ObjectiveTo provide a brief scale of mood measurement with satisfactory reliability and validity.MethodsThe 40-item BFS was abbreviated to a short-vcrsioncd BFS by item analysis.282 adult participants were surveyed by the brief BFS and NEO-FFI while NEO-FFI was taken as a criterion instrument.Reliability and validity of brief BFS were examined.ResultsThe brief BFS had 18 items including six dimensions ( activity,cheer,calmness,indignation,stir and depression),and the cronbach's α were 0.87,0.75,0.85,0.86,0.84 and 0.86 respectively and the retest reliability( r value) were 0.67,0.57,0.61,0.62,0.75 and 0.69 respectively.All the key fit indices of confirmatory factor analysis (CFA) of brief BFS were above 0.90.Besides,NEO-FFI had significant correlation with brief BFS.ConclusionThe brief BFS has satisfactory reliability and validity.

Objective To investigate the influence and clinical significance of knee lateral thrust gait to femorotibial angle and lateral joint space in the patients with knee varus deformity. Methods 44 patients (male 10, female 34; range 31-60 years old, mean 41 years old) with knee varus deformity and lateral thrust involved in this study. The femorotibial angle and lateral joint space were measured on the standing anteroposterior film (single-foot loading and double-feet loading) of knee in order to compare the changes of them. The double-feet loading film simulated the corresponding relationship between thighbone and tibiae at double-support time, as early knee lateral thrust. The single-foot loading film simulated the corresponding relationship between thighbone and tibiae at single-support time, as late knee lateral thrust. The changes of femorotibial angle and lateral joint space in the two positions showed the changes of corresponding relation between thighbone and tibiae during knee lateral thrust. Results The mean femorotibial angle was 188.50??4.48? and 185.50??4.46? at the time of single-foot loading and double-feet loading respectively. It indicated that the femorotibial angle was increasing at the time of single-foot loading. The mean width of lateral joint space was (9.92?0.86) mm and (7.70?0.78) mm at the time of single-foot loading and double-feet loading respectively. It demonstrated that lateral joint space was widening more at the time of single-foot loading. The result suggested the lateral thrust of knee led to these changes. The increasing of femorotibial angle meant an increase of knee adduction moment during gait. The increasing of lateral joint space led to lateral structures chronic instability. The increased knee adduction moment and lateral structures chronic instability were the important mechanisms for degeneration of knee medial department. Conclusion The knee lateral thrust gait results in the augments of femorotibial angle and lateral joint space. These lead to the increase of the load on knee medial compartment, lateral structures chronic instability and varus deformity increasing. Lateral thrust might cause aggravation of knee varus and gonarthrosis at knee medial compartment.

[Objective]To analyze the reasons of complications in high tibial valgus osteotomy in the varus osteoarthritic knee and its management.[Method]We studied the results of valgus-producing high tibial osteotomies in patients who had medial unicompartmental osteoarthritis and varus malalignment.We performed the operation for 126 patients from January 2000 to October 2004.Twenty-one patients had complications,including four men and seventeen women,with average age of 61 years(ranged:48～64 years).The femorotibial angle was measured on the standing anteroposterior film of knee preoperatively in order to get high accuracy in preoperative planning.A lateral closing-wedge osteotomy was performed,the osteotomy site was stabilized by Giebel blade plate or stepped staple.[Result]The mean duration of follow-up was 7.5 months(ranged,6 to 12 months).There were twenty-three complications(21 patients,16.7%):tibial fracture in four cases,deep-vein thrombosis in five cases,peroneal nerve palsy in three cases,recurrence of varus deformity in six cases,internal fixation failure in four cases(recurrence of varus deformity developed in two patients),a superficial wound infection developed in one patient.[Conclusion]To reduce the incidence of complications in high tibial valgus osteotomy,we should make familiarication with anantomy and take more accuracy in preoperative planning,improve surgical skill as well as appropriate perioperative management.

Objective To evaluation high tibial osteotomy combined with anteromedial transfer of the distal fragment for the treatment of medial and patellofemoral compartmental osteoarthritis of the varus knee. Methods High tibial osteotomy was performed in 30 knees of 24 patients with medial and patellofemoral compartmental osteoarthritis of the varus knee, which was combined with anteromedial transfer of the distal fragment. The patients included 5 males (7 knees), 19 females (23 knees), with the mean age 53 years (range, 49-55 years). All patients were followed-up with footprints to assess the foot progression angle preoperatively and at 6 months to 2 years after the osteotomy. Tibial torsion of these subjects was measured by computerized tomography preoperatively and after the osteotomy. The statistical evaluation was carried out by the paired t test. Results The foot progression angle was 8.95??2.99? preoperatively, and -2.23??4.11? postoperatively during walking. The tibial torsion was 33.77??8.12? preoperatively and 21.27??8.48? after the osteotomy. The statistical evaluation showed foot progression angle and tibial torsion preoperative were significant difference from those postoperative (P 0.05). This result revealed that the decrease of foot progression angle was equal with the decrease of tibial torsion postoperatively. Conclusion High tibial osteotomy combined with anteromedial transfer of the distal fragment may be the effective method for medial and patellofemoral compartmental osteoarthritis of the knee, but it would cause calf and foot internal rotation. The change of foot progression angle and tibial torsion can influence the effect of high tibial osteotomy. The magnitude of anteromedial transfer of the tibial tubercle must be individualized and be devised preoperatively. It is important to evaluate patellofemoral malalignment and to measure the magnitude of tibial internal rotation in operation.

Objective To evaluate the efficacy and safety of percutaneous transluminal angioplasty and stenting of intravascular stenting (PTAS) and internal medicine in the treatment of secondary severe stroke in young patients with severe symptomatic middle cerebral artery stenosis.Methods The clinical data of 77 cases with severe symptomatic middle cerebral artery stenosis(ste nosis rate≥70％)confirmed by digital subtraction angiography(DSA) were collected retrospectively in our hospital from January 2011 to June 2015.The patients were divided into PTAS group and medical treatment group,and the data were collected including the modified Rankin Score (mRS score) at admission,the US National Institutes of Health Stroke volume neurological impairments score (NIHSS score)at admission,as well as mRS score,the recurrence of ischemic stroke,death and intracerebral hemorrhage within 1 year.Results The primary end-point rates within 30 days after enrollment in PTAS group and medical treatment group were 0％ and 5.77％ respectively,and the stroke recurrence rates within 1 year were 4.35％ and 13.46％ respectively,The differ ence was not statistically significant(P＞0.05).Meanwhile,there was no death and intracerebral hemorrhage in both two groups.The rates of mRS≤1 were 91.30 ％ and 69.23 ％ respectively in PTAS group and medical treatment group,and the difference was statistically significant (P＜0.05).The rates of mRS≤2 were 95.65 ％ and 84.62 ％ respectively in PTAS group and medical treat ment group,and the difference was not statistically significant(P＞0.05).Conclusion PTAS is safe for the severe symptomatic middle cerebral artery stenosis,and is more efficient in dectasing the risk of recurrent stroke in young population compared with medical treatment.

[Objective]To evaluate efficacy and method of arthroscopic meniscoplasty for horizontal tear of discoid lateral meniscus in a short follow-up term. [Method]A series of 27 patients (27 knees) (mean age 32 years, range 6 years to 42 years) who underwent arthroscopic evaluation and treatment of a discoid lateral meniscus between 2002 and 2006 was reviewed. All the patients who were selected had the horizontal type of tear. Of those discoid menisci classified intraoperatively (n=27), 85.2% (n=23) were complete discoid lateral menisci and 14.2% (n=4) were incomplete discoid lateral menisci. No Wrisberg type was noted. Arthroscopic meniscoplasty was performed in all cases. The horizontal tear meant meniscus was divided into two leaves. The auther removed the unstable leaf to the peripheral rim and preserved the stable one. Arthroscopic meniscoplasty was performed in the stable leaf.[Result]All the patients were evaluated at follow-up according to the Lysholm knee Scoring Scale. At follow-up, patients were reviewed to recognize possible of retear and requirement of arthroscopic revision. The knee score of these patients improved from 72.48?4.64 points preoperatively to 92.18?4.52 points postoperatively. Recurrence of tear or requirement of arthroscopic revision was not noted at the final follow-up. [Conclusion]Arthroscopic meniscoplasty of the horizontal tear of discoid meniscus is an effective method.

ObjectiveTo explore the effects of the temperature of saline for irrigation of peritoneal cavity on expression of transforming growth factor beta- 1 in the peritoneum.MethodsSixty patients scheduled for the laparoscopic repair of gastroduodenal benign ulcer perforation were randomized into two groups then surgically treated with various temperature saline.Peritoneal biopsies were taken at the beginning and end of surgery.Tissue concentrations of total and active were measured using enzymelinked immunosorbent assa technique.ResultsAt the start of surgery,there were no significant differences between groups in the total and active fractions of TGFβ1 (P ＞0.05).At the end of procedure,the peritoneal total( 135.8 ±52.8) pg/mL and active( 136.5 ± 33.0) pg/mL concentrations were significantly lower(P ＜ 0.05) in patients receiving warm normal saline.A light,nonsignificant increase in total(361.3 ± 178.9) pg/mL and active ( 198.3 ± 87.5) pg/mL TGFβ1 levels was observed in patients receiving cold saline(P ＞ 0.05).ConclusionsThe choice of warm normal saline used in irrigation of peritoneal cavity during the laparoscopic operation can decrease peritoneal transforming growth factor beta-1 concentrations.Because of the broad biological effects of TGF31,including regulation of peritoneal healing and oncological processes,this observation may have important clinical perspective.

Child ; Humans ; Leukemia, Myelogenous, Chronic, BCR-ABL Positive ; complications ; diagnosis ; Male ; Priapism ; etiology ; surgery

Objective To explore the efficacy and safety of conversion from calcineurin inhibitor (CNI) to sirolimus (SRL) as major immunosuppressive therapy in lung transplant recipients.Method Retrospective analyses were conducted for the clinical data of all the patients undergoing lung transplantation in Wuxi People's Hospital between January 2011 and December 2014.Sixteen were given conversion treatment with Sirolimus in the postoperative irnmunosuppressive therapy.We analyzed the opportunity and reasons in the conversion treatment,and the safety,effectiveness and complications of the conversion treatment.Result The follow-up period was 8 to 25 months,and the median time of conversion was 6 months after operation (2-18 months).The indications of conversion concluded:malignant tumor (n =8),renal dysfunction (n =5),lymphangioleiomyomatosis (n =1) and intractable diarrhea caused by CNIs (n =2).Four cases suffered from interstitial pneumonitis associated with Sirolimus and one case suffered from spontaneous pneumothorax,and they all conversed back to CNIs.In those patients,cancer recurrence occurred in 4 cases (of them,there were 3 deaths),and 3 patients developed chronic rejection.Those recipients receiving the conversion treatment due to renal dysfunction showed recovery of renal function to some extent.Conclusion It's effective and safe to converse the immunosuppressive therapy based on Sirolimus.Sirolimus should be reduced or withdrawn when interstitial pneumonitis associated with Sirolimus occurred.

Objective To investigate the epidemiological features of out-of-hospital cardiac arrest (OHCA) in Zhejiang and to analysis factors associated with outcomes for providing evidence on improving the success rate of cardiopulmonary resuscitation (CPR). Methods Clinical data of 493 patients with OHCA collected from the emergency department (ED) of Zhejiang Provincial People's Hospital, Ningbo Emergency Medical Service Center and Shaoxing Emergency Medical Service Center from January 2012 to August 2016 were analyzed retrospectively. All the data were recorded following the Utstein style included causes of arrest, location of arrest, first arrest rhythm, witnessed by bystanders, bystander CPR, pre-hospital defibrillation, pre-hospital intubation, pre-hospital epinephrine administration, emergency medical services (EMS) response time, return of spontaneous circulation (ROSC) at scene/enroute, ROSC at ED, admission to hospital, survival to hospital discharge and neurological outcomes at discharge. Factors associated with 30 days survival rate of patients with OHCA were analyzed. Results 493 patients were enrolled, of whom 342 were male and 151 were female. The average age was (58.8±21.4) years. The causes of arrests consisted of cardiac etiology (219 cases), trauma (155 cases), respiratory disease (22 cases), drowning (19 cases), electrocution (8 cases) and others (70 cases). Most of the events occurred at home (65.1%) and public places (22.7%). 55.2% patients were witnessed by bystanders while bystander CPR was performed in only 2.6% cases. Asystole was the predominant rhythm (78.7%) observed by the ambulance crew at the arrest site while only 5.5% first arrest rhythms were ventricular fibrillation/ventricular tachycardia (VF/VT). Only 6.9% patients underwent pre-hospital defibrillation. Pre-hospital intubations were attempted in 16.4% patients. Epinephrine was administered in 56.4% patients at scene or in ambulances. EMS response time was (13.6±8.0) minutes. 4.5% patients had ROSC at scene/enroute and 7.7% had ROSC at ED. Only 9.7% patients were admitted to hospital and 1.2% discharged alive. 0.8% patients were still in hospital on 30th day. The 30-day survival rate was 2.0% (10/493) and only 0.8% patients had neurologically favorable survivals [with the cerebral performance category (CPC) score of 1 or 2]. Witnessed by bystanders (3.31% vs. 0.45%), VF/VT as the first arrest rhythm (7.41% vs. 1.72%), bystander CPR (15.38% vs. 1.67%), pre-hospital defibrillation (8.82% vs. 1.53%) and EMS response time < 10 minutes (3.57% vs. 0.74%) could improve 30-day survival rate of OHCA significantly (all P < 0.05). Conclusion Resuscitation survival of OHCA in Zhejiang province was unsatisfactory. Improvements are required in series aspects of OHCA survival chain.