Tortuosity of the internal carotid artery and the formation of internal carotid aneurysms: an exploratory study based on propensity score method / 中华放射学杂志

Objective:To investigate the correlation between the tortuosity of the internal carotid artery and the formation of internal carotid aneurysms.Methods:The clinical data of patients with suspected cerebrovascular disease admitted to the Jinling Hospital from July 2009 to March 2017 were retrospectively collected. All patients underwent head CT angiography and digital subtraction angiography. Patients with single internal carotid artery aneurysm were classified as the aneurysm group, and patients without obvious abnormal vascular disease were classified as the control group. The demographic information of the patients, including age, gender, history of hypertension and diabetes, were collected. The size of the aneurysm and the tortuosity parameters of the internal carotid artery were measured, including the classification of the tortuosity of internal carotid artery, anterior genu angle (A angle), posterior genu angle (P angle), sum of the angles of A angle and P angle (AP angle) and height difference of anterior genu and posterior genu (D value). SPSS software was used for propensity score matching (PSM). Independent sample t test, Mann-Whitney U test or χ 2 test, Fisher exact test were used to compare the differences of each parameter between the two groups. Spearman analysis was used to analyze the correlation between the tortuosity and aneurysm size. A multivariate logistic regression was used to analyze the independent risk factors of aneurysm formation and to predict the formation of internal carotid aneurysm. The receiver operating characteristic curve and the area under the curve were used for model performance. Results:After PSM, 108 patients were included in each group. The proportion of tortuous internal carotid artery in the aneurysm group was lower than that in the control group [19.4% (21/108) vs. 32.4% (35/108), χ 2=4.72, P=0.030]. A, P and AP angles in the aneurysm group were significantly larger than those in the control group ( U=7 105.50, P=0.006; U=7 139.00, P=0.004; t=-3.14, P=0.002). Multivariate logistic regression analysis showed that AP angle (OR=1.010, 95%CI 1.003-1.016, P=0.002) was an independent risk factor for aneurysm formation. The area under the curves of logistic regression model based on AP angle was 0.624 (95%CI 0.549-0.699). There was a weak correlation between the size of internal carotid artery aneurysm and AP angle ( r=0.210, P=0.002). Conclusions:The tortuosity of the internal carotid artery is associated with the formation of internal carotid artery aneurysms, and the AP angle is an independent risk factor for the formation of internal carotid artery aneurysms, and a weak positive correlation with the size of the aneurysm is observed. It provides a new idea for understanding the formation of internal carotid artery aneurysms from the morphological characteristics of the parent artery.

Systematic review and meta-analysis of health state utility for global patients with hemophilia / 中国药房

OBJECTIVE To systematically sort out and evaluate the health state utility of hemophiliac patients， and to provide reliable parameters for conducting pharmacoeconomic evaluation and health technology assessment. METHODS Retrieved from CNKI， Wanfang data， VIP， CBM， PubMed， Embase， the Cochrane Library， Scopus and Web of Science databases， relevant literature about the measurement of health state utility in hemophiliac patients was collected from the inception to February 2023. After screening literature， extracting data and evaluating the quality of literature， meta-analysis was performed for health state utility with Stata 15.1 software. RESULTS Thirty-eight papers were finally included， with the highest and lowest health utility values of 0.90 and 0.46， respectively. Those studies mostly adopted the EuroQol Five Dimensions Questionnaire （EQ-5D） （73.7%）. Results of meta-analysis showed that health state utility of global hemophiliac patients was 0.69，95% confidence interval was 0.65- 0.74； those of patients with mild， moderate and severe hemophilia were 0.79， 0.70， and 0.64， respectively； health state utility for patients with inhibitors （0.64） was lower than that of patients without inhibitors （0.69）； health state utility for the Chinese patient population was 0.55， which was higher than that of Iranian patients （0.46）， but lower than those of other developed countries. CONCLUSIONS There is some heterogeneity in the results of the studies across countries/regions， with higher health state utility in developed countries than in developing countries. As the severity of hemophilia increases， the trend of decreasing health state utility is obvious.

HPV infection and clinical characteristics in 159 male patients with condyloma acuminatum in Liaocheng, Shandong / 中国热带医学

@#Abstract: Objective The purpose of this study is to find out the epidemiological and clinical characteristics of male patients with condyloma acuminatum (CA) in Liaocheng area, as well as to improve the understanding of human papillomavirus (HPV) infection and put forward targeted prevention and treatment measures. Methods The clinical data of 159 male CA patients who admitted to Liaocheng People's Hospital from January 2021 to January 2022 were collected, and the epidemiological characteristics, clinical manifestations, infection sites, HPV gene subtypes and other information were analyzed retrospectively. Results Most of the 159 CA patients (range from 15 to 77 years old) were 31-40 years old (31.45%, 50/159), more than half of them had smoking history, and more than 60% had low income (<5 000 yuan/month), multiple sexual partners (≥2) and no condom use habit, 70.44% of the patients had prepuce long combined with prepuce balanitis. 91 cases (57.23%) were single infection, 102 cases (64.15%) were simple low-risk HPV infection. The analysis of risk factors between mixed infection and simple low-risk infection found statistically significant differences in age≤ 40 years old, unmarried, or less affected by education duration of 15 years or less, engaged in the business or service industry, the number of sexual partners or 2, knew not to clean and not to use condoms, while differences in smoking history, alcohol history, monthly income level, and age at first sexual intercourse were not statistically significant. Low-risk HPV6 and/or HPV11 were detected in 139 cases (87.42%). Fifty-seven patients (35.85%) were infected with at least one high-risk HPV. 72.33% of the patients had multiple warts, and the most common sites were around the coronal sulcus and frenulum of the penis Conclusions The incidence of multiple infections and high-risk subtypes is high in male CA patients in Liaocheng area, and most of the patients have low income, low education level and multiple sexual partners. Strengthening the treatment and education follow-up of this population may contribute to the treatment and prognosis of male CA in this area.

Cost-utility analysis of tislelizumab in the second -line treatment of advanced or metastatic esophageal squamous cell carcinoma / 中国药房

OBJECTIVE To evaluate the cost -effectiveness of tislelizumab in the second -line treatment of advanced or metastatic esophageal squamous cell carcinoma （ESCC）in China .METHODS A three -state Markov model was constructed to assess the cost -effectiveness of tislelizumab versus chemotherapy in the second -line treatment of advanced or metastatic ESCC and programmed death receptor 1（PD-L1）positive patients . The cycle length of the model was 1 month，and the time horizon of the model was set as 10 years. The discount rate of cost and utility was 5%. One-way sensitivity analysis ，probability sensitivity analysis and scenario analysis were used to verify the robustness of the base -case analysis results . RESULTS The results of the base-case analysis showed that compared with chemotherapy ，the incremental cost -effectiveness ratio （ICER）of tislelizumab in the second-line treatment of advanced or metastatic ESCC and PD -L1-positive patients were 26 864.01 yuan/QALY and 37 510.07 yuan/QALY，respectively，which was much lower than 1 time per capita gross domestic product （GDP）in 2021（80 976 yuan）. Results of scenario analysis showed that the ICER was less than 1 times per capita GDP ，regardless of the chemotherapy regimens（paclitaxel，docetaxel or irinotecan ）used. With the extension of the simulation time limit ，the ICER of tirelizumab regimen gradually decreased ，and the reduction rate gradually E-mail：lishunping@sdu.edu.cn decreased，but they were all less than 1 time China ’s per capita GDP in 2021. The results of the one -way sensitivity analysis showed that the 3 parameters with the most significant impact on the ICER were progression -free survival of tislelizumab group ，price of tislelizumab ，and the proportion of patients receiving follow-up treatment in the tislelizumab group . The results of the probability sensitivity analysis showed that the probability of tislelizumab with cost -effectiveness in the treatment of advanced or metastatic ESCC patients and PD -L1-positive patients were 99.09% and 99.94%，respectively，when using 3 times per capita GDP as the willingness -to-pay threshold . CONCLUSIONS Tislelizumab has economic advantages over chemotherapy alone in the second -line treatment of advanced or metastatic ESCC patients.

Anxiety of hearing impaired students in special schools during COVID-19 / 中国学校卫生

Objective@#To understand anxiety status among students with hearing loss under the epidemic of novel coronarirus pneumonia, and to provide evidence for promoting mental health of hearing impaired students.@*Methods@#On March 10, 2020, 612 hearing impaired students in special schools in 6 provinces,including Guizhou,Sichuan,Hunan,Zhejiang,Chongqing and Xinjiang were investigated online with anxiety scale.@*Results@#The detection rate of anxiety in hearing impaired students was 52.8%. There was significant difference in the detection rate of anxiety among hearing impaired students by different economic status(from very good,good,mederate,poor and very poor:54.1%,63.9%,51.4%,40.7% and 38.8%) and relationship with their parents(from very good,good,mederate,poor and very poor:45.1%,55.7%,60.0%,84.6%,87.5%) ( χ 2=16.59, 62.46, P <0.05).@*Conclusion@#The anxiety level of hearing impaired students was high under the epidemic of novel coronavirus pneumonia. Hearing impaired students from families with good economic conditions and poor parent child relations are prone to anxiety. It is particularly important to establish a good parent child relationship.

The hepatic ectonucleotide pyrophosphatase/phosphodiesterase 1 gene mRNA abundance is reduced by insulin and induced by dexamethasone

Hormones regulate hepatic gene expressions to maintain metabolic homeostasis. Ectonucleotide pyrophosphatase/phosphodiesterase 1 has been thought to interfere with insulin signaling. To determine its potential role in the regulation of metabolism, we analyzed its gene (Enpp1) expression in the liver of rats experiencing fasting and refeeding cycles, and in primary rat hepatocytes and human hepatoma HepG2 cells treated with insulin and dexamethasone using northern blot and real-time PCR techniques. Hepatic Enpp1 expression was induced by fasting and reduced by refeeding in the rat liver. In primary rat hepatocytes and HepG2 hepatoma cells, insulin reduced Enpp1 mRNA abundance, whereas dexamethasone induced it. Dexamethasone disrupted the insulin-reduced Enpp1 expression in primary hepatocytes. This is in contrast to the responses of the expression of the cytosolic form of phosphoenolpyruvate carboxykinase gene to the same hormones, where insulin reduced it significantly in the process. In addition, the dexamethasone-induced Enpp1 gene expression was attenuated in the presence of 8-Br-cAMP. In conclusion, we demonstrated for the first time that hepatic Enpp1 is regulated in the cycle of fasting and refeeding, a process that might be attributed to insulin-reduced Enpp1 expression. This insulin-reduced Enpp1 expression might play a role in the development of complications in diabetic patients.

Immunological mechanism of prednisone in the treatment of infantile spasm / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To investigate the immunological mechanism of prednisone in the treatment of infantile spasm (IS) by evaluating the immune function of IS children before and after treatment.</p><p><b>METHODS</b>Thirty children with IS were enrolled as IS group. Thirty healthy infants who underwent physical examination were enrolled as healthy control group. Fasting venous blood was collected for both groups before and after prednisone treatment. Chemiluminescence was used to measure serum levels of interleukin-1B (IL-1B), interleukin-2R (IL-2R), interleukin-6 (IL-6), interleukin-8 (IL-8), and tumor necrosis factor-α (TNF-α). Immunoturbidimetric assay was used to measure serum levels of immunoglobulin A (IgA), immunoglobulin M (IgM), and immunoglobulin G (IgG). Flow cytometry was used to measure the percentages of T lymphocyte subsets (CD3, CD4, and CD8). The clinical outcome and electroencephalographic findings were evaluated for all IS children after prednisone treatment.</p><p><b>RESULTS</b>The IS group had significantly higher serum levels of IL-2R, IL-8, and TNF-α than the healthy control group before treatment (P<0.05). The mean number of daily ictal clusters was positively correlated with the levels of IL-2R, IL-8, and TNF-α in IS children, the mean number of total daily seizures was positively correlated with IL-8 level, and any two indices out of IL-2R, IL-8, and TNF-α were positively correlated with each other (P<0.05). Among the 30 IS children treated with prednisone, 19 achieved seizure control; electroencephalography showed that 18 children achieved complete remission of hyperarrhythmia. After treatment, the IS group had significant reductions in the numbers of daily ictal clusters and total daily seizures, significant improvement in developmental quotient (P<0.05), and significant reductions in serum levels of IL-2R, L-8, and TNF-α, the percentage of CD4T lymphocytes, and CD4/CD8ratio (P<0.05), as well as a significant increase in the percentage of CD8T lymphocytes (P<0.05).</p><p><b>CONCLUSIONS</b>IS children have immune dysfunction. Prednisone can control seizures in IS children, possibly by regulating and improving immune dysfunction.</p>

Study on the position evaluation system of standardized residency training using the P-MEX / 医学研究生学报

The importance of physician professionalism has been recognized by the medical profession .Resident training is a critical period for the formation of physician professionalism .In the standardized training phase of resident physicians can not only focus on medical knowledge and clinical skills , professionalism training and assessment is equally important .Europe and the United States developed countries to core competence-oriented resident standardized training trainees assessment system is very stressed the assess-ment of professionalism , and in China's assessment is still in its embryonic stage .According to the inadequacy of position evaluation sys-tem in standardized residency training , this paper developed an evaluation system on the basis of the P-MEX evaluation method after extensive literature reviews on the exprience and practice of other countries .Combined with the actual conditions in our country , this e-valuation system consists of five items of primary index including 'doctor-patient communication skills','management and teamwork a-bility','lifelong learning and research ability','professional attitude'and'practical ability in medical law and ethics'and forty items of secondary index as the main content of the evaluation system .

Study on the position evaluation system of standardized residency training using the P-MEX / 医学研究生学报

The importance of physician professionalism has been recognized by the medical profession .Resident training is a critical period for the formation of physician professionalism .In the standardized training phase of resident physicians can not only focus on medical knowledge and clinical skills , professionalism training and assessment is equally important .Europe and the United States developed countries to core competence-oriented resident standardized training trainees assessment system is very stressed the assess-ment of professionalism , and in China's assessment is still in its embryonic stage .According to the inadequacy of position evaluation sys-tem in standardized residency training , this paper developed an evaluation system on the basis of the P-MEX evaluation method after extensive literature reviews on the exprience and practice of other countries .Combined with the actual conditions in our country , this e-valuation system consists of five items of primary index including 'doctor-patient communication skills','management and teamwork a-bility','lifelong learning and research ability','professional attitude'and'practical ability in medical law and ethics'and forty items of secondary index as the main content of the evaluation system .

A Novel Method for Analysis of Tyrosine Phosphopeptides Based on a Centrifugal Enrichment Device / 分析化学

Protein tyrosine phosphorylation is an important post-translational modification and has become one of the most active areas in proteome research in recent years. Protein tyrosine phosphorylation plays a key regulatory role in the numerous signal transduction processes and in the occurrence & development of tumor. The study of tyrosine phosphorylation and activity of it corresponding tyrosine kinases is of great significance for the research of drug targets for cancer treatment. However, tyrosine phosphorylation only represents less than 0. 1% of the total cellular protein phosphorylation. Therefore, there is a great challenge to identify tyrosine phosphorylation in real complex samples. In this work, a new centrifugal device by combining application of titanium dioxide ( TiO2 ) and C18 reversed phase packing materials for phosphopeptide enrichment and separation was developed, which led to simplified procedure, reduced sample loss and minimized interference.This new centrifugal device was made of pipette tips, adapters and Eppendorf tubes. Sample loading, phosphopeptides enrichment, washing, eluting and separation were combined into this device and could be achieved by simple centrifugation. This device was capable of paralleled sample processing with improved analysis throughput. Tandem enrichment by anti-phosphotyrosine antibody resulted in efficient enrichment and large scale identification of phosphotyrosine peptides by mass spectrometry. As a result, 967 phosphotyrosine sites corresponding to 545 proteins were successfully identified from 5 mg of mouse liver proteins, demonstrating the robustness and potential of this new strategy.

Relationship between radiographic parameters for postoperative wrist joint stability and the prognosis of patients with giant cell tumor of distal radius / 上海交通大学学报（医学版）

Objective·To analyze whether the radiographic parameters for wrist joint stability and some clinical features are associated with the prognosis of Campanacci grade 3 distal radial giant cell tumor of bone. Methods·Clinical and radiological data of 15 patients with giant cell tumors of distal radius who were treated with wide en bloc excision with fibular autograft and internal fixation from August 2003 to July 2016 were retrospectively reviewed. The relationship between clinical features (including age, tumor size, pathological fracture, articular invasion, primary or recurrent), radiographic parameters for wrist joint stability and the prognosis was investigated statistically. Results·There was only 1 patient lost at last follow-up. The average duration of follow-up was 62.3 ±43.3 months. The MSTS score was 21.6±2.0 before surgery and 23.1±2.2 after surgery with recovered function, although the difference was not significant statistically (P=0.106). The pain score (MSTS) improved significantly with 2.9±0.7 before and 4.1±0.5 after operation (P=0.000). The function score (MSTS) was 3.0±0.7 preoperatively and 3.7±0.7 postoperatively (P=0.012). The postoperative ranges of motion and grip strength compared to contralateral extremity were (63.4±12.6) % and (68.5±10.8)% respectively. Complications occurred in 5 patients (35.7%), with 1 infection, 3 non-union and 1 subluxation. No patient suffered from dysfunction of common peroneal nerve. The fibuloulnar angle after K wire removed was significantly larger in good MSTS group (8.8?±5.6?) than in excellent MSTS group (2.2?±2.4?) (P=0.018). The interval of distal fibuloulnar joint before and after K wire removed was significantly different (P=0.003). The Pearson correlation analysis suggested the time of bone union was positively correlated with fibular inclination (r=0.60, P=0.022). Conclusion·The radiographic parameters for wrist joint stability are associated with the patients' prognosis after wide en bloc excision and fibular autograft, which may guide the fibular reconstruction.

Ultrasound guided mandibular nerve and cervical plexus nerve block for clinical evaluation of parotid gland operation for postoperative analgesia / 临床麻醉学杂志

Objective To evaluate the effect of mandibular nerve and cervical plexus nerve block guided by ultrasound for postoperative analgesia of parotid gland operation.Methods Sixty pa-tients of both sexes (29 males,31 females),of ASA physical status Ⅰ or Ⅱ with parotid gland oper-ation,were randomly divided into two groups (n =30):nerve block group and traditional drug group. All patients received general anaesthesia.In traditional drugs group,according to patient's request, we used analgesic drugs.In nerve block group,after general anaesthesia,we provided mandibular nerve and cervical plexus nerve block guided by ultrasound.Both groups were recorded the amount of analgesic drugs and rest/motor VAS after operation 1st day and 2nd day,the ratio of using analgesic drugs was also recorded at the same time.Results Compared with traditional drugs group,the a-mount of analgesic drugs and rest/motor VAS was decreased in nerve block group on the 1st day after operation.But on the 2nd day after operation,there was no difference between them.The ratio of u-sing analgesic drugs of nerve block group was lower than that of traditional drug group. Conclusion Mandibular nerve and cervical plexus nerve block guided by ultrasound is effective for postoperative analgesia for parotid gland operation.

Discussion on innovative teaching management mode in large scale general hospital / 医学研究生学报

Teaching management is an important link in hospital training of high-quality medical talents and an indispensable part of the overall construction of hospitals.Aiming at the confusion of the teaching work and combined the teaching management practice of the hospital,we put forward "54321" teaching management model,introduced the operation and effectiveness of this model.In conclusion,we provide a way to further strengthen the teaching management for general hospitals.

An Electrochemical Sensor for Determination of Bisphenol A Based on Reduced Graphene/Silver Nanoparticles Composites / 分析化学

Graphene and silver nanoparticles showed good application potentials in electrochemistry due to their unique folded layered structure and good catalytic performance. In this work, reduced graphene oxide-Ag nanoparticles ( rGO/AgNPs ) composite material was prepared in situ by using hydrothermal reduction synthesis method with sodium citrate as reducing agent. The material was then used as modified electrodes to study the electrochemical behaviors of bisphenol A ( BPA) . The results of cyclic voltammetry and square wave voltammetry showed that the fast oxidation-reduction reaction of BPA could occur on the rGO/AgNPs modified glassy carbon electrode and lead to the sensitive determination of BPA. Under the optimal conditions, the oxidation current of BPA was linear to its concentration in the range of 0 . 1-40 . 0 μmol/L and the detection limit was 50 . 7 nmol/L ( S/N=3 ) . The presented method was also used for the determination of BPA in plastic samples with satisfactory results.

A Novel Method for Analysis of Tyrosine Phosphopeptides Based on a Centrifugal Enrichment Device / 分析化学

Protein tyrosine phosphorylation is an important post-translational modification and has become one of the most active areas in proteome research in recent years. Protein tyrosine phosphorylation plays a key regulatory role in the numerous signal transduction processes and in the occurrence & development of tumor. The study of tyrosine phosphorylation and activity of it corresponding tyrosine kinases is of great significance for the research of drug targets for cancer treatment. However, tyrosine phosphorylation only represents less than 0. 1% of the total cellular protein phosphorylation. Therefore, there is a great challenge to identify tyrosine phosphorylation in real complex samples. In this work, a new centrifugal device by combining application of titanium dioxide ( TiO2 ) and C18 reversed phase packing materials for phosphopeptide enrichment and separation was developed, which led to simplified procedure, reduced sample loss and minimized interference.This new centrifugal device was made of pipette tips, adapters and Eppendorf tubes. Sample loading, phosphopeptides enrichment, washing, eluting and separation were combined into this device and could be achieved by simple centrifugation. This device was capable of paralleled sample processing with improved analysis throughput. Tandem enrichment by anti-phosphotyrosine antibody resulted in efficient enrichment and large scale identification of phosphotyrosine peptides by mass spectrometry. As a result, 967 phosphotyrosine sites corresponding to 545 proteins were successfully identified from 5 mg of mouse liver proteins, demonstrating the robustness and potential of this new strategy.

Relationship between radiographic parameters for postoperative wrist joint stability and the prognosis of patients with giant cell tumor of distal radius / 上海交通大学学报（医学版）

Objective·To analyze whether the radiographic parameters for wrist joint stability and some clinical features are associated with the prognosis of Campanacci grade 3 distal radial giant cell tumor of bone. Methods·Clinical and radiological data of 15 patients with giant cell tumors of distal radius who were treated with wide en bloc excision with fibular autograft and internal fixation from August 2003 to July 2016 were retrospectively reviewed. The relationship between clinical features (including age, tumor size, pathological fracture, articular invasion, primary or recurrent), radiographic parameters for wrist joint stability and the prognosis was investigated statistically. Results·There was only 1 patient lost at last follow-up. The average duration of follow-up was 62.3 ±43.3 months. The MSTS score was 21.6±2.0 before surgery and 23.1±2.2 after surgery with recovered function, although the difference was not significant statistically (P=0.106). The pain score (MSTS) improved significantly with 2.9±0.7 before and 4.1±0.5 after operation (P=0.000). The function score (MSTS) was 3.0±0.7 preoperatively and 3.7±0.7 postoperatively (P=0.012). The postoperative ranges of motion and grip strength compared to contralateral extremity were (63.4±12.6) % and (68.5±10.8)% respectively. Complications occurred in 5 patients (35.7%), with 1 infection, 3 non-union and 1 subluxation. No patient suffered from dysfunction of common peroneal nerve. The fibuloulnar angle after K wire removed was significantly larger in good MSTS group (8.8?±5.6?) than in excellent MSTS group (2.2?±2.4?) (P=0.018). The interval of distal fibuloulnar joint before and after K wire removed was significantly different (P=0.003). The Pearson correlation analysis suggested the time of bone union was positively correlated with fibular inclination (r=0.60, P=0.022). Conclusion·The radiographic parameters for wrist joint stability are associated with the patients' prognosis after wide en bloc excision and fibular autograft, which may guide the fibular reconstruction.

Efficacy of adductor canal block combined with posterior branch of obturator nerve block for post-operative analgesia in elderly patients undergoing total knee arthroplasty / 中华麻醉学杂志

Objective To evaluate the efficacy of adductor canal block combined with posterior branch of obturator nerve block for postoperative analgesia in the elderly patients undergoing total knee ar-throplasty. Methods Sixty American Society of Anesthesiologists physical status Ⅰ or Ⅱ patients of both sexes, aged 65-75 yr, weighing 55-80 kg, scheduled for elective unilateral total knee arthroplasty, were divided into 2 groups(n=30 each)using a random number table: adductor canal block group(group A) and blockade of adductor canal and posterior branch of obturator nerve group(group AO). At the end of anesthesia induction, adductor canal block was performed under ultrasound guidance, and 0.5% ropiva-caine 20 ml was injected in A and AO groups, and in addition posterior branch of obturator nerve block was then performed under ultrasound guidance, and 0.5% ropivacaine 10 ml was injected in group AO. When postoperative visual analog scale score≥3, patient-controlled intravenous analgesia was performed with mor-phine 0.05 mg∕kg at a 10-min interval. When postoperative visual analog scale score was still≥3, mor-phine 0.025 mg∕kg was intravenously injected as rescue analgesic. The duration of first requirement for an-algesic, consumption of morphine within 24 and 48 h after operation, patient′s satisfaction with analgesia at 48 h after operation and development of nerve block-related complications and adverse reactions such as nau-sea, vomiting and itching were recorded. Results Compared with group A, the duration of first require-ment for analgesic was significantly prolonged, and the consumption of morphine within 24 h after operation was reduced in group AO(P<0.05). There was no significant difference between the two groups in the consumption of morphine within 48 h after operation, satisfaction score or incidence of nausea, vomiting and itching(P>0.05). Nerve block-related complications were not found in two groups. Conclusion Ad-ductor canal block combined with posterior branch of obturator nerve block produces better efficacy than ei-ther alone when used for postoperative analgesia in the elderly patients undergoing total knee arthroplasty.

Hypermethylation of testis derived transcript gene promoter significantly correlates with worse outcomes in glioblastoma patients / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Glioblastoma is the most common and lethal cancer of the central nervous system. Global genomic hypomethylation and some CpG island hypermethylation are common hallmarks of these malignancies, but the effects of these methylation abnormalities on glioblastomas are still largely unclear. Methylation of the O6-methylguanine-DNA methyltransferase promoter is currently an only confirmed molecular predictor of better outcome in temozolomide treatment. To better understand the relationship between CpG island methylation status and patient outcome, this study launched DNA methylation profiles for thirty-three primary glioblastomas (pGBMs) and nine secondary glioblastomas (sGBMs) with the expectation to identify valuable prognostic and therapeutic targets.</p><p><b>METHODS</b>We evaluated the methylation status of testis derived transcript (TES) gene promoter by microarray analysis of glioblastomas and the prognostic value for TES methylation in the clinical outcome of pGBM patients. Significance analysis of microarrays was used for genes significantly differently methylated between 33 pGBM and nine sGBM. Survival curves were calculated according to the Kaplan-Meier method, and differences between curves were assessed using the log-rank test. Then, we treated glioblastoma cell lines (U87 and U251) with 5-aza-2-deoxycytidines (5-aza-dC) and detected cell biological behaviors.</p><p><b>RESULTS</b>Microarray data analysis identified TES promoter was hypermethylated in pGBMs compared with sGBMs (P < 0.05). Survival curves from the Kaplan-Meier method analysis revealed that the patients with TES hypermethylation had a short overall survival (P < 0.05). This abnormality is also confirmed in glioblastoma cell lines (U87 and U251). Treating these cells with 5-aza-dC released TES protein expression resulted in significant inhibition of cell growth (P = 0.013).</p><p><b>CONCLUSIONS</b>Hypermethylation of TES gene promoter highly correlated with worse outcome in pGBM patients. TES might represent a valuable prognostic marker for glioblastoma.</p>

Application study of gait analysis on different syndrome types based on musculature zones of the knee osteoarthritis / 中国针灸

<p><b>OBJECTIVE</b>To study the gait characteristics of different syndrome types based on musculature zones of the knee osteoarthritis (KOA) and to discuss the application of modern biomechanical technology in objective study on syndrome differentiation which is based on musculature zones.</p><p><b>METHODS</b>Thirty knees out of 19 patients suffering from KOA with the different musculature zone syndrome types were measured the step angle, the heel impulse, the internal and external rotation figures and the percentage of the maximum vertical ground reaction time in the total time of the supporting period by using the Plantar Pressure Measurement System.</p><p><b>RESULTS</b>In the knees with abnormal musculature zones, the figures of step angle and the heel impulse of Foot Shaoyang Meridian and three foot yin meridians were significantly increased than normal (all P<0.05), while those figures of Foot Yangming Meridian were normal; in the knees of Foot Yangming Meridian with abnormal musculature zones, the external rotation mean figure in the midstance was significantly increased than normal (P<0.05); in the knees of Foot Shaoyang Meridian with abnormal musculature zones, the internal rotation mean figure in the propulsion was significantly increased than normal (P<0.05); in the knees of the three foot yin meridians with abnormal musculature zones, the mean external rotation figure in propulsion was significantly increased than normal (P<0.05); in the knees of the Foot Yangming Meridian with abnormal musculature zones, the time of maximum vertical ground reaction was significantly delayed (P<0.05).</p><p><b>CONCLUSION</b>The figures of the gait index in KOA patients with different musculature zone types are different, including the step angle, heel impulse, the internal and external rotation figures, the time of the maximum vertical ground reaction and so on, which could be used as the objective basis of syndrome differentiation based on musculature zones for KOA patients. Therefore, biomechanical technology can be applied in the syndrome differentiation based on musculature zones for KOA patients.</p>

A Study of Strephenopodia and Strephexopodia of Children with Spastic Cerebral Palsy Based on Gait Analysis / 中国康复理论与实践

@# Objective To find out the mechanism of strephenopodia and strephexopodia of children with spastic cerebral palsy by analyzing their gait character.MethodsForty children with spastic cerebral palsy and forty healthy children with normal walking ability were involved in this research.Footscan 7 gait analysis system was used to measure foot initial touchdown part,the ratio of different part touchdown phase to single supporting phase,the degree of strephenopodia and strephexopodia in different part.Two groups' characteristic parameters were analyzed by statistics method.ResultsSignificant differences were found in foot first touchdown part between two groups(P<0.05).The phenomenon that toes or metatarsus or whole foot first touch the earth was found in children with spastic cerebral palsy.The ratio of anterior foot and middle foot touchdown phase to single supporting phase were higher than normal children(P<0.05).In spastic cerebral palsy group the phenomenon of strephexopodia was more serious than strephenopodia during anterior foot touchdown phase.ConclusionLots of children with spastic cerebral palsy are suffering long-time compression pain and strephexopodia with anterior foot,active rectification must be performed during rehabilitation care.