Humans ; Poliomyelitis/diagnosis* ; Fractures, Bone ; Lower Extremity ; Spinal Cord Injuries/diagnosis*

Objective To probe into the effect of community health education in comprehensive treatment of type 2 diabetes mellltus(T2DM)patients.Methods 120 cases of T2DM patients were claasified randomly into the intervention group(55 cases)and the control group (65 cases).After systematic diabetes knowledge education was given to the intervention group,individualized intensive education was accepted by each patient of the intervention group.General diabetic education was taken by the control group.The levels of plasma glucose,urinary glucoee,glycosylated hemoglobin and blood-fat were tested before and 3,6 months after education.Results Six months after education,the level of self care ability,self care technique,self care sense of responsibility and health knowledge were higher than those before education in both groups.And six months after education the levels of HbAlc,TC and TG in the intervention group and the control group improved obviously.All indicators in the intervention group were better than those in the control group.Conctusions Community health education can effectively improve self care ability,self care technique,self care sense of responsibility and health knowledge of diabetes patients,and can improve their glucolipide metabolic level as well.

Objective To explore the CT and MR features of malignant peripheral nerve sheath tumor (MPNST) of adults.Methods The CT and MRI findings of 20 patients of MPNST confirmed by pathology were analyzed retrospectively.Results Among 20 cases,the lesions were located in the lower extremities (n=4),shoulder and spine (n=4),abdomen (n=3),chest wall (n=2),mediastinum (n=2),breast (n=1),prostate (n=1),scrotum (n=1),scalp (n=1),left maxillary sinus and orbital bottom (n=1).Nineteen cases appeared as solid masses and 1 case appeared as diffuse lesion.The maximum cross section of the lesions were about 1.41 cm× 1.42 cm-17.10 cm× 18.08 cm.Sixteen cases were ill defined margin and 4 cases were well-defined margin.CT scan showed 14 cases were lower density or isodensity and with patchy inhomogeneous density.Multiple calcification were found in 2 cases and osteolytic destruction were found in 7 cases.Enhanced CT of 10 cases showed solid component and gradually delayed enhancement,while cystic lesion and necrosis were not enhancement.The tortuous arteries were displayed in 7 cases.Seven cases were performed MRI and the lesions appeared as hypo-intensity on T1WI and hypo-intensity on T2WI with obviously high intensity of cystic component.Enhanced MRI of 3 cases showed significantly heterogeneous enhancement,cyst and necrosis had no enhancement.MR dynamic enhancement of 1 case showed time-signal intensity curve was platform type.DWI showed high signal.Conclusion MPNST has certain CT and MR characteristics which are helpful to improve the diagnostic accuracy.

AIM: To investigate the inhibition of the recombinant human endostatin adenavirus (Ad-Es) on the experimental choroidal neovascularization(CNV) models by intravitreous injection.METHODS: Experimental CNV models were induced by semiconductor laser in 30 male Brown Norway(BN) rats and randomly divided into 3 groups with 10 rats in each group.At 21d after photocoagulation, the single administration group were given intravitreous injection with Ad-Es 0.01mL;the repeated administration group were given intravitreous injection with Ad-Es 0.01mL and a repeated injection 7d later;the saline control group were given intravitreous injection with saline 0.01mL.At 7d after final administration, the leakage of fundus fluorescein angiography (FFA) was observed.Various CNV areas were measured by using laser confocal microscopy of choroidal flatmount method.Pathology and ultrastructure were observed with light microscopy, the expressions of CD105 were measured by immunohistochemistry.RESULTS: The leakage of CNV of the administration group abviously decreased as compared with those in the saline group, the leakage of repeated administration group decreased compared with that of single administration group (P<0.05).Laser confocal microscope quantitative CNV analysis showed that CNV area of the administration group was significantly smaller than that of control group, the area of repeated administration group was smaller than that of single administration group (P<0.05).Under the light microscope, the vascular endothelial cell number and quantity of the administration group were significantly lower than that of the control group, the cell number of repeated administration group was lower than that of single administration group.CD105 expression of the administration group was significantly weaker than that in the saline group;the expression of repeated administration group was weaker than that of single administration group.CONCLUSION: Ad-Es can effectively inhibit semiconductor laser induced CNV in BN rats, and the inhibition effect of repeated administration group is better than that of single administration group.It may be a useful new method in the treatment of CNV.

In practice of forensic medicine, potential disease can be associated with fatal asphyxia in restraint position. Research has demonstrated that nitric oxide (NO) and nitric oxide synthase (NOS) are plentifully distributed in skeletal muscle, contributing to the regulation of contractile and relaxation. In the current study, respiratory functions, indices of diaphragmatic biomechanical functions ex vivo, as well as NO levels in serum, the expressions of diaphragmatic inducible NOS (iNOS) mRNA, and the effects of L-NNA on contractility of the diaphragm were observed in sepsis induced by cecal ligation and puncture (CLP) under the condition of restraint position. The results showed that in the CLP12-18h rats, respiratory dysfunctions; indices of diaphragmatic biomechanical functions (Pt, +dT/dt(max), -dT/dt(max), CT, Po, force over the full range of the force-frequency relationship and fatigue resistance) declined progressively; the NO level in serum, and iNOS mRNA expression in the diaphragm increased progressively; force increased significantly at all stimulation frequencies after L-NNA pre-incubation. Restraint position 1 h in CLP12 h rats resulted in severe respiratory dysfunctions after relative stable respiratory functions, almost all the indices of diaphragmatic biomechanical functions declined further, whereas little change took place in NO level in serum and diaphragmatic iNOS mRNA expression; and the effects of L-NNA were lack of statistical significance compared with those of CLP12 h, but differed from CLP18 h group. These results suggest that restraint position and sepsis act together in a synergistic manner to aggravate the great reduction of diaphragmatic contractility via, at least in part, the negative modulation of NO, which may contribute to the pathogenesis of positional asphyxia.
Animals ; Asphyxia ; Diaphragm/physiology* ; Muscle Contraction ; Muscle, Skeletal ; Nitric Oxide/metabolism* ; Nitric Oxide Synthase ; Nitric Oxide Synthase Type II ; Rats ; Respiration Disorders ; Restraint, Physical ; Sepsis

Adult ; Female ; Humans ; Male ; Middle Aged ; Occupational Health ; statistics & numerical data ; Regression Analysis ; Risk Factors ; Stress, Psychological ; psychology ; Surveys and Questionnaires ; Workplace ; psychology

OBJECTIVETo investigate the clinical effect and safety of chiropractic in treating cervicogenic sudden hearing loss.

METHODSFrom January 2011 to October 2013, 90 patients with cervicogenic sudden hearing loss were randomly divided into treatment group and control group according to the random number table produced by SPSS 19.0 software. In the treatment group, there were 17 males and 28 females, aged from 31 to 62 years old with an average of (47.57±9.43) years; course of disease was from 1 to 3 days with an average of (1.43±0.68) days; pure-tone audiometry score was from 46.5 to 77.8 dB with the mean of (61.20±9.83) dB; Northwick Park Neck Pain Questionnaire (NPQ) score was from 17 to 31 scores with an average of (23.46±7.18) scores. In the control group, there were 15 males and 30 females, aged from 28 to 64 years old with an average of (45.77±6.99) years; course of disease was from 1 to 3 days with an average of (1.50±0.73) days; pure-tone audiometry score was from 48.1 to 75.0 dB with the mean of (63.91±8.05) dB; Northwick Park Neck Pain Questionnaire (NPQ) score was from 20 to 29 scores with an average of (25.61±10.43) scores. The patients of control group were treated with dexamethasone intravenous drip of 10 mg, 3 days later, decreased to 5 mg, 3 days again. And with the methycobal intravenous drip of 500 μg, treatment continued for 10 days. The patients of treatment group were treated with chiropractic additionally except for the therapeutic methods of control group. Chiropractic included local muscle loosening, attacking point, bilateral pulling atlanto-axial joint, and continuous treatment for 10 days. The pure-tone audiometry score and NPQ score were compared between two groups after treatment.

RESULTSAfter the treatment, pure-tone audiometry score and NPQ score in treatment group improved to (40.23± 8.14) dB and (12.70±8.29) scores respectively, which were obviously better than that of control group's (37.70±10.61) dB and (21.24±11.13) scores (P<0.05).

CONCLUSIONCompared with routine method for cervicogenic sudden hearing loss, additional chiropractic can improve hearing and relieve neck pain effectively.

Cervical Vertebrae ; Female ; Hearing Loss, Sudden ; therapy ; Humans ; Male ; Manipulation, Chiropractic ; methods ; Medicine, Chinese Traditional ; Middle Aged

Objective:To observe the changes of macular microvessels in patients with retinal vein occlusion (RVO) and macular edema (ME) after intravitreal injection of aflibercept (IVA), and analyze its correlation with best corrected visual acuity (BCVA).Methods:A retrospective case study. Thirty patients (30 eyes) with monocular RVO with ME (RVO-ME) who were diagnosed in the clinical examination of Tianjin Eye Hospital from April 2019 to February 2020 were included in the study. Among them, there were 12 males (12 eyes) and 18 females(18 eyes); the average age was 54.30±13.17 years. The average course of disease was3.43±1.97 months. Both eyes were examined by BCVA and optical coherence tomography (OCTA). The on-demand injection was adopted after the first injection in IVA treatment regimen. The macular area 6 mm×6 mm in both eyes was scanned with an OCTA instrument, and the area of the foveal avascular area (FAZ), FAZ circumference (PERIM), and out-of-roundness were measured at baseline and 1, 3, and 6 months after treatment. Index (AI), blood flow density within 300 μm width of FAZ (FD-300), foveal retinal thickness (CMT), superficial retinal capillary plexus (SCP), deep retinal capillary plexus (DCP) blood flow density. The paired t test was used to compare the quantitative parameters of the affected eye and the contralateral healthy eye at baseline; the changes of the quantitative parameters at baseline and 1, 3, and 6 months after treatment were analyzed by repeated measures analysis of variance. Pearson correlation analysis was used to analyze the correlation between BCVA, retinal perfusion, and macular blood supply parameters at 6 months after IVA treatment. Results:At baseline, compared with the contralateral healthy eye, the FAZ area ( t=-4.091), PERIM ( t=-5.098) and AI ( t=-9.093) of the RVO-ME eye were enlarged, and FD-300 ( t=7.237) and overall SCP and DCP blood flow density ( t=8.735, 9.897) decreased, the difference was statistically significant ( P<0.001). Six months after treatment, the BCVA of RVO-ME eyes was significantly increased, CMT decreased, FAZ area expanded, and AI decreased ( t=8.566, 16.739, -6.469, 9.719; P<0.001), the difference was statistically significant. There was no significant change in the blood flow density of FD-300 and overall SCP and DCP, and the difference was not statistically significant ( t=1.017, 1.197, 0.987; P>0.05). Compared with baseline, the FAZ area of RVO-ME eyes gradually expanded at 3 and 6 months after treatment, and the difference was statistically significant ( F=21.979, P<0.001). Correlation analysis results showed that BCVA at 6 months after treatment was positively correlated with the overall SCP and DCP blood flow density at baseline and 6 months after treatment ( r=-0.538, -0.484, -0.879, -0.854; P<0.05). There was a negative correlation with the area of FAZ 6 months after treatment ( r=0.544, P=0.001). The number of ME recurrences was negatively correlated with BCVA and overall SCP and DCP blood flow density 6 months after treatment ( r=0.604, -0.462, -0.528; P<0.05), it was positively correlated with FAZ area ( r=0.379, P=0.043). Conclusion:Within 6 months of IVA treatment in RVO-ME eyes, ME is significantly reduced and visual acuity is improved; SCP blood flow density decreases, and FAZ area expands.

Objective Compare the three kind of criteria in evaluating the incidences of postop-erative cognitive dysfunction in non-cardiac surgery.Methods Four hundred and sixty one non-cardiac surgery patients were randomly enrolled in this study group and two hundred forty four non-surgery patients as control group.Patients??cognitive state was measured on preoperative and postoperative 1 and 3 d by mini-mental state examination(MMSE).POCD was assessed by patients??education level, one standard deviation and Z-score scale,respectively.Results On the first and third day after sur-gery,Z-score scale assess POCD result showed the highest relevance ratio and 95%CI as well as the lowest education level.The education scale showed the lowest incidence of POCD.Education level criteria was positive on postoperative 1 and 3 day,while one case on postoperative 1 day and four cases on postoperative 3 day were negative by Z-score scale.Conclusion The incidence of POCD in same pa-tients by three kind of criteria are different.The Z-score scale is recommended to evaluate the POCD in order to avoid misdiagnosis.

Background The sex hormones plays an important role in the incidence of dry eye,especially for the regulation of function.However,the effects of sex hormones on lacrimal gland epithelial cells are below understand.Objective This study was to investgate the effects of estradiol and testosterone on the apoptosis of lacrimal gland cells induced by H2O2.Methods The lacrimal gland tissue was obtained from 2- or 3-month-old clean male New Zealand rabbits and the lacrimal gland epithelial cells were cultured in vitro using esplant culture method.The cells were identified by pan cytokeratin antibodies with immunocytochemistry.lacrimal gland epithelial cells were incubated in the 96 well plate at the density of 5 × l04 cells/ml for 44 hours.Estradiol or testosterone with the concentrations of 1 × 10-5,1 × 10-6,1 × 10-7,1 × 10-8 mol/L were added into the medium for 24 hours respectively and 1× 10-4 mol/L H2O2 treated the cells for 1 hour to induce the apoptosis in experimental groups.The cells treated by only 1 × 10-4 mol/L H2O2 were used as apoptotic control group,and the cells cultured by regular method were used as blank control group.The cell viability in different groups was detected using MTT at 570 nm ( A570 ),and the apoptotic rates of the cells were assayed using Annexin V/PI double staining.This use and maintain of experimental animals followed the Regulation for the Administration of Affairs Concerning Experimental Animals by State Science and Technology Commission.Results The cultured cells showed the irregular polygon in shape,and about 80％ cells was positive response for cytokeratin.MTT assay showed that the lower A570 values were detected in the H2O2-induced group,various concentrations of estradiol or testosterone groups compared with blank control group (P＜0.01 ).The A570 values in 1 × 10-5,1 × 10-6,1 × 10-7 mol/L estradiol groups or 1 × 10-6 mol/L testosterone group were significantly higher than ones of H2 O2-induced group (P＜0.01 ).Compared with corresponding concentrations of testosterone groups,the A570values in various concentrations of estradiol groups were elevated( P＜0.01 ).The apoptosis rates at the early and later phase were significantly declined in both estradiol group and testosterone group in comparison with H2 O2-induced group (P ＜ 0.01,P＜ 0.05 ),and those in estradiol group were lower than the testosterone group( P＜0.01,P＜0.05 ).Conclusions Estradiol and testosterone suppress the apoptosis of lacrimal gland cells induced by H2O2,and the stronger effect is found in estrogen.The inhibition of estrogen on lacrimal gland cell apoptosis show a dose-dependent manner to some extent.