Objective: To objectively evaluate the short-term and long-term efficacies of arthrolysis under brachial plexus anesthesia in treating adhesive capsulitis of the shoulder (ACS). Methods: One hundred patients diagnosed with ACS were divided into two groups using the random number method. The two groups both received same active rehabilitation exercises. Besides, 55 cases in the treatment group were given one session of arthrolysis under brachial plexus anesthesia, and 45 cases in the control group were given tuina treatment. Changes in the visual analog scale (VAS) score, Melle score and pressure pain index were observed 1 month and 3 months after treatment. The therapeutic efficacies were also compared. Results: The total effective rate was 96.4％ at the 1-month follow-up and 96.4％ at the 3-month follow-up in the treatment group. The total effective rate was 33.3％ at the 1-month follow-up and 28.9％ at the 3-month follow-up in the control group. There were significant differences between the two groups comparing the total effective rate at the two time points (both P<0.05). The scores of VAS, Melle and pressure pain were significantly different at the 1-month and 3-month follow-ups from those before treatment in the treatment group (all P<0.05); the three scores did not show significant differences at the 1-month and 3-month follow-ups compared with those before treatment in the control group (all P>0.05). Conclusion: Based on the active rehabilitation exercises, one session of arthrolysis under brachial plexus anesthesia can release the adhesion and restore the range of motion and function of shoulder joint in ACS patients. It is superior to rehabilitation exercises plus tuina treatment comparing both short-term and long-term efficacies.

Biotechnology ; China ; International Agencies ; organization & administration ; Safety ; Societies ; organization & administration

Objective To investigate the correlation between cognitive function and cerebral microbleeds (CMBs) in patients with acute cerebral infarction.Methods The clinical and imaging findings in patients with acute stroke were analyzed retrospective.CMBs were counted according to the findings of MRI.The general conditions,CMB site and leukoaraiosis severity of the patients were recorded in detail.The cognitive function of the patients was assessed with the Montreal cognitive assessment scale (MoCA) the next day in the hospital.MoCA assessment follow-up was conducted at 3,6 and 9 months.The changes in cognitive function of the patients with acute cerebral infarction and its relationship with CBMs were analyzed.Results A total of 82 patients with ischemic stroke were enrolled in the study,33 of them had CBMs and 49 had no CBMs.The systolic blood pressure (155.03 ± 19.68 mm Hg vs.142.20 ± 21.22 mm Hg;t =2.762,P =0.007) and the National Institutes of Health Stroke Scale (NIHSS) score (6.21 ±4.57 vs.4.00 ±3.98; t =2.322,P =0.023) in the CBM group were significantly higher than those in the non-CBM group.Multivariate logistic regression analysis showed that the systolic blood pressure level (odds ratio [OR] 1.032,95％ confidence interval [CI] 1.008-1.057; P=0.009) and the NIHSS score (OR 1.163,95％ CI 1.013-1.311;P=0.014) were the independent predictors of CBMs in patients with acute cerebral infarction.CMBs were closely associated with MoCA scores,and the longer follow-up time,the correlation would stronger.The executive function (rs =0.318,P =0.004),visual space function (rs =0.403,P =0.000) and calculation function (rs =0.362,P=0.001) in patients with CMBs were significantly impaired.The more serious of CMBs,the lower of the scores in above 3 cognitive domains,and the damage would be more serious.Conclusions CMBs are closely associated with cognitive function impairment in patients with acute cerebral infarction.The more serious of CMBs,the more serious of cognitive function impairment will be,and with the extension of time,cognitive function impairment in patients with CMBs will aggravate.

Objective:To explore clinical and histopathological characteristics of primary biliary cirrho-sis-autoimmune hepatitis overlap syndrome.Methods:Clinical data and pathological findings of 10 pa-tients were reviewed.Results:Serum glutamine transpeptidase,alkaline phosphatase levels,alaninetransaminase,aspartate transaminase,serum IgG and IgM were elevated in all the patients.They were allpositive for anti-mitochondrial antibody and AMA-M2.Nine patients were positive for anti-nuclear anti-body and one patient was positive for anti liver-kidney microsome antibody.Liver biopsies in these pa-tients revealed:ten patients had bile duct lesion,hepatitis activities ranged from moderate to severe,andfibrosis ranged from S1 to S3.Conclusion:PBC-AIH overlap syndrome is mostly found in middle-agedwomen.It has the clinical and histopathological characteristics of both PBC and AIH.Accurate andprompt diagnosis of overlap syndrome patients should be based on the clinical presentation,biochemicaland immune indexes,and hepalic pathological changes.

MR arthrography is a useful modality for evaluating the labrocapsular ligamentous complex (LCLC) of the shoulder. This study was performed to describe normal anatomic variations and pitfalls in image interpretation related to evaluation of the LCLC. MR arthrogram of 56 shoulders in 41 asymptomatic young, active, male volunteers were prospectively reviewed to evaluate the labral shapes, capsular insertions and images which may mimic the lesions of glenohumeral instability. The anterior and posterior parts of the labra, respectively, varied in shape: triangular (72%,36%), round (13%,35%), cleaved (8%,1%), notched (2%,0%), flat (5%,24%), and absent (0%,4%). The anterior and posterior capsular insertions, respectively, varied in site: Mosely and Oevergaard type I (82%,62%), type II (13%,36%), and type III (5%2%). A number of pitfalls in image interpretation were discovered. Articular cartilage undercutting the labrum (29%) and middle glenohumoral ligament in proximity to anterior labrum (5%) simulated a labral tear. Joint fluid interposed in the central, superior portion of the sublabral sulci (25%) simulated a SLAP lesion. Synovial fold (38%) in the axillary pouch resembled a loose body. Knowledge of normal variations and pitfalls in MR arthrogram image interpretation of labral-capsular-ligamentous complex will help the orthopedist to accurately detect debilitating derangements associated with the glenohumeral instability.
Arthrography* ; Cartilage, Articular ; Humans ; Joints ; Ligaments ; Male ; Prospective Studies ; Shoulder ; Volunteers

PURPOSE: We assessed whether weight reduction is an effective intervention for the management of lower urinary tract symptoms (LUTS) and investigated the relationship between obesity and LUTS. MATERIALS AND METHODS: This was a prospective randomized controlled trial that enrolled obese men older than 50 years with LUTS. The study period was 52 weeks. All patients received standardized alpha-adrenergic blocker therapy for the treatment of benign prostatic hyperplasia (BPH) during the run-in period. Patients were randomized to receive either a standardized prerecorded video program on the general principle of weight reduction or a comprehensive weight reduction program. Patients were assessed at different time points with symptom assessment, uroflowmetry, transrectal ultrasound, and metabolic assessment. RESULTS: Sixty-five patients were allocated to each study arm. After the study period, no significant difference in weight reduction was found between the two arms. When the pre- and postintervention parameters were compared, none were statistically different between the 2 arms, namely nocturia, International Prostate Symptom Score, quality of life assessment, and uroflowmetry parameters. When the whole study population was taken as a single cohort, these parameters were also not significantly different between the group with a body mass index of 25 to <30 kg/m2 and the group with a BMI of 30 to 35 kg/m2. CONCLUSIONS: We found no association between obesity and LUTS. This could have been due to the less marked weight difference in our cohort. Whereas weight reduction may be an effective measure to improve LUTS, the implementation of a successful program remains a challenge.
Adrenergic alpha-Antagonists/*therapeutic use ; Aged ; Body Mass Index ; Humans ; Lower Urinary Tract Symptoms/*drug therapy ; Male ; Middle Aged ; *Obesity ; Prospective Studies ; Prostatic Hyperplasia/diagnosis/*drug therapy ; Quality of Life ; Severity of Illness Index ; Treatment Outcome ; *Weight Loss

Objective To find a way to measure and count plane distribution of cells distributed on single layer and compare differences of undifferentiated mesenchymal cells of periosteum germinal layer from different parts of the body.Methods After counting the number of undifferentiated mesenchymal cells of periosteum germinal layer from different parts of the body microscopically and figuring out the number of cells per area unit in each periosteum specimen,the obtained data were statistically analyzed and the stratum structure of periosteum observed microscopically.Results The homogeneity of variance test showed homoscedasticity,with no statistical significance(P＞0.05).The analysis of variance found homoscedasticity but showed no statistical significance(F=0.253,P＞0.05).The periosteum of patel- la,tibial plateau and costa had two layers,while the periosteum of costal cartilage had three layers. Conclusions There is no conspicuous difference upon proliferation and evoluting activities of periosteum from different parts of body.Therefore,it is unnecessary to choose specific parts for drawing the periote- um in clinical situation.In the meantime,the structure of periosteum from different parts diversifies.

PURPOSE: Augmentation enterocystoplasty (AE) has been shown to improve clinical symptoms in patients with end-stage bladder disease (ESBD). Herein, we report the long-term outcomes of a series of patients with different etiologies of ESBD who received AE. METHODS: We retrospectively reviewed 102 patients with ESBD who received AE at the Hualien Tzu Chi General Hospital from 1992 to 2014. ESBD in this study was defined as including neurogenic lower urinary tract dysfunction (NLUTD) due to spinal cord injury (SCI) or myelomeningocele, inflammatory bladder disease (IBD), ESBD occurring after pelvic cancer surgery, and other etiologies. Complications including active lower urinary tract problems and urinary tract infection (UTI), as well as patients’ self-reported satisfaction with the procedure, were evaluated. RESULTS: A total of 102 patients were included in the study. A majority of patients received AE for NLUTD (n=43), followed by IBD (n=38), ESBD after pelvic cancer surgery (n=15), and the other etiologies (n=6). Patients had a mean age of 39.4±18.7 years and were followed for a mean of 78 months. All patients had significantly increased cystometric bladder capacity and compliance at the time of follow-up. Fifty-four patients (52.9%) reported moderate to excellent satisfaction with the outcome, and there were no significant differences among the groups (P=0.430). The most common reason for dissatisfaction was the need for clean intermittent catheterization (CIC; 41.7%), followed by urinary incontinence (25.0%) and recurrent UTI (16.7%). CONCLUSIONS: AE is a safe and effective procedure for patients with ESBD. Postoperative urinary incontinence and UTI as well as the need for CIC may affect quality of life and decrease patient satisfaction.
Compliance ; Cystitis ; Follow-Up Studies ; Hospitals, General ; Humans ; Intermittent Urethral Catheterization ; Lower Urinary Tract Symptoms ; Meningomyelocele ; Patient Satisfaction ; Pelvic Neoplasms ; Quality of Life ; Retrospective Studies ; Spinal Cord Injuries ; Urinary Bladder Diseases* ; Urinary Bladder* ; Urinary Bladder, Neurogenic ; Urinary Incontinence ; Urinary Tract ; Urinary Tract Infections

PURPOSE: Stress urinary incontinence (SUI) in men is a complication secondary to prostatectomy or resulting from neurological lesions. This study presents our experiences with male suburethral slings over the past decade. METHODS: In this study, we considered patients who presented with SUI and were diagnosed with an intrinsic sphincteric deficiency due to postprostatectomy incontinence (PPI) or other causes (non-PPI). Patients who underwent the suburethral sling procedure using a polypropylene mesh and a cardiovascular patch were retrospectively included. An urodynamic study was performed before and after the operation. Global response assessment (GRA) and SUI grading were used for surgical outcome. The revision rate and the infection rate were also evaluated. RESULTS: A total 31 patients were enrolled in this study; the mean patient age was 59.5±18.9 years, and the mean follow-up period was 36.9±29.4 months. Fourteen patients comprised the non-PPI group and 17 were in the PPI group. The preoperative SUI of all patients were categorized as a moderate to severe problem according to the SUI grade, with a mean score of 2.32±0.48 before the operation and 0.48±0.57 after the operation. With a mean score of 2.35±0.71, GRA showed that the patients were satisfied with the treatment. After the sling procedure, 4 patients (13%) reported a mild improvement, 12 (38.7%) a moderate improvement, while 15 (48.4%) reported an excellent improvement. Six patients (19.4%), including 5 from the non-PPI group (35.7%) and 1 (5.9%) from the PPI group (P=0.037), underwent sling removal because of infection. CONCLUSIONS: The male suburethral sling procedure using a polypropylene mesh and a cardiovascular patch is a safe, efficacious, and inexpensive surgical procedure for PPI. In cases of neurological incontinence, however, the higher infection rate in non-PPI patients means that they should be carefully managed.
Follow-Up Studies ; Humans ; Male* ; Multiple Endocrine Neoplasia Type 1 ; Polypropylenes* ; Prostatectomy ; Retrospective Studies ; Suburethral Slings ; Urinary Incontinence* ; Urodynamics

Adult ; Aged ; Arteriosclerosis ; epidemiology ; prevention & control ; Female ; Genotype ; Humans ; Incidence ; Inflammation ; epidemiology ; prevention & control ; Interleukin-10 ; blood ; genetics ; Kidney Failure, Chronic ; complications ; genetics ; Male ; Middle Aged ; Polymorphism, Genetic