OBJECTIVETo evaluate clinical effect and safety of floating needle therapy and duloxetine in treating patients with persistent somatoform pain disorder (PSPD).

METHODSTotally 108 PSPD patients were randomly assigned to the floating needle treatment group, the duloxetine treatment group, and the placebo treatment group, 36 in each group. Patients in the floating needle treatment group received floating needle therapy and placebo. Those in the duloxetine treatment group received duloxetine and simulated floating needle therapy. Those in the placebo treatment group received the placebo and simulated floating needle therapy. All treatment lasted for six weeks. Efficacy and adverse reactions were evaluated using Simple McGill pain scale (SF-MPQ) and Treatment Emergent Symptom Scale (TESS) before treatment and immediately after treatment, as well as at the end of 1st, 2nd, 4th, and 6th week of treatment, respectively. Hamilton Depression Scale (HAMD, 17 items), Hamilton Anxiety Scale (HAMA) were assessed before treatment and at the end of 1st, 2nd, 4th, and 6th week of treatment, respectively. Patients in the floating needle treatment group and the duloxetine treatment group with the total reducing score rate of SF-MPQ in Pain Rating index (PRI) ≥ 50% after 6 weeks' treatment were involved in the follow-up study.

RESULTS(1) Compared with the same group before treatment, SF-MPQ score, HAMD score and HAMA total scores all decreased in all the three groups at the end of 1st, 2nd, 4th, and 6th week of treatment (P < 0.05, P < 0.01). Besides , each item of SF-MPQ significantly decreased immediately after treatment in the floating needle treatment group (P < 0.01). Compared with the placebo treatment group, SF-MPQ, HAMD, and HAMA total score in the floating needle treatment group significantly decreased after 1, 2, 4, and 6 weeks of treatment (P < 0.05, P < 0.01). SF-MPQ score, HAMD score and HAMA total score in the duloxetine treatment group also significantly decreased after 2, 4, and 6 weeks of treatment (P < 0.05, P < 0.01). (2) There were 3 patients (8.3%) who had adverse reactions in the floating needle treatment group, 17 (50.0%) in the duloxetine treatment group, and 7 (21.2%) in the placebo treatment group. Compared with the placebo treatment group, the incidence of adverse reaction increased in the duloxetine treatment group (χ² = 6.04, P < 0.05). Besides, it was higher in the duloxetine treatment group than in the floating needle treatment group (χ² = 14.9, P < 0.05). (3) There were 19 patients in the floating needle treatment group and 17 patients in the duloxetine treatment group involved in the follow-up study. Compared with 6 weeks after treatment, no significant difference was observed at 3 and 6 months after treatment in the score of SF-MPQ, HAMD, and HAMA in the floating needle treatment group and the duloxetine treatment group. No significant difference was observed between the two groups (P > 0.05). There were 5 patients (29.4%) who had adverse reactions in the duloxetine treatment group, and no adverse reactions were observed in the floating needle treatment group. The adverse reaction rate was significantly different between the two groups (χ² = 4.26, P < 0.05).

CONCLUSIONSFloating needle therapy and duloxetine were effective in treatment of patients with PSPD. However, floating needle therapy could relieve pain more rapidly than duloxetine, with obviously less adverse reactions.

Acupuncture Therapy ; methods ; Analgesics ; therapeutic use ; Anxiety Disorders ; Duloxetine Hydrochloride ; therapeutic use ; Follow-Up Studies ; Humans ; Needles ; Pain ; Pain Management ; methods ; Pain Measurement ; Psychiatric Status Rating Scales ; Somatoform Disorders ; therapy ; Treatment Outcome

OBJECTIVETo evaluate the clinical efficacy of autologous semitendinosus and gracilis tendon grafting with anchor repair for the treatment of chronic achilles tendon rupture and severe scarring.

METHODSFrom April 2010 to October 2012,26 patients with chronic achilles tendon rupture(with Myerson type III ) and severe scarring were treated with autologous semitendinosus and gracilis tendon grafting with anchor repair. There were 19 males and 7 females,with an average age of 32 years old (ranged, 22 to 47 years). The time from injury to surgery was from 3 to 12 months (7 months on average). The plantar flexion strength of all injuried feet attenuated and single heel rise test were positive in 26 cases before operation. Plaster immobilization and routine rehabilitation therapy were performed after operation. Clinical effects were evaluated by Arner-lindholm criterion and complications were observed after operation.

RESULTSAll the patients were followed up from 12 to 24 months with a mean of 16 months. No complications such as achilles tendon re-rupture, wound infection, etc were found during follow-up period. According to the Arner-Lindholm standard, 15 cases got excellent results and 11 good.

CONCLUSIONUsing autologous semitendinosus and gracilis tendon grafts with anchor repair to treat chronic achilles tendon rupture and severe scarring is a perfect surgical procedure.

Achilles Tendon ; injuries ; surgery ; Adult ; Chronic Disease ; Cicatrix ; surgery ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Rupture ; Young Adult

Objective:To analyze the influence of digital skills mastery on life satisfaction among middle-aged and elderly adults and explore the underlying mechanism.Methods:Using the latest empirical data,this study employs latent category analysis,ordered logistic regression,generalized propensity score matching,generalized structural equation model,and KHB decomposition.Results:Internet users are classified into basic survival,practical life,and advanced mastery types based on their digital skills;Higherlevels of digital skills mastery significantly improve life satisfaction,though the effect plateaus after initial gains;social connection effect and health information effect positively,while negative experience effect negatively,mediate this relationship,with health information effect contributing the most to the mediating effect.Conclusions:Higher levels of digital skills mastery can improve life satisfaction among middle-aged and elderly adults,but it presents a'double-edged sword'effect.Expanding network coverage,enhancing digital skills,and improving the digital environment are essential to better integrate middle-aged and elderly adults into the digital society and mitigate negative impacts.

BACKGROUNDThe expression of TES, a novel tumor suppressor gene, is found to be down-regulated in the left anterior descending aorta of patients with coronary artery disease (CAD) compared with non-CAD subjects. This study aimed to investigate the expression of TES during the development of atherosclerosis in rabbits.

METHODSThirty-two New Zealand rabbits were randomly divided into a normal diet (ND) and high-fat diet (HFD) groups. Body weight and serum lipid levels were measured at 0, 4, and 12 weeks after diet treatment. The degree of atherosclerosis in thoracic aortas was analyzed by histological examinations. The expression of Testin in the tissue samples was inspected via immunohistochemical and immunofluorescence confocal microscopy. Real time-polymerase chain reaction and Western blot analysis were performed to evaluate the expression of TES/Testin at mRNA and protein levels in the aortic tissues.

RESULTSAfter 12 weeks postenrollment, rabbits in HFD group had a higher level of serum lipids and atherosclerotic plaque compared to ND group (P < 0.05). Testin expression was detected at high levels in the endothelium and a weak expression on the subendothelium area. The expression of TES mRNA was markedly reduced by 10-fold in the aortic tissues in the HFD group compared with the ND group (P = 0.015), and the protein level was also significantly decreased in the HFD group (P < 0.05).

CONCLUSIONSReduced TES/Testin expression is associated with the development of atherosclerosis, implicating a potentially important role in the pathogenesis of atherosclerosis.

Animals ; Aorta ; metabolism ; Atherosclerosis ; etiology ; metabolism ; Diet, High-Fat ; adverse effects ; Proteins ; genetics ; metabolism ; Rabbits

Achilles Tendon ; injuries ; surgery ; Adolescent ; Adult ; Child ; Female ; Humans ; Male ; Middle Aged ; Rupture ; surgery ; Suture Anchors ; Suture Techniques ; instrumentation ; Young Adult

Objective To investigate the difference between mammary gland tissues and breast cancer tissues.Methods Monoclonal antibodies against Mam-A immunized epitopes were screened for immunohistochemical staining of normal breast tissues and breast cancer tissues.The average optical density was used as an index to identify the quantitative data by computer-aided technology to screen epitope-specific antibodies with significant difference in staining characteristics between two types of tissues.Furthermore the feasibility and effectiveness of breast cancer diagnosis were evaluated.Results Four anti-Mam-A epitope-specific monoclonal antibodies,mAb1152,mAb11617,mAb995 and mAb656,were obtained.Immunohistochemical staining showed that the average density of mAb1152,mAb11617 and mAb995 was significantly different between the two types of tissues.The difference was significant between normal breast tissues and breast cancer tissues under the same conditions.The results showed that mAb11617 was better than mAb1152 and mAb995.At the best working point,mAb11617 was the best,the specificity was 90％ and the sensitivity was 59.62％.Further analysis showed that the sensitivity of mAb11617 combined with mAb995 in the diagnosis of in situ breast cancer was 81.48％ and the specificity was 90％,which was of great diagnostic significance.Conclusion There is significant difference between breast tissues and breast cancer tissues in Mam-A protein immunological activity or expression.This difference,which can be recognized by the specific antibody staining and computer aided technology,is of important diagnostic value.

Objective:To investigate the expression of miR-126 in human colon cancer cell lines with different metastatic potential and its effect on the proliferation, invasion and metastasis of colon cancer cells, and to explore the possible mechanism.Methods:The expression of miR-126 in human colon cancer cell lines(SW480,SW620 and HCT116) was determined by Real-time fluorescence quantitative PCR.miR-126 mimics were transiently overexpressed in SW620 cells throuIgh liposome transfection and the negative control group was set up.The proliferation ability of cells was detected by CCK8 method and the mobility of cells was detected by wound healing assay and Transwell migration and invasion assay.The expression of E-cadherin,Vimentin was determined by Western blot.Results:The expression of miR-126 was decreased in SW620 and HCT116 cells with high metastatic potential compared SW480 cells with low metastatic potential.The overexpression of miR-126 significantly inhibited the proliferation,migration and invasion ability of SW620 cells and Western blot indicated that miR-126 overexpression increased the expression of E-cadherin and decreased the expression of Vimentin in SW620 cells,which was significantly different from that of negative control(P<0.05).Conclusion:Low expression of miR-126 is closely related to metastasis of colon cancer and the effect of miR-126 on the biological behavior of colon cancer cells may be mediated by the regulation of the EMT process.

[Abstartc] Objetcive: To analyze the effect of p21 protein activated kinase 4( PAK4) on epithelial-mesenchymal transition of breast cancer cells.Met hods: The mRNA and protein expression of PAK4,E-Cadherin,N-Cadherin and Vimentin were detected by qRTP-CR and Western blot in breast cancer cells transfected with pcDNA -PAK4 or siRNA PAK4;The biology behaviors of MCF-7 cells and MDA-MB-231 cells transfected with pcDNA-PAK4 or siRNA PAK4 were analysed by cell migration assay ,invasion assay.Results:Overexpressing PAK4 could significant increase in the migration and invasion compared with vector-infected cells, decrease the expression of epithelial marker E-cadherin and upregulate the expression of mesenchymal markers N-cadherin and Vimentin in detached MCF7 cells.Silenced PAK4 gene in detached MDA-MB-231 cells could suppress the migration and invasion ,decrease the levels of the mesenchymal markers and increased the levels of the epithelial markers at both mRNA and protein levels .Conclusion:PAK4 plays a key role in EMT of breast cancer cells ,and its promoting EMT effect associated with upregulating the expression of Slug .

OBJECTIVETo analyze locking plates with bone graft fusion in treating displaced intraarticular calcaneal fractures and determine whether it is beneficial in maintaining restoration of calcaneal height and anatomic reduction of the articular surface.

METHODSFrom January 2007 to January 2008, 22 patients with displaced intraarticular calcaneal fractures were treated with locking plates with and without bone graft (divided into the bone graft group and non-bone graft group). There were 17 males and 5 females, ranging in age from 18 to 59 years with the mean of 35 years. Sanders III was in 14 cases and Sanders IV in 8 cases. Autologous iliac bone filled defects with locking plates fixation for the bone graft group; just locking plates fixation were performed for non-bone graft group. The Böhler angle and Gissane angle were measured before and after operation. The foot function of two groups were compared according to Maryland standard at the 6th month, 1, 2 years after operation.

RESULTSAll patients were followed up with an average of 25 months. There was no significant difference in the recovery of Böhler angle and Gissane angle between two groups (P > 0.05). After the 6 months,1, 2 years, there was no significant difference in the foot function between two groups (P > 0.05), in bone graft group, excellent result was in 6, 7 ,7 cases respectively; and in non-bone graft group, excellent results in 5, 6, 7 cases respectively.

CONCLUSIONBone graft in the surgical treatment of calcaneal fractures is not an advantage.

Adolescent ; Adult ; Bone Plates ; Bone Transplantation ; Calcaneus ; injuries ; surgery ; Female ; Humans ; Intra-Articular Fractures ; surgery ; Male ; Middle Aged ; Young Adult

PURPOSE: Complete removal of the caudate lobe, which is sometimes necessary, is accomplished via isolated caudate lobectomy or hepatectomy that includes the caudate lobe. It is impossible, however, to confirm the right and ventral margins of the caudate lobe by preoperative imaging. This study was undertaken to determine whether we could identify the right and ventral margins of the caudate lobe preoperatively using Synapse 3D visualization software. METHODS: Ninety-four preoperative 3-dimensional (3D) computed tomographic images (1-mm slices) of the liver from candidate donors were examined. The images of the caudate lobe were subjected to a counter-staining method according to Synapse 3D to delineate their dimensions. We first examined whether the right margin of the caudate lobe exceeded the plane formed by the root of the right hepatic vein (RHV) and the right side of the inferior vena cava (IVC). Second, we determined whether the ventral margin of the caudate lobe exceeded the plane formed by the root of the middle hepatic vein (MHV) and the root of the RHV. RESULTS: For the right margin, 17 cases (18%) exceeded the RHV-IVC plane by a mean of 10.2 mm (range, 2.4–27.2 mm). For the ventral margin, 28 cases (30%) exceeded the MHV-RHV plane by a mean of 17.4 mm (range, 1.2–49.1 mm). CONCLUSION: Evaluating the anatomy of caudate lobe using Synapse 3D preoperatively could be helpful for more precise anatomical resection of the caudate lobe.
Hepatectomy ; Hepatic Veins ; Humans ; Imaging, Three-Dimensional ; Liver ; Methods ; Synapses ; Tissue Donors ; Vena Cava, Inferior