Objective To evaluate the outcome of open repair of Bankart lesion in the treatment of anterior instability of shoulder.Methods From March 2001 to June 2005,34 cases (36 shoulders) of anterior instability of shoulder underwent open repair of Bankart lesion.Twenty-seven shoulders with Bankart injury were diagnosed by CT scan.Nine shoulders were diagnosed as ALPSA(anterior labrum periosteal sleeve avulsion).Twenty-five shoulders presented with anterior instability only,and 11 combined anterior and inferior instability.Twenty-seven cases had a definite history of injury.Twelve cases presented with Hill-Sachs sign.We used open incision to repair lesions to the capsule glenoid labrum complex with suture anchors.Results The average duration of follow-up was 2.2 years (six months to four years).By Walch-Duplay score system,the good to excellent rate was 86.1%,the moderate rate 8.3%,and the poor rate 5.6%.Redislocation occurred in one case after operation due to injury.The rate of recurrence was 3%.Conclusion Open repair of Bankart lesion in the treatment of anterior shoulder in- stability can lead to good recovery of shoulder function,few complications and a low rate of recurrence.

Objective:To explore the clinical effect of Pingchuan Decoction combined with routine western medicine therapy in the treatment of acute attack of bronchial asthma in children. Methods:From January 2017 to June 2019, 118 children with acute attack of bronchial asthma were selected from the Seventh People’s Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, and they were randomly divided into control group (59 cases) and observation group (59 cases) according to the random number table. The control group was treated with routine western medicine therapy, and the observation group was treated with Pingchuan Decoction on the base of control group, and both groups were treated for 14 days. The main symptom scores before and after treatment were evaluated. The percentage of forced vital capacity expressed as percent predicted (FVC% pred) and the forced expiratory volume in 1 second expressed as percent predicted (FEV1% pred) were measured by pulmonary function meter. The levels of CD3 +, CD4 + and CD4 +/CD8 + in peripheral blood were detected by flow cytometry. The adverse reactions during the treatment were recorded and the clinical efficacy was evaluated. Results:The total clinical effective rate was 93.2% (55/59) in the observation group and 71.2% (42/59) in the control group, where the difference between the two groups was statistically significant ( χ2=9.790, P=0.002). After treatment, the scores of cough, wheezing and wheezing rale in the observation group were significantly lower than those in the control group ( t=27.695, 17.573, 32.827, P<0.001). After treatment, FVC% pred [(80.21 ± 4.06)% vs. (71.71 ± 3.95)%, t=11.526], FEV1% pred [(78.84±3.92)% vs. (72.26 ± 3.59)%, t=9.508] in the observation group were significantly higher than those in the control group ( P<0.01). The levels of CD3 + [(74.05 ± 5.13)% vs. (67.44 ± 4.98)%, t=7.101], CD4 + [(48.43 ± 4.31)% vs. (42.20 ± 4.06)%, t=8.082] and the ratio of CD4 +/CD8 + (1.67 ± 0.29 vs. 1.34 ± 0.25, t=6.620) in the observation group were significantly higher than those in the control group ( P<0.01). During the treatment, the incidence of adverse reactions was 10.2% (6/59) in the observation group and 6.8% (4/59) in the control group, and there was no significant difference between the two groups ( χ2=0.437, P=0.509). Conclusion:The Pingchuan Decoction combined with routine western medicine therapy can reduce the clinical symptoms of children with acute attack of bronchial asthma, improve lung function, improve organism immunity and clinical effect with safety.

Objective To assess the influence of allergic rhinitis(AR)on the quality of life and anxiety and depression symptoms in the elderly.Methods Retrospective analysis of elderly patients with AR treated at our hospital from January 2015 to October 2016 was conducted on quality of life and anxiety and depression symptoms.The participants were investigated using the rhino-conjunctivitis quality of life questionnaire(RQLQ),self-rating depression scale(SDS)and self rating anxiety scale (SAS).The correlation between SDS,SAS and RQLQ was also analyzed.Results RQLQ scores of AR patients in 7 demensions were higher than those of healthy individuals (P＜ 0.05 for all).The scores of SAS(44.8±10.1 vs.40.7±4.9)and SDS(46.7 ±12.2 vs.41.3±4.8)in AR patients were also higher than in healthy individuals (F =21.59 and 26.63,respectively,each P＜ 0.01).Furthermore,anxiety and depression symptoms were significantly associated with seven RQLQ dimensions.Conclusions Compared with healthy individuals,elderly patients with AR has poor quality of life,which is further negatively impacted by increased anxiety and depressive symptoms.Appropriate intervention measures should be taken to alleviate anxiety and depressive symptoms and enhance quality of life for elderly patients with AR.

Objective To study the status of anxiety and depression on clinical decision-making participation of laryngeal cancer patients.Methods A total of 82 laryngeal cancer patients participated in the investigation by questionnaire to study the clinical decision-making participation by control preferences scale.The degree of anxiety and depression was investigated by self-rating anxiety scale and self-rating depression scale.Results During the clinical decision-making process,40.24％ of the patients were passive,29.27％ had their families as absolute representatives,20.73％ took part collaborating with their families and only 9.76％ were active.47.56％ had anxiety and 64.63％ depression,and the anxiety and depression influenced their participation in clinical decision-making postively and passively relatively.Conclusions Patients with laryngeal cancer are passive in clinical decision-making and most of them have anxiety and depression.Doctors should enhance the communication with patients,which can help to eliminate adverse psychological emotions and make satisfying clinical decision-making.

Objective To research the pathogen characteristics and influencing factors for peritonsillar peripheral space infections in acute tonsillitis patients,so as to take measure to reduce the peritonsillar peripheral space infections.Methods 898 acute tonsillitis patients who received treatment were chosen as study subjects.Bacteria analyzer was adopted to identify pathogens.Chi-square test was used to analyze the univariate factor,and logistic regression analysis was conducted to different factors.Results 228 patients were involved the complications of peritonsillar peripheral space infections(cellulitis in 52 cases or abscesses in 176 cases),and the infection rate was 25.4％.Bacterial cultivation performed in 177 patients and positive results were detected in 107.The top three infections bacteria were Staphylococcus aureus (21.5％),Streptococcus viridians (19.6％) and Klebsiella pneumoniae (15.9％).Univariate factor analysis found that the history diabetes and peritonsillar peripheral space infections,age,acute phase of smoking and drinking,fatigue,nutritional status,class of antibiotic use,tonsillitis type,educational level and the long first diagnosis time were risk factors for peritonsillar peripheral space infections,and the differences were significant (x2 =39.851,8.818,89.041,87.266,30.417,21.499,13.472,64.548,12.223,62.871,70.749,all P ＜ 0.05).Logistic regression analysis found that acute phase of smoking and drinking,age,fatigue,tonsillitis type and the long first diagnosis time were independent risk factors for peritonsillar peripheral space infections patients with acute tonsillitis (OR =2.873,5.311,5.876,0.290,2.244,2.369,all P ＜ 0.05).Nutritional status and educational level had beneficial effect to peritonsillar infections event (OR =0.290,0.461,all P ＜ 0.05).Conclusion Acute tonsillitis is easy to cause peritonsillar peripheral space infection,it should be paid much attention and strengthened prevention.The pathogens causing peritonsillar peripheral space infections in acute tonsillitis is still mainly Staphylococcus aureus.After the analysis of related factors,the certain measures should be taken to reduce the complications rate of peritonsillar peripheral space infections in acute tonsillitis.

Family Health ; Humans ; Paraganglioma ; diagnosis

Twenty-three patients with uniloculated deep neck abscesses (UDNA),in whom the antibiotic therapy failed and CT-guided percutaneous catheter drainage (PCD) was performed from January 2005 to June 2015,were included in the study.Catheter placement was carried out using Trocar technique in all cases.Open surgical drainage was performed when PCD procedures failed.The abscess was completely drained and open surgical drainage was avoided in 19 cases (83％);the surgical drainage was performed because of muhiple internal septation in 3 (13％) case,and 1 (4％) case died from uremia.In this series the technical success rate and clinical success rate of PCD were 96％ (22/23) and 83％ (19/23),respectively.All patients were followed-up by CT scan.No other complications and no mortality occurred during the procedure,while postoperative pneumatosis developed in 1 case.CT-guided PDC is a safe and highly effective low-cost procedure for the treatment of patients with UDNA who failed medical therapy,it may be considered as an alternative to open surgery.

Aim To observe the effects of panaxdiol saponins component ( PDS-C) extracted and isolated
from Chinese ginseng herb as new Chinese patent med-icine on the promotion of hematopoiesis and the regula-tion of the immune system in treating mice models with aplastic anemia ( AA ) . Methods For preparation of immune mediated AA models, BALB/c mice were ex-posed to sublethal doses of 5. 0 Gy γ radiation, fol-lowed by transplanted lymphocytes from DBA/2 donor mice. The mice models were divided into six groups in-cluding normal control, AA model, PDS-C treated groups with lower, medium and higher dosages, cy-closporine ( CsA) as positive drug control. Both PDS-C and CsA were administered by gastrogavage for 15 days. The peripheral blood cells counts and bone mar-row pathological examination were tested, the percenta-ges of Th1/Th2/Treg cells from spleen were measured, the protein expression levels of T-bet, GATA-3 and FOXP3 transcription factors in spleen cells were detec-ted. Results Curative effect of PDS-C on treating AA
mice was satisfactory. The peripheral hemoglobin, white blood cells and platelet counts in PDS-C groups with medium and higher doses were significantly higher than those in model control. Meanwhile, PDS-C ele-vated the percentages of Th2 cells and Treg cells, but decreased the percentage of Th1 cells, as well as up-regulated the GATA-3 , FOXP3 and down-regulated the T-bet protein levels. Conclusion PDS-C possesses the activities of promoting hematopoiesis obviously. It can improve marrow myelosuppression, enhance the re-covery of hematopoiestic function, and elevate the pe-ripheral blood cells counts. PDS-C also pays its immu-noregulatory efficacy though recovering from unbal-anced Th1/Th2/Treg cells in treating immune media-ted AA mice.

Objective: To investigate the quality of life(QoL) and emotion symptoms(anxiety symptom and depressive symptom), and its influencing factors in patients with permanent peripheral facial paralysis(PPFP). Methods: A case-control trial was conducted to evaluate the QoL status and emotion symptoms of 79 PPFP patients(PPFP group, disease course >12 months) between January 2017 and January 2018 from the Affiliated Hospital of Yangzhou University, and 42 healthy individuals were selected as control group.The generic questionnaire medical outcomes study short-form 36 items health survey(SF-36), Chinese version of facial clinimetric evaluation(FaCE) scale, self-rating depression scale(SDS) and self-rating anxiety scale(SAS) were evaluated.The correlation among SF-36, SDS, SAS and FaCE was evaluated.SPSS 21.0 software was used to analyze the data. Results: By the assessment of SF-36, the score of vitality[(73.23±15.04)points], social function[(72.41±15.46)points], role-emotion[(72.53±15.27)points] and mental health[(73.35±14.54)points] in four dimensions of the PPFP group were lower than those of the control group [(97.56±3.76)points, (96.51±3.32)points, (97.09±2.49)points and (96.63±2.37)points](t=-10.506, -10.144, -10.505, -10.403, all P<0.001), but the scores of physical function, role-physica, bodily pain and general health in four domains of the PPFP group were similar with those of the control group (all P>0.05). By the assessment of FaCE, the total score of the PPFP group was lower than those of the control group [(48.63±17.44)points vs.(100.00±0.00)points, t=-19.281, P<0.05]. The score of SDS in the PPFP group was higher than those of the control group[(48.43±11.57)points vs.(40.63±5.39)points](t=4.174, P<0.001), but the score of SAS had no statistically significant difference between the two groups (P>0.05). According to the assessment of the correlation among SF-36, SDS, SAS and FaCE, the total scores of FaCE in the PPFP group was related only to SF-36 related mental health dimensions and SDS(r=-0.848~0.908, all P<0.001). Multiple linear regression analysis showed that marital status(t=-2.442, P=0.017), occupation(t=-2.377, P=0.020), and age(t=-5.501, P=0.000) were negatively correlated with the SDS scores; with/without synkinesis(t=3.604, P= 0.042), disease course(t=4.152, P=0.000), and the level of House-Brackmann grading system(HBGS)(t=2.116, P=0.038) were positively associated with the SDS of the PPFP group.However, disease course (t=-2.616, P=0.011), HBGS(t=-6.523, P=0.000) were negatively correlated with the total scores of FaCE, and with/without synkinesis(t= 2.767, P=0.000) was positively associated with the total scores of FaCE. Conclusion The patients with PFPP have a poorer quality of life and experienced greater psychological distress than healthy individuals.The present study suggested that age, gender, occupation, marital status, disease course, with/without synkinesis, the sources of PPFP and the level of HBGS are associated with depression increasing and quality of life decreasing in PPFP patients.

Objective To improve the recognition of meconium ileus and pseudohypoaldosteronism type Ⅰ and to explore the relationship between neonatal meconium ileus and cystic fibrosis.Methods The clinical and follow-up data of a premature infant with meconium ileus and pseudohypoaldosteronism type Ⅰ was analyzed.Relevant literature was reviewed.Results The child was a very low-birth weight premature infant who didn′t pass meconuim within 24 hours of birth and persistent abdominal distention was noted.Laparotomy was performed on day 4.Thick and inspissated meconium was found in the ileum with perforation.The atretic intestine was resected,and a double-barreled enterostomies was performed.On day 30,the child presented hyponatremia,hyperkalemia,high levels of plasma renin and aldosterone and was given 9 g/L salt supplementation.At 6-month age,9 g/L salt supplementation was discontinued.Anastomosis was performed at 8-month age.The child recovered with a good prognosis whose catch-up growth was obtained at 18-month age and didn′t pre-sent manifestations of cystic fibrosis.Conclusions This case could be diagnosed as meconium ileus and pseudohypoaldosteronism type Ⅰ.The relationship between neonatal meconium ileus and cystic fibrosis is different in China and the regions of Caucasian.