Normobaric oxygen inhibits AQP4 and NHE1 expression in experimental focal ischemic stroke

The aim of the present study was to determine the effect of 60% normobaric oxygen (NBO) on neurological function, brain edema and the expression of hypoxia-inducible factor-1α (HIF-1α), aquaporin 4 (AQP4) and Na⁺/H⁺ exchanger 1 (NHE1) in a rat model of cerebral ischemia-reperfusion injury. Male Sprague-Dawley rats underwent transient focal cerebral ischemia via right middle cerebral artery occlusion (MCAO) for 120 min followed by 48 h of reperfusion. The rats were exposed to NBO at 60 and 100% or no treatment during reperfusion for 48 h. Neurological impairment score (NIS) was evaluated prior to the sacrifice of all rats. Hematoxylin-eosin staining was performed after 48 h of reperfusion with NBO treatment. The infarct volume and brain water content (BWC) were determined to assess brain ischemic injury at 24 and 48 h. The levels of HIF-1α, AQP4 and NHE1 expression in brain tissue samples were determined by western blotting and reverse transcription-quantitative polymerase chain reaction analysis. During reperfusion, the protein and mRNA expression of HIF-1α, AQP4 and NHE1 increased over time (up to 48 h). Exposure to 60 and 100% NBO during reperfusion following MCAO improved NIS, and alleviated BWC and infarct volume after 24 and 48 h, with further improvements in the 100% NBO group, compared with 60%. Additionally, the molecular mechanisms involved in the effects of NBO may be associated with reduced AQP4 and NHE1 expression and increased HIF-1α expression. However, 60% NBO therapy during reperfusion following an acute ischemic stroke did not achieve the same effects as 100% NBO. Further experimental studies should be performed to elucidate the mechanism and beneficial effects of 60% NBO, as it is more cost-effective to use, compared with 100% NBO.

Effect of sertraline in the treatment and prevention of poststroke depression: A meta-analysis

BACKGROUND

Morbidity of poststroke depression (PSD) remains high worldwide. Additionally, PSD causes multiple sequelae. Although sertraline has been reported to be effective in treating PSD, many studies remain inconsistent.

METHODS

PubMed, Embase, Scopus, Cochrane Central Register of Controlled Trials, Clinical trials. gov, Wan fang Data (Chinese), VIP (Chinese), and CNKI (Chinese) were retrieved from inception to April 2017. Randomized controlled trials (RCTs) and self-controlled trials (SCTs) were recruited, which met the inclusion criteria in our study. The depression rating scores, the incidence of PSD, activities of daily living (ADL), neurological impairment scores, and adverse effects were assessed.

RESULTS

Around 11 studies were recruited in our work, including 1258 participants. For trials enrolled, the results were depicted: the reduction of depression rating scores was significant in sertraline groups (WMD -6.38; 95% CI -8.63 to -4.14; P < .00001); the incidence of PSD was significantly lower in sertraline groups (RR 0.48; 95%CI 0.35-0.67; P < .0001); there was obvious improvement of ADL (WMD 11.48; 95% CI 4.18-18.78; P = .002 <0.05) and neurological impairment (WMD -3.44; 95% CI -6.66 to -0.21; P = .04 <0.05); no significant difference between sertraline and control groups in the morbidity of adverse events (RR 0.94; 95% CI 0.83-1.06; P = .33 >0.05). However, in sensitivity analyses, the conclusions of the reduction of depression rating scores and the improvement of ADL were altered.

CONCLUSIONS

The study suggests that sertraline has a potentially protective role compared with control groups and demonstrates sertraline is safe. However, the reduction of depression rating scores and the improvement of ADL should be considered carefully.

Epithelial SERPINB10, a novel marker of airway eosinophilia in asthma, contributes to allergic airway inflammation

Serine peptidase inhibitor, clade B, member 10 (SERPINB10) expression is increased in IL-13-stimulated human bronchial epithelial cells and in a murine model of allergic airway inflammation. However, the role of SERPINB10 in asthma remains unknown. We examined the association between epithelial SERPINB10 expression and airway eosinophilia in subjects with asthma and the role of Serpinb10 in allergic airway inflammation in an animal model. Epithelial SERPINB10 mRNA and protein expression were markedly increased in subjects with asthma ( n = 60) compared with healthy controls ( n = 25). Epithelial SERPINB10 mRNA levels were significantly correlated with airway hyperresponsiveness (AHR) and three parameters reflecting airway eosinophilia including the percentage of sputum eosinophils, the number of eosinophils in bronchial submucosa, and fraction of exhaled nitric oxide in subjects with asthma. Moreover, epithelial SERPINB10 expression was strongly correlated with the epithelial gene signature ( CLCA1, POSTN, and SERPINB2) for type 2 status. In normal human bronchial epithelial cells cultured at air-liquid interface, knockdown of SERPINB10 suppressed IL-13-stimulated periostin (encoded by POSTN) and CCL26 (eotaxin-3) expression by inhibiting the activation of p38 MAPK. Epithelial CCL26 mRNA levels were correlated with SERPINB10 expression in subjects with asthma. Airway knockdown of Serpinb10 alleviated AHR, airway eosinophilia and the expression of periostin and Ccl26 in a murine model of allergic airway disease. Taken together, epithelial SERPINB10 is a novel marker for airway eosinophilia in asthma. Epithelial SERPINB10 contributes to allergic airway eosinophilic inflammation, at least in part, by regulating the expression of periostin and CCL26.

[Effect of resection of adenoids and tonsillectomy on immune function in children with obstructive sleep apnea hypopnea syndrome]

Objective:To remove the immune function of children with obstructive sleep apnea hypopnea syndrome by resection of adenoids and tonsillar. Method: The fasting peripheral venous blood of children with OSAHS and healthy children were collected. The lymphocyte subsets, NK cells and immunoglobulin levels were compared between the two groups. The fasting blood samples of OSAHS children were collected again after 2d, 30d, 60d and 90d after operation. The changes of lymphocyte subsets, NK cells and immunoglobulin levels were observed after operation. Result: Before operation, at the 0.05 test level, it was not yet clear that the levels of IgG, IgM, IgA, NK, CD3+, CD4+ and CD8+ in OSAHS children were significantly different from those in the control group. The levels of IgA, CD3+ and CD4+ decreased significantly in children at 2d and OSAHS after operation, and IgG, IgM, IgA, NK, CD3+ and IgA continued to rise after 60d until ninetieth day after operation. Conclusion: There is no statistical disorder of immune level in children with OSAHS compared with healthy children. The implementation of adenoidectomy and tonsillectomy in children with OSAHS, the level of immunity in 90 days can be restored to the preoperative level.

Intra-articular oxygen-ozone versus hyaluronic acid in knee osteoarthritis: A meta-analysis of randomized controlled trials

OBJECTIVE

Knee osteoarthritis (OA) is a common disease, imposing a great burden through pain and decreased function. Numerous methods have been tested for pain management in knee OA and the optimal method is currently still under debate. We performed a meta-analysis from randomized controlled trials (RCTs) to compare the efficacy and safety of intra-articular hyaluronic acid (HA) and oxygen-ozone in the treatment of knee OA.

METHODS

Electronic databases included PubMed, Embase, web of science and the Cochrane Library. High quality RCTs comparing HA with oxygen-ozone in the treatment of knee OA were selected. We assessed statistical heterogeneity for each RCT with the use of a standard Chi2 test and the I² statistic. Quality assessment was performed by using Cochrane Collaboration's tool. All data were carried out with Stata 14.0 software.

RESULTS

A total of four RCTs including 289 patients were included. The present meta-analysis indicated that there was a significant difference between groups regarding the visual analog scale (VAS) and WOMAC stiffness and function. The improvements in WOMAC pain were similar. No significant difference in adverse events occurrence was observed.

CONCLUSION

Intra-articular injection of HA was associated with a significantly reduction in VAS score at 1st month compared to oxygen-ozone. And there was significant differences in WAMAC stiffness, and function at 6-month follow-up between groups. Based on the current evidence available, more RCTs are needed for further investigation.

Benefit finding for Chinese family caregivers of community-dwelling stroke survivors: A cross-sectional study

AIMS AND OBJECTIVES

To identify whether benefit finding is a mediator or moderator in the relationship between caregiver burden and psychological well-being (anxiety and depression) in Chinese family caregivers of community-dwelling stroke survivors.

BACKGROUND

Family caregivers not only bear a heavy burden, a high level of anxiety and depression, but also experience benefit finding (positive effects result from stressful events). However, the relationships among benefit finding, caregiver burden and psychological well-being in Chinese family caregivers are not well known.

DESIGN

This study was a cross-sectional correlational design.

METHODS

Caregivers (n = 145) of stroke survivors were recruited from two communities in Zhengzhou, China. Data were collected by face-to-face interviews with structured questionnaires, examining caregiver burden, benefit finding and psychological well-being of caregivers. A hierarchical regression analysis explored whether caregiver burden and benefit finding were associated with anxiety and depression of caregivers. The moderator role of benefit finding was examined by testing the significance of the interaction between caregiver burden and benefit finding. A mediational model was used to test benefit finding as a mediator between caregiver burden and psychological well-being of caregivers using process in spss 21.0.

RESULTS

Caregiver burden and benefit finding were significantly associated with both anxiety and depression of caregivers. Benefit finding did not portray a moderating role, but portrayed the mediator role in the relationship between caregiver burden, anxiety and depression in caregivers.

CONCLUSION

This study provides the preliminary evidence to nurses that intervention focus on benefit finding may help improve the psychological well-being of caregivers.

RELEVANCE TO CLINICAL PRACTICE

This study offers nurses rational for assessing caregiver's negative emotions and benefit finding. By targeting benefit finding, the nurse may guide caregivers in benefit identification and implement interventions to reduce anxiety, depression and caregiver burden.

Residue and distribution of triforine in different cultivars and fruit periods of watermelon under field conditions

The dissipation of triforine in the immature and mature fruit periods was investigated under field conditions. Residue levels of triforine in watermelon were determined by gas chromatography with an electron capture detector (GC-ECD). The decline curves of triforine residues in the watermelon corresponded with first-order kinetics. The half-lives of triforine in Dark Belle and Shiny Boy were 2.10-2.57 days and 2.31-2.67 days respectively. Meanwhile, the half-lives of triforine in the immature and mature fruit periods were 1.69-2.04 days and 2.89-3.85 days, respectively. In the terminal residue experiment, the terminal residues of triforine in the watermelon flesh and peel were below 0.01 mg/kg to 0.05 mg/kg and 0.03 mg/kg to 0.36 mg/kg, respectively. The dissipation rates of triforine varied in different cultivars of watermelon, and even in the same cultivar, the half-lives of triforine significantly varied in the different fruit periods. Although triforine is a fungicide within the suction, the terminal residues in the peel and flesh were very significant.

[Diagnostic value of computed tomographic perfusion imaging of whole liver for quantitative assessment of blood flow state in liver cancer after transcatheter arterial chemoembolization]

Objective: To investigate the diagnostic value of whole liver CT perfusion imaging in the quantitative evaluation of hemodynamic changes before and after transcatheter arterial chemoembolization (TACE). Methods: Twenty-six patients with hepatocellular carcinoma underwent TACE therapies were recruited. Whole -liver computed tomographic perfusion imaging (CTPI) was performed 2~3 days before TACE and 1 month after TACE. We measured the following perfusion parameters: hepatic arterial perfusion (HAP), portal venous perfusion (PVP), total liver perfusion (TLP), hepatic arterial perfusion index (HAPI), and time-to-peak (TTP).The F-test, t-test and Rank sum test were used for statistical analysis. Results: A total of 34 HCC lesions were detected. According to the deposition of lipiodol after TACE, they were divided into a lipiodol dense group (21) and a lipiodol light group (13). The length of hepatocellular carcinoma lesions after TACE showed a decreasing trend compared with preoperative TACE. The lesions in the lipiodol dense group had smaller lesions than those in the lipiodol light group. The preoperative and postoperative longitudinal diameters were (3.12 ± 0.58) cm vs. (1.93 ± 0.79) cm, (2.98 ± 2.01) cm vs. (2.58 ± 2.00) cm, the differences were statistically significant (t = 15.1, 8.65, P < 0.05). The preoperative HAP and HPI of the lipiodol dense group were the highest, and the peritumoral within 1cm was higher than that of the surrounding liver parenchyma. The PVP, TLP, and TTP were highest in the surrounding of liver parenchyma, and 1 cm higher than the tumor area in the background. The corresponding perfusion parameters were statistically significant (P < 0.05); HAP and HPI were 1 cm higher than the surrounding liver parenchyma. After the operation, PVP, TLP and TTP were lower than the background liver parenchyma, the difference was statistically significant (P < 0.05); HAP and HPI decreased by 1 cm after the operation, and the PVP, TLP, and TTP increased. There was no significant difference after operation in the blood perfusion of background liver parenchyma (P ˃ 0.05). The HAP and HPI decreased, and the PVP and TTP increased in the lipiodol light group after operation (P < 0.05). There was no significant difference between the other two regions (P ˃ 0.05). Conclusion: There was no blood perfusion in the lipiodol deposition area after TACE. The perfusion volume of hepatic artery in the peritumoral 1 cm and lipiodol light group decreased and the portal venous perfusion increased. CTPI can quantitatively evaluate blood perfusion state, which is of great significance for the determination of treatment plans before TACE treatment to assume the postoperative therapeutic effect in liver cancer.

[The value of high resolution diffusion weighted imaging in differentiating benign and malignant epithelial tumors of parotid gland]

Objective: To investigate the diagnostic value of RESOLVE DWI in the evaluation of benign and malignant epithelial tumors of parotid gland. Methods: A total of 106 patients in the First Affiliated Hospital of Zhengzhou University with epithelial tumors of parotid gland confirmed by pathology from July 2015 to October 2017 were retrospectively analyzed. All patients underwent preoperative routine MRI and RESOLVE DWI, the ADC average values were calculated, t test were used to compare the ADC values of benign and malignant epithelial tumors of parotid gland. Diagnostic performance of ADC value was compared using receiver operating characteristic (ROC)curves. Results: All lesions were solitary, including 69 benign epithelial tumors and 37 malignant epithelial tumors. The mean ADC values of pleomorphic adenoma and basal cell adenoma, adenolymphoma and malignant epithelial tumors were (1.47±0.16)×10(-3) mm(2)/s, (0.83±0.19)×10(-3) mm(2)/s and(1.14±0.14)×10(-3) mm(2)/s, the mean ADC value of adenolymphoma lower than the rest of the two groups, there were statistically significant differences among them (P<0.05). Using 0.94×10(-3) mm(2)/s≤ADC value≤1.28×10(-3)mm(2)/s as the critical value for diagnosing malignant epithelial tumors of parotid gland and comparing with pathological results, the result obtained had a sensitivity of 81.1%, specificity of 88.9%. ADC value had high correlations compared with pathological results, kappa value was 0.600. Conclusion: RESOLVE DWI can be applied in differential diagnosis between benign and malignant epithelial tumors of parotid gland.

[Influence of intravenous thrombolysis on prognosis of acute ischemic stroke in patients with moderate to severe leukoaraiosis]

Objective: To investigate the influence of intravenous thrombolysis on prognosis of acute ischemic stroke in patients with moderate to severe leukoaraiosis and to analyze influencing factors of the clinical prognosis. Methods: We consecutively included acute ischemic stroke patients with middle cerebral artery occlusion (n=101) from Department of Neurology or Emergency, and patients were divided into two groups according to whether on intravenous thrombolysis therapy (IVT) or not. The Fugl-Meyer scale score (FMS) was used to assess motor function outcome and the National Institutes of Health Stroke Scale (NIHSS) score was used to assess neurologic function. Clinical data were obtained and compared between the two groups. Patients were followed up for 90 days, the primary clinical endpoint events included stroke recurrence and death, and the key secondary endpoint events included other vascular events after IVT. Multivariate linear regression analysis was used to analyze the relevant factors influencing the motor function 90 days later. Results: Among the 101 enrolled patients, 37 (36.6%) were classified as IVT group and 64 (63.4%) as no IVT group. In IVT group, hemorrhagic transformation and symptomatic intracranial hemorrhage were observed in 32.4% (12/37) and 13.5% (5/37) of the patients, which were higher than those in the no IVT group (9.4% (6/64) and 1.6% (1/64) , respectively) (χ(2)=8.511, P=0.004; χ(2)=5.993, P=0.014). And there was no significant difference between the two groups in NIHSS score and FMS score at any time point. In addition, there was no significant increase in 90-day FMS score in the two groups compared with the FMS score on admission (83±9 vs 80±12; 86±8 vs 80±10). After followed up for 90 days, the primary clinical endpoints were obtained in 32 patients (32/101; 31.9%), including 18 cases of stroke recurrence (18/101; 17.8%) and 14 cases of death (14/101; 13.9%). No significant difference was found in primary clinical endpoints between the two groups. Multivariate linear regression analysis revealed that symptomatic intracranial hemorrhage (t=-2.318; P=0.023), baseline NIHSS score (t=-4.263; P=0.000), recurrent stroke (t=-9.114; P=0.000) and hemorrhage transformation (t=-2.121; P=0.037) were risk factors of poor 90-day motor function recovery, but not application of intravenous thrombolysis therapy (t=0.328; P=0.744). Conclusions: Acute ischemic stroke patients with moderate to severe LA have higher risk of hemorrhagic transformation and symptomatic intracranial hemorrhage after intravenous thrombolysis. However, there is no association of intravenous thrombolysis therapy with motor function recovery.

Effects of modified 8-week reminiscence therapy on the older spouse caregivers of stroke survivors in Chinese communities: A randomized controlled trial

OBJECTIVE

Our aim was to evaluate the effectiveness of a modified 8-week reminiscence therapy on the burden, positive experience, and life satisfaction of older spouse caregivers and the life satisfaction of stroke survivors.

METHODS

We conducted a randomized controlled trial by using 75 older stroke couples recruited from communities in Zhengzhou, China. We randomly assigned participants to 1 of 3 groups: Group 1 (G₁ , 25 couples, all attend intervention) and Group 2 (G₂ , 22 couples, only caregivers attend intervention), who participated in a modified 8-week reminiscence therapy, and a waiting list (control) group (G₃ , 28 couples). Interviewers blinded to treatment group assignment administered the life satisfaction to both stroke survivors and caregivers, caregiver burden, and positive experience for caregivers, at preintervention, immediately postintervention, and at 1 month and 3 months after cessation of the intervention.

RESULTS

We found a statistically significant interaction between treatment groups and assessment time points for the 4 outcome measures (P < .001). Although the effects were decreased after intervention at 1 month, the improvement in caregivers' positive experience, life satisfaction, burden, and life satisfaction of stroke survivors were still significant (P < .001).

CONCLUSIONS

The use of a modified 8-week reminiscence therapy in this study sample improved the life satisfaction of stroke survivors and their spouse caregivers, improved the positive experience of caregivers, and decreased the burden of caregivers.

Testing the validity and reliability of the Self-Administration of Medication (SAM) instrument in Chinese chronic disease patients: A cross-cultural adaptation

AIMS

To develop a culturally appropriate and functional standard Mandarin Chinese translation of the Self-Administration of Medication tool and to examine its validity and reliability.

METHODS

We used Brislin's guidelines for the translation and back-translation procedures. We recruited 130 patients from June 2015 to September 2016. Correlation analysis, Cronbach's alpha coefficient, split-half reliability, item analysis and the content validity index, and exploratory factor analysis were performed.

RESULTS

Strong and moderate correlations were seen between the total Self-Administration of Medication score and nurses' and patients' perceptions. Item analysis indicated that the correlation coefficient ranged from 0.744 to 0.975. Cronbach's alpha ranged from 0.933 to 0.976. The split-half reliability ranged from 0.911 to 0.936 for the instrument's subscales, and 0.953 for the total scale. The content validity index value ranged from 0.823 to 0.972 for individual items and was 0.968 for the total scale. The factor loading matrix of the SAM ranged from 0.514 to 0.837. A moderate correlation existed between the scores of the Self-Administration of Medication tool and the Barthel Index.

CONCLUSION

The Chinese version of the Self-Administration of Medication tool is statistically acceptable and can be used in the evaluation of self-medication ability based on self-report and nurses' assessment.

[Neck lymphatic metastasis, surgical methods and prognosis in early tongue squamous cell carcinoma]

Objective: To investigate the different pattern of neck lymph node metastasis, the choice of surgical methods and prognosis in early tongue squamous cell carcinoma. Methods: A total of 157 patients with early oral tongue squamous cell carcinoma were included in this study. Statistical analysis was performed to identify the pattern of lymph node metastasis, to determine the best surgical procedure and to analyze the prognosis. Results: The occurrence of cervical lymph node metastasis rate was 31%(48/157). Neck lymphatic metastasis was significantly related to tumor size (P=0.026) and histology differentiation type (P=0.022). The rate of metastasis was highest in level Ⅱ [33% (16/48)]. In level Ⅳ, the incidence of lymph node metastasis was 5%(7/157), and there was no skip metastases. The possibility of level Ⅳ metastasis was higher, when level Ⅱ (P=0.000) or Ⅲ (P=0.000) involved. The differentiation tumor recurrence, neck lymphatic metastasis and adjuvant radiotherapy were prognostic factors (P<0.05). Multivariate analyses revealed histology differentiation type, neck lymphatic metastases and adjuvant radiotherapy were the independent prognostic factors. Conclusions: Neck lymphatic metastasis rate is high in early tongue squamous cell carcinoma, simultaneous glossectomy and neck dissection should be performed. Level Ⅳ metastasis rate is extremely low, so supraomohyoid neck dissection is sufficient for most of the time. The histology differentiation type, neck lymphatic metastasis and adjuvant radiotherapy are independent prognostic factors.

Plasminogen activator inhibitor-1: a risk factor for deep vein thrombosis after total hip arthroplasty

Background

The onset of deep vein thrombosis (DVT) in patients after total hip arthroplasty (THA) may expand or enlarge and subsequently lead to significant mortality. The objective of this study was to investigate potential risk factors for DVT in patients after THA.

Methods

Eligible patients with hip joint diseases who were scheduled for unilateral primary THA at our hospital were prospectively included into this study. The demographic and clinical features, preoperative plasma biomarkers were detailed, recorded, and compared. The multiple logistic regression analysis was used to evaluate potential risk factors for DVT.

Results

A total of 214 subjects were enrolled into our study cohort for the final analysis, and 23 of them have suffered DVT with an incidence of 9.5%. The performance of logistic regression analysis showed that preoperative expression of plasminogen activator inhibitor-1 (PAI-1) was an independent risk factor for the onset of DVT in patients after THA (OR 1.18, 95% CI 1.04–1.29; p = 0.011).

Conclusions

Our study indicated preoperative plasma PAI-1 expression as an independent risk factor for DVT in patients who underwent THA.

Dissipation and residue of clothianidin in granules and pesticide fertilizers used in cabbage and soil under field conditions

The single application of 0.5 % clothianidin granules, a novel formulation, was used to control pests in vegetables under a high dose. In this article, residues of clothianidin in cabbage and soil samples under field conditions from Guangzhou, Nanning, and Qianjiang were determined by HPLC. The terminal residues of clothianidin in cabbage were less than the limit of detection (<LOD) at pre-harvest intervals of 30 days, and these values were lower than the maximum residue limit of 0.2 mg kg^-1 in cabbage set by the Codex Alimentarius Commission. To test on the influence of the pesticide fertilizers' effect on clothianidin residual, clothianidin granules and fertilizers of chicken manure, urea, and organic fertilizer were mixed into different pesticide fertilizers through their normal field using dosage and evaluate residual influence of clothianidin in different formula. After analysis of variance of the effect factors, the effect of different pesticide types on half-life was not significant, but the effect of sample types was significant. Clothianidin granules and pesticide fertilizers could be safely applied in cabbage under a single high-dose administration.

Validity and reliability of Chinese version of Adult Carer Quality of Life questionnaire (AC-QoL) in family caregivers of stroke survivors

The Adult Carer Quality of Life questionnaire (AC-QoL) is a reliable and valid instrument used to assess the quality of life (QoL) of adult family caregivers. We explored the psychometric properties and tested the reliability and validity of a Chinese version of the AC-QoL with reliability and validity testing in 409 Chinese stroke caregivers. We used item-total correlation and extreme group comparison to do item analysis. To evaluate its reliability, we used a test-retest reliability approach, intraclass correlation coefficient (ICC), together with Cronbach’s alpha and model-based internal consistency index; to evaluate its validity, we used scale content validity, confirmatory factor analysis (CFA) and exploratory factor analysis (EFA) via principal component analysis with varimax rotation. We found that the CFA did not in fact confirm the original factor model and our EFA yielded a 31-item measure with a five-factor model. In conclusions, although some items performed differently in our analysis of the original English language version and our Chinese language version, our translated AC-QoL is a reliable and valid tool which can be used to assess the quality of life of stroke caregivers in mainland China. Chinese version AC-QoL is a comprehensive and good measurement to understand caregivers and has the potential to be a screening tool to assess QoL of caregiver.

[Application of adjacent micro flap in the repair of skin defect in head and face]

Objective:The aim of this study is to sum up the different surgical repair methods and techniques for the skin defect of head and face.Method:A retrospective study on 97 cases of the face and head skin defect caused by trauma and tumor resection in nearly five years, including 37 cases on nasal, 21 cases on cheek, 9 cases on frontal, 13 cases on temporal, and 17 cases on ear. After resecting skin lesion in security boundary, skin defect were repaired by transposition adjacent flap, zone vascular pedicle flap, myocutaneous flap and the mucosal flap.Result:Seventy-one cases of the postoperative flap healed and stitches discharged in a week; 24 cases of flap edge small necrosis in small, one flap occurred most necrosis, and one skin flap occurred infection and necrosis.Conclusion:Facial skin defect can be repaired primarily by various types of micro adjacent flap. Flap survival is closely related to surgical techniques and postoperative treatment. Retroauricular groove flap has been widely used to repair skin defect of multiple regions for ear.

Small incision releasing of transverse carpal ligament in diagnosis and treatment of mild carpal tunnel syndrome

Carpal tunnel syndrome (CTS) is a medical condition due to compression of the median nerve as it travels through the wrist at the carpal tunnel. Few studies have been carried out to examine the effectiveness of mini-open technique for carpal tunnel release using minor wrist skin crease incision in patients with mild CTS. Therefore, the present study was designed to improve the neurophysiological parameters for the diagnosis of mild CTS, and to examine the effectiveness of small incision surgery for the clinical treatment of mild CTS. To this end, we applied the electrophysiological diagnosis of difference between median and ulnar palmar latencies (PMPU) and the difference of median and ulnar latencies from D4 stimulation (D4MD4U) in 80 patients with mild CTS, whom were diagnosed by hand surgeon at the First Hospital of Jilin University. Those patients showed normal in median nerve electrophysiological examination, and received minor wrist skin crease incision surgery. All patients were followed up and received electromyography (EMG) examination. We showed that D4MD4U and PMPU methods are sensitive diagnosis methods for mild CTS, and mini-open wrist crease incision is beneficial for the treatment of mild CTS in clinical settings.

Delays in diagnosis and treatment of pulmonary tuberculosis in AFB smear-negative patients with pneumonia

BACKGROUND

Diagnostic and treatment delays increase the severity and transmission of pulmonary tuberculosis (PTB). This study aimed to evaluate TB diagnostic and treatment delays in acid-fast bacilli (AFB) smear-negative patients.

METHODS

This was a retrospective observational study. Patients with positive AFB culture of Mycobacterium tuberculosis complex (MTC) were selected from among hospitalised patients with a diagnosis of pneumonia. Admission ward, anti-tuberculosis treatment and the duration of AFB culture were compared between smear-positive and smear-negative patients.

RESULTS

Of the 70 patients with positive isolation of MTC in AFB culture, 27 (38.5%) were smear-negative; of these, 18 (66.7%) were not isolated while in hospital, and 17 (63%) were neither diagnosed nor treated for TB. In contrast, 41 of the 43 smear-positive patients (95.3%) were directly admitted or quickly transferred to the isolation room and started on anti-tuberculosis treatment (P < 0.001). Samples from smear-negative patients required more time to grow MTC in AFB culture than those of smear-positive patients (23 days vs. 14 days, P < 0.001). Diabetes was significantly associated with AFB smear positivity, with an odds ratio of 12.2.

CONCLUSIONS

Negative AFB smears caused significant diagnostic and treatment delay. Patients staying in the general ward were exposed to TB patients who were not diagnosed in time.

[Clinical and genetic analysis of a family with Joubert syndrome type 10 caused by OFD1 gene mutation]

Objective: To investigate the genetic cause for a family with multiorgan dysplasia and "molar tooth sign" on MRI image. Method: The patient, a 3 months and 21 days old boy, was clinically examined and the medical history of his family was collected. Next generation sequencing was performed to analyze his clinical and genetic causes. Result: Clinical manifestation of the child displayed multiorgan dysplasia, such as six finger deformity, short limbs, coloboma of optic disc and choroid, situs inversus.Cranial MRI showed "molar tooth sign" . The gene sequencing confirmed that the child carried a de novo deletion of c. 2843_2844 delAA in OFD1 gene. Conclusion: The child has typical clinical features of Joubert syndrome, such as MRI "molar syndrome" , developmental abnormalities of ocular tissue and limb, visceral inversion, and so on.The OFD1 gene had a novel deletion mutation through gene detection. Combined clinical features with gene detection, it was clear that the child was a rare case of Joubert syndrome type 10 which was the first case of Joubert syndrome caused by OFD1 gene mutation in China.

The effect of platelet-rich plasma on arthroscopic double-row rotator cuff repair: a clinical study with 12-month follow-up

OBJECTIVE

The aim of the study was to assess the effect of platelet-rich plasma on arthroscopic double-row rotator cuff repair.

METHODS

The study included 60 patients with arthroscopic rotator cuff repair. Thirthy patients (mean age: 57.2±7.4; 16 males and 14 females) underwent arthroscopic double-row repair alone (Group 1), another 30 (mean age: 56.9±6.0; 15 males and 15 females) had an injection of platelet-rich plasma (PRP) (Group 2). The groups were compared with DASH as a primary outcome score and Constant-Murley score, visual analog scale, measurement of active forward flexion, and external and internal rotation as secondary outcome measures. Magnetic resonance imaging was used to assess the integrity of the repair at 12 months postoperatively.

RESULTS

Primary and secondary outcome measures statistically improved in both groups postoperatively (p<0.05). Overall mean primary and secondary postoperative outcome measures were not significantly different between the 2 groups. A retear was seen in 9 subjects (30%) in Group 1 and 4 subjects (14%) in Group 2 (p<0.05).

CONCLUSION

The local injection of PRP into a primary arthroscopic double-row cuff repair resulted in lower recurrence rates than repairs without the novel biological augmentation material.

The influence of emission control on particle number size distribution and new particle formation during China's V-Day parade in 2015

Temporary strict emission control strategies were conducted to ensure good air quality for China's V-Day parade (August 20-September 3, 2015) in Beijing and nearby cities. The influence of the emission control on particle number size distribution (PNSD) was evaluated based on the long-term measurements of PNSD at a rural site (Shangdianzi) located northeast of Beijing. This study also presented the comparison results of PNSD during the parade in 2015 and the Olympics in 2008 (August 8-23), as well as the same period without strict emission control in 2010-2013 (August 20-September 3). Compared with the same period in 2010-2013 and 2008 Olympics, the accumulation mode particle number concentration showed a significant reduction in 2015, and the PM₁ mass concentration decreased by approximately 60-90%. The alleviation of the PM₁ was also associated with the weather conditions. The back trajectories analysis results showed that the southerly air mass passing through the polluted areas accounted for 14% of the total back trajectories in 2015, which contributed to approximately 60% in the other years. During the control period in 2015, there were six new particle formation (NPF) events observed, with a higher frequency, but a lower formation rate and growth rate than the same period in 2010-2013. The comparison of the condensation sink (CS), sulfuric acid, solar radiation and relative humidity among the different years indicated that at Shangdianzi station, the first factor in determining the NPF occurrence was the CS, and the second factor could be the concentration level of precursor vapors participating in the NPF event (e.g., sulfuric acid).

The attitudes of primary healthcare providers towards web-based training on public health services in rural China: a cross-sectional study

OBJECTIVES

To explore the attitudes of primary healthcare workers, including township public health workers (TPHWs) and village doctors (ViDs), towards web-based training on basic public health services (BPHS) and to examine the factors influencing their attitudes.

STUDY DESIGN

Cross-sectional study.

METHODS

Questionnaires addressing training status, needs, and attitudes towards web-based public health training were administered to 2768 primary healthcare workers from May to September 2013. Multivariate logistic regression models were used to identify the factors that were significantly associated with a positive attitude towards web-based public health training.

RESULTS

Among the 2768 participants, 90.6% of the TPHWs and 86.9% of the ViDs expressed a positive attitude towards web-based BPHS training. TPHWs who had a positive attitude towards previous public health training (odds ratio [OR] = 2.75, 95% confidence interval [CI] = 1.28-5.93) and better computer skills (OR = 2.59, 95% CI = 1.03-6.48) were more likely to adopt web-based training on BPHS, as were ViDs who had better computer skills (OR = 2.54, 95% CI = 1.58-4.11) and better Internet speeds (neutral: OR = 2.81, 95% CI = 1.58-5.01; satisfied: OR = 2.53, 95% CI = 1.28-5.01). TPHWs who tended to read papers (OR = 0.24, 95% CI = 0.11-0.50) and were aged 50 years or older (OR = 0.34, 95% CI = 0.14-0.87), as were ViDs who tended to read papers (OR = 0.48, 95% CI = 0.29-0.77), expressed a more negative attitude towards web-based BPHS training.

CONCLUSIONS

The findings indicated that most primary healthcare workers have a positive attitude towards web-based BPHS training. More priority measures, such as conducting computer training, improving Internet quality and integrating mobile technology, are recommended and will further improve the implementation of web-based public health training programs.

Double-layer versus single-layer bone-patellar tendon-bone anterior cruciate ligament reconstruction: a prospective randomized study with 3-year follow-up

PURPOSE

To evaluate the clinical results of a randomized controlled trial of single-layer versus double-layer bone-patellar tendon-bone (BPTB) anterior cruciate ligament (ACL) reconstruction.

METHODS

Fifty-eight subjects who underwent primary ACL reconstruction with a BPTB allograft were prospectively randomized into two groups: single-layer reconstruction (n = 31) and double-layer reconstruction (n = 27). The following evaluation methods were used: clinical examination, KT-1000 arthrometer measurement, muscle strength, Tegner activity score, Lysholm score, subjective rating scale regarding patient satisfaction and sports performance level, graft retear, contralateral ACL tear, and additional meniscus surgery.

RESULTS

Forty-eight subjects (24 in single-layer group and 24 in double-layer group) who were followed up for 3 years were evaluated. Preoperatively, there were no differences between the groups. At 3-year follow-up, the Lachman and pivot-shift test results were better in the double-layer group (P = 0.019 and P < 0.0001, respectively). KT measurements were better in the double-layer group (mean 2.9 versus 1.5 mm; P = 0.0025). The Tegner score was also better in the double-layer group (P = 0.024). There were no significant differences in range of motion, muscle strength, Lysholm score, subjective rating scale, graft retear, and secondary meniscal tear.

CONCLUSIONS

In ACL reconstruction, double-layer BPTB reconstruction was significantly better than single-layer reconstruction regarding anterior and rotational stability at 3-year follow-up. The results of KT measurements and the Lachman and pivot-shift tests were significantly better in the double-layer group, whereas there was no difference in the anterior drawer test results. The Tegner score was also better in the double-layer group; however, there were no differences in the other subjective findings.