Objective To discuss curative effect analysis of minithoracotomy herniography ligation to treat indirect inguinal hernia in children .Methods 110 cases of children with indirect inguinal hernia were selected and divided into experimental group and control group in accordance with different methods of operation with 55 cases of patients for either group respectively .The children in experimental group were given minithoracotomy herniography ligation,while the children in control group were given routine operation mode of abdominal incision .The operation time,operative blood loss,pain score,length of stay,cure rate,postoperative complication and reoccurrence .Results The cure rates of children in two groups were both 100%,the operation time ,operative blood loss ,pain score 24 hours after operation , length of stay , postoperative reoccurrences of reoccurrence and complication in experimental group [(31.47 ±5.36)min,(10.53 ±2.15)mL,(4.51 ±1.05)score,(4.85 ±1.17)d,0、7.2%]were much better than that in control group[(34.15 ±6.12) min,(18.17 ±3.16) mL,(5.01 ±1.31) score,(6.68 ±1.58) d,10.9%, 21.8%](t=2.10,2.98,2.14,2.46,χ2 =4.69,all P<0.05).Conclusion Minithoracotomy herniography ligation has the following advantages to treat indirect inguinal hernia in children , short operation time , little operative blood loss,light postoperative pain ,quick postoperative recovery ,low postoperative reoccurrence rates and complication rates and etc,which is a safe and effective operation method .

Chronic active Epstein-Barr virus infection( CAEBV) is an undefined illness, which is often characterized by severe. chronic, or recurrent infectious mononucleosis-like syndrome, such as fever, hepatosplenomegaly, persistenthepatitis and extensive lymphadenopathy . Patients with CAEBV have high viral loads in their penpheral blood and/ or an unusual pattem of EBV-related antibodies. It is an intractable disease with a poor prognosis. Patients with CAEBV have high mortality from hepatic failure, opportunistic infection, or hemophagocytic lymphohistiocytosis. A definite treatment has not been established . There is accumulating evidence that the clonal expansion of EBV-infected T or natural killer cells play a key role in the pathogenesis of CAEBV.

Objective To survey the social support status and demands for family caregivers of the disabled elderly.Methods A cross-sectional survey based on convenience sampling was conducted among 779 disabled elderly and their family caregivers from May to June 2013 in five communities of Beijing Dongcheng District.Barthel index was used to measure the degree of functional impairment of the elderly.Self-rating Depression Scales (SDS) was used to evaluate depression symptoms of caregivers.Social Support Rating Scale (SSRS) and social support demand questionnaire were used to measure the social support status and social support demands of caregivers,respectively.Multiple linear regression analysis was used to analyze the influence factors of social support.Results Total 779 caregivers were identified and 744 caregivers completed the questionnaires with a valid response rate of 95.5％.Among 744 family caregivers the social support levels were low with an average SSRS score of 31.16 ± 6.86.There were significant differences in SSRS scores among caregivers of disabled elderly with different characteristics (age,married status and the Barthel index score) (all P ＜ 0.05);and there were significant differences in SSRS scores among caregivers with different characteristics (age,educational level,married status,current employment,relationship with patients,caregiving time daily,subjective care burden,living with patients,number of caregivers and depression status) (all P ＜ 0.05).Multiple linear regression analysis showed that the Barthel index score of the disabled elderly,the relationship with the elderly,depression status of the caregivers and the subjective care burden were correlated with the social support level of family caregivers (all P ＜0.05);the standard regression coefficients of above significant factors were 0.098,0.190,0.134 and 0.155,respectively.The social support demands of family caregivers were various;the average score was 2.44 ± 0.64,the top three demands were provision of care subsidy for the disabled elderly (average score was 2.95 ± 0.93),provision of care allowance for family caregivers (average score was 2.90 ± 0.93) and the guidance of safe medication (average score was 2.83 ± 0.83).Conclusions Family caregivers for the disabled elderly obtain low level social support in the surveyed area.Since the earegivers have various social support demands,the social support and assistance for them should be specific,effective and comprehensive.

Objective:To analyze the consistency of HER-2 expression among endoscopic biopsy and radical operation specimens of gastric adenocarcinoma and to investigate the clinical application value of HER-2 detection in trastuzumab treated patients. Methods:From March 2013 to February 2014, 167 patients from Shanghai Changhai Hospital were diagnosed with gastric adenocarcinoma using endoscopic biopsy specimens. The corresponding surgical specimens were collected for pathological analysis. The relevant clinical and pathological data were collected. HER-2 protein expression of endoscopic biopsy specimens was detected by immunohistochemistry (IHC). HER-2 protein expression and gene amplification status of the corresponding tumor resection specimens were detected by IHC and fluorescence in situ hybridization (FISH). Results were analyzed for clinicopathological characteristics. Results:Among the 167 cas-es, 18 cases (10.8%) were HER-2 positive, including 10 cases showing IHC3+and 8 cases showing IHC2+with FISH positive. The consis-tency rate result among endoscopic biopsy and surgical operation specimens was 82%. Excluding the cases showing IHC2+, the true positive rate and the true negative rate were 73.3%and 97.0%, respectively. Conclusion:HER-2 detection of endoscopic biopsy speci-men by IHC shows great predictive value. The main reason for the difference of surgery and biopsy specimens is the heterogeneity of tumor expression. Increasing the number of specimens and combined testing with FISH are important methods to reduce misjudge-ment.

Objective To investigate the effect of community comprehensive intervention on health behavior and self-rated health status among family caregivers of disabled elderly.Methods One hundredand twenty family caregivers of disabled elderly were selected from community health service centers of Beijing Dongcheng District,and were given 6 month-comprehensive community intervention (intervention group);121 family caregivers of disabled elderly from another community were selected as the control group.The knowledge and skills of caregiving,health behaviors (daily exercise time,daily relaxation time) and self-rated health status were evaluated before and 6 months after intervention.Results The knowledge and skill scores in intervention group were improved by 50.781 points,the daily exercise time and daily relaxation time were prolonged by 0.491 h and 0.837 h,respectively after the intervention (all P＜0.05).There was no significant difference in self-rated health status of two groups before and after intervention (P ＞0.05).Conclusion Community comprehensive intervention improves the knowledge and skills of caregiving,and the health behaviors among family caregivers of disabled elderly,but the intervention measures does not impact the self-rated health status of family caregivers.

Objective To explore the relationship between care burden and social support among family caregivers of disabled elders in Beijing urban area.Methods A cross-sectional survey based on convenience sampling was conducted among 744 family caregivers in Dongcheng District in Beijing urban area.All subjects were interviewed by the Zarit Burden Interview (ZBI),Social Support Rating Scale (SSRS) and general social and demographical material lists.And then we analyzed the correlation between social support and care burden.Results The mean scores of ZBT and SSRS were (40.3 ± 15.2) and (31.1 ± 6.9)respectively.And a negative correlation existed between the level of caregiver burden and total social support.The care burden of disability elders was negatively associated with objective support,subjective support and social support availability (P ＜ 0.05).Conclusions There is a close relationship between care burden and social support among family caregivers of disabled elders.The more objective support,subjective support and social support availability the caregivers acquire,the less burden they bear.

Objective To assess whether highly cross-linked polyethylene liners are superior to conventional polyethylene liners in total hip arthroplasty (THA).Methods Randomized controlled trials (RCTs) of highly cross-linked and conventional polyethylene liners in THA were retrieved from MEDLINE,PubMed,EMBASE,Cochrane Central,CBMdisc,CBM,and VIP.Until April 2012,reference lists of the included articles and related reviews were manually searched as supplements.Meta analysis was performed with RevMan 5.1.Mean difference (MD) was used to assess the linear wear rate in highly cross-linked group versus conventional group.Odds ratio (OR) was used to estimate the osteolysis and revision incidence in the two groups.Results Meta analysis indicated that the two-dimensional linear wear rate [MD =-0.08,95％ CI (-0.1,0.06),P ＜ 0.05],three-dimensional linear wear rate [MD=-0.15,95％CI (-0.22,0.08),P＜0.05],volumetric wear rate [MD=-53.03,95％ CI (-84.39,-21.67,P＜0.05],total linear wear [MD=-0.19,95％CI (-0.23,-0.15),P＜0.05],and osteolysis incidence [OR =0.23,95％ C1 (0.13,0.39),P ＜ 0.05] were significantly reduced in highly cross-linked group than in conventional group.There were no statistical differences between the two groups concerning the creep value of the polyethylene liners and revision incidence.Conclusions Highly cross-linked polyethylene liners for primary THA present a low incidence of wear and osteolysis.As the number and quality of the included studies are limited,a long-term follow-up of more large-sample and high-quality RCTs are needed to evidence the outcome.

Objective To explore the effect of melatonin on mitochondria in streptozotocin (STZ)-induced diabetic rats and its potential mechanism. Methods The diabetic rat models were induced by intraperitoneal injection of STZ, and the diabetic rats were randomly divided into two groups: diabetes mellitus group (DM group) and melatonin-treated group (DM± MT group). The normal non-diabetic rats were served as control group. Mitochondrial membrane potential and mitochondrial swelling were measured, the expression of voltage-dependent anion channel (VDAC)was assayed by immunohistochemistry in the heart, liver and kidney among the different groups after 8 weeks. Results (1)Compared with DM group, mitochondrial membrane potential in the heart,liver and kidney were significantly elevated in DM± MT group (553.6± 193.5 vs. 311.4 ± 133.7;745.7±115.8 vs. 358.9±158.7; 951.6±246.1 vs. 425.8±177.9, all P＜0.05). (2)Compared with DM group, mitochondrial swelling in the heart, liver and kidney was reinforced in DM ± MT group. (3)Compared with DM group, the expressions of VDAC in the heart, liver and kidney were significantly up-regulated in DM± MT group (76.93 ± 8.263 vs. 58.59 ± 7.62, 50.69 ± 6.33 vs.40.11±6.30, 77.86±8.59 vs. 61.44± 12.86, all P＜0.05). Conclusions Melatonin has protective effect on the activity of mitochondria in the heart, liver and kidney in diabetic rats possibly by up-regulating the expression of VDAC.

OBJECTIVETo compare the effects between mild moxibustion and specific electromagnetic spectrum therapy apparatus (TDP) for obsolete collateral ligament injury of interphalangeal joints.

METHODSSixty patients were randomly divided into a mild moxibustion group and a TDP group, 30 cases in each one. In the mild moxibustion group, pure moxa sticks were used at the affected digital joints locally for 20-30 min a time. In the TDP group, TDP was applied at the affected digital joints locally for 20-30 min a time. The treatment was given once a day for two courses, and 10-day treatment was made into a course. Visual analogue scale (VAS) for pain, swelling degree of the affected digital joints before and after treatment were observed and the clinical efficacy and safety were evaluated in the two groups.

RESULTSThe excellent rate was 56.7% (17/30) and the excellent and, good rate was 83.4% (25/30) in the mild moxibustion group,which were better than 36.7% (11/30) and 76.7% (23/30) in the TDP group respectively (both P < 0.01). After treatment the score of VAS and digital joints swelling degree were improved than those before treatment in the two groups (P < 0.01, P < 0.05), and the improvements of the mild moxibustion group were better than those of the TDP group (P < 0.01, P < 0.05).

CONCLUSIONMild moxibustion can apparently relieve the painful and swelling degree of obsolete collateral ligament injury of interphalangeal joints, which is superior to TDP.

Acupuncture Points ; Adolescent ; Adult ; Collateral Ligaments ; injuries ; Electromagnetic Radiation ; Female ; Humans ; Joint Diseases ; therapy ; Magnetic Field Therapy ; Male ; Moxibustion ; Pain Measurement ; Young Adult

Aim To explore the influence of metformin(a first-line drug for type 2 diabetes) on ATP-induced inflammasome activation and the release of interleukin-1β(IL-1β) by LPS-activated peritoneal macrophages, a commonly-used inflammatory cell model.Methods Peritoneal macrophages were elicited by intraperitoneal injection of 30 g·L-1 thioglycollate into C57BL/6 mice.Inflammasome was activated and cell pyroptosis was induced by LPS plus ATP treatment, and the pyroptotic cells were calculated after propidium iodide(PI) staining.The protein levels of IL-1β and caspase-1 expressed in the cells and released from them into the supernatant were evaluated by Western blot.Immunofluorescent microscopy was recruited to detect the subcellular distribution and fluorescent intensity of the purinergic P2X7 receptor(P2X7R).Results Metformin per se did not induce pyroptosis in LPS-activated peritoneal macrophages, but it significantly and dose-dependently increased cell pyroptosis induced by ATP treatment.At protein levels, maturated IL-1β(17 ku) could not be released from the cells upon single LPS or LPS plus metformin stimulation;but after ATP was added, maturated IL-1β was released into the supernatants of the cells.Moreover, metformin dose-dependently increased the protein levels of both maturated IL-1β and active caspase-1 released by the LPS-activated peritoneal macrophages upon ATP stimulation.Conclusion Metformin intensifies the activation of inflammasome and increases the release of active caspase-1 and maturated IL-1β upon ATP stimulation in the LPS-activated peritoneal macrophages, which should promote inflammatory responses.