OBJECTIVE: To analyze the clinical effect of rotator cuff repair and small incision rotator cuff repair under the total arthroscopy in elderly patients with rotator cuff injury. METHODS: A total of 60 elderly patients with rotator cuff injury from January 2017 to November 2018 were selected as the research objects, including 37 males and 23 females;aged from 61 to 77 years old with an average of (63.45±12.34) years old;disease duration ranged from 6 to 12 months, with an average of (5.32±1.02 ) months;29 cases on the left side and 31 cases on the right side. Among them, 30 patients underwent total arthroscopic rotator cuff repair (observation group), 30 patients underwent small-incision rotator cuff repair(control group). The scores of University of California, Los Angeles(UCLA) shoulder rating scale, before and after surgery in the two groups were observed and recorded. The American Shoulder and Elbow Surgeons(ASES) score, Constant-Murley score, shoulder flexion range of motion, external rotation range of motion, abduction range of motion, visual analogue scale(VAS) within 72 hours after surgery, as well as the complcations were compared. RESULTS: The postoperative UCLA score, ASES score and Constant-Murley score between two groups were significantly higher than those before operation (P<0.05). There was no significant difference in postoperative UCLA, ASES and Constant-Murley score between two groups (P>0.05). The shoulder flexion range of motion, external rotation range of motion and abduction range of motion between two groups were significantly higher than those before operation (P<0.05). There was no significant difference between the two groups after operation (P>0.05). The VAS at 24, 48 and 72 h after operation in observation group were significantly lower than those in control group (P<0.05). The total incidence of complications in observation group(13.33%, 4/30) was sinificantly lower(P<0.05)than that in control group(33.33%, 10/30). CONCLUSION Total arthroscopic rotator cuff repair and small incision rotator cuff repair can improve the shoulder function after rotator cuff injury in elderly, but the degree of pain and complications within 72 hours after total arthroscopic rotator cuff repair are significantly better than small incision rotator cuff repair, which can be selected according to the clinical situation and needs of patients.
Male ; Female ; Humans ; Aged ; Middle Aged ; Rotator Cuff Injuries/surgery* ; Arthroscopy ; Rotator Cuff/surgery* ; Shoulder Joint/surgery* ; Treatment Outcome ; Pain

Objective To investigate the value of ultrasound and contrast-enhanced ultrasound (CEUS) in the differential diagnosis of mass-type autoimmune pancreatitis (AIP) and pancreatic ductal adenocarcinoma (PDAC). Methods A retrospective analysis was performed for the clinical data, ultrasound findings, and CEUS findings of 11 patients with mass-type AIP who were diagnosed in Tangshan Workers' Hospital from January 2015 to December 2020, and their characteristic manifestations were analyzed and compared with the data of 23 patients with PDCA. The chi-square test was used for comparison of categorical data between two groups. Results For the 11 patients with mass-type AIP, CEUS had a diagnostic accuracy of 63.64%, and all of these patients had hypoechoic single lesions; the patients with clear boundaries, regular morphology, pancreatic duct dilatation or cutoff, and blood flow signal accounted for 54.55%, 63.64%, 18.18%, and 36.36%, respectively, while in the PDCA group, such patients accounted for 30.43%, 34.78%, 78.26%, and 21.74%, respectively, and there was a significant difference in the presence or absence of pancreatic duct dilatation or cutoff between the two groups( χ 2 =11.089, P < 0.05), with no significant differences in the other indices (all P > 0.05). For the 11 patients with mass-type AIP, CEUS showed that 7 patients (63.64%) had hyperenhancement and 4 (36.36%) had iso-enhancement in the arterial phase, and 5 patients (45.45%) had hyperenhancement in the arterial phase and 6 (54.55%) had iso-enhancement in the venous phase; for the 23 patients with PDCA, 22 (95.65%) had hypoenhancement of lesions in both arterial and venous phases, and there were significant differences in the enhancement pattern in arterial and venous phases between the two groups ( χ 2 =30.345 and 30.084, both P < 0.05). Conclusion The enhancement pattern of CEUS and the presence or absence of pancreatic duct dilatation or cutoff have a relatively high value in the differential diagnosis of mass-type AIP and PDCA.

Objective: To investigate the helping role of Kangfuxin liquid on early enteral nutrition in craniocerebral injury patients with mechanical ventilation, and the indirect effect on mechanical ventilation. Methods: 60 craniocerebral injury patients with mechanical ventilation and early enteral nutrition were selected, and they were randomly divided into treatment group and control group according to the digital table, 30 cases in each group.All patients were given conventional treatment and nutritional support, the patients in the treatment group were given Kangfuxin liquid.Before and 7 days after treatment, the levels of albumin(ALB), pre albumin(PA) and totalprotein(TP) were tested.The incidence of abdominal distension, reflux and aspiration in 7 days were recorded.The time of mechanical ventilation and the stay time in ICU were recorded.The mortality rate in 28 days was recorded. Results: 7 days after treatment, the levels of ALB[(33.47±4.82)g/L vs.(30.47±4.64)g/L], PA[(206.21±41.87)mg/L vs.(185.62±38.94)mg/L]and TP[(57.82±5.96)g/L vs.(54.47±6.17)g/L]in the treatment group were higher than those in the control group(t=2.456, 2.338, 2.139, all P<0.05). The incidence rates of abdominal distension(20.00% vs.53.33%), reflux(16.67% vs.43.33%), time of mechanical ventilation[(11.76±2.02)d vs.(13.02±1.96)d]and the stay time in ICU[(13.74±2.31)d vs.(15.43±2.14)d]in the treatment group were lower than those in the control group(χ²=7.177, 5.07, t=2.452, 2.940, all P<0.05). There was no statistically significant difference in 28-day mortality rate (P>0.05). Conclusion Kangfuxin liquid has helping role on early enteral nutrition in craniocerebral injury patients with mechanical ventilation.And it is helpful to shorten the time of mechanical ventilation.

Objective: To investigate the impact of serum brain-derived neurotrophic factor (BDNF) levels on depression of hypertensive cerebral hemorrhage(HICH) patients with conservative treatment. Methods: From April 2014 to December 2017, a total of 63 patients with HICH hospitalized in the Department of Neurosurgery, Tangshan Gongren Hospital were enrolled. There were 38 males and 25 females patients. All had intracranial hematoma volume within 30 ml and received conservative treatment. Serum BDNF levels were detected using enzyme linked immunosorbent assay. The paralysis grade was assessed using National Institutes of Health Stroke Scale (NIHSS) on admission and the 21 st day after admission. The Zung Depression Self-rating Scale(SDS) was used to evaluate depression 21 days after admission. Patients with SDS score ≥53 were divided into the depression group and with SDS score < 53 were divided into the non-depression group. The differences of serum BDNF levels between the two groups were compared. Risk factors for depression of HICH patients with conservative treatment were analyzed by binary Logistic regression analysis. Results: The SDS score of the depression group (54. 7 ± 1.5) on the 21st day after admission was significantly higher than that of the non-depression group (44. 6 ± 6. 5, 1 =7. 020, P <0. 01). The serum BDNF levels of the depression group was lower than that of the non-depression group(7. 0 ± 1. 4 p, g/L vs. 8. 6 ± 1. 8 p, g/L, t = - 3. 433, P = 0. 001). The paralysis grade of the depression group was higher than that of the non-depression group on the 21st day after admission (5. 4 ± 1. 5 vs. 3. 8 ± 1. 1, t =4. 951, P <0. 01). In the depression group, the serum BDNF level was negatively correlated with SDS score(r = -0. 535, P =0. 013).blood loss(r= - 0. 578, P = 0. 006) and paralysis grade(r= -0. 715, P<0. 01) on the 21st day after admission. In binary Logistic regression analysis, serum BDNF level was a protective factor for depression in HICH patients undergoing conservative treatment(OR, 0. 990, 95% CI 0. 983-0. 997, P = 0. 008). Conclusion: The lower the serum BDNF levels of HICH patients with conservative treatment, the more prone to depression.

Objective: To study the effect of rhythmic breathing on pain in burn patients. Methods: A total of 100 patients with burns in Tangshan Workers Hospital were randomly selected from August 2015 to August 2017. They were randomly divided into control group and experimental group by random number table method, with 50 cases in each group. Baseline variables were recorded for each patient, and pain scores for each patient was scored on the fourth day after admission by the pain scale questionnaire score. At the same time, from the fourth day of admission, each group began to give sterile dressings to treat burns. The control group only used a conventional care mode that included dressing coverage therapy. The experimental group added rhythmic breathing on this basis. The pain scores were scored on the 5th day, the 6th day, and the 7th day after admission. The pain scores of the 3 days in each group were compared, and the difference in pain scores between the 2 groups was compared. Results: In the experimental group, the pain scores on the 5th day, the 6th day and the 7th day of admission were (1.53±1.90), (1.68±1.37), and (1.97±1.18) points, respectively, and the control group was (3.64±0.85). (3.74±0.78), (3.85±0.81) points, there were significant differences in pain scores between the two groups (U=5.76, 8.65, 7.79, P<0.01). There was no significant difference in pain scores on the 5th day, 6th day and 7th day in the observation group (P>0.05). There was statistically significant difference in pain scores between the control group on day 5, day 6, and day 7 (χ²=6.83, P<0.01). Conclusions Rhythmic breathing relieves pain after burns.

OBJECTIVE: To observe the intervention effect of damage control orthopaedic(DCO) strategy on fat embolism syndrome(FES) associated with long shaft fracture of lower limbs. METHODS: Retrospective analysis was made on the clinical data of 163 patients with FES associated with lower limb long shaft fractures admitted from January 2015 to May 2021. They were divided into two groups based on the time point of implementing DCO strategy in January 2018. Total of 92 patients were admitted from January 2015 to December 2017 as the control group, and other 71 patients were admitted from January 2018 to May 2021 as the intervention group. The hospital mortality, arterial oxygen saturation (SaO₂), arterial partial pressure of oxygen (PaO₂) and oxygenation index (OI), hemoglobin (Hb), platelet count(PLT), Harris score of hip joint, HSS score of knee joint, AOFAS score of ankle joint, clinical efficacy and complications were observed and compared between two groups. RESULTS: Total of 163 patients were followed up for 12 to 18 months with an average of (16.91±1.22) months. The in-hospital mortality rate in the intervention group was 2.82% (2/71), and that in the control group was 16.30% (15/92), the difference between two groups was statistically significant(χ²=6.455, P<0.05). After the intervention, SaO₂, PaO₂ and OI in two groups were higher than those before the intervention(P<0.05), and after the intervention, SaO₂, PaO₂ and OI in two groups were statistically significant(P<0.05). Hb and PLT in two groups after intervention were higher than those before intervention (P<0.001), and there was statistically significant difference in Hb and PLT between two groups after intervention (P<0.05). The Harris score of hip joint, HSS score of knee joint and AOFAS score of ankle joint in both groups after 3 months of treatment were better than those before treatment (P<0.05). The total clinical effective rate of the intervention group was higher than that of the control group(χ²=4.194, P<0.05). The total incidence of complications in the intervention group was lower than that in the control group(χ²=4.747, P<0.05). CONCLUSION DCO strategy is helpful to reduce the in-hospital mortality of patients with FES associated with long shaft fracture of lower extremities, eliminate FES symptoms and stabilize vital signs, gain time advantage for phase Ⅱ definitive surgery, and has significant clinical intervention effect, which is worth popularizing.
Humans ; Orthopedics ; Retrospective Studies ; Fractures, Bone ; Treatment Outcome ; Lower Extremity ; Embolism, Fat/therapy*

OBJECTIVE: To compare the therapeutic effect on type 2 diabetes mellitus (T2DM) complicated with angina pectoris of coronary heart disease between the combined therapy of acupuncture and western medication and the simple administration of western medication. METHODS: A total of 134 patients with T2DM and angina pectoris of coronary heart disease were randomly divided into two groups, i.e. an acupuncture plus medication group (67 cases, 3 cases dropped off) and a medication group (67 cases, 4 cases dropped off). The routine western medication was used according to symptoms in the patients of both groups. In the acupuncture plus medication group, on the base of medication, acupuncture was applied to Jianshi (PC 5), Quchi (LI 11), Neiguan (PC 6), etc. The needles were retained for 20 min in each treatment and 3 treatments of acupuncture were required weekly. The treatment was given consecutively for 8 weeks in the two groups. Separately, before and after treatment, the symptom scores of TCM were observed and the indexes were detected, including glycolipid metabolism [fasting plasma glucose (FPG), 2-h plasma glucose (2hPG), glucosylated hemoglobin (HbA1c), triacylglycerol (TG) and total cholesterol (TC)], islet β cell function [homeostasis model assessment-β (HOMA-β), homeostasis model assessment-IR (HOMA-IR), fasting insulin (FINS) and insulin sensitivity index (ISI)], cardiac function indexes [cardiac output (CO), early diastolic peak velocity/late diastolic peak velocity (E/A), left ventricular end diastolic diameter (LVEDD) and left ventricular ejection fraction (LVEF)], as well as electrocardiogram QT dispersion (QTd). Besides, the clinical therapeutic effects were compared between the two groups. RESULTS: After treatment, the TCM symptom scores and the values of FPG, 2hPG, HbA1c, TG, TC, HOMA-IR, FINS, E/A and LVEDD as well as QTd were all lower than those before treatment in the two groups ( CONCLUSION The combined therapy of acupuncture and medication is effective in treatment of T2DM complicated with angina pectoris of coronary heart disease. Such therapy effectively improves glucolipid metabolism, islet β cell function, cardiac function and myocardial blood supply. Its curative effect is better than the simple administration of western medicine.
Acupuncture Therapy ; Angina Pectoris/etiology* ; Blood Glucose ; Coronary Disease/drug therapy* ; Diabetes Mellitus, Type 2/drug therapy* ; Humans ; Stroke Volume ; Ventricular Function, Left

Objective To assess the value of 18 F-FDG PET/CT, contrast-enhanced ultrasound, and their combination in the differential diagnosis of benign and malignant pancreatic lesions. Methods A retrospective analysis was performed on patients with pancreatic lesions who underwent 18 F-FDG PET/CT and contrast-enhanced ultrasound who were admitted to Tangshan Gongren Hospital from January 2015 to December 2020. The imaging results were confirmed by pathology examination to evaluate diagnostic sensitivity, specificity, accuracy, positive and negative predictive value. The t -test was used for comparison of continuous data between two groups, and the chi-square test was used for comparison of categorical data between groups. Results There were 83 malignant lesions and 25 benign lesions in 108 patients. The sensitivity, specificity, accuracy, positive and negative predictive value were 86.75%, 80.00%, 85.19%, 93.51% and 64.52% for 18 F-FDG PET/CT; and 69.88%, 76.00%, 71.30%, 90.63% and 43.18% for contrast-enhanced ultrasound, respectively. The two methods differed significantly in sensitivity and accuracy (all P < 0.05), but not in specificity, negative and positive predictive value (all P > 0.05). When combined with the contrast-enhanced ultrasound, 18 F-FDG PET/CT had an increased sensitivity, specificity, accuracy, positive and negative predictive value of 90.36%, 84.00%, 88.89%, 94.94% and 72.41%, respectively, though this was not statistically significant due to the increased signal of blood supply in the lesions. Conclusion 18 F-FDG PET/CT has a better performance than contrast-enhanced ultrasound in the differential diagnosis of benign and malignant pancreatic lesions, and their combination can improve the diagnostic value.

OBJECTIVE：To in vestigate the effects of dexmedetomidine （Dex）on SIRT 1/Akt/GSK3β/β-catenin signaling pathway in cerebral injury of sepsis model rats ，and explore the mechanism of its protecitve effect on cerebral injury. METHODS ： A total of 80 male SD rats were randomly divided into sham operation group （Sham group ），sepsis group （CLP group ），CLP+Dex group（10 μg/kg Dex），CLP+Dex+Sirtinol group （10 μg/kg Dex+2 μL/100 g SIRT 1 inhibitor sirtinol ），with 20 mice in each group. Two hours before modeling ，CLP+Dex+Sirtinol group was injected with sirtinol via lateral ventricle. Sepsis model was induced by cecal ligation and perforation in each group （in sham group ，only operation was performed but no ligation was performed）. At 0，3，6 h after modeling ，CLP+Dex group and CLP+Dex+Sirtinol group were given Dex （10 μg/kg） intraperitoneally，Sham group and CLP group were given constant volume of normal saline intraperitoneally. Cerebral tissue water content，Evans blue （EB）content，apoptosis in cerebral cortex ，the levels of IL- 1β and TNF-α in cerebral tissue as well as the protein expression of SIRT 1，p-Akt，p-GSK3β and β-catenin in hippocampus were detected 24 h after last medication. RESULTS ： Compared with Sham group ，cerebral tissue water content ，EB content ，the number of apoptotic cells in cerebral cortex as well as the levels of IL- 1β and TNF-α in cerebral tissue were increased significantly（P＜0.05），while the protein expression of SIRT 1， p-Akt，p-GSK3β and β-catenin in hippocampus were decreased significantly （P＜0.05）. Compared with CLP group ，cerebral tissue water content ，EB content ，the number of apoptotic cells in cerebral cortex as well as the levels of IL- 1β and TNF-α in cerebral tissue were decreased significantly in CLP+Dex group （P＜0.05），while the protein expression of SIRT 1，p-Akt，p-GSK3β and β-catenin in hippocampus were increased significantly （P＜0.05）. Sirtinol could significantly reverse the above-mentioned cerebral protection and factor regulation effects of Dex （P＜0.05）. CONCLUSIONS ：Dex can protect the cerebral tissue of sepsis model rats，which may play an anti-inflammatory and anti-apoptotic role by activating SIRT 1/Akt/GSK3β/β-catenin signaling pathway ，so as to reduce cerebral edema ，protect blood-brain barrier and reduce cerebral injury.

STK1 is one important MAPK gene regulating the conidial development, osmotic stress and pathogenicity of Setosphaeria turcica. At first, the Pichia pastoris GS115 expression vector pPIC3.5K-EGFP containing enhanced green fluorescent protein gene (EGFP) was constructed, then STK1 gene was first amplified by PCR with the template of cDNA of S. turcica model isolate 01-23, and then cloned into the vector pPIC3.5K-EGFP with enhanced green fluorescent protein gene (EGFP) to construct the STK1-EGFP fusion gene expression vector pPIC3.5K-STK1-EGFP. The vector was transformed into the susceptible cells of Pichia pastoris GS115 by electric shock process, and the transformants were identified by MD medium screening and PCR determination. The STK1 gene and EGFP gene could be expressed effectively and stably in the transformants as detected by RT-PCR and fluorescence observation. In addition, we also found that the Kozak sequence before the start codon of STK1 gene could increase 4.8 folds expression level of STK1- EGFP fusion gene. The above research results laid a good foundation for subcellular localization and antibody preparation of STK1 protein.