Objective To study the comprehensive quality of pre-hospital care of patients with acute coronary syndrome (ACS) in our country,and the factors affecting the efficiency of medical intervention of pre-hospital care.Methods An epidemiological investigation with target population-based cross-sectional study was carried out,and specifically designed questionnaire for determining the efficiency of pre-hospital care of patients with ACS was used to collect information of 272 patients from 13 emergency pre-hospital care centers.Results After analysis of the data from 13 majormedical centers,it could be classified into 4 patterns of pre-hospital care,namely directive pattern,pre-hospital pattern,dependent pattern and independent pattern.The results of analysis showed that the distance for ambulance driving in directive pattern was shorter than that in dependent pattern,but the call-response in directive pattern was quicker than that in pre-hospital pattern and dependent pattern,while the call-arrival time in directive pattern was longer than that in independent pattern and dependent pattern.The analysis of the on-site preliminary treatment in four patterns of pre-hospital care showed that there were differences in the establishment of intravenous access,aspirin,nitrate and ECG ( P ＜ 0.05 ).The total effective rate of pre-hospital care for ACS was 48％,while effective rate of independent pattern reached 70％.Factors affecting therapeutic effect on ACS resulting in better outcomes included pre-hospital pattern ( OR =4.097 ),directive pattern ( OR =5.158 ),and use of nitrate ( OR =3.045 ) and oral administration of medicine ( OR =8.215 ). Conclusions Independent pre-hospital pattern had the best therapeutic effect in the pre-hospital care of patients with ACS,and pre-hospital pattern had the best on-site preliminary disposal.Use of nitrate and oral administration of medicine showed the best benefit to the therapeutic effect.

Objective To explore the influences of Bushen Zhuanggu Granule (BZG)on contents of sexual hormones and metabolism of calcium and phosphorous in early menopausal women.Methods One hundred and Twenty-two early menopausal women were allocated to two groups:Group A was treated with BZG and Group B with nylestriol.Serum contents of sexual hormones and indexes of calcium and phosphorous metabolism were observed before and after treatment.Results After six months of treatment,the contents of serum estradiol(E 2)and alkaline phosphatase(ALP)were increased and the ratio of urine calcium and creatinine(Ca/Cr)decreased(P 0.05).The contents of follicle stimulating hormone(FSH)and luternizing hormone(LH)were increased in Group A as compared with Group B(P

Objective Adopting serology assay-fluorescent antibody to membrane antigen (FAMA) as "gold standard" , sero-prevalence status of varicella-zoster virus (VZV) infection was investigated, in Guangzhou. Methods FAMA test was established with VZV infected human embryo fibroblasts as antigens and fluorescein isothiocyanate(FITC) labeled goat anti-human IgG as the secondary antibody. Sensitivity and specificity of the assay were evaluated. The sero-prevalence of anti-VZV IgG in 592 serum specimens randomly collected from a clinical laboratory, was analyzed with FAMA. Results Data from FAMA test showed no cross-reaction with other Herpesviruses when it was used to detect VZV antibodies. The overall prevalence of VZV antibody was 76.52%. Age-specific prevalence rates of VZV antibody in different age groups as: 1-3, 4-6, 7-13, 14-19, 20-29, 30-39, 40-49, ≥50, were found to be 14.67%, 51.56%, 73.91%, 91.26%, 92.78%, 95.65%, 98.11% and 100%, respectively.The sero-prevalence of 1-3 age group appeared the lowest but rose sharply with the increase of age but showing no association with gender. Conclusion Our data indicated that VZV infection occurred in early childhood, in Guangzhou, suggesting that the primary recipients of VZV vaccine should be under the 1-3 age group. Additional subjects for vaccination would be children above 3 years old with no history of VZV infection, and serology test negative for VZV. The assay was validated by its excellent specificity and could be used as the first choice in the detection of protective antibodies against VZV infection.

STUDY DESIGN: Retrospective study. PURPOSE: To investigate influence of bone mineral density (BMD) on the surgical correction of lumbar degenerative kyphosis (LDK). OVERVIEW OF LITERATURE: No studies so far have reported the influence of BMD on the surgical correction of LDK. METHODS: Forty LDK patients with more than 2 years follow-up were studied. Pelvic incidence (PI), pelvic tilt, sacral slope, sagittal vertical axis (SVA), lumbar lordosis (LL), and thoracic kyphosis were measured preoperatively, immediate postoperatively and at final follow-up. Adverse outcomes: proximal adjacent fractures, sagittal decompensation, pseudoarthrosis, and cage subsidence were documented. RESULTS: There were 37 females and 3 males. Average age was 65.1+/-4.5 years and mean follow-up was 34.2+/-16.7 months. 42.5% were Takemitsu type 3 curves, 27.5% type 2, 20.0% type 4 and 10.0% type 1. 37.5% had osteopenia, 40.0% osteoporosis and 22.5% had severe osteoporosis. SVA improved from 237.0+/-96.7 mm preoperatively to 45.3+/-41.8 mm postoperatively (p=0.000). LL improved from 10.5degrees+/-14.7degrees to -40.6degrees+/-10.9degrees postoperatively (p=0.000). At final follow-up SVA deteriorated to 89.8+/-72.2 mm and LL to 34.7degrees+/-15.8degrees (p=0.000). The association between late sagittal decompensation, pseudoarthrosis, or proximal adjacent fractures and osteoporosis was insignificant. The difference between immediate postoperative LL and PI (PIDiff) had a significant association with sagittal decompensation and pseudoarthrosis. CONCLUSIONS: Osteoporosis did not influence the degree of correction, late sagittal decompensation, proximal adjacent fractures, and pseudoarthrosis in LDK. PIDiff had a significant association with sagittal decompensation and pseudoarthrosis.
Animals ; Axis, Cervical Vertebra ; Bone Density* ; Bone Diseases, Metabolic ; Female ; Follow-Up Studies* ; Humans ; Incidence ; Kyphosis* ; Lordosis ; Male ; Osteoporosis ; Pseudarthrosis ; Retrospective Studies

Background: Posttraumatic acquired facial deformities require surgical treatment, with optionsincluding scar revision, fat grafts, implant insertion, and flap coverage. However, each techniquehas specific advantages and disadvantages. Methods: From 2016 to 2018, 13 patients (eight with scar contracture and five with a depressedscar) were treated using dermofat grafts from the groin. The harvested dermofat was then insertedinto the undermined dead space after the contracture was released, and a bolster suture wasdone for fixation considering the patient’s contour and asymmetry. A modified version of the VancouverScar Scale and satisfaction survey were used to compare deformity improvements beforeand after surgery. Results: In most cases, effective volume correction and an aesthetically satisfactory contourwere maintained well after dermofat grafting, without any major complications. In some cases,however, lipolysis proceeded rapidly when inflammation and infection were not completely eliminated.A significant difference was found in the modified Vancouver Scar Scale before and aftersurgery, with a p-value of 0.001. The average score on the satisfaction survey was 17.07 out of 20points. Conclusion A dermofat graft with the groin as the donor site can be considered as an effectivesurgical option that is the simplest and most cost-effective method for the treatment of acquiredfacial deformities with scar contracture.

Liposarcomas of the spermatic cord are rare and often clinically and histologically misdiagnosed, leading to ineffective management and poor outcomes. We present a case of metastatic dedifferentiated liposarcoma of the spermatic cord, which recurred after excision of a misdiagnosed well-differentiated liposarcoma 3 years prior. Due to its size and high-grade metastasis, the tumor was unresectable, leading to treatment with systemic chemotherapy. Complications arose including partial compression of the testicular artery and urethral obstruction secondary to local mass effect. Tumor biopsy was characterized by a unique immunohistochemical profile which helped to explain the unique processes leading to mass effect, vascular and urethral compression, and bilateral scrotal swelling. The patient’s family history of malignancy and 22/22q trisomy identified in the tumor biopsy were also interesting contributors. In conclusion, accurate diagnosis of spermatic cord tumors is essential for effective treatment, and further data collection is required to improve management of advanced metastatic disease.

Objective To compare characteristics of stress variations in 3D finite element models of normal and degenerative lumbar vertebrae and the dose-effect relationship, and analyze the mechanism of mechanical balance by traditional Chinese medicine (TCM) manipulation on degenerative lumbar vertebrae. Methods The 3D finite element model of intact, real human degenerative lumbar vertebrae (L4-5) was established to simulate the physiological activity of flexion and extension in lumbar vertebrae. The characteristics of stress variation in degenerative lumbar vertebrae under external loading, namely, the TCM manipulation was analyzed, and the stress variation in degenerative lumbar vertebrae under gradual increasing-external loading was analyzed as well, which was compared with the stress and strain variation in normal lumbar vertebrae under different motion status. Results Under different motion status, the stress distributions on lumbar disc as well as the elastic modulus of nucleus pulposus and fiber ring showed a gradually increasing tendency with lumbar degeneration increasing. TCM manipulation could change the stress distributions on lumbar disc, enlarge the space of spinal canal to a certain degree, and decrease the stress on nerve root. Stresses on small joints of the vertebral body and vertebral pedicle under posterior extension were larger than those under anterior flexion, while stresses on intervertebral disc under anterior flexion were greater than those under posterior extension, which showed a gradually increasing trend from top to bottom. Conclusions The mechanical environment of human lumbar vertebrae can be balanced by TCM manipulation, for the purpose of improving and treating lumbar disc diseases. The comparison with the 3D finite element model of normal human lumbar vertebrae and investigation on lumbar degeneration from perspective of changes in biomechanical environment and characteristics can provide scientific basis for clinic application of TCM manipulation in prevention and treatment of lumbar degenerative diseases, as well as new research idea for studying mechanical mechanism of TCM manipulation in effective prevention and treatment of lumbar lesions.