OBJECTIVETo explore clinical efficacy of double Endobutto reconstituting coracoclavicular ligament combined with repairing acromioclavicular ligament in stage I in treating acromioclavicular dislocation with Rockwood type III - V .

METHODSFrom January 2010 to September 2013, 56 patients with Rockwood type III - V acromioclavicular dislocation were treated by operation, including 20 males and 36 femlaes, aged from 32 to 52 years old with an average of 38.5 years old. Twenty-five patients were on the left side and 31 cases on the right side. The time from injury to operation was from 3 to 14 days, averaged 7 days. All patients were diagnosed as acromioclavicular dislocation with Rockwood type III - V, and double Endobutto were used to reconstituting coracoclavicular ligament, line metal anchors were applied for repairing acromioclavicular ligament. Postoperative complications were observed, Karlsson and Constant-Murley evaluation standard were used to evaluate clinical effects.

RESULTSAll patients were followed up from 8 to 24 months with average of 11 months. According to Karlsson evaluation standard at 6 months after operation,42 cases were grade A, 13 were grade B and 1 was grade C. Constant-Murley score were improved from (42.80±5.43) before operation to (91.75±4.27) at 6 months after operation. All items at 6 months after operation were better than that of preoperative items. Forty-eight patients got excellent results, 7 were moderate and only 1 with bad result. No shoulder joint adhesion, screw loosening or breakage were occurred during following up.

CONCLUSIONDouble Endobutto reconstituting coracoclavicular ligament combined with repairing acromioclavicular ligament in stage I for the treatment of acromioclavicular dislocation with Rockwood type III - V could obtain early staisfied clinical effects, and benefit for early recovery of shoulder joint function.

Acromioclavicular Joint ; injuries ; surgery ; Adult ; Bone Plates ; Bone Screws ; Female ; Humans ; Ligaments, Articular ; injuries ; surgery ; Male ; Middle Aged ; Reconstructive Surgical Procedures ; Shoulder Dislocation ; surgery ; Treatment Outcome

Objective To investigate the effects of television-watching and computer-using on sleep/wake patterns, sleep duration and sleep problems of school-aged children in Shanghai. Methods A total of 4 108 school-aged children from 10 primary schools of Shanghai were enrolled by multi-stage cluster sampling and surveyed by questionnaires. The information of television-watching and computer-using, family and personal condition was investigated by self-prepared questionnaire, and the Chinese version of Children's Sleep Habits Questionnaire was employed to survey the sleep behaviors of children. The effects of television-watching and computer-using on sleep/wake patterns, sleep duration and sleep problems were analyzed by multiple linear regression analysis and Logistic regression analysis. Results The percentage of children who watched television≥2 h per day was 4.1% during weekdays, and that came to 49.2% during weekends. In terms of frequency of computer-using, most children reported "rarely" (88.2%, 0-1 time/week), followed by "often" (11.0%, 2-4 times/ week) and "usually" (0.8%, 5-7 times/week). With the age increase, the percentages of children who watched television≥2 h per day and those who "often" used computer gradually increased. It was revealed by multiple linear regression analysis and Logistic regression analysis that television-watching and computer-using were not only positively correlated with later bedtime, later wake time and shorter sleep duration but also significantly associated with sleep problems such as bedtime resistance, sleep onset delay, sleep duration disorder, sleep anxiety and parasomnia. Conclusion Television-watching and computer-using exert influences on sleep behaviors of sleep/wake patterns, sleep duration and sleep problems. Concerns about the potential negative effects of television-watching and computer-using on sleep behaviors may help to promote healthy sleep patterns and improve sleep quality.

Objective To investigate the blood pressure control rate and related influencing factors in hypertensive outpatients. Methods In this multicentre, cross-sectional registration survey, hypertensive outpatients were recruited from department of cardiology, nephrology and endocrinology of 92 tertiary hospitals in 22 cites across China. Each centre enrolled more than 50 hypertensive outpatients aged 18 years or older between 20 April 2009 and 31 May 2009. Outpatients were surveyed by clinical interview with BP measurement and questionnaire. Results A total of 5086 subjects were enrolled, 2032 in department of cardiology, 1510 in department of endocrinology and 1544 in department of nephrology, 27. 1% and 25. 3 % patients were in Grade 2 or Grade 3 hypertension, 37. 2% patients were complicated with diabetes, 22. 4% with coronary artery disease, and 18.4% with renal-dysfunction. Overall, controlled BP was achieved in 30.6% patients. The control rate was 45.9% in uncomplicated hypertensive patients, 31.3% in hypertensive patients with coronary artery disease, 14. 9% in patients with diabetes, and 13. 2% in patients with renal-dysfunction. Calcium channel blocker (56. 6% ) and angiotensin-Ⅱ receptor blockers (32. 0% ) were the most frequently used medications. The mean number of antihypertensive agents prescribed per patient was 1.73, over 54. 1% patients were treated with more than 2 antihypertensive drugs. Combination therapy or single-pill combination with various anti-hypertensive components was prescribed to 8.3% and 12. 7% hypertensive patients as initial therapy. Multiple logistic regression analysis showed that lower BMI, no alcohol intake, free medical care, no diabetes, no renal-dysfunction, lipid-lowering therapy, shorter interval of visiting physicians, regular taking antihypertensive medications, physical activity were the factors related to satisfactory blood pressure control rate in hypertensive outpatients. Conclusions Blood pressure control rate among Chinese hypertensive outpatients was increased compared with epidemiological survey in 2002. BMI, co-morbidities, lower combination treatment rate, poor compliance were the key reasons for lower BP control rate. Increased use of combination therapy instead of monotherapy should be encouraged to hypertensive outpatients to improve BP control rate.

Animals ; Bone Density ; Bone and Bones ; metabolism ; Calcium ; metabolism ; Genetic Predisposition to Disease ; Humans ; Osteoporosis ; genetics ; Polymorphism, Genetic ; Receptors, Calcitriol ; genetics ; Rickets ; etiology ; genetics

OBJECTIVETo investigate the clinical characteristics and managements of pyothorax due to postoperative cervical anastomotic leakage after esophageal cancer surgery.

METHODSFrom January 2006 to January 2013, 3342 patients with esophageal carcinoma underwent esophagectomy and cervical esophagogastric anastomosis. Of them, 19 patients developed pyothorax following cervical anastomotic leakage and their clinicopathological data were analyzed retrospectively.

RESULTSAll the patients underwent a cervical anastomosis via a three-incisional approach (right cervicothoracic mid-abdominal incision, RT group, n=1094) or a two-incisional approach (left cervicothoracic incision, LT group, n=2248). The total number of cervical anastomotic leakage cases was 237, of which 152 cases were in LT group (6.8%), and 85 cases in RT group (7.8%), respectively (P=0.287). The incidence of pyothorax was 2.0% (n=3) in LT group, and 18.8% (n=16) in RT group, respectively (P<0.01). Fourteen cases develop pyothorax within 3 days after operation. The main symptoms were high fever, dyspnea and chest pain. All the pyothorax patients received conservative treatments, including thoracic closed drainage, nasogastric tube placement, jejunal stoma, nutritional support, antibiotics and symptomatic treatment. Sixteen cases were cured, while 3 cases were dead.

CONCLUSIONSThe right thoracotomy approach predisposes the cervical anastomotic leakage-associated pyothorax. Sufficient drainage and sufficient nutritional support are critical to the treatment.

Aged ; Anastomotic Leak ; Drainage ; methods ; Empyema, Pleural ; etiology ; surgery ; Esophageal Neoplasms ; surgery ; Esophagectomy ; adverse effects ; Female ; Humans ; Male ; Middle Aged ; Postoperative Complications ; surgery ; Retrospective Studies

OBJECTIVETo evaluate the effect of capsaicin on nude mice xenografted with colorectal carcinoma cells, and to explore its mechanism of action.

METHODSA nude mouse model of colorectal cancer was established by subcutaneous inoculation of human colorectal carcinoma HT-29 cells. Terminal deoxynucleotidyl transferase-mediated nicked labeling assay (TUNEL) was undertaken to detect the cell proliferation and apoptosis in the xenograft tissue in nude mice. Immunohistochemical (IHC) staining and Western blot were used to detect the expression of HSP27, Cyt-C and active caspase-3.

RESULTSThe tumor growth of the groups C10 and C20 was significantly slower than that of the group NS. The integrated optical density (IOD) of both the group C5 (2532.14 ± 578.11) and group C10 (6364.03 ± 1137.98) was significantly higher than that of the group NS (760.12 ± 238.05), (P < 0.05). The integrated optical density (IOD) of the group C20 was (15743.96 ± 1855.95), significantly higher than that of the groups C10, C5 and NS (all were P < 0.01). Immunohistochemistry showed that the cytoplasmic expression of HSP27 was strongly positive in the group NS, and significantly reduced with the increasing dose of capsaicin in the treated groups. The expression of active caspase-3 and Cyt-C in the group NS was weakly positive, and was significantly increased with the increasing dose of capsaicin in the groups C5 and C10 (P < 0.05), and the expression of active caspase-3 and Cyt-C of the group C20 was significantly higher than that of the groups C5, C10 and NS (P < 0.01). Western blot analysis showed that both the expressions of HSP27 of the group C5 (0.73 ± 0.05) and the group C10 (0.41 ± 0.03) were significantly lower than that of the group NS (P < 0.05). The expression of HSP27 of the group C20 (0.22 ± 0.06) was significantly lower than that of the groups C5, C10 and NS (P < 0.01). The expressions of active-caspase-3 and Cyt-C in the group C5 were (2.57 ± 0.34) and (2.03 ± 0.38), significantly higher than those of the group NS (P < 0.05). The expressions of active-caspase-3 and Cyt-C in the group C10 were (4.23 ± 0.45) and (3.13 ± 0.44), also significantly higher than those of the group NS (P < 0.05). The expressions of active-caspase-3 and Cyt-C in the group C20 were (5.78 ± 0.48) and (4.92 ± 0.52), significantly higher than those of the group C5, C10 and NS (P < 0.01). TUNEL analysis showed that there was a significant difference of cell apoptosis in comparison of each two groups. The higher dose of capsaicin was used, the more apoptosis was observed.

CONCLUSIONSCapsaicin can significantly inhibit the tumor growth and induce cell apoptosis in the colorectal carcinoma xenograft in nude mice. Its mechanism of action is possibly related with the down-regulation of HSP27 expression and up-regulation of expression of active caspase-3 and Cyt-C in the colorectal carcinoma xenograft in nude mice.

Animals ; Antineoplastic Agents, Phytogenic ; administration & dosage ; pharmacology ; Apoptosis ; drug effects ; Capsaicin ; administration & dosage ; pharmacology ; Caspase 3 ; metabolism ; Cell Proliferation ; drug effects ; Cytochrome c Group ; metabolism ; Dose-Response Relationship, Drug ; Female ; HSP27 Heat-Shock Proteins ; metabolism ; HT29 Cells ; Humans ; Mice ; Mice, Inbred BALB C ; Mice, Nude ; Neoplasm Transplantation ; Random Allocation ; Tumor Burden ; Xenograft Model Antitumor Assays

OBJECTIVETo understand prevalence of sleep problems and presence of improper sleep habit of children aged one to 23 months in Shanghai, and to identify their related factors.

METHODSTotally, 1 252 normal children, without severe illness and abnormal delivery history, aged one to 23 months were randomly selected from five districts of Shanghai. Under strict quality control system, their parents were interviewed with questionnaire to look into their familial and social environment, as well as sleep-related factors.

RESULTSFully-completed information was obtained in 1 129 of 1 252 children, with a response rate of 90.18%. Prevalence of sleep problems in children was 65.90% in Shanghai, remarkably higher than in the other areas. Prevalence of nightmare, level of fright at night, snore and sleep apnea in boys were significantly higher than those in girls. Prevalence of improper sleep habit in children was also higher, including sleeping with their parents, parental presence at sleep onset and irregular sleep time. Main risk factors related to children's sleep problems were maternal anxiety, children's irregular sleep time, parental presence at sleep onset, difficulty-type temperament and maternal poor sleep during pregnancy.

CONCLUSIONSIn Shanghai, prevalence of sleep problems in children aged one to 23 months was relatively higher and main risk factors for them were social, cultural and familial environment, especially negligence of cultivating proper sleep habit and parental improper response to children's poor sleep behavior.

Adaptation, Psychological ; China ; epidemiology ; Humans ; Infant ; Maternal Behavior ; psychology ; Mother-Child Relations ; Prevalence ; Risk Factors ; Sex Factors ; Sleep Wake Disorders ; epidemiology ; Surveys and Questionnaires ; Time Factors

OBJECTIVETo survey the sleep habits (bedtime, wake time), sleep duration, and sleep problems in school-age children of China.

METHODFrom November to December, 2005, a total of 19,299 school-age children from 55 elementary schools of 9 cities entered the study by a cross-sectional survey. A parent-administered questionnaire and the Chinese version of the Children's Sleep Habits Questionnaire were applied to investigate children's sociodemographic characteristics and sleep behaviors, respectively.

RESULTSThe mean sleep duration was 9 hours and 10 minutes (9:10, SD:48 min) during the weekdays and 9:48 (SD: 63 min) during the weekends. In about 71.4% and 41.8% school-aged children the sleep duration per day did not reach the lowest criterion of 10 hours recommended by the Ministry of Education of China during weekdays and weekends, respectively. Sleep problems were common with prevalence ranging from 14.5% for sleep-disordered breathing to 75.3% for daytime sleepiness. Parasomnia (chi(2) = 13.76, P < 0.01) and sleep-disordered breathing (chi(2) = 119.83, P < 0.01) were more prevalent in boys than in girls; however, sleep anxiety was more prevalent in girls than in boys (chi(2) = 19.42, P < 0.01). Except for night waking, other types of sleep problems were significantly associated with age.

CONCLUSIONSInadequate sleep duration and sleep problems prevail among school-age children, which indicates that children's sleep health may be a major public health concern in China.

Child ; China ; epidemiology ; Cross-Sectional Studies ; Female ; Habits ; Humans ; Male ; Sleep ; Sleep Stages ; Sleep Wake Disorders ; epidemiology ; Students ; Surveys and Questionnaires ; Urban Population

OBJECTIVETo compare the immunity of morbid obesity (MO) before and after laparoscopic adjustable gastric banding (LAGB).

METHODS15 cases, with a mean body mass index (BMI) of 35.8 kg/m(2), were treated by LAGB from Jun. 2003 to Oct. 2003 in our department. Patients' immune parameters were determined preoperatively and 1, 3 and 6 months postoperatively. 15 cases with a normal BMI (23.6 kg/m(2)) were set as controls.

RESULTSBefore surgery, the MO had a significant lower level of CD(4)(+), CD(4)(+)/CD(8)(+) and a higher level of serum interleukin-2 (IL-2), Interleukin-6 (IL-6) than the controls (P < 0.01). There was a significant reduction of weight and BMI 6 months postoperatively (P < 0.01). At the same time, CD(4)(+) increased and serum IL-2 decreased significantly. But CD(4)(+)/CD(8)(+)and serum IL-2, IL-6 were still abnormal compare to the controls.

CONCLUSIONSMO may combined with an abnormal immunity. But after enough weight loss induced by LAGB, it can be partly reversed.

Adolescent ; Adult ; Female ; Follow-Up Studies ; Gastroplasty ; methods ; Humans ; Laparoscopy ; Male ; Obesity, Morbid ; immunology ; surgery ; Weight Loss

OBJECTIVETo evaluate the effectiveness of parental education on reducing lead exposure of children by examining the changes in blood lead levels of children whose parents receiving or not receiving educational intervention.

METHODSTwo hundred children with confirmed blood lead levels beyond 100 microg/L were selected. They were randomized into two groups, 107 children in study group and 93 in control. At the beginning of the study, parents of both study and control groups were called for interview to complete KABP questionnaire and lead study questionnaire. The study group was provided with interventional measures while control group was not contacted until the end of study. Intervention of parental education was undertaken by means of a TV program, a set of slides and a brochure, and focused on the questions regarding harmful effects of lead poisoning, the sources of environmental lead and prevention of this preventable disease. Tests for blood lead level were repeated for both study and control groups 3 months after the determination of the initial blood lead level.

RESULTSAll the relevant knowledge of health effect, lead sources and prevention of childhood lead poisoning of participating parents of study group were improved significantly (chi(2) = 14.06, 13.07, 10.08, 28.26, P < 0.01) after educational intervention while parents control group also were significantly improved in the sub-catalogs of concept and prevention (chi(2) = 7.69, 8.64, P < 0.01), but not the health effect and sources of childhood lead poisoning. Children and parents' behavior in study group was improved accordingly and significantly. Less children ate popcorn (chi(2) = 4.08, P < 0.05), less children drank tap-water in the morning (chi(2) = 23.04, P < 0.01), more kids washed their hands before eating (chi(2) = 5.82, P < 0.05), less kids played on road side (chi(2) = 9.60, P < 0.01), and more parents changed their coat or took shower or washed hands before going home after work (chi(2) = 4.00, P < 0.05). But in the control group only the number of kids playing on road side was decreased significantly (chi(2) = 9.60, P < 0.01). A general decline in blood lead levels was detected in both groups with statistical significance at P < 0.01. However, the decrease in blood lead levels was more remarkable in the study group. There was average reduction of 55 microg/L (35%) in blood lead levels for study group (t = 4.979, P < 0.01) and an almost 33 microg/L (20%) for control (t = 3.398, P < 0.01). The reduction in blood lead level was 22 microg/L greater in study group (t = 3.531, P < 0.01). The study also showed that the effectiveness of the educational interventions depended upon various aspects. Fourteen variables were included in the stepwise multiple regression equation of blood lead level changes. Such as parents' occupational exposure to lead, the improvement of knowledge about prevention of childhood lead poisoning, the chang of habit of snacks intake, parents' education levels, the change of attitude of parents for the childhood lead poisoning, etc.

CONCLUSIONEducating parents is proved to be an effective approach for children with mild and moderate lead poisoning.

Child ; Environmental Exposure ; Health Behavior ; Health Education ; Humans ; Lead ; blood ; Lead Poisoning ; blood ; therapy ; Parents ; education