.451), While was 16.63(F=10.50,P=0.000) in the blank control group, 10.34(F=3.12,P=0.046) in the irradiation group, and 12.80(F=8.06,P=0.001) in the cisplatin treatment group, respectively.The tumor growth among the three groups of irradiation at 1 h, 24 h or 72 h after lobaplatin was also similar, which was slower than the blank control group, the irradiation group and the lobaplatin treatment group.At the 15th day, the relative volume of tumor in the three combined treatment groups were 3.49, 4.90 and 3.86(F=0.32,P=0.727), While was 16.63(F=15.21,P=0.000) in the blank control group, 10.34(F=4.12,P=0.016) in the irradiation group, and 14.28(F=10.67,P=0.000) in the lobaplatin treatment group, respectively.The sensitizing enhancement ratio (SER) at 1 h, 24 h and 72 h after the injection were 2.13, 2.03 and 3.45 of cisplatin, and 2.53, 2.00 and 2.50 of lobaplatin, respectively.Conclusions After intravenous bolus injection, the cisplatin concentration in the tumor can be kept at least 96 hours, which results in a persistent radiosensitizing effect.Lobaplatin and cisplatin have similar anti-tumor and radiosensitizing effect.
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Objective To evaluate the outcomes of single-point anastomosis of the fallopian tube under a laparoscope.Methods Totally,31 patients(58 fallopian tubes)were treated with laparoscopic single-point anastomosis using 3-mm laparoscopic instruments after ligation(17 cases)or failed hysteroscopic recanalization(14)of the fallopian tubes.Ureteral catheter or transcervical guidewire or stents were used if the sizes of the tubes were irregular.Results The 58 fallopian tubes were anastomosed successfully by a single operation.Radiography performed 3 months postoperation showed bilateral fallopian tube occlusion in 2 patients,and lateral tube occlusion in 5.The postoperative patency rate was 84.5%(49/58).A 6-to 36-month follow-up was carried out in 26 of the 31 patients.Among the 26 patients,17 had uterine pregnancy with a pregnancy rate of 65.4%(17/26),2 patients had fallopian tubal pregnancy,and 7 had no pregnancy.Conclusions Laparoscopic single-point anastomosis is feasible after ligation or failed recanalization of the fallopian tube.Patients have less surgical trauma,faster recovery and less intra-abdominal injury by treating with the procedure.