Objective To investigate the clinical efficacy of flexible ureteroscopic lithotripsy combined with percutaneous nephrolithotomy treating for partial staghorn calculi.Methods 84 patients diagnosed as partial staghorn calculi in our hospital were randomly divided into group A and B with each group 42 patients.Patients in group A received the conventional minimally invasive percutaneous nephrolithotomy in the prone position,and patients in group B received the percutaneous nephrolithotomy combined with flexible ureteroscopic lithotripsy in the modified Valdivia position.The post-operative stone free rate and complications were recorded.Results The surgery time in group B was longer than that in group A [(106.44±18.46)min vs(83.69±10.29)min],with statistically significant difference(P<0.05).However,the first stone free rate in group B was higher than that in group A(85.71% vs 59.52%,P<0.05),and the blood loss in group B was lower than that in group A [(70.02±9.15)ml vs(87.41±9.89)ml,P<0.05].The common complication of patients in two groups was fever(temperature >38.5℃),but there was no notably difference between the two group(P>0.05).Conclusion Compared with the regular percutaneous nephrolithotomy,flexible ureteroscopic lithotripsy combined with percutaneous nephrolithotomy treating partial staghorn calculi has the shorter operation time,the less blood volume and the higher first stone free rate.Furthermore,the combination method did not significantly increasing the incidence of patient's complication.

Objective To explore the clinical effect of Tuina therapy for knee osteoarthritis (KOA) patients and their musculus quadriceps fexoris strength. Methods The 114 patients with KOA who met the inclusion criteria were randomly divided into the observation group and the control group (57 in each group). The patients in observation group were treated with Tuina therapy, and the control group were treated with Meloxicam. All the patients were treated for 30 days. The Isokinetic muscle strength test was used to evaluate the strength of the four biceps femoris muscle, and HSS score and pain score were observed before and after treatment. Results The total effective rate of the observation group was 91.2% (52/57), and the control group was 71.9% (41/57). The difference between 2 groups was statistically significant (χ2=3.971, P=0.018). After treatment, the HSS scores (79.0 ± 2.0 vs. 66.3 ± 1.4; t=3.121, P<0.01) in observation group were significantly higher than that in control group, and the pain scores (1.7 ± 1.1 vs. 3.2 ± 1.1; t=2.953, P<0.01) in observation group were significantly lower than that in control group. The PT (59.91 ± 25.90 Kgm vs. 55.17 ± 25.88 Kgm, t=2.652), AP (30.04 ± 12.59 W vs. 28.02 ± 17.03 W, t=3.618), TW (496.47 ± 257.26 Nm vs. 466.19 ± 225.70 Nm, t=3.227) of 60/s isokinetic muscle strength test and PT (37.22 ± 18.73 Kgm vs. 32.54 ± 15.22 Kgm, t=2.511), AP (39.43 ± 18.02 W vs. 36.14 ± 23.88 W, t=2.183), TW (326.03 ± 159.38 Nm vs. 267.66 ± 156.93 Nm, t=2.073) of 180/s isokinetic muscle strength test in observation group were significantly higher than those in control group (P<0.05). Conclusions Tuina therapy could improve KOA patients' musculus quadriceps fexoris strength, which curative effect were better than oral treatment of Meloxicam.

Objective To investigate the efficacy of lower cervical spine fracture and dislocation treated by Halo-vest reduction combined with anterior decompression and internal fixation.Methods From January 2009 to December 2012,26 cases of lower cervical spine fracture and dislocation underwent Halovest reduction combined with anterior decompression and internal fixation.There were 18 males and 8 females,aged 19-64 years (mean,42.1 years).Injury resulted from traffic crashes in 11 cases,high falls in 9,and hit by heavy objects in 6.Segment of injury was C5/6in 10 cases,C6/7in 9,C3/4in 4,and C4/5in 3.Prior to anterior decompression/internal fixation and fusion,the Halo-vest external fixation was performed.Neurological performance was evaluated after operation.Results All the patients were followed up for 24-36 months (mean,27.4 months).According to the X-ray films and CT scan at the final follow-up,the alignment of the cervical spine was maintained and the implanted bone was completely fused without internal fixation breaking or loosening.Preoperative neurological status according to the Frankel grading was grade A in 6 cases,grade B in 8,grade C in 7,and grade E in 2.After operation,there were 5 cases in grade A,3 in grade B,4 in grade C,5 in grade D,and 9 in grade E.All together,6 cases presented two-grade improvement in neurological status,13 one-grade improvement,and 5 no changes (P ＜ 0.05).Conclusion Halo-vest reduction combined with anterior decompression and internal fixation is safe and effective in treatment of lower cervical spine fracture and dislocation.

BACKGROUND:There is controversial in choosing the treatment method for the treatment of traumatic subaxial cervical fracture-dislocation and spinal cord injury.
OBJECTIVE:To evaluate the clinical effect of implant internal fixation and Halo-vest external fixation on the stability after treatment of subaxial cervical fracture-dislocation.
METHODS:A retrospective analysis was conducted on 17 patients with subaxial cervical fracture-dislocation in the Department of Orthopedics, the Second Affiliated Hospital of Shantou University Medical Col ege between January 2009 to December 2011, including 13 male patients and 4 female patients, the age was ranged from 21-65 years, average 41.6 years. There were six cases of high fal ing injury, three cases of crush injury and eight cases of traffic accident injury. The hospitalization time after injury was 2 hours to 5 days, average 2.5 days. Al the patients received Halo-vest external fixation under local anesthesia, then distraction gradual y, and received anterior decompression graft and titanium screw fixation under reduction. The treatment effect was evaluated
through Frankel classification and imaging examination.
RESULTS AND CONCLUSION:Al the patients were fol owed-up for 12-24 months, average 15.4 months. Normal anteraposterior X-ray film showed fracture reduction, the cervical vertebra restored to the normal
sequence and physiological curvature;CT showed graft fusion without internal fixation fracture and loosing;
according to Frankel classification, marked effect (decreased for 2 grade) in five cases, effective (decreased for 1
grade) in 10 cases, and ineffective in two cases. Implant internal fixation combined with Halo-vest external fixation is safe and reliable in the instability fixation of subaxial cervical fracture-dislocation, and can better restore the spinal sagittal alignment.

Objective To explore health-related quality of life (HRQOL) in patients with chronic Keshan disease in China and the influence factors.Methods According to the Diagnosis of Keshan Disease (WS/T 210-2011),146 patients with chronic Keshan disease were selected from the follow-up chronic Keshan disease patients with standard treatment in Shandong.The HRQOL was assessed in those patients by use of the Chinese version of SF-36.Correlation analysis and multiple linear regression were used to analyse the influence factors of HRQOL.Results All dimension scores were significantly lower than those of general population (t =-5.12--13.13,all P ＜ 0.01).There were significant differences in Role-Physical dimensions (RP,F =47.09,P ＜ 0.01) and Physiological Function dimension (PF,F =31.49,P ＜ 0.01) between patient groups with different severity of left ventricular ejectio,n fraction (LVEF),RP dimension (F =8.47,P ＜ 0.01) and Vitality dimension (VT,F =11.29,P ＜ 0.01) in patients varies with left ventricular end-diastolic dimension (LVEDD).The scores of some dimensions were correlated with age,family income,course of disease,LVEF and LVEDD,heart function grading,labor ability (r =-0.49-0.36,P ＜ 0.05 or ＜ 0.01).The multivariate linear regression analysis indicated that the influencing factors of physiological status were NYHA cardiac function classification,course of disease,family income and body mass index (BMI).The influencing factor of mental health states was NYHA cardiac function classification.The influencing factors of the total HRQOL score were NYHA cardiac function classification,course of disease and family income.Conclusions The HRQOL of patients with chronic Keshan disease is significantly declined as compared with the general population and the lowest is RP.NYHA functional class,course of disease and family income are relative dominant predictor of patients HRQOL among all variables.

Objective To observe the dilated cardiomyopathy ( DCM ) in non-Keshan disease areas in Shandong Province and assess scientifically the effectiveness of prevention and control measures on Keshan disease (KSD). Methods According to the scheme of DCM condition survey of our country in non-Keshan disease areas, seven representative counties(cities, areas) were chosen by their similarities in natural environment, production and life style to KSD areas; one or two townships ( towns ) were chosen in each county ( city , area ); one village was selected as a survey point in each township ( town ) . In each survey point , about four hundred and twenty natural populations were checked by asking detailed history, physical examination, and electrocardiography (ECG) tracings, and suspicious people were taken chest X-ray examination and cardiac ultrasound(UCG). The samples of inside and outside environmental were collected in partial residents and the selenium contents were detected by 2,3-diaminonaphthalene fluorometric method. At the same time the income, food of inhabitant and other basic information were collected. Results ① In 13 survey villages, sixty-four hundred and sixty-three residents were surveyed and 2 DCM cases and 111 similar potential KSD cases were detected, the detection rate was 1.75%(113/6 463). ② Sixty-four hundred and sixty-three residents were traced by ECG and the incidence of abnormal ECG was 20.4%(1 318/6 463), and sinus bradycardia, T-wave changes, sinus tachycardia, ST-T changes, occasional ventricular beating earlier, complete right bundle branch block, left anterior branch block, room premature beat, left ventricular high voltage, auriculo-ventricular block, et al were common. ③Samples of hair(260), wheat(260), corn (240) and soil (104) were collected, and the selenium contents were (0.353 ± 0.082), (0.035 ± 0.009), (0.024 ± 0.008) and (0.164 ± 0.019)mg/kg, respectively. Annual per capita income of each survey point was 2 500-8 670 yuan, and the residents’ main staple food was flour. Conclusion The results of DCM condition in non-Keshan disease areas of Shandong Province are stable and have provided a scientific basis for drawing up the national standard of eliminating KSD.

Objective To investigate the characteristics of chronic Keshan disease (CKD) and ischemic cardiomyopathy ( ICM ) and provide a basis for differential diagnosis . Methods Forty-two cases of CKD were randomly sampled from 6 Keshan disease districts in Sishui, Zoucheng, Juxian, Wulian, Yishui and Qingzhou Counties of Shandong Province, as CKD group. Thirty-one cases of ICM were selected from Qianfushan Hospital as ICM group. Echocardiography was used to analyze the cardiac morphology , hemodynamic and function. Results Left atrial internal diameter(LA), left ventricular(LV), end-diastolic internal diameter(LVd), right ventricular diameter(RV) and right atrial transverse diameter(RAtd) of the CKD group[(45.14 ± 6.93),(68.48 ± 6.24),(28.90 ± 3.14),(52.79 ± 6.62)mm] were higher than those of ICM group[(40.68 ± 5.12),(60.55 ± 4.07),(24.35 ± 2.12), (47.68 ± 8.53)mm , t = 3.03, 6.55, 7.38, 2.88, all P < 0.01]. In CKD group, several atrioventricular carities were enlarged, and the ventricular wall tended to become thin. In ICM group, left atrioventricular cavities were enlarged, and the apex of LV was thin spherical. The LV ejection fraction(LVEF) and fractional shortening of LV (LVFS) of the CKD group [(40.50 ± 10.68)%, (22.81 ± 6.24)%] were lower than those of the ICM group [(54.61 ± 6.58)%, (30.71 ± 4.29)%, t = - 6.957, - 5.976, all P < 0.01]. Diffuse hypokinetic motion of LV reduced in 85.7%(36/42) of CKD patients, and 83.9%(26/31) of ICM patients had segmental LV dyskinesia. Slight regurgitation of single valve was common in ICM group , but several regurgitation of multiple valves were more common in CKD group. Conclusion Echocardiography is a valuable noninvasive technology for differentiating CKD and ICM.

Adult ; Cardiomyopathies ; epidemiology ; prevention & control ; Cardiomyopathy, Dilated ; epidemiology ; prevention & control ; Child ; China ; epidemiology ; Enterovirus Infections ; epidemiology ; prevention & control ; Environmental Monitoring ; Humans ; Male

Background Researches showed that mitochondria and oxidative stress play a crucial role in retinal photochemical injury,but the relationship between the damage of human retinal pigment epithelium (RPE) cell-induced by blue light and light-irradiated time is less studied.Objective The aim of this study was to research the possible mechanism of RPE oxidative damage induced by blue light in vitro.Methods Human RPE cells were isolated from healthy donors and cultured.The cells were divided into the normal control group and the light exposure group.The cells of light exposure group were irradiated using the blue light of (4.0±0.5) mW/cm2 for 0.5,1,2,3,4,5,6,12 and 24 hours,respectively,and the cells of the normal control group were cultured in dark environment.Cellular viability was detected by MTT method,and the ultrastructure change of subcellular organelles in RPE cells was examined under the transmission electron microscope (TEM).The content of reactive oxygen species (ROS) was assayed by flow cytometry for the assessment of oxidative stress reaction.The relative expressions of nicotinamide adenine dinucleotide phosphate (NADPH) mRNA and cyclooxygenase 1 (COX1) mRNA in the cells were detected by real-time fluorescence quantitative PCR to evaluate the mitochondria function.Results The percentages of cellular viability were (100.00±20.00) ％,(95.73±0.89) ％,(94.67±2.56) ％,(84.23±0.16) ％,(78.57±3.09)％,(75.43±2.18)％,(66.13±1.42)％,(53.43±1.91)％ and (47.97±1.36)％ in the normal control group and light exposure for 1-hour,2-hour,3-hour,4-hour,5-hour,6-hour,12-hour and 24-hour groups,respectively,showing a significant difference among the groups (F =172.270,P =0.000),and the percentages of light exposure for the more than 3 hours groups were significantly lower than those of the normal control group (all at P＜ 0.05).The vacuoles-like degeneration,mitochondrial swelling,decreased microvilli were seen under the TEM.The contents of ROS in RPE cells were (14.75±2.49)％,(19.04± 1.02) ％,(22.81 ±3.20)％,(28.75±2.15)％,(33.06±0.96) ％,(40.64±2.11) ％,(48.25±2.50) ％ and (60.44±2.68) ％ in the normal control group and light exposure for 0.5-hour,1-hour,2-hour,3-hour,4-hour,5-hour,6-hour groups,and with significant increases in ROS contents in various light exposure groups compared with the normal control group (all at P＜0.05).The relative expression levels of NAPDH mRNA in the cells were gradually elevated 3 hours after light exposure with the increase of time in comparison with the normal control group (all at P＜0.05),and the relative expression levels of COX1 mRNA in the cells were higher in the light exposure for 2-hour,3-hour,4-hour and 5-hour group compared with the normal control group (all at P＜0.05),and after that the COX1 mRNA levels were gradually declined and were close to the normal level.Conclusions Blue light irradiation for more than 3 hours causes oxidative stress damage of mitochondria in RPE in vitro,and the damage was more obvious after irradiation for 5-6 hours.

Objective To investigate the regulations of Bax , Bcl-2 in the protection of lipoic acid-niacin diad in acrolein-induced apoptosis in ARPE-19 cells. Methods The ARPE-19 cells were cultured in medium containing 10% fetal bovine serum , at 37 ℃ with 5% CO2. The ARPE-19 was transferred to 6-well plate after reaching to 70% confluence. After starvation for 24 h , the cells in 6-well plates were divided into three groups , including the blank control group , the acrolein treatment group with 50 μmol/L acrolein for 24 h , and the protection group with 100 μmol/L lipoic acid-niacin diad for 24 h and with the acrolein for another 24 h. The apoptotic cells were detected by flow cytometry assay , and expressions of Bcl-2 , Bax protein were detected by Western Blot assay. Results The percentages of normal healthy cells were 94.8%, 60.98%, and 91.34% in the blank control group , 50 μmol/L acrolein group and 100 μmol/L diad contained of lipoic acid and niacin group , respectively. The ratios of Bax/Bcl-2 protein expression were 0.293 9, 1.389 2, and 0.555 8 in the blank control group, 50 μmol/L acrolein group and 100 μmol/L diad contained of lipoic acid and niacin group, respectively. Conclusion The protective effect of lipoic acid-niacin diad on acrolein-induced apoptosis in ARPE-19 cell through promoting Bcl-2 expression and inhibiting Bax expression.