Effects of thunder-fire moxibustion combined with external application of Chinese herbal ointment at the trigger point on lumbodorsal myofascial pain syndrome of cold-damp stagnation type / 中国基层医药

Objective:To investigate the clinical efficacy of thunder-fire moxibustion combined with external application of Chinese herbal ointment at the trigger point on lumbodorsal myofascial pain syndrome of cold-damp stagnation type.Methods:A total of 90 patients with lumbodorsal myofascial pain syndrome of cold-damp stagnation type admitted to Zhejiang Provincial Hospital of Integrated Traditional Chinese and Western Medicine from September 2021 to April 2022 were included in this study. They were randomly divided into three groups ( n = 30/group) using the random number table method. Patients in the Chinese herbal ointment group were treated by external application of Chinese herbal ointment at the trigger point. Patients in the thunder-fire moxibustion group were treated with thunder-fire moxibustion. Patients in the combined therapy group were treated with thunder-fire moxibustion combined with external application of Chinese herbal ointment at the trigger point. All patients were treated for 28 consecutive days. Clinical efficacy was compared among the three groups. Before and after treatment, the Visual Analogue Scale score, local tenderness score, Oswestry Disability Index score and Pittsburgh Sleep Quality Index score were compared among the three groups. Results:Total response rate (96.67%) in the combined therapy group was significantly higher than 73.33% in the thunder-fire moxibustion group and 66.67% in the Chinese herbal ointment group ( χ2 = 9.01, 4.70, both P < 0.05). Visual Analogue Scale score and local tenderness score in the combined therapy group were (1.96 ± 0.93) points and (1.00 ± 0.69) points, respectively, which were significantly lower than (2.43 ± 0.87) points and (1.37 ± 0.56) points in the thunder-fire moxibustion group and (2.77 ± 0.86) points and (1.50 ± 0.57) points in the Chinese herbal ointment group ( F = 6.22, 5.38, both P < 0.05). The Oswestry Disability Index score in the combined therapy group was (19.80 ± 3.80) points, which was significantly lower than (22.30 ± 2.82) points in the thunder-fire moxibustion group and (23.60 ± 3.71) points in the Chinese herbal ointment group ( F = 9.07, both P < 0.05). After treatment, the Pittsburgh Sleep Quality Index score in the combined therapy group was (5.30 ± 1.12) points, which was significantly lower than (6.50 ± 1.33) points in the thunder-fire moxibustion group and (6.73 ± 1.41) points in the Chinese herbal ointment group ( F = 10.59, both P < 0.05). Conclusion:Thunder-fire moxibustion combined with external application of Chinese herbal ointment at the trigger point is highly effective on lumbodorsal myofascial pain syndrome of cold-damp stagnation type than monotherapy. The combined therapy can markedly reduce pain and greatly improve lumbodorsal function and sleep quality.

Application value of metagenomic next generation sequencing in the diagnosis of non-tuberculous spinal infection / 中华骨科杂志

Objective:To investigate the application value of metagenomic next generation sequencing (mNGS) in the diagnosis of spinal infectious diseases except tuberculosis and non-tuberculous mycobacterium infection.Methods:According to the inclusion and exclusion criteria, the clinical data of 171 patients with suspected non-tuberculous infectious diseases of spine from January 2019 to November 2020 were analyzed retrospectively. All patients underwent puncture biopsy of spine or surgery to obtain tissue specimens, then tissue biopsy were measured, and Foci purulent blood or lavage fluid was obtained for routine bacterial and mNGS. The differences of reporting time, sensitivity (positive rate) and specificity (true negative rate) were compared between the two methods. The pathogenic microorganism spectrum of spinal infection was analyzed. The effects of specimen collection method, preoperative antibiotic use and specimen type on the detection of pathogenic microorganisms were analyzed.Results:According to the diagnostic criteria of non-tuberculous infectious diseases of the spine, there were 136 cases of infection, among which 111 cases had specific pathogenic microorganism. The average reporting time of traditional culture and mNGS were 81.67+15.52 h and 36.33+11.92 h. There were 43 positive cases and 5 false positive cases in traditional culture, the sensitivity was 31.62%, and the specificity was 85.71%; There were 76 positive cases and 19 false positive cases in mNGS, the sensitivity was 55.88%, and the specificity was 45.71%. There were significant statistical differences in the sensitivity, specificity and reporting time for detection of pathogenic microorganisms by mNGS. The top 3 pathogens of non-specific infection were Staphylococcus aureus and Staphylococcus, Escherichia coli and Streptococcus. Eleven patients with non-tuberculous specific infection were confirmed, including 2 positive cases with traditional culture, 11 positive cases with mNGS. A higher detection rate for rare specific infections were expressed in mNGS. Logistic regression analysis indicated that the standard antibiotic use 4 weeks before surgery and specimen acquisition methods had significant effects on the traditional culture results, while the specimen acquisition methods had no statistically significant effects on the mNGS.Conclusion:Metagenomic next generation sequencing has a higher sensitivity to the detection of pathogenic microorganisms in the diagnosis of non-tuberculous spinal infectious diseases, especially for the detection of rare pathogenic microorganisms, which has a high diagnostic value.

Small interfering RNA targeting of keratin 17 reduces inflammation in imiquimod-induced psoriasis-like dermatitis / 中华医学杂志(英文版)

BACKGROUND@#Psoriasis is a common chronic inflammatory skin disease with 2% to 3% prevalence worldwide and a heavy social-psychological burden for patients and their families. As the exact pathogenesis of psoriasis is still unknown, the current treatment is far from satisfactory. Thus, there is an urgent need to find a more effective therapy for this disease. Keratin 17 (K17), a type I intermediate filament, is overexpressed in the psoriatic epidermis and plays a critical pathogenic role by stimulating T cells in psoriasis. Therefore, we hypothesized that inhibiting K17 may be a potential therapeutic approach for psoriasis. This study aimed to investigate the therapeutic effect of K17-specific small interfering RNA (siRNA) on mice with imiquimod (IMQ)-induced psoriasis-like dermatitis.@*METHODS@#Eight-week-old female BALB/c mice were administered a 5% IMQ cream on both ears to produce psoriatic dermatitis. On day 3, K17 siRNA was mixed with an emulsion matrix and applied topically to the left ears of the mice after IMQ application every day for 7 days. The right ears of the mice were treated in parallel with negative control (NC) siRNA. Inflammation was evaluated by gross ear thickness, histopathology, the infiltration of inflammatory cells (CD3+ T cells and neutrophils) using immunofluorescence, and the expression of cytokine production using real-time quantitative polymerase chain reaction. The obtained data were statistically evaluated by unpaired t-tests and a one-way analysis of variance.@*RESULTS@#The severity of IMQ-induced dermatitis on K17 siRNA-treated mice ears was significantly lower than that on NC siRNA-treated mice ears, as evidenced by the alleviated ear inflammation phenotype, including decreased ear thickness, infiltration of inflammatory cells (CD3+ T cells and neutrophils), and inflammatory cytokine/chemokine expression levels (interleukin 17 [IL-17], IL-22, IL-23, C-X-C motif chemokine ligand 1, and C-C motif chemokine ligand 20) (P < 0.05 vs. the Blank or NC siRNA groups). Compared to the NC siRNA treatment, the K17 siRNA treatment resulted in increased K1 and K10 expression, which are characteristic of keratinocyte differentiation (vs. NC siRNA, K17 siRNA1 group: K1, t = 4.782, P = 0.0050; K10, t = 3.365, P = 0.0120; K17 siRNA2 group: K1, t = 4.104, P = 0.0093; K10, t = 4.168, P = 0.0042; siRNA Mix group: K1, t = 3.065, P = 0.0221; K10, t = 10.83, P < 0.0001), and decreased K16 expression, which is characteristic of keratinocyte proliferation (vs. NC siRNA, K17 siRNA1 group: t = 4.156, P = 0.0043; K17 siRNA2 group: t = 2.834, P = 0.0253; siRNA Mix group: t = 2.734, P = 0.0250).@*CONCLUSIONS@#Inhibition of K17 expression by its specific siRNA significantly alleviated inflammation in mice with IMQ-induced psoriasis-like dermatitis. Thus, gene therapy targeting K17 may be a potential treatment approach for psoriasis.

Case-control study on cortical bone trajectory screw and pedicle screw internal fixation for the treatment of senile patients with lumbar tuberculosis / 中国骨伤

OBJECTIVE@#To compare clinical effect of cortical bone trajectory (CBT) screw and pedicle screw (PS) internal fixation in treating senile patients with lumbar tuberculosis.@*METHODS@#From January 2014 to January 2017, 42 senile patients with lumbar tuberculosis were divided into CBT group and PS group, 21 patients in each group. In CBT group, there were 12 males and 9 females, aged from 64 to 81 years old with an average of (72.52±9.25) years old, T value of bone mineral density was (-2.69±0.17) g / cm, posterior CBT screw internal fixation and anterior debridement, interbody fusion with bone grafting was performed. In PS group, there were 11 males and 10 females, aged from 63 to 85 years old with an average of (71.42±9.81) years old, T value of bone mineral density was (-2.70±0.21) g / cm, PS internal fixation and anterior debridement, interbody fusion with bone grafting were performed. Length of posterior incision, intraoperative bleeding volume, operation time, time of bone graft fusion and complications between two groups were compared. Level of erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), segment kyphotic Cobb angle before and after operation were compared, VAS score was used to evaluate pain releasing, JOA score was applied to evaluate clinical effect.@*RESULTS@#All patients were followed up from 12 to 21 months with an average of (15.00±3.57) months. No reoccurrence of lumbar tuberculosis and screw loosing occurred. There were statistical difference in length of incision, intraoperative bleeding volume, operation time between two groups (0.05). There were no statistical differences in complications, time of bone graft fusion and segment kyphotic Cobb angle at 1 week after operation between two groups (>0.05). There was difference in Cobb angle at 12 months after operation (0.05), but VAS score at 3 months after operation were improved after operation between two groups (<0.05).For JOA score, there were no difference between two groups before operation, 3 and 12 months after operation, and JOA score at 3 and 12 months after operation were improved than that of before operation between two groups (<0.05).@*CONCLUSION@#Both of CBT screw internal fixation and PS screw internal fixation could achieve satisfying results for the treatment of elderly patients with lumbar tuberculosis. PSinternal fixation has a long fixation but great trauma. However, CBT screw internal fixation only needs to fix adjacent segments of the lesion to reduce the fixation range, which has advantages of less trauma and strong screw holding force.

Plasma Macrophage Migration Inhibitory Factor and CCL3 as Potential Biomarkers for Distinguishing Patients with Nasopharyngeal Carcinoma from High-Risk Individuals Who Have Positive Epstein-Barr Virus Capsid Antigen-Specific IgA / Journal of the Korean Cancer Association, 대한암학회지

PURPOSE: The purpose of this study was to identify novel plasma biomarkers for distinguishing nasopharyngeal carcinoma (NPC) patients from healthy individuals who have positive Epstein-Barr virus (EBV) viral capsid antigen (VCA-IgA). MATERIALS AND METHODS: One hundred seventy-four plasma cytokines were analyzed by a Cytokine Array in eight healthy individuals with positive EBV VCA-IgA and eight patients with NPC. Real-time polymerase chain reaction, Western blotting, enzyme-linked immunosorbent assay (ELISA), and immunohistochemistry were employed to detect the expression levels of macrophage migration inhibitory factor (MIF) and CC chemokine ligand 3 (CCL3) in NPC cell lines and tumor tissues. Plasma MIF and CCL3 were measured by ELISA in 138 NPC patients, 127 EBV VCA-IgA negative (VN) and 100 EBV VCA-IgA positive healthy donors (VP). Plasma EBV VCA-IgA was determined by immunoenzymatic techniques. RESULTS: Thirty-four of the 174 cytokines varied significantly between the VP and NPC group. Plasma MIF and CCL3 were significantly elevated in NPC patients compared with VN and VP. Combination of MIF and CCL3 could be used for the differential diagnosis of NPC from VN cohort (area under the curve [AUC], 0.913; sensitivity, 90.00%; specificity, 80.30%), and combination of MIF, CCL3, and VCA-IgA could be used for the differential diagnosis of NPC from VP cohort (AUC, 0.920; sensitivity, 90.00%; specificity, 84.00%), from (VN+VP) cohort (AUC, 0.961; sensitivity, 90.00%; specificity, 92.00%). Overexpressions of MIF and CCL3 were observed in NPC plasma, NPC cell lines and NPC tissues. CONCLUSION: Plasma MIF, CCL3, and VCA-IgA combination significantly improves the diagnostic specificity of NPC in high-risk individuals.

Feasibility study of preoperative percutaneous catheter drainage in the treatment of lumbar tuberculosis with psoas abscess / 中国骨伤

OBJECTIVE@#To investigate the effect of preoperative percutaneous drainage in lumbar tuberculosis with psoas abscess, through compare the clinical efficacy of two different methods.@*METHODS@#Thirty-six patients with lumbar tuberculosis complicated with psoas abscess in corresponding with the inclusion criteria were admitted in Zhejiang Province Traditional Chinese Medicine Hospital from January 2015 to January 2017. The patients were divided into group A and group B according to the different therapeutic methods. All patients were given the standard anti tuberculosis treatment, and percutaneous catheter drainage was used in group A after admission immediately for psoas abscess before operation, while group B with no special treatment. At 3 weeks after anti tuberculosis treatment, 2 patients were excluded in group B, which had to postpone operation because of no reduction in erythrocyte sedimentation rate(ESR) and C reactive protein(CRP). Finally 34 patients were enrolled in this study. There were 18 cases in group A, including 10 males and 8 females, aged from 24 to 73 years old with an average of(42.5±10.2) years. There were 16 cases in group B, including 9 males and 7 females, aged from 23 to 75 years old with an average of(42.3±9.8) years. All patients were treated with posterior pedicle screw fixation, anterior debridement and bone graft fusion. Anterior surgery bleeding volume, operation time, anterior incision length, postoperative anus exhaust time, VAS score, Cobb angle, ESR, CRP changes and postoperative sinus formation were compared between two groups.@*RESULTS@#All patients were followed up for 6 to 21 months with an average of 13 months. At the last follow-up, no mixed infection, tuberculosis recurrence, pedicle screw loosening and nail withdrawal were found. The average operative time, anterior surgery bleeding volume and anterior incision length of group A were less than that of group B(0.05). There was 1 case sinus formation in group A and 5 cases in group B, there was significant difference in sinus formation rate between two groups (0.05). Spinal cord nerve injury was obvious improved after operation, but there was no significant difference between two groups.@*CONCLUSIONS@#Preoperative percutaneous catheter drainage is a safe and feasible method for the treatment of lumbar tuberculosis with psoas abscess. It can increase the effect of anti tuberculosis before operation, reduce the surgical trauma and reduce the incidence of postoperative complications. It can be recommended in clinical application.

Effect of Electroacupuncture on Central Dopamine Receptor in Morphine-dependent Rats / 上海针灸杂志

Objective To observe the change of dopamine receptor in ventral tegmental area (VTA), nucleus accumbens (NAc) and prefrontal cortex (PFC) in morphine-dependent rats, and the regulation effect of electroacupuncture (EA). Method Thirty male SD rats were randomized into a control group, a model group and an EA group, 10 rats each. Morphine-dependent rat models were induced by morphine self-administration. In the EA group, bilateral Jiaji points (EX-B2) of T5 and L2 were selected, and the EA intervention lasted 4 d. Western blotting method was adopted to observe the change of the contents of dopamine receptor D1 and D2 in VTA, NAc and PFC of the rats. Result After the intervention, compared to the model group, the morphine intake was reduced significantly in the EA group (P<0.05); the level of D2 declined significantly in VTA of rats in the model group (P<0.05); the level of D1 increased significantly and D2 declined significantly in NAc of rats in the model group (P<0.05); the level of D1 declined significantly and D2 increased significantly in PFC of rats in the model group (P<0.05); EA produced regulation effect on the altered contents of D1 and D2 in the cerebral areas mentioned above, approaching the normal level. Conclusion EA can inhibit the hunger of addiction rats for morphine to some extent; the contents of dopamine receptors in dopamine projection pathway will take adaptive changes after morphine addiction, while EA can regulate the abnormal expressions of dopamine receptors, producing a protective effect on dopamine receptors of morphine-dependent rats.

Clinical application of modified inverted L-shape incision by extraperitoneal approach to lumbosacral tuberculosis / 中国骨伤

<p><b>OBJECTIVE</b>To explore the clinical effects of one-stage posterior transpedicular screw system internal fixation combined with anterior debridement and bone grafting with modified inverted L-shape incision by extraperitoneal approach in treating multiple lumbosacral tuberculosis.</p><p><b>METHODS</b>The clinical data of 15 patients with multiple lumbosacral tuberculosis underwent operation from February 2008 to December 2014 were retrospectively analyzed. There were 9 males and 6 females with an average of (47.0±13.9) years old. The lesions involved L₄-S₁ in 12 cases, L₄-S₂ in 1 case, L₃-S₁ in 2 cases. Five cases complicated with nerve root symptoms and 2 cases with cauda equina symptoms. All patients were treated with posterior transpedicular screw system internal fixation combined with anterior L₄,₅, L₅S₁ debridement and bone grafting with modified inverted L-shape incision by extraperitoneal approach. Operation time, blood loss, incision length, first passage of gas by anus were recorded. The condition of bone fusion and focus absorption were observed by lumbar CT and MRI; and ESR and CRP were regularly rechecked.</p><p><b>RESULTS</b>Fifteen patients were followed up for 18-24 months with an average of (20.0±2.73) months. All lumbosacral pain obtained improvement, and no hardware loosening, breaking, or bone graft block loosening was found. The operative time of anterior-posterior approach surgery was 210-250 min with an average of (231.0±12.1) min; the blood loss was 320-705 ml with an average of(495.0±130.3) ml; the incision length was 15-21 cm with an average of (16.4±3.4) cm, and the extended length of inverted L-shape incision was 6 to 9 cm with an average of (7.1±2.6) cm. The time of first passage of gas by anus was 14 to 40 h with an average of (24.1±7.4) h after operation. All bone graft obtained fusion at final follow-up, and spinal cord symptoms got recovery, ESR and CRP restored normal level with no recurred at 3 months after drug withdrawal.</p><p><b>CONCLUSIONS</b>The treatment of multiple lumbosacral tuberculosis with posterior transpedicular screw system internal fixation combined with anterior debridement and bone fusion with modified inverted L-shape incision by extraperitoneal approach is feasible and practical. This method has advantages of little trauma, good exposure, less complications and high security.</p>

Inter-laboratory comparisons of measuring instruments for power frequency electromagnetic fields in the workplace / 中国职业医学

OBJECTIVE: To evaluate the major influence factors affecting the quality and accuracy of measuring instruments for power frequency electromagnetic fields in occupational hygiene technical service organizations by developing interlaboratory comparison in workplaces. METHODS: Six measuring instruments for power electromagnetic fields from 6occupational hygiene technical service organizations in Guangdong Province were selected by typical sampling method. A high-voltage substation was selected as a standard source. We set measurement sites underneath it as inter-laboratory comparison spots for power frequency electromagnetic fields. The stability of the standard source was evaluated by pairedsamples t-test and measure results were analyzed by z-score evaluation method based on quartile robust statistical technology. RESULTS: During and after the inter-laboratory comparison,the intensity of electric field and magnetic field of the standard source showed no significant difference [( 555. 03 ± 2. 94) vs( 555. 68 ± 3. 20) V / m,( 2. 30 ± 0. 06) vs( 2. 29 ± 0. 07) μT,P > 0. 05],which met the demand of stability of inter-laboratory comparison. The data of electric field measured by 2 measuring instruments without remote-reading system were found to be high because of proximity effect from its handheld status. The z-score of inter-laboratory( zB) of other 4 measuring instruments with remote-reading system ranged from- 0. 52 to 1. 10,while the z-score of within-laboratory( zW) ranged from- 1. 28 to 0. 37,and both results of| zB| and | zW| were satisfactory( < 2. 00). The zBof power frequency magnetic field measured by the 6 measuring instruments ranged from- 0. 67 to 1. 26,while zWranged from- 0. 59 to 0. 90,and both | zB| and | zW| were also satisfactory( < 2. 00). CONCLUSION: It is feasible that the inter-laboratory comparison of measuring instruments of power frequency electromagnetic fields could be implemented by a high-voltage substation as a standard source. The measuring instruments without remote-reading system could be used to measure the intensity of magnetic field but not the electric field. The measuring instruments with remote-reading system could be used to measure the intensity of either the electric field or the magnetic field,and the measurement results are satisfactory.

Mid-term outcome of surgical operation for thoracolumbar tuberculosis / 中国骨伤

<p><b>OBJECTIVE</b>To investigate the mid-term outcome of operation for thoracolumbar tuberculosis. METHODS : Twenty-eight patiens with thoracolumbar tuberculosis underwent one stage anterior debridement,interbody fusion with bone graft and posterior pedicle screw internal fixation treatment from July 2006 to July 2011. There were 17 males and 11 females. Total 17 patients had nerve injuries ,including 6 cases of grade B, 5 cases of grade C, 6 cases of grade D according to Frankel classification. The poisoning symptoms of tuberculosis and recovery of spinal function were observed. The bone fusion and recovery of [umbar function were evaluated.</p><p><b>RESULTS</b>All the patients were followed up ,and the duration ranged from 39 to 85 months (mean 57 months). The clinical symptoms were controlled gradually, and the thoracolumbar back pain was alleviated after operation. Among the 17 patients with complications of nerve injuries, 3 patients were improved from preoperative grade B to postoperative grade D, 3 patients were improved from preoperative grade B to postopertive E, 5 patients with preoperative grade C and 6 patients with preoperative D were almostly recovered to normal after operation. According to JOA scoring system for curative effect evaluation, the excellent and good rate at the 3rd month, the 1st year, the 3rd year and the 5th year after operation were 67.86% ,82.14% ,85.71% ,89.29% and 91.30% respectively. The results at the 6th month and the 1st year had no statistical differences compared to the results at the 3rd month (P > 0.05); but the results at the 3rd year and the 5th year were better than that at 3 months after operation (P < 0.05); and the results between 3 yesrs and 5 years after operation had no statistical differences (P < O.05). The degeneration of adjacent segments were evaluated according to the California University (Universith of California at Los Angeles , UCLA) score. The degeneration rate was 53.57% (15/28) at the 3rd year after surgery, which was better than that before surgery. Twenty-three patients were followed up for 5 years ,and the degeneration rate was 86.96% (20/23) ,which was better than those of before surgery and 3 years after surgery.</p><p><b>CONCLUSION</b>The surgical treatment for thoracolumbar spinal tuberculosis can achieve the thorough debridement, reconstruction of spinal stability, recovery of lumbar function and promote the functional recovery of the spinal cord, which is an effective method of treatment. However, the mid term follow-up showed that more severe degenerative changes were found in the postoperative adjacent segment.</p>

Clinical effect of staged repair and reconstruction of multiple ligament injuries in knee joints / 中国骨伤

<p><b>OBJECTIVE</b>To evaluate clinical outcomes of anterior cruciate ligament (ACL) and posterior cruciate ligament (PCL) reconstruction under arthroscopy combined with limited open repair of medial collateral ligament (MCL) for the treatment of multiple ligament injuries of knee joints.</p><p><b>METHODS</b>From March 2006 and June 2012,the data of 14 patients (14 knees) with multiple injuries of ACL, PCL, and MCL were collected. There were 8 males and 6 females with an average age of (31.8 +/- 8.1) years old (ranged, 20 to 49 years old). All the patients were performed with X-ray and MRI examination, and the results showed that 10 patients had combined with injuries of anterior cruciate ligament (ACL), posterior cruciate ligament (PCL) and medial collateral ligament (MCL); 4 patients had ALC,PCL and posterolateral corner (PLC) injuries. Four patients had medial meniscus injuries and 2 patients had lateral meniscus injuries. The MCL,PLC and meniscus injuries were treated with operation on the first stage, and functional exercises were performed 3 weeks after fixation. The reconstruction operation of ACL and (or) PCL was performed at the second stage under arthroscopy 3 to 6 months later when the movement range of knee joint recovered to the normal level with obvious relaxation.</p><p><b>RESULTS</b>All incisions healed by primary intention. All the patients were followed up with a mean duration of 48.9 months (ranged, 24 to 80 months). The Lysholm score was improved from preoperative 19.6 +/- 0.9 to the latest follow-up 87.1 +/- 2.8 (t=12.3, P<0.01). The International Knee Documentation Committee (IKDC) rating: 9 cases nearly recovered to normal, 5 cases were abnormal.</p><p><b>CONCLUSION</b>For multiple ligament injuries in the knee, staged repair and reconstruction can effectively restore knee joint stability and function.</p>

Reliability and validity of Meaningful Life Measure-Chinese Revised in Chinese college students / 南方医科大学学报

<p><b>OBJECTIVE</b>To test the reliability and validity of Meaningful Life Measure-Chinese Revised (MLM-CR) in Chinese college students.</p><p><b>METHODS</b>A total of 1035 college students were evaluated with MLM-CR, Satisfaction with Life Scale (SWLS), Purpose in Life (PIL) and Patient Health Questionnaire-2 (PHQ-2), and 120 of the students were examined with PIL-SF twice.</p><p><b>RESULTS</b>All the items in MLM-CR had good discrimination indexes (r=0.753-0.838, P<0.001). Confirmatory factor analysis confirmed the hypothesized five-factor model of MLM-CR (Χ/df=3.4, GFI=0.946, AGFI=0.924, RMR=0.069, NFI=0.953, CFI=0.966, RMSEA=0.048). The total internal consistency reliability of MLM-CR was 0.942, and the alpha coefficients of the 5 dimensions ranged from 0.782 to 0.877; the total split-half reliability was 0.920, and the split-half reliability of the 5 dimensions ranged from 0.752 to 0.830; the total test-retest reliability was 0.871, and the test-retest reliability of the 5 dimensions ranged from 0.783 to 0.805. The criterion validity of MLM-CR in correlation with SWLS, PIL and PHQ-2 was 0.66, 0.755 and -0.388, respectively (P<0.01). The Average score of MLM-CR of the college students was 5.20∓0.90, and the scores were significantly higher in female students than in the male students (P<0.001).</p><p><b>CONCLUSION</b>MLM-CR has good psychometric properties for application in comprehensive evaluation of personal meaning in life.</p>

Biomechanical study on different internal fixation methods of joint stability reconstruction of distal tibiofibular syndesmosis injury / 中国骨伤

<p><b>OBJECTIVE</b>To evaluate biomechanical properties in different methods of internal fixation combined with distal tibiofibular syndesmosis injury, in order to provide a theoretical basis for clinical choice.</p><p><b>METHODS</b>Six lower limbs specimens were collected and divided into 5 groups, including normal group, distal tibiofibular syndesmosis injury (injury group), 3 cortexes group, 4 cortexes group and hook-plate fixation group. Neutral position, plantar flexion position (30°), dorsiflexion (20°) supination external rotation position of foot movement were simulated on universal materials tester. Strength, stiffness and stability of ankle joint in 4 kinds of motion conditions were measured.</p><p><b>RESULTS</b>There was significant differences in strength and stiffness of ankle joint between injury group and normal group in 4 different kinds of motion conditions (P<0.05). Strength and stiffness of ankle joint in 3 cortexes group, 4 cortexes group and hook-plate fixation group were improved obviously in 4 different kinds of motion conditions, and biomechanical indexes were recovered normally or better than normal group. Stiffness of the three fixation groups were better than normal group,but there was no significant differences among three groups (P > 0.05), while stiffness of hook-plate fixation group was closed to normal group.</p><p><b>CONCLUSION</b>For distal tibiofibular syndesmosis injury, 1 screw with 3 cortexes, 4 cortexes and hook-plate had a positive impact on strength, stiffness and stability of distal tibiofibular syndesmosis injury stress,and could restore the normal stabllity of ankle joint after reconstruction. While fixing by screw fixation would limit the rototary motion of ankle joint,ankle mortise could not adapt to changes of talus bone, thus induces screw breakage and traumatic arthritis. Hook-plate fixation is more suitable than 3 cortexes or 4 cortexes fixation for bilmechanical properties,and its' stress is more balance and can reduce postoperative complcations.</p>

Effect of baicalin on inflammatory factors and oxygen free radical metabolism in patients with traumatic shock / 中国基层医药

Objective To investigate the effect of baicalin on inflammatory factors and oxygen free radical metabolism in patients with traumatic shock.Methods 38 patients with traumatic shock were treated with baicalin 200mg intravenous injection when admitted to hospital.Before and 1 h after treatment,TNF-α,IL-6,IL-8,MDA and SOD were measured in blood.Results Compared with before treatment,TNF-,IL-6,IL-8,and MDA levels were decreased after treatment (t =7.32,6.12,20.21,16.10,all P ＜ 0.05),while SOD activity was significantly increased (t =1.69,P ＜ 0.01).Conclusion Baicalin could inhibit the production and release of inflammatory factors TNF-α,IL-6,IL-8 in patients with traumatic shock,reduce the damage of oxygen free radicals to the cells.Early treatment with baicalin had protective effect on patients with traumatic shock.

The un-healing cause of its management after operation of thoracolumbar tuberculosis / 中国骨伤

<p><b>OBJECTIVE</b>To analyze the un-healing cause and management after operation of thoracolumbar tuberculosis.</p><p><b>METHODS</b>From January 2008 to December 2011, the data of 12 patients with postoperative un-healing thoracolumbar tuberculosis were retrospectively analyzed. There were 5 males and 7 females, with an average age of 51.3 years old (ranged, 42 to 65). All the patients occurred different degree of vertebral destruction, abscess-formation, kyphosis and nerve functional injury at the first operation. Among them, 11 patients underwent debridement and fusion with autogenous iliac bone grafting and internal fixation, 1 patient underwent debridement and fusion with autogenous iliac bone grafting. At 2-6 months after operation, internal fixation loosening, fusion failure, abscess-ormation, or erythrocyte sedimentation rate increasing occurred in the patients. For the patients to adjust anti-tuberculosis scheme, 2 patients were treated with puncture to multiple abscess combining with rifampicin local injection; 10 patients were reoperated with debridement and internal fixation adjusting.</p><p><b>RESULTS</b>At 1-2.5 years (mean 1.8 years) after follow-up, 9 cases were cured finally. Re-admission had 3 cases because of re-occurred erythrocyte sedimentation rate increasing and abscess-formation at the 2-4 months after operation, whose bacterial culture showed more than 2 kinds of drug fast, and the treatment effect was still not ideal after adjusting anti-tuberculosis scheme.</p><p><b>CONCLUSION</b>Insufficient anti-tuberculosis and bad nutritional status before operation,incomplete debridement and unreasonable fixation style during operation, inadequate drainage, irregular anti-tuberculosis and drug fast of Bacillus tuberculosis after operation are main reasons leading to un-healing of tuberculosis. Therefore, actively improving malnutrition, making individual operation plan before operation, ensuring complete debridement, rebuilding spinal stability, removing the compression of spinal cord, combining with postoperative effective, enough, regular combination chemotherapy are important guarantee to cure of spinal tuberculosis.</p>

FEM simulation of complex lumbar spinal stenosis decompression surgery / 生物医学工程学杂志

This paper aims to establish an accurate finite element model of complete lumbar spine with complex lumbar spinal stenosis (LSS), and then to do comparison and analysis of normal model and decompression surgery model. Firstly, we chose some patients with complex LSS and then collected the CT scanned data. Then we generated a complete FE model of Lumbar with complex LSS using a specially designed modeling system, and we also created a normal lumbar model and a decompression treated model. We applied same boundary conditions in all the three models. The results showed that the active movement range of complex LSS was smaller than that of the normal model, but the movement range of the decompression model was larger than that of the normal. There are stress concentration around the endplate and disk at the degenerative intervertebral? disk L4-L5 and adjacent disk L3-L4 for LSS model, and the stress of the decompression model increased more significantly. This simulation demonstrated that the treatment of simple decompression for lumbar spine with complex LSS can release the pain, but may result in unstability and accelerate the degeneration.

Application of modified posterior decompression for the treatment of thoracolumbar burst fractures / 中国骨伤

<p><b>OBJECTIVE</b>To study therapeutic effects of self-designed canal decompressor in the posterior surgical treatment of thoracolumbar burst fractures, and provide evidence for widespread application.</p><p><b>METHODS</b>From January 2008 to December 2008, the self-designed canal decompressor was used in 43 patients (30 males and 13 females, ranging in age from 22 to 49 years) with thoracolumbar burst fractures. According to Denis classification, there were 12 cases of type A, 24 cases of type B, 6 cases of type D and 1 case of type E. Affected segment: 16 patients in T12,19 patients in L1 and 8 patients in L2. The index of intra-operative blood loss, postoperative 24 h wound drainage volume, and operative time were compared with those of 16 patients who undergone traditional operation. The preoperative and postoperative vertebral canal volume, Cobb angles, residual vertebral body height, neurological outcome, and back pain were evaluated and compared.</p><p><b>RESULTS</b>All the patients healed without wound infection, neurological symptoms and other complications. Forty-three patients were followed up ranging from 12 to 24 months, with a mean of (16.5 +/- 2.5) months. Compared with traditional posterior operation, the blood loss and operative time in modified posterior approach group had statistically significant difference, but the postoperative 24 h wound drainage had no significant difference between the two groups. CT scan indicated that applying the canal decompressor allowed efficient restore of canal volume from preoperative (49.4 +/- 16.7)% to postoperative (12.8 +/- 4.2)%. The X-ray showed Cobb angles reduced from preoperative (30.1 +/- 2.4)degrees to postoperative (5.1 +/- 0.6) degrees. Mean vertebral height was restored to (81.5 +/- 5.5)% after operation. Follow-up evaluation indicated that neurological recovery presented in 33 patients,with an average improvement of 0.87 Frankel grades. Neurological deterioration was not observed.</p><p><b>CONCLUSION</b>Applying the canal decompressor enables efficient and safe spinal decompression, restore the height of the injured vertebrae, reconstruction of the anterior-middle column stability,and prevention of postoperative vertebral height and Cobb angle lost.</p>

Case-control study on two different methods in the treatment of Bennett fractures / 中国骨伤

<p><b>OBJECTIVE</b>To compare the clinical outcomes between two different methods in the treatment of Bennett fractures.</p><p><b>METHODS</b>From May 2005 to June 2009, 31 patients with Bennett fractures were treated with gypsum and percutaneous fragment pin fixation. In gypsum fixation group,there were 17 cases including 12 males and 5 females with an average age of (43.9-5.7) years; according to Buechler classification: 3 cases were I region fracture, 11 cases were II region fracture, 3 cases were III region fracture. In percutaneous fragment pin fixation group,there were 14 cases including 8 males and 6 females with an average age of (45.6 +/- 6.1) years; according to Buechler classification: 3 cases were I region fracture, 9 cases were II region fracture and 2 cases were II region fracture. The observing and comparing items of the two groups included: (1) length of stay, time of fracture healing,failure of fixation; (2) postoperative radiographs comparison according to method of Kjaer-Petersen; (3) cannon scores used for outcome measurement.</p><p><b>RESULTS</b>All the patients in the two groups were followed up, the duration ranged from 6 to 15 months,with an average of (9.0 +/- 3.5) months. The length of stay were (7.0 +/- 2.5) d in gypsum fixation group and (9.0 +/- 3.9) d in percutaneous fragment pin fixation group with statistically significant differences (P < 0.05). The postoperative reduction quality according to method of Kjaer-Petersen, in gypsum fixation group:4 patients got an excellent result, 8 good and 5 poor; in percutaneous fragment pin fixation group,the above data were 8, 6 and 0 respectively;there were statistically significant differences (P < 0.05 ) between the two groups. The time of fracture healing were (6.0 +/- 0.5) weeks in gypsum fixation group and (6.0 +/- 1.9) weeks in percutaneous fragment pin fixation group with no statistically significant differences (P > 0.05). Cannon scores were evaluated at postoperative 3 months,in gypsum fixation group: 6 patients got an excellent result, 8 good and 3 fair; in percutaneous fragment pin fixation group,the above data were 8, 5 and 1 respectively; there were no statistically significant differences (P > 0.05) between two groups. Two patients had fracture re-displacement in gypsum fixation group, and no failure cases in percutaneous fragment pin fixation group.</p><p><b>CONCLUSION</b>There are satisfied therapeutic effects in two different methods for the treatment of Bennett fractures. However, gypsum fixation has advantage of easy to operate and atraumatic, but unstability and easy to displacement; percutaneous fragment pin fixation has advantage of fixed solidly and better in functional rehabilitation, but big in surgical trauma and long in length of stay.</p>

Treatment of intertrochanteric fractures with proximal femur nail antirotation / 中华创伤杂志

Objective To summarize the experiences in treatment of intertochanteric fractures with proximal femur nail antirotation (PFNA). Methods A retrospective study was done on 136 patients with intertrochanteric fractures treated with PFNA from March 2006 to September 2008. Postoperative reduction quality, long-term radiographic results and function of hip were evaluated separately. All the patients had closed fractures. The operation involved orthopedic traction bed, C-arm image intensifier,closed reduction or limited open reduction and locking technique. Results All patients were followed up for 10-18 months (average 14.5 months), which showed fracture healing in all patients. According to Harris criterion, the function of the hip joint obtained excellence in 129 patients ( 94.9% ). Conclusion PFNA has advantages of simple procedure, minimal invasion, firm fixation and early functional exercises and is an effective method for treatment of intertrochanteric fractures.

Effects of bu yang huan wu decoction on astrocytes after cerebral ischemia and reperfusion / 中国中药杂志

<p><b>OBJECTIVE</b>To study the effects of Bu Yang Huan Wu Decoction on astrocytes after cerebral ischemia and reperfusion.</p><p><b>METHOD</b>Cerebral ischemia model in gerbils was produced by ligating bilateral common carotid artery. The dynamic expressin of GFAP were determined by immunochemistry after cerebyal ischemia for 15 min followed by reperfusion for 24 hours and 48 hours.</p><p><b>RESULT</b>GFAP positive reactions reached a peak after cerebral ischemia for 15 min followed by reperfusion for 24 hours. Bu Yang Huan Wu Decoction decreased the expression. GFAP positive reactions decreased after cerebral ischemia for 15 min followed by reperfusion for 48 hours, Bu Yang Huan Wu Decoction increased the expression.</p><p><b>CONCLUSION</b>The regulation of Bu Yang Huan Wu Decoction on astrocytes after cerebral ischemia and reperfusion may be related to repairing process after cerebral ischemia.</p>