Achilles tendon thickening does not affect elasticity and functional outcome after surgical repair of Achilles rupture: A retrospective study.

PURPOSE: Previous studies have confirmed that Achilles tendon occurs Achilles thickening after repair surgery of the rupture. Although this mechanism has been elucidated in the laboratory, there are few reports on its impact on clinical function. We designed a retrospective study to investigate the Achilles thickening after Achilles tendon rupture repair and its correlation between the elasticity and postoperative function. METHODS: In this retrospective analysis, patients who underwent surgical treatment for acute Achilles tendon rupture from April 2016 to April 2020 were included. All the patients were regularly followed up at 3 months, 1 year, and 2 years after surgery. American Orthopaedic Foot Ankle Surgeon (AOFAS) scale and Leppilahti score were used to evaluate functional outcomes. Achilles elasticity was measured by ultrasound shear wave of elasticity. Achilles thickening was calculated as maximal transverse and longitudinal diameter in cross-sectional plane of magnetic resonance scan. Sample t-tests was used for different follow-up periods. Correlation between Achilles thickening and other factors were analyzed using Pearson's method. p < 0.05 indicates a statistically significant difference. RESULTS: AOFAS scale and Leppilahti score at 1 year were significantly higher than at 3 months postoperatively (both p < 0.001). These functional scales were also improved at 2-year follow-up significantly (both p < 0.001). The dorsiflexion difference showed gradually recovery in each follow-up period (t = -17.907, p < 0.001). The elasticity of the Achilles appeared to continuously decreases during the postoperative follow-up period in all position sets (p < 0.001). In thickening evaluation, the cross-sectional area of the thickest plane of Achilles was significantly higher at 1 year postoperatively (310.5 ± 25.2) mm2 than that at 3 months postoperatively ((278.0 ± 26.2) mm2, t = -8.219, p < 0.001) and became thinner in 2-year magnetic resonance scan ((256.1 ± 15.1) mm2, t = 16.769, p < 0.001). The correlations between Achilles thickening, elasticity, and functional outcome did not show statistical significance (p > 0.05) in every follow-up period. CONCLUSION: Achilles tendon thickens after surgery in the 1st year, but begins to gradually return to thinning about 2 years after surgery. There was no significant correlation between the increase and decrease of thickening and the patients' clinical function scores, Achilles elasticity, and bilateral ankle dorsiflexion difference.

Reliability and validity of the Chinese version of the trauma-specific frailty index (TSFI) for geriatric trauma patients.

BACKGROUND: Pre-traumatic frailty in geriatric trauma patients has caught attention from emergency medical workers and the assessment of it thus become one of the important aspects of risk management. Several tools are available to identify frailty, but limited tools have been validated for geriatric trauma patients in China to assess pre-traumatic frailty.The aim of this study is to translate the Trauma-Specific Frailty Index(TSFI) into Chinese, and to evaluate the reliability and validity of the translated version in geriatric trauma patients. METHODS: A cross-sectional study was conducted. The TSFI was translated with using the Brislin model, that included forward and backward translation. A total of 184 geriatric trauma patients were recruited by a convenience sampling between October and December 2020 in Hospital of Chengdu University of Traditional Chinese Medicine, Sichuan. Using reliability or internal consistency tests assessed with Cronbach's alpha coefficient, split-half reliability and test-retest reliability. Content validity and construct validity analysis were both performed. Sensitivity, specificity and maximum Youden index(YI) were used to determine the optimal cut-off value. The screening performance was examined by Kappa value. RESULTS: The total study population included 184 subjects, of which 8 participants were excluded, resulting in a study sample size of 176 elderly trauma patients (the completion rate was 95.7%). The Chinese version of Trauma-Specific Frailty Index(C-TSFI) have 15 items with 5 dimensions. Cronbach's alpha coefficient of the C-TSFI was 0.861, Cronbach's alpha coefficient of dimensions ranged from 0.837 to 0.875, the split-half reliability of the C-TSFI were 0.894 and 0.880 respectively, test-retest reliability ranged from 0.692 to 0.862. The correlation coefficient between items and the C-TSFI ranged from 0.439 to 0.761. The content validity index for items (I-CVI) of the C-TSFI scale was 0.86~1.00, and the scale of content validity index (S-CVI) was 0.93. The area under curve (AUC) of the C-TSFI was 0.932 (95%CI 0.904-0.96, P < 0.05), the maximum YI was 0.725, the sensitivity was 80.2%, the specificity was 92.3%, and the critical value was 0.31. Kappa value was 0.682 (P < 0.05). CONCLUSIONS: The Chinese version of TSFI could be used as a general assessment tool in geriatric trauma patients, and both its reliability and validity have been demonstrated.

Prevalence and Risk Factors of Postdialysis Fatigue in Patients Under Maintenance Hemodialysis: A Systematic Review and Meta-Analysis.

PURPOSE: Despite the high prevalence of postdialysis fatigue (PDF) in maintenance hemodialysis patients, no meta-analysis on the prevalence and risk factors of PDF has yet been published. This study aimed to identify the prevalence of PDF and explore its related factors. METHODS: PubMed, Embase, CENTRAL, Web of Science, Cumulative Index to Nursing and Allied Health Literature (CINAHL), and the four Chinese databases (National Knowledge Infrastructure [CNKI], Chinese Biomedical Literature database [SinoMed], Wanfang Digital Periodicals [WANFANG], and Chinese Science and Technology Periodicals [VIP] database) were searched from inception up to July 2022. This study was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. The articles were independently searched by two reviewers, and the relevant data were extracted. The Agency for Healthcare Research and Quality was used to assess the quality of the included studies. RESULTS: Thirteen articles with 2,118 participants were included. The pooled prevalence was 60.0%. The meta-analysis results revealed that the ultrafiltration volume, mean arterial pressure after dialysis, and good sleep quality were potentially associated with PDF, whereas only good sleep quality (odds ratio 0.24, 95% confidence interval 0.19-0.30) was significantly associated with PDF. CONCLUSION: PDF is common in maintenance hemodialysis patients, which is related to the ultrafiltration volume, sleep quality, and mean arterial pressure after dialysis. However, the mechanism underlying the risk factors and PDF remains unknown. Further research is warranted to investigate the risk factors, intervention, treatment, and mechanism in maintenance hemodialysis patients.

Effects of polysaccharides-riched Prunus mume fruit juice concentrate on uric acid excretion and gut microbiota in mice with adenine-induced chronic kidney disease.

The present study aimed to determine the effects of polysaccharides-riched Prunus mume fruit juice concentrate (PFC) on uric acid (UA) excretion and the gut microbiota in mice with chronic kidney disease (CKD). C57BL/6 mice were randomly allocated to four groups: two that were fed AIN93M diet, one of which was administered 500 mg/kg PFC, and two that were fed AIN93M diet containing 0.2% adenine, one of which was administered 500 mg/kg PFC. PFC promoted UA excretion, which may have been mediated through increases in the protein expression of ATP-binding cassette transporter G2 (ABCG2), organic anion transporter 1 (OAT1), organic carnitine transporter 2 (OCTN2), and reductions in the protein expression of glucose transporter 9 (GLUT9) and urate transporter 1 (URAT1) in kidneys of CKD mice. ABCG2 expression in the intestine was also increased by PFC administration. Additionally, PFC significantly increased large intestinal short-chain fatty acids (SCFAs) concentrations, and the number of gut microbial species, and reduced the abundance of the genera Bacteroides, Pseudoflavonifractor, Helicobacter, Clostridium_IV and Allobaculum, which have a negative effect on UA excretion. In conclusion, PFC may promote UA excretion in CKD mice by altering the expression of urate transporters and regulating the gut microbiota.

[Adsorption Characteristics and Long-term Effectiveness Evaluation of Iron-nitrogen Co-doped Biochar for Secondary Water-Soluble Organic Matter].

In order to economically and efficiently remove dissolved organic matter (DOM) in the secondary water of wastewater treatment plants, this study adopted iron-nitrogen co-doped biochar material (Fe-N-C) as a new adsorbent and systematically analyzed the effect of this new carbon material on the secondary water DOM, as well as the adsorption performance, kinetic process, selectivity, and mechanism of action. In addition, the long-term performance and reusability of the adsorption material were thoroughly investigated through a fixed-bed adsorption device. The results show that Fe-N-C had outstanding adsorption performance for secondary water DOM. When the dosage was only 1.0 g·L-1, the removal rates of TOC, UV254, and UV280 were as high as 40.18%, 76.92%, and 78.26%, respectively, which are far higher. Regarding the adsorption effect of pure biochar and conventional activated carbon, the adsorption process conformed to the pseudo-second-order kinetics and Freundlich adsorption isotherm model, indicating that the adsorption process is a multilayer chemical adsorption involving valence electrons and the exchange of electrons. The three-dimensional fluorescence spectroscopy, molecular weight distribution, and resin analysis results, such as classification and characterization, showed that Fe-N-C had selective adsorption for different components in the secondary water DOM. The fixed bed adsorption column with Fe-N-C as the core had the maximum removal rate of secondary water TOC, UV254, and UV280 as high as 94.09%, 95.65%, and 97.18%, respectively, and had good stability. It was close to adsorption saturation when the processing capacity reached 620 times the bed volume. However, after the regeneration heat treatment, the adsorption performance was remarkably restored. These results are expected to provide reference for the further development of high-efficiency adsorption water treatment technology.

[Degradation Characteristics and Mechanism of Ibuprofen by Ozone Catalyzed by Nitrogen-Doped Biochar].

This study used a novel nitrogen-doped biochar (N-C) to catalyze the oxidative degradation of IBP in water by ozone and studied the catalytic ozone oxidation degradation of ibuprofen (IBP) efficiency and mechanism. Furthermore, it explored the influence of pH, ozone dosing quantity, catalyst dosing quantity, different anions, and background of water quality conditions on the IBP degradation efficiency. The results showed that, compared with that of some common carbon-based catalysts (g-C3N4, biochar, and granular-activated carbon) and metal catalysts (MnO2 and Fe3O4), the N-C catalytic ozone system had a very outstanding oxidation degradation performance of organic pollutants; the removal rate of IBP reached 100% in 5 min, and the utilization rate of ozone was increased from 10% to 46%. The treatment efficiency of the system was enhanced with the increase in pH. Compared with that by increasing the ozone dosage, the treatment capacity of the system was significantly improved by increasing the concentration of catalyst. The quenching experiment and EPR further confirmed that N-C could effectively catalyze ozone to produce more reactive oxygen species, such as superoxide radicals (·O2-) and H2O2. It was also found that·O2- was the main active substance in the reaction system and played a leading role in the degradation of IBP.

Reliability, validity and responsiveness of the Mandarin (Simplified) Chinese version of the EORTC QLQ-OH45 among cancer patients.

PURPOSE: The goal of our study was to evaluate the reliability, validity, responsiveness and acceptability of the Mandarin (simplified) Chinese version of the EORTC QLQ-OH45. METHODS: From October 2017 to February 2018, 393 cancer patients were enrolled from three different hospitals in China. A forward and backward translation was made to develop the Mandarin (simplified) Chinese version of EORTC QLQ-OH15. The QLQ-C30 and QLQ-OH15 questionnaires (which we have assembled and named QLQ-OH45 in this paper) were self-administered. Results were statistically analysed using SPSS 21.0. The reliability and validity tests of the questionnaires were assessed by Cronbach's α coefficient, Pearson correlation test and Mann-Whitney U tests. Responsiveness to change was measured in an independent sample of patients with head and neck cancer undergoing surgery or radiotherapy or chemotherapy. RESULTS: An acceptable internal consistency reliability for most multiple-item scales was demonstrated, as Cronbach's α coefficients were greater than 0.7 for most multiple-item scales, excepting for cognitive functioning (0.36) and oral health-related QoL functioning (0.55). All domain's test-retest reliability coefficients (r) was higher than 0.8. Multi-trait scaling analysis showed good convergent and discriminant validity. A difference in the quality of life (QoL) between older (≥65 years) and younger (<65 years) groups of patients was showed by the known-group comparisons. Low correlations were found between the scales of the QLQ-OH15 and QLQ-C30 in all areas. CONCLUSION: The Mandarin (simplified) Chinese version of QLQ-OH45 demonstrates satisfactory psychometric properties and can be used to measure the oral health-related QoL (OHRQoL) for Chinese cancer patients.

Mechanisms of enhanced inorganic phosphorus accumulation by periphyton in paddy fields as affected by calcium and ferrous ions.

The effect of periphyton propagation in paddy fields on phosphorus biogeochemical cycling has received little attention. In this phytotron study, inorganic phosphorus (Pi) accumulation by periphyton was investigated for varying inputs of calcium [Ca(II)] or ferrous­iron [Fe(II)], and lighting conditions. Results indicated that additions of Ca(II) or Fe(II) enhanced abiotic accumulation of Pi by up to 16 times, and decreased solution Pi concentration by up to 50%, especially under light condition. The enhanced Pi accumulation into periphyton intensified with increasing Pi concentration, and Pi accumulation showed a positive linear relationship with Ca or Fe accumulation. Abiotic accumulation of Pi induced by Ca(II) was mainly through Ca-phosphate precipitation, and co-precipitation of P with carbonates at pH>8. Accumulation with added Fe(II) was mainly considered to be through Fe(III) phosphate precipitation coupled with adsorption of Pi by ferric hydroxides. Moreover, Fe(II) was more effective than Ca(II) in promoting abiotic accumulation of Pi by periphyton. Our results indicate the potential for controlling environmental factors to enhance the role of periphyton in biogeochemical cycling and P-use efficiency in paddy rice fields and to reduce P discharged to neighboring water bodies.

Moxibustion for Primary Dysmenorrhea at Different Interventional Times: A Systematic Review and Meta-Analysis.

Primary dysmenorrhea (PD) is one of the most common diseases in gynecology at present. Some clinical trials have reported the effects of moxibustion and confirmed temporal factors are the important elements influencing the efficacy of moxibustion. However, no systematic review has yet been conducted. In this study, we assessed the effects of moxibustion in patients with PD enrolled in randomized controlled trials (RCTs) and the difference among different intervention times to start moxibustion. We extracted data for studies searched from 10 electronic databases and evaluated the methodological quality of the included studies. We discussed three outcomes: effective rate, pain remission, and the level of PGF2α in serum. Current clinical researches showed that, compared with nonmoxibustion treatments for PD, moxibustion leads to higher effective rate and lower level of PGF2α in serum. However, there was no difference in using moxibustion to treat PD at different intervention times. Based on the theory of Chinese medicine and the results of this study, choosing 5 ± 2 days before menstruation to start moxibustion can achieve good efficacy for PD patients. However, more high-quality RCTs are needed to confirm the conclusions.

Diagnosis and evaluation of gastric cancer by positron emission tomography.

Gastric cancer is the second leading cause of cancer mortality worldwide. The diagnosis of gastric cancer has been significantly improved with the broad availability of gastrointestinal endoscopy. Effective technologies for accurate staging and quantitative evaluation are still in demand to merit reasonable treatment and better prognosis for the patients presented with advanced disease. Preoperative staging using conventional imaging tools, such as computed tomography (CT) and endoscopic ultrasonography, is inadequate. Positron emission tomography (PET), using (18)F-fluorodeoxyglucose (FDG) as a tracer and integrating CT for anatomic localization, holds a promise to detect unsuspected metastasis and has been extensively used in a variety of malignancies. However, the value of FDG PET/CT in diagnosis and evaluation of gastric cancer is still controversial. This article reviews the current literature in diagnosis, staging, response evaluation, and relapse monitoring of gastric cancer, and discusses the current understanding, improvement, and future prospects in this area.