Effects of SuperPATH approach versus posterolateral approach in total hip replacement on inflammatory response, hip function, and quality of life in patients with hip diseases / 中国基层医药

Objective:To investigate the effects of SuperPATH approach versus conventional posterolateral approach in total hip replacement on inflammatory response, hip function, and quality of life in patients with hip diseases. Methods:The clinical data of 140 patients with hip diseases who underwent total hip replacement in Shanxian Central Hospital from March 2017 to May 2019 were retrospectively analyzed. These patients were divided into SuperPATH approach ( n = 70) and posterolateral approach ( n = 70) groups. Operation-related indexes, inflammatory response indexes, hip function, quality of life, and pain were compared between the two groups. Results:Intraoperative blood loss was significantly less in the SuperPATH approach group than in the posterolateral approach group [(105.40 ± 15.11) mL vs. (196.89 ± 24.26) mL, t = 26.74, P < 0.001]. Incision length, postoperative time to getting out of bed, length of hospital stay in the SuperPATH approach group were (6.85 ± 1.42) cm, (2.92 ± 0.28) days, and (6.67 ± 1.36) days, respectively, which were significantly shorter than those in the posterolateral approach group [(13.07 ± 1.89) cm, (8.36 ± 1.45) days, (10.91 ± 1.34) days, t = 19.36, 30.82, 18.58, P < 0.001]. Operative time was significantly longer in the SuperPATH approach group than in the posterolateral approach group [(69.38 ± 8.62) minutes vs. (60.45 ± 7.79) minutes, t = 6.43, P < 0.001). The scores of social role functioning, general health perceptions, vitality, mental health, bodily pain, emotional role functioning, physical functioning, and physical functioning measured 6 months after surgery were significantly higher in the SuperPATH approach group than in the posterolateral approach group ( t = 9.12, 11.80, 11.64, 11.69, 6.45, 11.79, 6.04, 10.74, all P < 0.001). There were no significant differences in C-reactive protein and erythrocyte sedimentation rate measured 3 and 14 days after surgery between the two groups (both P > 0.05). Harris score used for evaluation of hip function 1 month after surgery was significantly higher in the SuperPATH approach group than in the posterolateral approach group [(76.42 ± 4.17) points vs. (69.37 ± 5.11) points, t = 8.94, P < 0.001]. The Visual Analog Scale score 3 days after surgery was significantly lower in the SuperPATH approach group than in the posterolateral approach group [(3.18 ± 0.21) points vs. (4.26 ± 0.29) points, t = 25.23, P < 0.001]. Conclusion:Compared with the conventional posterolateral approach, the SuperPATH approach for total hip arthroplasty takes longer operative time, but it can better reduce early postoperative pain, promote hip function recovery, and improve quality of life.

The protective effect and mechanism of icarisideⅡ in a rat model of radiation cystitis / 中华泌尿外科杂志

Objective:To investigate the protective effect and mechanism of Icaritin Ⅱ (ICAⅡ) on bladder in radiation cystitis model.Methods:A total of 18 10-week-old male SD rats were selected from July 2021 to March 2022 and divided into control group, model group and treatment group by random number table method, with 6 cases in each group. Model group and treatment group were given a single dose of 20 Gy X-ray irradiation in the pelvic area. 24 h after irradiation, the treatment group was given ICAⅡ 4.5 mg/(kg·d) gavage, while the control group and model group were given the same volume of solvent (10% anhydrous ethanol, 20% isopropyl alcohol, 30% polyethylene glycol and 40% deionized water) gavage for 4 consecutive weeks. Drug eluting for 1 week. The bladder volume and leakage point pressure of the three groups of rats were measured by multi-conducting physiological apparatus, and the bladder function was evaluated. HE staining, Masson staining, ELISA, TUNEL staining and western blotting were performed on the bladder samples of the three groups of rats. The pathological changes (thickness of bladder mucosa, ratio of smooth muscle to collagen fiber), oxidative stress level (superoxide dismutase SOD, malondialdehyde), apoptosis rate, protein levels of inflammatory factors (IL-6, NF-kB) and anti-oxidative stress signaling pathway factors (Nrf2, HO-1) of the three groups of rats were compared.Results:After 4 weeks of modeling, in the model group, the bladder volume [(1.01±0.12)ml vs. (1.58±0.21)ml, P=0.001], the bladder leakage point pressure [(38.79±4.12) cmH 2O (1 cmH2O=0.098 kPa)vs.(60.59±3.81) cmH 2O, P=0.001], the ratio of smooth muscle of bladder wall to collagen fiber [1.78±0.17 vs.3.15±0.57, P=0.001], SOD[(6.31±0.73) U/mg vs.(14.67±1.04) U/mg, P=0.001] were lower than the control group, and the differences were statistically significant. In the model group, the thickness of bladder mucosa [(47.33±1.78)μm vs.(20.83±2.33)μm, =, P=0.001], malondialdehyde [(1.01±0.13) nmol/mg vs.(0.49±0.03) nmol/mg, P=0.001], IL-6 (0.87±0.11 vs. 0.33±0.10, P=0.001), NF-kB (0.71±0.14 vs. 0.29±0.07, P=0.001), apoptosis rate [(11.60±3.04)% vs. (3.91±1.40)%, P=0.007] was higher than the control group, and the differences were statistically significant. In the treatment group, the bladder volume [(1.27±0.13)ml, P=0.030], bladder leakage point pressure [(47.83±2.50)cmH 2O, P=0.004], smooth muscle to collagen fiber ratio (2.78±0.68, P=0.015), SOD[(10.48±0.85) U/mg, Compared with model group, bladder mucosa thickness [(31.94±3.20)μm, P=0.001], malondialdehyde [(0.64±0.09) nmol/mg, P=0.001], IL-6 (0.69±0.11, P=0.035), NF-kB (0.45±0.06, P=0.002) and apoptosis rate [(6.05±0.60)%, P=0.030] were lower than those in model group. The protein expression level of Nrf2 in model group (0.73±0.08 vs. 0.58±0.11, P=0.023) was higher than that in control group, but there was no significant difference in the protein expression level of downstream antioxidant factor HO-1 (0.50±0.14 vs. 0.35±0.06, P=0.060). Nrf2 protein expression level (0.88±0.03, P=0.027) and HO-1 expression level (0.68±0.07, P=0.026) in treatment group were higher than those in model group. Conclusion:ICAⅡ can reduce radiation cystitis injury, and its mechanism may be related to anti-oxidative stress and reducing inflammation.

Advances in the application of preventive extended-field radiotherapy to advanced cervical cancer / 中华放射肿瘤学杂志

Cervical cancer is a common malignant tumor in gynecology, and its morbidity and mortality rates rank the fourth among female malignant tumors. Lymph node metastasis is the most important pattern of metastasis and a critical independent prognostic factor for cervical cancer. Considering the high missed diagnosis rate of para-aortic lymph node metastasis, and the high treatment failure rate caused by para-aortic lymph node metastasis after cervical cancer treatment, a small number of clinicians have applied preventive extended-field radiotherapy in the treatment of patients with Ⅲ B and Ⅲ c1 cervical cancer in recent years. This article reviews the prognosis and side effects of preventive extended-field radiotherapy in patients with stage Ⅲ B and Ⅲ c1 cervical cancer.

A qualitative study of depressed inpatients participating in mindfulness therapy experience / 中国实用护理杂志

Objective:To explore the process of how depressed patients regulate themselves around the cores of mindfulness therapy-cognition, non-judgement and living in the present.Methods:The phenomenology of the qualitative research was adopted. The themes are analyzed, organized and refined through semi-structured in-depth interviews with 23 depressed patients, and using the Cloaizzi 7-step analysis.Results:A total of four themes are analyzed: multiple psychological experiences, mindfulness therapy to change thinking patterns, to promote self-identity, and to form self-coping strategies.Conclusions:Depressed patients are often passive and affected by negative emotions and automatic thoughts when they first participate in mindfulness therapy. Based on patients′ processual experience of participating in mindfulness therapy, health care professionals should focus on the patients′ self-regulation process and develop regulative strategies so as to help patients better understand and adapt to mindfulness therapy, reduce the recurrence of depression, and improve their qualities of life.

Effects of Hericium erinaceus Polysaccharide on the Content of Short-chain Fatty Acids in the Intestine of Ulcerative Colitis Model Rats / 中国药房

OBJECTIVE： To investigate the effects of Hericium erinaceus polysaccharide on the content of short-chain fatty acids （SCFAs） in the intestine of ulcerative colitis model rats. METHODS： A total of 40 SD rats were randomly divided into blank group， model group and H. erinaceus polysaccharide low-dose and high-dose groups （0.5， 1.0 g/kg）， with 10 rats in each group. Except for blank group， other groups were given acetic acid enema to induce ulcerative colitis model. The next day after modeling， H. erinaceus polysaccharide groups were given relevant medicine solution intragastrically； blank group and model group were given relevant volume of water intragastrically， for 10 consecutive days. Colon tissue was collected， and pathological changes of colon tissue were observed by HE staining. The pathological changes of colon in rats were observed with naked eyes and scored so as to evaluate the therapeutic efficacy. The contents of 6 kinds of SCFAs （acetic acid，propionic acid，butyric acid，isobutyric acid，pentanoic acid and isovaleric acid） in intestine of rats were determined by GC-MS. RESULTS： Compared with blank group， inflammatory lesions of colonic mucosal epithelium in model group rats were obvious； colonic mucosal ulcer score increased significantly （P＜0.01）； the contents of 5 kinds of SCFAs and the total amount of SCFAs in colon except for propionic acid were decreased significantly （P＜0.01）. Compared with model group， the degree of colonic histopathological damage in H. erinaceus polysaccharide groups was significantly reduced； colonic mucosal ulcer scores were significantly reduced （P＜0.05 or P＜0.01）； the contents of 5 kinds of SCFAs and the total amount of SCFAs in colon except for propionic acid were increased significantly （P＜0.05 or P＜0.01）. CONCLUSIONS： H. erinaceus polysaccharide can effectively improve the pathological condition of ulcerative colitis model rats； its regulation of intestinal SCFAs （especially acetic acid and butyric acid） may be an important mechanism of its anti-ulcerative colitis.

Effect of bladder training on bladder function recovery in the male patients after mid-low rectal cancer surgery: a prospective, open, randomized controlled study / 中华胃肠外科杂志

OBJECTIVE@#To investigate the efficacy and safety of the bladder training in male patients before urinary catheter removal after mid-low rectal cancer surgery.@*METHODS@#This was a prospective, open, randomized controlled study.@*INCLUSION CRITERIA@#male patients; pathologically diagnosed as mid-low rectal adenocarcinoma; distance from tumor lower edge to anal margin ≤10 cm; standard radical surgery for rectal cancer, including intestinal resection and regional lymph node dissection.@*EXCLUSION CRITERIA@#previous history of benign prostatic hyperplasia or history of prostate surgery; bladder dysfunction such as dysuria and urinary retention before surgery; local resection of rectal tumor or extended resection. According to the above criteria, 92 patients who underwent colorectal surgery at the Union Hospital of Fujian Medical University from June to December 2016 were prospectively included. The patients were randomly divided into bladder training group (n=43) and bladder non-training group (n=49) according to the random number table method. The study was approved by the Ethics Committee of the Union Hospital of Fujian Medical University (ethical approval number: 2016KY005) and registered with the China Clinical Trial Registration Center (ChiCTR) (registration No.ChiCTR-IOR-16007995). The implementation of patient's treatment measures, the data collection and analysis were based on the three-blind principle, using envelopes for distribution concealment. In the bladder training group, bladder training was routinely performed from the first day after operation to catheter removal, and in bladder non-training group the catheter was kept open till its removal. The catheter was removed in the early morning at the 5th day after surgery, and the spontaneous urine output was recorded and the residual urine volume of the bladder was measured after the first urination. The international prostate symptom score (IPSS) was applied to evaluate the patient's urinary function before and after surgery.@*RESULTS@#The age of whole group was (58.6±10.9) years old, the body mass index was (22.4±2.7) kg/m , and the distance from tumor lower edge to anal margin was (6.5±1.9) cm. The baseline data, such as age, body mass index, distance from tumor lower edge to anal margin, preoperative IPSS score, preoperative bladder residual urine volume, neoadjuvant radiotherapy and chemotherapy, preventive ileostomy and surgical procedure were not significantly different between two groups (all P>0.05). There was no significant difference in IPSS scores evaluated at the second day (3.6±4.0 vs. 3.5±3.4, t=0.128, P=0.899) and one month (3.7±2.9 vs. 3.0±3.1, t=1.113, P=0.269) after catheter removal between the bladder training group and bladder non-training group. No significant difference in the postoperative residual urine volume of bladder (media 44 ml vs. 24 ml, Z=-1.466, P=0.143), the first spontaneous urination volume (median 200 ml vs. 150 ml, Z=-1.228, P=0.219) after catheter removal, and postoperative hospital stay [(8.2±4.5) days vs. (9.1±5.5) days, t=-0.805, P=0.423] was found. Urinary infection rate was 20.9%(9/43) in the training group, which was even higher than 8.2%(4/49) in the non-training group, but the difference was not significant(χ²=3.077, P=0.079). No patient needed re-catheterization in either group.@*CONCLUSIONS@#The routine bladder training after mid-low rectal cancer surgery does not improve the urinary function, and can not reduce the residual urine volume of bladder after catheter removal. This routine clinical practice is not helpful for the bladder function recovery after rectal cancer surgery.

EGFR Mutation Status among NSCLCs in Southern Shaanxi / 现代生物医学进展

Objective:To analyze the EGFR gene polymorphism in the non-small cell lung (NSCLCs) cancer in southern of Shaanxi Province.Methods:The next generation sequencing technology was used to detect the mutation of exon 18,19,20 and 21 of EGFR gene.We analyzed EGFR gene mutation rate in NSCLCs patients.233 patients was involved in our study.Results:82 cases with EGFR gene mutations was found,the mutation rate of exon18,19,20 and 21 was 1.3％,16.3％,0％ and 18％ respectively.The mutation rate of EGFR in male patients was lower (31.2％,39/125) than that of female cases (39.8％,43/108),the mutation rate of squamous cell carcinoma (22％,9/41) was lower than that of adenocarcinoma (39.1％,75/192).Conclusions:NSCLCs patients from southern Shaanxi Province had high mutation rate ofEGFR gene,and exon 19 and exon 21 mutations were in the majority.EGFR gene mutation rate was not related to gender and pathological types.

Efficacy of lateral collateral ligament reconstruction surgery combined with arthroscopy in treatment of chro-nic lateral ankle instability / 中国基层医药

Objective To study the clinical efficacy of lateral collateral ligament reconstruction surgery com-bined with arthroscopy in treatment of chronic lateral ankle instability.Methods 60 cases with chronic lateral ankle instability were selected,the patients were divided into the study group and the control group according to a random number table,which has 30 cases in each group.The control group was received conservative treatment, the study group was underwent exploratory arthroscopic ankle cleanup combined with peroneus brevis tendon lateral ligament reconstruction surgery.Scores before and after treatment of the two groups were detected in American bare foot and ankle surgery-hindfoot score system( AOFAS) .And excellent rate,the recurrence rate and complication rate between the two groups were compared.Results AOFAS score before treatment of the two groups had no significant difference (P>0.05),AOFAS score after treatment of two groups were significantly higher,and that of the study group was sig-nificantly higher than the control group,the difference was statistically significant (t=9.837,10.873,8.789,all P<0.05);Excellent rate of the study group was 96.7% (29/30) significantly higher than the 73.3% (22/30) in the control group,recurrence rate of the study group was 0.0% (0/30),significantly lower than the 13.3% (4/30) in the control group,the complication rate of the study group was 3.3%(1/30),significantly lower than the 20.0%(6/30)in the control group,the difference was statistically significant (χ2 =13.982,15.037,13.298,all P<0.05). Conclusion Lateral collateral ligament reconstruction surgery combined with arthroscopy in treatment of chronic lat-eral ankle instability has better clinical efficacy,the recurrence rate is low,and has less complications.

Safe range of artificial acetabular cup installation angle for different head-neck ratios / 中国组织工程研究

BACKGROUND:Improper angle of prosthesis placement often induces acetabular cup impact, and limits the scope of activity of artificial hip joint, and cannot meet the requirement of daily life. At present, the angle of acetabular cup instal ation remains controversial during total hip arthroplasty. Moreover, there is lack of targeted guide for the acetabular cup instal ation during hip arthroplasty with different head-neck ratios. OBJECTIVE:To explore the safe range of the artificial acetabular cup instal ation angle for different head-neck ratios. METHODS:In accordance with the calculation formula of range of internal rotation and external rotation, abduction and adduction, flexion and extension after total hip replacement, interpretation of dynamical variety law of acetabular abduction and anteversion, and deriving inequalities depending on Widmer’s standard of artificial hip joint normal activities range:(1) external rotation range was at least 40°, and internal rotation range was at least 80°. (2) Abduction range was at least 50°, and adduction range was at least 50°. (3) Anteflexion range was at least 130°, and extension range was at least 40°. The safety scope of artificial hip joint instal ation angle at different head-neck ratios was determined by solving the above three groups of inequality. RESULTS AND CONCLUSION:The safe range of the artificial acetabular cup instal ation angle for different head-neck ratios was different. To meet the normal hip joint activities, the head-neck ratios of artificial hip should be greater than 22/12. Artificial hip joint activities gradual y increase with the enlargement of head neck ratios. With enlarging the head-neck ratios, the acetabular cup instal ation safety angle scope of abduction and anteversin gradual y increases and the extreme of abduction increases gradual y, then with anteversion increasing gradual y, the abduction upper extreme of the security scope gradual y decrease and lower extreme of the security scope gradual y increase, tending to 45° symmetrical y. When anteversion is the biggest, the abduction should be 45°.

Adipose-derived stem cells combined with gelatin sponge for repair of rabbit radial defects / 中国组织工程研究

BACKGROUND:Adipose-derived stem cells discovered recently are a new kind of adult stem cells, and have a strong multi-differentiation capacity. However, there are rare studies concerning in vivo osteogenic capacity of adipose-derived stem cells. OBJECTIVE:To investigate the effect of adipose-derived stem cells combined with gelatin sponge on repairing bone defects. METHODS:Adipose-derived stem cells from rabbit inguinal fat pads were isolated and cultured, and then induced using an osteogenic medium containing bone morphogenetic protein 2 fol owed by injection of gelatin sponge. Radial defect models of rabbits were prepared. Compound of adipose-derived stem cel s and gelatin sponge was implanted into the lesion side, while gelatin sponge alone was implanted into the contralateral side. Rabbits were kil ed at weeks 6 and 12 after bone defect repair for X-ray examination, CT scan, and hematoxylin-eosin staining. RESULTS AND CONCLUSION:Lane-Sandhu X-ray and Lane-Sandhu histological scores after compound implantation were significantly higher than those after repair with gelatin sponge alone. It indicates that adipose-derived stem cel s combined with gelatin sponge can promote bone defect healing of rabbits, showing an obvious osteogenic capacity in vivo.

Effect of Tantalum rod implantation on early ischemic necrosis of femoral head / 中国基层医药

Objective To investigate the effeit of Reconstruction of tantalum metal rod implantation in the treatment of early ischemic necrosis of femoral head( Steinberg Ⅰ～Ⅱ period) ,to explore the early femoral head ischemic necrosis of minimally invasive treatme(n)t. Method 24 patients( Steinberg Ⅰ～Ⅱ period) using C-arm fluoroscopy machine,under the greater trochanter through the neck hole to avascular necrosis zone,the first zone of the medullary sclerosis core decompression, re-implantation of tantalum rod to the subchondral bone is about 0.5 cm, through the Harris score before and after surgery for comparison. Results After follow-up 9(2 ～ 12) months,preoperative pain and function were significantly limited nuitigation. The excellent rate was 83% after opertion. MRI manifestations in patients with stable,non-ischemic necrosis increased performance. Conclusion Core decompression can significantly reduce the pressure on the femoral head hardening region, tantalum rod weight-bearing area of femoral head implant provides a structural support for subchondral bone. This method has the characteristics decompression,structural support,minimally invasive,it is worth for clinical use.

An epidemiology survey of bone mineral density and osteoporosis in 1204 elderly people in Xuzhou area / 中国综合临床

Objective To analyze the changes of bone mineral density (BMD) and the incidence of osteoporosis in elderly people in Xuzhou area by measuring BMD, and provide reference to osteoporosis prevention and control. Methods From 2005 to 2008, BMD were measured in 1204 elderly people by dual energy X-ray absorptiometry (DEXA). The measurement included the neck of femur and L2-4 of lumbar. All subjects were divided into multiple sections with every 5 year interval. Osteoporosis was diagnosed according to the criteria of BMD peak minus 2. 5 SD. BMD values and the incidence of osteoporosis were analyzed among different age and gender groups. Results BMD of different sites decreased year by year in both male and female in Xuzhou area. After 55years of age BMD decreased more in female than in male ( P ＜ 0. 01 ). The incidence of osteoporosis in female was higher than that in male. Conclusions We should reinforce the health education on osteoporosis prevention. Intervention should be conducted in females older than 55 years and males older than 65 years to decrease the occurrence of osteoporosis.

Observation of efficacy of open-door expansion laminoplasty in treatment of 36 cases with cervical stenosis / 中国基层医药

Objective To observe the efficacy of open - door expansion laminoplasty in treatment of 36 cases with cervical stenosis. Methods 36 cases with cervical stenosis were all carried out open - door expansion laminoplasty. Then the efficacy and JOA17 scores were observed. Results 36 patients were followed up, the surgery fine rate was 85% ,JOA17-score of peroperation and postoperation was 5.23 and 10. 25 respectively. Conclusion The open - door expansion laminoplasty was a safe and effective surgery methods in treatment of cervical stenosis