Animals ; Central Nervous System ; radiation effects ; Humans ; Mice ; Microwaves ; Rats

Objective:To compare the clinical effects of ultrasound-guided intra-articular and coracohumeral ligament glucocorticoid injections versus ultrasound-guided intra-articular glucocorticoid injections alone on frozen shoulder in the elderly.Methods:A total of 44 patients with frozen shoulder admitted to the rehabilitation department of the Affiliated Hospital of Sichuan Nursing Vocational College from September 2019 to June 2020 were enrolled.They were randomly divided into the experimental group and the control group, with 22 patients in each group.The experimental group received two consecutive ultrasound-guided intra-articular injections and two coracohumeral ligament injections, while the control group received two consecutive ultrasound-guided intra-articular injections.The shoulder's passive range-of-motion(PROM), the 11-point numeric rating scale(NRS)as well as the Shoulder Pain and Disability Index(SPADI)were conducted before treatment, 1 week after the first treatment(1 week), 1 week after the second treatment(2 weeks)and 10 weeks after the second treatment(12 weeks).Results:There was no significant difference in baseline characteristics between the two groups(all P>0.05). Flexion, abduction, extension and external rotation increased whereas NRS and SPADI decreased after treatment, compared with pre-treatment in the experimental group( F=11.341, 20.965, 20.403, 32.470, 82.970 and 102.154, all P<0.05)and in the control group( F=7.012, 8.937, 23.265, 31.966, 52.500 and 41.356, all P<0.05). Compared with the control group, extension( t=0.365, 0.143 and 0.236, all P<0.05)and external rotation( t=0.205, 0.620 and 2.751, all P<0.05)increased at 1, 2 and 12 weeks after treatment.SPADI scores were lower in the experimental group than in the control group at 12 weeks after treatment( t=2.063, P=0.045). There was no significant difference in NRS, flexion or abduction between the two groups at any time point after treatment(all P>0.05). No serious adverse reactions occurred during treatment in either group. Conclusions:Both ultrasound-guided intra-articular injections plus coracohumeral ligament injections and ultrasound-guided intra-articular injections can effectively alleviate pain and improve function in elderly patients with frozen shoulder, but the former has better effects on extension.For patients with clear restricted extension and external rotation, ultrasound-guided intra-articular injections combined with coracohumeral ligament injections may achieve better clinical effects.

Objective To evaluate the olfactory function and its influence factors by using Sniffin ’ Sticks test, and to compare the quality of Parkinson ’s disease (PD) recognition between Sniffin’ Sticks and 16 kinds of odor identification in Sniffin ’ Sticks(SS-16) tests.Methods The Sniffin’Sticks test was used to assess the olfactory function of 68 PD patients and 76 healthy volunteers , and the relationship between smell and age, disease duration, Unified Parkinson’ s Disease Rating Scale score, Hoehn-Yahr (H-Y) rating, and cognitive function level (Montreal Cognitive Assessment) was analyzed.Results (1)The prevalence of olfactory dysfunction in PD group (83.3%) was significantly higher than that in control group (21.2%).The Sniffin’ Sticks test showed that the odor threshold score (6.6 ±3.2, P=0.000), odor discrimination score (6.6 ±3.3, P=0.000), 16 kinds of odor identification score (6.8 ±2.4, P=0.000) in PD group were significantly lower than those in control group.( 2 ) When comparing the PD cases and healthy controls in recognition , the sensitivity and the specificity of the Sniffin ’ Sticks test were 0.897 and 0.737, respectively, similar to the SS-16 test.However, the Sniffin’ Sticks test showed advantage compared with odor threshold and odor discrimination.( 3 ) The olfactory score in PD group was positively correlated with cognitive function (r=0.243, P=0.046), and was unrelated with age, gender, disease duration, and disease severity.The olfactory score in control group was negatively correlated with age (r=-0.270, P=0.018), but positively correlated with cognitive function (r=0.281, P=0.014).Conclusions There is a higher incidence of olfactory dysfunction in PD patients than in control group.Sniffin’ Sticks test is superior to SS-16 test in quantitative and qualitative analysis of olfactory function in PD patients.Two tests both have high sensitivity and specificity in the recognition of PD .

Objective To observe the clinical efficacy of moxibustion in treating knee osteoarthritis (KO) and analyze its cost-effectiveness.Method Fifty-eight KO patients were randomized into a moxibustion group and an electroacupuncture (EA) group, 29 cases in each group. The two groups were treated 3 times a week, for successive 4 weeks. The knee joint function and Visual Analogue Scale (VAS) for knee joint pain were scored before and after the treatment, and the two groups were analyzed by using health economic methods.Result The knee joint function scores were significantly changed after the treatment in the two groups (P<0.05); the excellent rate was 96.6％ in EA group versus 75.9％ in moxibustion group, and the general excellent rate in EA group was markedly higher than that in moxibustion group (P<0.05); the total effective rate for pain was 93.1％ in moxibustion group versus 96.6％ in EA group, and the between-group difference was statistically insignificant (P>0.05). The cost-effectiveness ratio was 6.42 in moxibustion group versus 16.86 in EA group; the incremental cost-effectiveness ratio was 298.55 in EA group. Conclusion Moxibustion and EA both can effectively improve knee joint function and mitigate knee joint pain, while compared with EA, moxibustion has a higher health economic value.

Objective This study applied the theory of planned behavior to investigate the leisure exercise situation among patients with type 2 diabetes mellitus (T2DM) and its influencing factors. Methods The questionnaire was self-designed based on the theory of planned behavior, which had good reliability and validity. Structural equation modeling was used to estimate the determinants of leisure exercise and the potential intermediate effect. Results 774 patients with T2DM were enrolled in this study. 52.6% were over 60 years old. The median amount of leisure exercise was 0.0 thousand-step equivalent with quartile of (0.0, 2.0). Structural equation modeling showed that the effects of attitude (β=0.080) and intention (β=0.277) on leisure exercise were significant. Besides, perceived behavioral control (β=0.180) had an indirect effect on exercise through intention. Conclusions In general, most patients with type 2 diabetes have insufficient amount of exercise. Improving attitude, control and intention to exercise would be one crucial part of exercise health education among patients with T2DM.

BACKGROUNDThere is a paucity of studies investigating the clinical and biochemical characteristics of pain in chronic heart failure (CHF) patients. This study aimed to determine the clinical and biochemical characteristics and outcomes in Chinese patients with CHF and symptoms of pain.

METHODSSociodemographics, serum levels of creatinine, NT-proBNP, high-sensitivity C-reactive protein (hs-CRP), tumor necrosis factor (TNF)-α, interleukin (IL)-6 and IL-10, and two-dimensional echocardiographic left ventricular ejection fraction (LVEF) were determined in 305 patients with CHF. A questionnaire packet including the Brief Pain Inventory (BPI) and the Minnesota Living with Heart Failure Questionnaire (MLHFQ) was used to assess the degree of pain rated on a 0 - 10 scale and the quality of life (QOL). A six-minute walking test was performed during routine clinic visits. Major adverse cardiac events (MACE) were recorded; including all-cause or cardiac mortality and rehospitalization because of myocardial infarction, worsening heart failure or stroke at follow-up.

RESULTSPain occurred in 25.6% of CHF patients, and was more common when the New York Heart Association (NYHA) functional class was worse. More patients with pain were female in gender, and had more co-morbidities, lower LVEF, and shorter distance during the 6-minute walking test. Despite similar serum levels of creatinine, N-terminal prohormone of brain natriuretic peptide (NT-proBNP), IL-6 and IL-10, the TNF-α levels were higher and MLHFQ scores were greater in CHF patients with pain. At follow-up, CHF patients with moderate to severe pain (≥ 4 scale) had higher rates of all-cause and cardiac mortality and rehospitalization because of myocardial infarction, worsening heart failure or stroke. Multivariate regression analysis revealed that the presence of pain was an independent risk factor for MACE and reduced QOL in CHF patients.

CONCLUSIONSPain occurs in all stages of the CHF trajectory, and its incidence increases as clinical functional status is worsened. The presence of pain exerts a negative impact on clinical outcome and QOL in patients with CHF.

C-Reactive Protein ; metabolism ; Echocardiography ; Female ; Heart Failure ; metabolism ; physiopathology ; Humans ; Interleukin-10 ; blood ; Interleukin-6 ; blood ; Male ; Pain ; metabolism ; physiopathology ; Tumor Necrosis Factor-alpha ; blood

OBJECTIVETo probe the diagnostic value of the infrared radiation spectrum of acupoint for ulcerative colitis (UC).

METHODSA high sensitivity PHE 201 infrared spectrum instrument was used to determine the infrared radiation spectrum of Hegu (LI 4) and Shangjuxu (ST 37) in 34 cases of UC.

RESULTSOf 59 waves detected, there were significant differences in infrared radiation intensity of 28 different waves between the healthy people and the patients with UC in right Hegu (LI 4) (P < 0.05 or P < 0.01) and 13 waves in left Hegu (LI 4) (P < 0.05); there were significant differences in 16 different waves in right Shangjuxu (ST 37) (P < 0.05 or P < 0.01) and in 17 waves in left Shangjuxu (ST 37) (P < 0.05 or P < 0.01); there was a significant difference in 18 waves between right and left Hegu (LI 4) of the patients (P < 0.05 or P < 0.01) and 7 waves between right and left Hegu (LI 4) of the healthy people (P < 0.05). There was a significant difference in 4 waves between right and left Shangjuxu (ST 37) of the patients and one wave between right and left Shangjuxu (ST 37) of the healthy people (P < 0.01).

CONCLUSIONBoth Hegu (LI 4) and Shangjuxu (ST 37) show changes of infrared radiation spectrum when the intestine gets lesion, and Hegu (LI 4) can better show the change.

Acupuncture Points ; Acupuncture Therapy ; Adult ; Colitis, Ulcerative ; therapy ; Female ; Humans ; Infrared Rays ; Intestine, Large ; anatomy & histology ; Male ; Middle Aged

OBJECTIVETo investigate the effect of transcatheter hepatic arterial chemoembolization (TACE) therapy on the survival and prognosis of recurrent hepatocellular carcinoma (HCC) after surgical resection.

METHODSThe data of 130 surgically resected but recurrent HCC patients treated by TACE were reviewed retrospectively. The survival and influencing factors on the prognosis were analyzed.

RESULTSThe overall 1-, 3-, 5-year survival rates of these 130 patients were 83.0%, 45.5% and 17.6% respectively (median survival time 2.4 years). Ninty-four of the series were treated with TACE alone, which gave the 1-, 3- year survival rates of 76.4% and 37.1%, respectively (median survival time 2.1 years). Thirty-six out of 130 patients treated with TACE plus percutaneous ethanol injection (PEI), the 1-, 3-year survival rates were 100.0% and 66.5% respectively with a median survival time (MST) of 3.5 years. The survival of TACE plus PEI group was significantly better, and the mortality risk was significantly lower than that of TACE alone group (P < 0.05). The mortality risk of those with > 5 cm diameter recurrent tumor or with distant metastasis was significantly higher than those with < or = 5 cm diameter tumor or without metastasis (P < 0.05).

CONCLUSIONTACE combined with PEI may improve the survival of recurrent HCC patients.

Adolescent ; Adult ; Aged ; Antineoplastic Combined Chemotherapy Protocols ; administration & dosage ; Carcinoma, Hepatocellular ; pathology ; therapy ; Chemoembolization, Therapeutic ; Child ; Cisplatin ; administration & dosage ; Ethanol ; administration & dosage ; Female ; Fluorouracil ; administration & dosage ; Hepatic Artery ; Humans ; Iodized Oil ; administration & dosage ; Liver Neoplasms ; pathology ; therapy ; Male ; Middle Aged ; Mitomycin ; administration & dosage ; Neoplasm Recurrence, Local ; therapy ; Postoperative Period ; Treatment Outcome

BACKGROUNDPotentially lethal ventricular arrhythmias (PLVAs) occur frequently in survivors after acute myocardial infarction and are increasingly recognized in other forms of structural heart diseases. This study investigated the prevalence and prognostic significance of PLVAs in patients with chronic heart failure (CHF).

METHODSData concerning demographics, etiology of heart failure, NYHA functional class, biochemical variables, electrocardiographic and echocardiographic findings, and medical treatments were collected by reviewing hospital medical records from 1080 patients with NYHA II-IV and a left ventricular (LV) ejection fraction ≤ 45%. PLVAs were defined as multi-focal ventricular ectopy (> 30 beats/h on Holter monitoring), bursts of ventricular premature beats, and nonsustained ventricular tachycardia. All-cause mortality, sudden death, and rehospitalization due to worsening heart failure, or cardiac transplantation during 5-year follow-up after discharge were recorded.

RESULTSThe occurrence rate of PLVAs in CHF was 30.2%, and increased with age; 23.4% in patients < 45 years old, 27.8% in those between 45 - 65 years old, and 33.5% in patients > 65 years old (P = 0.033). Patients with PLVAs had larger LV size and lower ejection fraction (both P < 0.01) and higher all-cause mortality (P = 0.014) during 5-year follow-up than those without PLVAs. Age (OR 1.041, 95%CI 1.004 - 1.079, P = 0.03) and LV end-diastolic dimension (OR 1.068, 95%CI 1.013 - 1.126, P = 0.015) independently predicted the occurrence of PLVAs. And PLVA was an independent factor for all-cause mortality (RR 1.702, 95%CI 1.017 - 2.848, P = 0.031) and sudden death (RR 1.937, 95%CI 1.068 - 3.516, P = 0.030) in patients with CHF.

CONCLUSIONPLVAs are common and exert a negative impact on long-term clinical outcome in patients with CHF.

Adult ; Aged ; Arrhythmias, Cardiac ; mortality ; physiopathology ; Electrocardiography ; Female ; Heart Failure ; physiopathology ; Humans ; Male ; Middle Aged ; Regression Analysis

This study was carried out to compare the effective dose, size specific dose estimation (SSDE) and scan length between genders and between CT scanner with different slice number. A total of 245 set data of radiation dose and scan length for CT scanning procedure involving thorax, abdomen and pelvis regions were obtained retrospectively for comparisons. 111 patients (60 males and 51 females) were scanned using 160-slices CT scanner while 134 patients (71 males and 63 females) were scanned using 640-slices CT scanner. Generally, there were no significant differences in the radiation dose and scan length among genders. However, differences for SSDE in CT thorax and CT thorax-abdomen-pelvis (TAP) protocols exist whereby in CT thorax protocol, 640-slices CT scanner had a significantly higher value of SSDE (9.06±2.67 mGy) than that in 160-slices CT scanner (7.82±1.33 mGy). Similarly to the CT TAP protocol, whereby 640-slices CT scanner had a significantly lower value in SSDE (9.17±1.59 mGy) than that in 160-slices CT scanner (10.76±3.72 mGy). In conclusion, there was no significant difference in the radiation dose and scan length between genders but significant difference was only observed in SSDE due to the presence of body size variation among the study population especially in different CT scanners.