OBJECTIVE: To evaluate the clinical efficacy of ultrasound-guided needle knife release with different pathways for carpal tunnel syndrome (CTS). METHODS: Sixty CTS patients were randomly divided into a transverse group and a longitudinal group, with 30 patients in each group. The transverse group received the needle knife release under ultrasound above and below the median nerve along the short axis, while the longitudinal group received the needle knife release under ultrasound above the median nerve along the long axis. The patients' visual analogue scale (VAS) scores, Levine scores, and median nerve cross-section area (CSA) were assessed before treatment, on the 7th, 14th, and 30th days after treatment. The median nerve conduction indexes (motor conduction: latency [Lat], amplitude[Amp], motor conduction velocity [MCV]; sensory conduction: Lat, Amp, sensory conduction velocity [SCV]) were evaluated before treatment and on the 30th day after treatment. RESULTS: Compared before treatment, the VAS scores, Levine scores, and median nerve CSA were reduced in both groups on the 7th, 14th, and 30th days after treatment (P<0.05); the transverse group showed lower VAS and Levine scores and smaller CSA than those in the longitudinal group (P<0.05). On the 30th day after treatment, motor and sensory Lat was reduced (P<0.05), motor and sensory Amp was increased (P<0.05), and MCV and SCV were faster (P<0.05) in both groups. The transverse group had shorter Lat, higher Amp, and faster MCV and SCV than those in the longitudinal group (P<0.05). CONCLUSION The ultrasound-guided needle knife release with transverse and longitudinal pathways could both effectively alleviate pain and improve median nerve conduction in CTS patients, with the transverse pathway showing superior efficacy to longitudinal pathway.
Humans ; Carpal Tunnel Syndrome/therapy* ; Female ; Middle Aged ; Male ; Adult ; Median Nerve/physiopathology* ; Acupuncture Therapy/instrumentation* ; Treatment Outcome ; Neural Conduction ; Aged ; Ultrasonography

The widespread of tigecycline resistance gene tet(X4) has a serious impact on the clinical efficacy of tigecycline. The development of effective antibiotic adjuvants to combat the looming tigecycline resistance is needed. The synergistic activity between the natural compound β-thujaplicin and tigecycline in vitro was determined by the checkerboard broth microdilution assay and time-dependent killing curve. The mechanism underlining the synergistic effect between β-thujaplicin and tigecycline against tet(X4)-positive Escherichia coli was investigated by determining cell membrane permeability, bacterial intracellular reactive oxygen species (ROS) content, iron content, and tigecycline content. β-thujaplicin exhibited potentiation effect on tigecycline against tet(X4)-positive E. coli in vitro, and presented no significant hemolysis and cytotoxicity within the range of antibacterial concentrations. Mechanistic studies demonstrated that β-thujaplicin significantly increased the permeability of bacterial cell membranes, chelated bacterial intracellular iron, disrupted the iron homeostasis and significantly increased intracellular ROS level. The synergistic effect of β-thujaplicin and tigecycline was identified to be related to interfere with bacterial iron metabolism and facilitate bacterial cell membrane permeability. Our studies provided theoretical and practical data for the application of combined β-thujaplicin with tigecycline in the treatment of tet(X4)-positive E. coli infection.
Humans ; Tigecycline/pharmacology* ; Escherichia coli/metabolism* ; Reactive Oxygen Species/therapeutic use* ; Plasmids ; Anti-Bacterial Agents/metabolism* ; Escherichia coli Infections/microbiology* ; Bacteria/genetics* ; Microbial Sensitivity Tests

BACKGROUND: Current oral restoration membranes are expensive with a potential risk of zoonotic virus, so new membranes are in need. OBJECTIVE: To prepare fish skin acellular dermal matrix and evaluate its efficiency of decellularization, biomechanical properties and biocompatibility, in order to explore its feasibility as an oral restoration membrane. METHODS: The skin of Astroconger Myriaster was harvested to prepare acellular dermal matrix by decellularization via a combination of physical method and chemical and biological reagents. The micromorphology of the material was observed under scanning electron microscope. Tissue composition was analyzed by hematoxylin-eosin, Masson and PAS staining. The DNA content was detected using a kit. The biocompatibility was evaluated through cytotoxicity and animal skin stimulation tests. RESULTS AND CONCLUSION: The prepared acellular dermal matrix: (1) was white or light yellow, with strength and toughness; (2) exhibited a double-layered structure composed of a dense layer and a loose layer; (3) was mostly composed of collagen without PAS positive substance, showing good decellularization; (4) had a significantly lower DNA content than natural fish skin and commercial oral restoration membrane; and (5) possessed good biocompatibility, with very low cytotoxicity and no stimulation to the animal skin. Therefore, the prepared acellular dermal matrix of fish skin shows a potential in the preparation of oral guided tissue regeneration membrane.

Objective The purpose of the retrospective study was to introduce a treatment option for atypical Hangman fractures (AHF) based on a new classification.Methods Sixty-seven patients with Hangman fractures were treated with a comprehensive treatment strategy.Firstly,Hangman fractures were classified as typical or atypical (AHF) lesions using computed tomography scans of the cervical spine.Secondly,AHF was divided into 1 of 4 types (type A1,A2,B1,and B2) devised by us to clarify the feature of injury.Thirdly,the injury status of disco-ligamentous complex (intact/indeterminate/ruptured) was evaluated using magnetic resonance imaging.If it was a stable lesion,conservative treatment was recommended.If not surgical treatment using anterior or/and posterior stabilization and fusion at C2-C3 level was used.Results Fifty-one patients were identified with AHF.According to our classification,thirty patients were classified as type A1,14 cases as typeA2,5 cases as type B1,and 2 cases as type B2 lesions.Thirteen AHF without C2-C3 instability (12 as type A1 and 1 as type B1) were treated with non-operative treatment,and 38 AHF with C2-C3 instability (18 as type A1,14 as type A2,4 as type B1,and 2 as type B2) were treated with operative treatment.Three patients (all with type A1 lesions) with slightly displacement of C2-3 underwent isolated direct screw osteosynthesis.The remaining 35 underwent posterior stabilization and fusion at C2-C3 level:24 patients with posterior approach with C2 lag screws and C3 non-lag screws fixation and fusion (11 as type A1,10 as type A2,2 as type B1,and 1 as type B2);3 patients with posterior approach with C1 and C3 screw-rod fixation and fusion (1 as type A1 and 1 as type B1);7 with anterior approach by C2-3 discectomy and fusion (3 as type A1 and 4 as type A2);and 2 with anterior and posterior approach (1 as type B1 and 1 as type B2).The average follow-up period was 26 months (range,12-86 months).Neck pain improved significantly at 3-month follow-up,and neurologic status improved at least 1 grade in 12 patients with neurologic deficits at final follow-up.Radiological evaluation showed bony fusion in all patients at 12-month follow-up.Radiological evaluation showed that all 13 AHF without C2-C3 instability treated with non-operative treatment gained fractures fusion at 3-6 month follow-up.Posterior approaches with C1 or C2 and C3 screw-rod fixation and fusion were found to obtain a better alignment of C2-C3 and satisfactory fusion of C2 pedicle factures than anterior approach.Conclusion The treatment option for AHF based on a new classification is helpful in managing such fractures,resulting in good clinical and radiological outcomes.C2 lag screws with or without C3 pedicle screws fixation via posterior approach may not only reduce fractures but also obtain alignment of C2-C3 effectively.

Objective To evaluate the effects of focal vibration on the physical properties and surface electroyograms of persons with neck-shoulder pain.Methods Thirty-four patients with neck-shoulder pain received 3 to 5 applications of vibratory stimulation of the inner side of the trapezius and scapula for 30 s each time.They reported their pain level using a visual analogue scale.Muscle tone and the elasticity and stiffness of the trapezius muscle were measured bilaterally using a MyotonPRO Muscular Function Evaluation System.Surface electromyography (sEMG) was performed bilaterally during arm extension while standing.The testing was repeated four times:before treatment (baseline),immediately after treatment (IAT),2 hours after treatment (2AT) and 6 hours after treatment (6AT).Results There was a significant reduction in reported pain at IAT and 2AT compared to baseline,but no significant difference was found between the perceived pain at baseline and at 6AT.The values of oscillation frequency,logarithmic decrement and dynamic stiffness had decreased significantly at IAT and 2AT compared to baseline.The average AEMG during upper-arm flexion of the trapezius on the painful side had increased significantly at IAT comparcd to that before the treatment,while the average IEMG and MF were both significantly higher than before the treatment.At 2AT the average AEMG and IEMG were both still significantly higher than at the baseline,but there was no longer a significant difference in the average MF.By 6AT none of the three indicators differed significantly from those before the treatment.Conclusions A single session of focal vibration can relieve pain,increase muscle activation as well as decrease muscle stiffness for people with neck-shoulder pain within 2 hours.

Objective To evaluate the efficacy of pedicle screw fixation combined with bucking bar technique in treatment of C2 pedicle fractures.Methods A retrospective case series study was conducted for 26 cases of C2 pedicle fractures undergone posterior pedicle screw fixation after putting the bucking bar on the anterior surface of C2 via oral cavity from April 2004 to April 2014.There were 19 males and 7 females,with a mean age of 42 years (range,27-71 years).Bilateral C2 pedicle screw placement status,operation time and intraoperative blood loss were recorded.American Spinal Injury Association (ASIA) impairment scale and Visual Analogue Scale (VAS) were used for outcome evaluation.Fracture reduction and symptoms such as sore throat,expectoration,hoarse voice,dysphagia and condition of posterior pharyngeal wall were detected after operation.Results Pedicle fixation of C2 pedicle fractures was completed successfully in 21 cases,repeat C2 pedicle fixation took place in three,and C1-3 fixation was conducted for two.Operation time was (83.2 ± 16.6) min and blood loss was (171.2 ± 115.5)ml.One of the cases experiencing repeat manipulation for screw insertion had transient body balance disorder caused by cerebellar ischemia and recovered within 2 days.X-ray and CT showed complete reduction in 17 cases and incomplete reduction in nine cases.Bony fusion was obtained 6 months after operation.Twenty cases were followed up for 3-46 months (mean,26 months).Final follow-up showed anatomical reduction and bony healing in 19 cases,while malunion in other three cases.ASIA grade improved from C to D in one case,whereas the rest showed a complete neurological recovery (ASIA grade E).VAS improved from preoperative 3-8 points [(5.2 ± 2.5) points] to 0-4 points [(1.6 ±1.5) points] at the final follow-up (P ＜ 0.05).Mild swollen sore throat occurred in four cases after operation.Laryngoscopy showed injury to the posterior pharyngeal wall mucosa (Grade Ⅰ in six cases and Grade Ⅱ in two cases),which were healed within 5-7 days after operation.Conclusion For C2 pedicle fractures,pedicle screw fixation combined with bucking bar technique via oral cavity benefits fracture reduction and stability without apparent impairment to the soft tissue of pharyngeal mucosa.

To observe the effect of pIgR on Salmonella Enteritidis induced inflammation in jejunum and ileum in Chicken,7 day Hyline chickens were taken orally with Salmonella Enteritidis (SE) and killed after 1 d,3 d,7 d and 14 d.The mRNA expression of Toll-like receptor 4(TLR4),MyD88,TRAF6,NF-κB and pIgR was detected by real-time RT-PCR and pIgR protein level was detected by Western blot.The results showed that TLR4 signaling pathway was activated and mR-NA level of the pIgR in jejunum and ileum was enhanced (P＜0.01) and protein level of the pIgR in jejunum and ileum was up-regulated by SE.The study proved that TLR4 signal pathway on mucosal cell surface of jejunum and ileum was activated and expression of pIgR was up-regulated and gut mucosal immunity of chicken was strenghtened.

Objective To evaluate the treatment outcome, prognostic factors, radiation dose, and toxicities in patients with early-stage primary diffuse large B-cell lymphoma of Waldeyer's ring (WR-DLBCL) treated with intensity-modulated radiotherapy (IMRT).Methods This study included 80 patients with a confirmed diagnosis of stage Ⅰ-Ⅱ primary WR-DLBCL who were admitted to our hospital from 2008 to 2015.Only 3 patients received radiotherapy alone, and the other patients received radiotherapy and chemotherapy.After chemotherapy, 24 patients achieved complete remission (CR), and 53 patients achieved partial remission (PR).IMRT was given to the primary lesion and cervical lymphatic drainage region.Survival analysis was performed using the Kaplan-Meier method and log-rank test.The Cox model was used for analysis of prognostic factors.The toxicities were scored using the RTOG criteria.Results The median follow-up was 64 months.The 5-year locoregional control (LRC), overall survival (OS), and progression-free survival (PFS) rates were 94%, 88%, and 84%, respectively.The dose-volume histogram showed that the maximum, mean, and minimum doses to primary gross tumor volume were 54.47 Gy, 52.27 Gy, and 38.83 Gy, respectively.Prognostic analysis showed that age>60 years and increased lactate dehydrogenase (LDH) were influencing factors for OS (P=0.009 and 0.002), and that aged>60 years, IPI ≥2, and increased LDH were influencing factors for PFS (P=0.001, 0.035, and 0.007).Among all patients, 12, 53, and 8 experienced grade 1-3 radiation-induced acute oral mucositis, respectively, and 16 and 13 experienced grade 1 and 2 xerostomia as the late toxicity, respectively.Conclusions For patients with early-stage primary WR-DLBCL, IMRT results in satisfactory OS, PFS, and LRC and has tolerable early or late radiation-induced toxicities.

Objective:To develop a method for the determination of palladium in bendamustine hydrochloride by GFAAS. Meth-ods:The sample was destroyed by heat, and the content of palladium was determined by GFAAS with the detection wavelength of 247. 6 nm. Results:The absorbance and the content of palladium showed a good linear relationship within the range of 20-60 ng· ml-1(r=0. 998 4). The average recovery of palladium was 102. 9%(RSD=1. 7%, n=9). Conclusion: The method is sensitive and simple, which can be used for the determination of palladium in bendamustine hydrochloride.

BACKGROUND:Studies have shown that placement, needling point, angle and length of pedicle screws for thoracic vertebral fractures have been unified. Many studies concerned axial pul-out force and biomechanical behavior of a single screw, but few reports addressed the biomechanical behavior after the replacement with three kinds of screw connecting to rods. OBJECTIVE:To further observe and compare biomechanical behavior after three kinds of thoracic screw placement connecting rod using biomechanical testing, to understand the strength of thoracic pedicle screw replacement connecting rods, and the effects of its puling out on the stress of the bone surrounding the placement site. METHODS:The fresh frozen specimens of thoracic vertebra were divided into three groups at random: the pedicle fixation group, the transverse process-vertebral body fixation group, and modified rib transverse process fixation group. Thoracic pedicle screw system was inserted by the standard placement method in each group. The experiment was measured on the mechanical equipment. During puling out, the strength that bone bore was described with dynamic curve, folowed by statistical analysis. The difference in the gripping force on the thoracic vertebra among three kinds of screw placement method was compared. RESULTS AND CONCLUSION: Among three kinds of screw placement methods and among three kinds of screw placement methods on the injured vertebral body, the gripping force was significantly bigger in the pedicle fixation group than in the transverse process-vertebral body fixation group and modified rib transverse process fixation group (P < 0.01). No significant difference in the gripping force was detected between the transverse process-vertebral body fixation group and modified rib transverse process fixation group. Results verified that the stability of loading ability was apparently better in the pedicle fixation group compared with the transverse process-vertebral body fixation group and modified rib transverse process fixation group.