OBJECTIVETo study the effectiveness of pie-crusting technique in improving the stiff knee.

METHODSFrom February 2012 to December 2013, 13 patients with stiff knee were reviewed retrospectively. There were 6 males and 7 females, ranging in age from 39 to 70 years old (averaged, 55.6 years old). Of the 13 cases, 8 patients had stiffness following fracture (comminuted tibial plateau fracture in 4, femoral supracondylar fracture in 3 and patellar fracture in 1), 5 patients had TKA-related stiffness.

RESULTSA follow-up lasted 8 to 12 months (mean 10 months)in 13 cases. The mean maximum flexion increased from (37 ± 6)° preoperatively to (52 ± 7)° after arthrolysis, and (108 ± 7)° after pie-crusting. At the final follow-up, mean maximum flexion was (105 ± 6)°. According to Judet evaluation system, 10 patients got an excellent result and 3 good. No major complications, such as extensor lag, skin necrosis, deep infection, dislocation of the patella or recurrent stiffness were found.

CONCLUSIONThe percutaneous technique of pie-crusting is a simple, minimally invasive and effective treatment for knee stiffness.

Adult ; Aged ; Female ; Follow-Up Studies ; Humans ; Joint Diseases ; physiopathology ; surgery ; Knee Joint ; physiopathology ; surgery ; Male ; Middle Aged ; Range of Motion, Articular ; Treatment Outcome

Dendritic Cell Sarcoma, Interdigitating ; Humans ; Lymph Nodes ; Male ; Middle Aged

Adult ; Antidepressive Agents ; therapeutic use ; Depression ; complications ; drug therapy ; Drugs, Chinese Herbal ; therapeutic use ; Dyspepsia ; drug therapy ; psychology ; Female ; Gastric Emptying ; drug effects ; Gastrointestinal Agents ; therapeutic use ; Gastrointestinal Motility ; drug effects ; Humans ; Male ; Middle Aged ; Phytotherapy ; Powders

OBJECTIVETo evaluate the reliability and diagnosis accuracy of 5 special tests used for the diagnosis of subacromial impingement syndrome (SAIS).

METHODSA prospective blinded cohort study was taken,in which 105 patients with shoulder pain were reviewed. All the patients took 5 special syndrome tests including Neer syndrome, Hawkins-Kennedy syndrome, painful arc empty can test and external rotation resistance test, also underwent arthroscopic surgical examination. The Nikolaus's criterion was regarded as a golden standard for SAIS. Data accuracy analysis was calculated through a receiver operating characteristic (ROC) curve, sensitivity, specificity, positive likelihood ratio (+LR) and negative likelihood ratio (-LR). The binary Logistic regression analysis was used to find out the best test combination for ruling in or out SAIS. The interrater reliability was assessed by the Kappa coefficient and percent agreement.

RESULTSThe ROC analysis indicated a significant area under the curve (AUC) (AUC=0.62 to 0.73, P<0.05) for all tests except the Hawkins-Kennedy. Tests with a +LR greater or equal to 2.0 were the painful arc,empty can,external rotation resistance, Tests with a-LR less than 0.5 were Neer,painful are ,external rotation resistance. The regression analysis found the painful arc, empty can and external rotation resistance made the best combination for diagnosis SAIS,while the painful are and external rotation resistance made the best combination for ruling out SAIS. The difference of ROC analysis was significant with a cut-off of 3 positive tests out of 5 tests. All tests had moderate to good agreement (Kappa=0.42 to 0.71).

CONCLUSIONThe single test of painful arc, empty can and external rotation resistance, as well as 3 or more positive tests of the 5 tests can help confirm the diagnosis of SAIS, while the single test of Neer, painful arc and external rotation resistance are help rule out the diagnisis of SAIS. The tests of painful arc, empty can and ex ternal rotation resistance are the best combination for the diagnosis of SAIS (when 2 or more are positive), while the tests of painful arc and external rotation resistance are the best combination for ruling out SAIS (when both are negative)

Adult ; Aged ; Aged, 80 and over ; Cohort Studies ; Female ; Humans ; Male ; Middle Aged ; Physical Examination ; methods ; Prospective Studies ; Reproducibility of Results ; Shoulder Impingement Syndrome ; diagnosis

OBJECTIVETo study the scientific evidence of the traditional preparation of Dachengqi: "Boiling Aurantii Immaturus and Magnoliae Officinalis first, and then adding Rhei to decoct together. Discarding the dregs, adding Natrii Sulfas into the decoction and drinking the upper solution when the Natrii Sulfas has dissolved completely".

METHODThe concentrations of free and combined anthraquinonoids(emodin, rhein, chrysophanol, physcion) in different decoctions were determined with HPLC method respectively.

RESULTWhen Natrii Sulfas, Aurantii Immaturus and Magnolias Officinalis are decocted with Rhei in different schemes, the concentrations of anthraquinonoids were changed regularly.

CONCLUSIONThe scientific evidence of traditional preparation method greatly increased the concentrations of the active components in Dachengqi.

Anthraquinones ; analysis ; Citrus ; chemistry ; Drug Combinations ; Drugs, Chinese Herbal ; chemistry ; Emodin ; analogs & derivatives ; analysis ; Hot Temperature ; Magnolia ; chemistry ; Materia Medica ; chemistry ; Plant Extracts ; chemistry ; Plants, Medicinal ; chemistry ; Rheum ; chemistry ; Sulfates ; Time Factors

Introduction: Atrial fibrillation (AF) is the most common cardiac arrhythmia in singapore. We describe a cohort of multi-ethnic Asian patients with AF, with the aim to evaluate anticoagulation use and to identify factors predictive of stroke, bleeding and all-cause mortality. Materials and Methods: this was a single centre, retrospective cohort study. All patients with an admission diagnosis of AF between 1 January 2000 and 31 December 2010 were identified. Of these patients, those who had follow-up data up to 31 December 2012 were included in the study. results: there were 1095 eligible patients. the mean age was 67±14 years, mean cHADs2 score was 2±1 and mean HAs-bLED score 2±1. Of the 1095 patients, 657 (62.0%) had a cHADs2 score ≥ 2 but only 215 (32.7%) were eventually prescribed warfarin. Patients not on warfarin were older (p<0.0001) and were more likely females (p<0.0001). Among patients not on warfarin, 52% had HAs-bLED score ≤3. Multivariate analysis revealed that warfarin use and high HAs-bLED score were associated with increased bleeding risk. Age, Indian ethnicity and cHADs2 score were predictive of ischemic stroke. All-cause mortality was significantly related to age, presence of heart failure and HAs-bLED score. conclusions: Anticoagulation management of AF patients remains inadequate. Objective assessment of bleeding risks should be performed before withholding anticoagulation.

Objective To study the effects of recombinant ciliary neurotrophic factor(CNTF) on expression of growth related proteins in related neurons after sciatic nerve repair in rats. Methods After a segment of the sciatic nerve of the rat was removed, the distal and proximal ends were sutured into a recombinant CNTF-containing silicone tube. Growth associated protein 43 ( GAP-43 ) and somatostatin (SOM) in the L4 spinal cord, L4 or L5 spinal ganglia were examined and measured by immunohistochemistry and in situ hybridization using computerized image processing system. Results An increase in the GAP-43 immunoreactivity in the large, medium neurons of spinal anterolateral nucleus was more significant in the CNTF-treated group compared with those in the 0.9% saline (SAL) -treated group, while a decrease in SOM mRNA hybridization signals in those neurons were more significant in the CNTF-treated group. There were no significant differences in the aforementioned immunoreactivity and hybridization signals of spinal ganglia between the CNTF-treated group and the SAL-treated group. Conclusion The results suggest that recombinant CNTF administration up-regulate GAP-43 expression and down-regulate SOM mRNA expression in the related motor neurons, but not sensory neurons, after reconnection of transected sciatic nerve.

BACKGROUNDEdaravone had been validated to effectively protect against ischemic injuries. In this study, we investigated the protective effect of edaravone by observing the effects on anti-apoptosis, regulation of Bcl-2/Bax protein expression and recovering from damage to mitochondria after OGD (oxygen-glucose deprivation)-reperfusion.

METHODSViability of PC12 cells which were injured at different time of OGD injury, was quantified by measuring MTT (2-(4,5-dimethylthia-zol-2-yl)-2,5-diphenyltetrazolium bromide) staining. In addition, PC12 cells' viability was also quantified after their preincubation in different concentration of edaravone for 30 min followed by (OGD). Furthermore, apoptotic population of PC12 cells that reinsulted from OGD-reperfusion with or without preincubation with edaravone was determined by flow cytometer analysis, electron microscope and Hoechst/PI staining. Finally, change of Bcl-2/Bax protein expression was detected by Western blot.

RESULTS(1) The viability of PC12 cells decreased with time (1 - 12 h) after OGD. We regarded the model of OGD 2 h, then replacing DMEM (Dulbecco's Modified Eagle's Medium) for another 24 h as an OGD-reperfusion in this research. Furthermore, most PC12 cells were in the state of apoptosis after OGD-reperfusion. (2) The viability of PC12 cells preincubated with edaravone at high concentrations (1, 0.1, 0.01 micromol/L) increased significantly with edaravone protecting PC12 cells from apoptosis after OGD-reperfusion injury. (3) Furthermore, edaravone attenuates the damage of OGD-reperfusion on mitochondria and regulated Bcl-2/Bax protein imbalance expression after OGD-reperfusion.

CONCLUSIONNeuroprotective effects of edaravone on ischemic or other brain injuries may be partly mediated through inhibition of Bcl-2/Bax apoptotic pathways by recovering from the damage of mitochondria.

Animals ; Antipyrine ; analogs & derivatives ; pharmacology ; Apoptosis ; drug effects ; Flow Cytometry ; Ischemia ; prevention & control ; Microscopy, Electron ; Mitochondria ; drug effects ; Neuroprotective Agents ; pharmacology ; PC12 Cells ; Proto-Oncogene Proteins c-bcl-2 ; analysis ; Rats ; bcl-2-Associated X Protein ; analysis

OBJECTIVETo evaluate the roles of expression and early protein E2 and E6 load of human papillomavirus type 16 (HPV16) on cervical cancer in order to explore the relation between disruption of E2 and development of cervical cancer.

METHODSA case-control study was conducted, including 141 cervical cancer patients as cases who had been diagnosed by cytological approaches and histological approaches in Shanxi province Tumor Hospital, China. Two type of controls including 137 hospital controls with hysteromyoma by cytology or histology and eligible 129 controls from 1582 healthy women in the community who took part in community-organized physical examination with neither CIN2-3 nor invasive cancer, nor other gynecologic diseases were recruited. HPV16 E2 and E6 oncogenes were detected by multiple polymerase chain reaction (multi-PCR). The levels of E2 and E6 were analyzed used Bio-1D+ + software provided by VILBER pattern formatter.

RESULTSThe positive rates of HPV16 E6 in cancer cases (46.8%) were significantly higher than that in hysteromyoma group (24.1%) or healthy control group (2.3%) and accounted for 2.77 of OR (95% CI: 1.66-4.63) and 36.96 of OR(95% CI: 11.22-121.71) respectively. The expressions and loads of HPV16 E6 and E2 in cases were significantly higher than that in two control groups. Meanwhile, the expression or level of E6 was higher than that of E2 in each group. Disruption rate of E2 was 22.73% and the ratio of E6 to E2 was 1.24 in cervical cancer group.

CONCLUSIONThe positive rates and levels of HPV16 E6 or E2 found in cervical cancer were higher than that in hysteromyoma and healthy women. High expression of E6 and disruption of E2 might play an important role in the development of HPV-induced cervical cancer.

Adult ; Aged ; Case-Control Studies ; DNA, Viral ; genetics ; DNA-Binding Proteins ; genetics ; Female ; Gene Expression Regulation, Viral ; Human papillomavirus 16 ; genetics ; Humans ; Middle Aged ; Oncogene Proteins, Viral ; genetics ; Papillomavirus Infections ; genetics ; virology ; Polymerase Chain Reaction ; Repressor Proteins ; genetics ; Uterine Cervical Neoplasms ; genetics ; virology

OBJECTIVETo study the current status of geriatric tuberculosis (TB) and its impact on TB control program under the directly observed treatment short-course (DOTS) strategy in China.

METHODSUsing the prevalence information regarding the epidemiology of geriatric TB from the National Random Survey in 2000, a case-control study was carried out to analyze the case detection, treatment and management of geriatric TB patients between DOTS area and non-DOTS area.

RESULTSThe prevalence of sputum smear positive (SS+) in the age group of 65 or above was 440/100 000 which was 3.6 times of the average prevalence of SS+ of all age groups. Geriatric SS+ patients took up 28.8% of all the TB patients in 13 provinces with implementation of DOTS and 28.9% in 15 provinces without. The population of TB case in the age group 65 or above occupied 11.4% of all the newly registered SS+ case in 13 DOTS provinces from 1992 to 2000.

CONCLUSIONThe prevalence of geriatric SS+ was high. In both DOTS and non-DOTS areas, the proportion of geriatric SS+ was high but the registration rate of new SS+ was low among all the age groups. Both high prevalence and low case detection rate of geriatric TB became main issues to be under concern in the TB control strategy in China.

Age Factors ; Aged ; Aged, 80 and over ; Case-Control Studies ; China ; epidemiology ; Communicable Disease Control ; statistics & numerical data ; Directly Observed Therapy ; statistics & numerical data ; Female ; Humans ; Male ; Middle Aged ; Outcome Assessment (Health Care) ; statistics & numerical data ; Prevalence ; Retrospective Studies ; Tuberculosis, Pulmonary ; epidemiology ; prevention & control ; World Health Organization