Objective To observe the effect of low intensity pulsed ultrasound (LIPU) in repair of the articular cartilage injury in rabbits. Methods Osteochondral defects in the cartilage surfaces of femoral intercondylar fossae were made in 33 healthy adult New Zealand White rabbits, of which the knee lesions of the left hind legs were treated with LIPU (LIPU group) while that of the right ones used as control group. All animals in two groups were sacrificed respectively at the 2nd, 4th and 8th weeks postoperatively for gross appearance observation and histological examination. Results The ultrasound-treated tissues became more mature with in advance repair or regeneration. The repaired tissues in the LIPU group were near to normal hyaline cartilage tissues at the 8th week postoperatively, while the repaired tissues in the control group were weak, near to fibrocartilaginous tissues. Conclusion LIPU can promote repair of articular cartilage injury in rabbits.

Objective To analyze the characteristic of trauma in 246 fatal falls. Methods We collect 246 cases of fatal falls from Pudong district of Shanghai from 2005 to 2014, and then analyze the characteristics of trauma by using different parameters. Results The height in suicides by fall is higher than accidents by fall (25.7m:13.98m). In all fatal falls, head has a higher possibility in suffering trauma than other body regions (75.2%), while neck has a lower possibility (6.5%). The possibility of head trauma in accidents by fall is higher than suicides by fall (89.4%:75.2%). Conclusion Comparing with suicides by fall, victims in accidents by fall have lack of protection from limbs. Besides, the low rate of ifnding neck trauma suggests legal physicians should be more careful in examining this area.

Objective To explore the alteration of brain pain functional areas in patients with functional dyspepsia (FD) irritable bowel syndrome (IBS) overlap by rectal balloon volume stimulation and magnetic resonance imaging (MRI) and the differences with IBS alone patients and healthy individuals were compared.Methods A total of 11 IBS alone patients,16 IBS overlapped with FD patients (IBS-FD) and 10 healthy controls were recruited.Sensory thresholds and visual analogue scale (VAS) were recorded during the rectal balloon air injection process. The changes of brain activated areas were analyzed by functional MRI (fMRI) when the rectum was stimulated at the volume of 50,100 and 150 ml.The data were analyzed by least significant difference (LSD) test.Results Under rectal volumetric stimulation,the sensory thresholds of IBS-FD group and IBS alone group were (53.14 ± 16.05) ml and (59.20 ± 20.55) ml and the difference was not statistically significant (LSD test,P＞0.05).There was no significant difference in VAS score between IBS alone group and IBS-FD group (LSD test,P＞0.05).Rectal stimulated under different volume,the results of fMRI indicated the activation of anterior cingulated cortex, dorsolateral prefrontal cortex,postporietal cortex,thalamus and insular cortex in both IBS alone group and IBS-FD group.And there was no significant difference in activated areas and intensity between IBS alone group and IBS-FD group (LSD test,P＞0.05).Conclusions There was no significant difference in activations of brain areas between IBS alone and IBS-FD patients under rectal volumetric stimulation. Under rectal volumetric stimulation,although symptoms overlapped,there was no evidence of the overlap of braingut axis and visceral hypersensitivity between IBS alone and IBS-FD.

Objective This study aims to explore the characteristics of gender and age in six different suicide methods in urban area of China. Methods We collected 548 suicides from Shanghai, Jinhua, Wuhan, Loudi and Duyun, and then analyzed the age and gender characteristics in each suicide method. Results In the age characteristics, the mean age for jumping and hanging was oldest (about 55 years old), followed by drowning and hanging (about 49 years old), oral intake poisoning was much younger (about 49 years old), while carbon monoxide poisoning was youngest (about 37 years old). In the gender differences, male were more than females in suicides by sharp object (52:24), hanging (67:33) and jumping (55:45), while females were more than males in suicides by drowning (58:42). Conclusion The age and gender difference was eminent in different suicide methods. Carbon monoxide poisoning was the youngest age group in suicides and males involved more than females in suicides by mechanical methods.

Objective To investigate the enhanced CT features of papillary renal cell carcinoma (PRCC)and its subtypes (PRCC-Ⅰ, PRCC-Ⅱ)and chromophobe renal cell carcinoma(CRCC).Methods The CT features of 30 tumors with pathologically proved PRCC and CRCC were analyzed retrospectively,including location,size,enhanced types,calcification and necrosis etc.The differences in the CT features among PRCC and its subtypes and CRCC were evaluated.Results 1 2 cases of PRCC with single lesion (7 in the right kidney and 5 in the left)were shown;1 case was multifocal PRCC with 1 lesion in the right kidney and 2 lesions in the left.1 5 cases of CRCC were single lesion(9 in the right kidney and 6 in the left).The medium tumor maximum size of CRCC was larger than that of PRCC,and the PRCC-Ⅰ tumors tended to be smaller than PRCC-Ⅱ ones.53% of the PRCC had heterogeneous enhancement,and all calcification and necrosis were found in PRCC-Ⅱ lesions.Of all the CRCC,27% had uniform enhancement,20% had calcification and 40% had necrosis or central scar.There was no significant difference between PRCC and its subtypes and CRCC in location, maximum size,heterogeneity,calcification,necrosis and central scar.The degree of enhancement of CRCC(89.53 HU)was significantly greater than that of PRCC(66.60 HU),PRCC-Ⅰ(71.75 HU)and PRCC-Ⅱ(64.73 HU)in the cortical phase(P<0.05).The enhancement peak in the nephrographic phase was CRCC,PRCC-Ⅰ,PRCC and PRCC-Ⅱ from high to low in turn,which were all higher than that in cortical phase.In the excretory phase,the enhancement of all lesions was declined.Conclusion Contrast-enhanced CT is of certain value in the differential diagnosis among PRCC and its subtypes and CRCC.The enhancement degree of CRCC in the cortical phase is significantly greater than that of PRCC and its subtypes.The enhancement peak of PRCC and its subtypes and CRCC appears in the nephrographic phase.

Objective:To investigate the effect of the adaptive computerized cognitive training(ACCT) on patients with mild cognitive impairment(MCI).Methods:A total of 114 patients with mild cognitive impairment (53 cases in the treatment group and 61 cases in the observation group) were selected.In the treatment group, routine treatment combined with ACCT were given for 24 weeks, then routine treatment only for 24 weeks, 48 weeks altogether. In the observation group, routine treatment was given for 48 weeks.At week 0, 24, 48, both groups were assessed by scales including: mini-mental state examination (MMSE), Montreal cognitive assessment(MoCA), numerical memory span test, activities of daily living, Hamilton depression scale(HAMD)and Hamilton anxiety scale(HAMA). SAS 9.4 was used for statistical analysis.The data were analyzed by χ 2 test, rank sum test and multi-level model analysis. Results:Interactions between group and time on MMSE( treatment group: 0 week 22.0 (21.0, 23.0), 24 weeks 24.0 (24.0, 25.0), 48 weeks 25.0 (24.0, 26.0); observation group: 0 week 23.0 (21.0, 24.0), 24 weeks 23.0 (21.0, 24.0), 48 weeks 23.0 (21.0, 24.0)), MoCA( treatment group: 0 week 18.0 (17.0, 20.0), 24 weeks 22.0 (20.0, 23.0), 48 weeks 22.0 (20.0, 24.0); observation group: 0 week 19.0 (17.0, 20.0), 24 weeks 19.0 (18.0, 20.0), 48 weeks 19.0 (18.0, 20.0)), IADL( treatment group: 0 week 11.0 (10.0, 13.0), 24 weeks 12.0 (10.0, 12.0), 48 weeks 12.0 (10.0, 12.0); observation group: 0 week 12.0 (11.0, 13.0), 24 weeks 11.0 (10.0, 12.0), 48 weeks 11.0 (10.0, 12.0)), DST-forwards and HAMD scores were significant(all P<0.05), and DST-backwards had significant group main effect ( P<0.05). Further simple effect analysis showed that the influence of group and time on MMSE, MoCA and DST-forwards were statistically significant (all P<0.05), and the influence of time on IADL and HAMD were statistically significant (both P<0.05). Further comparison of the difference between the two groups at each time point: D-value of MMSE, MoCA, DST-forwards, and DST-backwards score in the treatment group were higher than those in the observation group, while D-value of HAMD score was lower than that in the observation group, and the differences were statistically significant (all P<0.05). Conclusion:ACCT may have long term effect on improving the cognitive function and depression of MCI patients.

Objective:To evaluate the clinical outcomes of patients with borderline developmental dysplasia of the hip (BDDH) and cam-type femoroacetabular impingement syndrome (FAIS) after hip arthroscopy.Methods:Data were retrospectively reviewed for patients with BDDH and cam-type FAIS who underwent hip arthroscopy surgery from June 2017 to December 2019. A total of 32 patients were enrolled, with a mean age of 36.13±8.67 years (range, 20-50 years), including 15 males and 17 females. The preoperative lateral center-edge angle was 22.3°±1.6° (range 20.1°-24.7°), while the preoperative α angle was 64.1°±4.6° (range, 56.0°-69.8°). All patients were treated with arthroscopic limited acetabular plasty, labral repair, femoral osteoplasty, and capsular plication after excluding from external hip diseases by ultrasound-guided hip blocking test. The visual analogue scale (VAS), modified Harris Hip Scores (mHHS) and International Hip Outcome Tool-12 (iHOT-12) scores were used to evaluate the clinical effects.Results:All patients were followed up, and the mean follow-up time was 2.5±0.8 years (range, 2.0-4.7 years). The VAS score decreased from 6.07±1.56 to 1.96±0.92 at 1 year and to 1.86±1.01 at 2 years after operation ( F=112.64, P<0.001); the mHHS score increased from 53.87±13.04 to 86.12±8.64 at 1 year and to 88.71±8.15 at 2 years after operation ( F=101.70, P<0.001); the iHOT-12 score was improved from 40.00±7.33 to 76.27±9.50 at 1 year and to 78.67±10.31 at 2 years after operation ( F=134.91, P<0.001). The α angle improved to 40.27°±4.52° (range, 34.8°-49.7°) with significant difference ( t=9.24, P<0.001). Conclusion:Hip arthroscopy can achieve satisfied short-term outcomes in treating BDDH and cam-type FAIS with few complications and less trauma.

Background:Primary health care system is a critical component of diabetes care and management.This article aimed to analyze the availability of glucose-lowering drugs in primary health institutions (PHIs) in China,and to explore the relationship between availability of glucose-lowering drugs and medication adherence among type 2 diabetes mellitus (T2DM) patients.Methods:This cross-sectional study conducted in Shandong Province,eastern China (hereafter referred to as Shandong),between August and December 2017.In total,2520 community-managed T2DM patients were se-lected from 68 PHIs in Shandong,including 62 village-level and 6 township-level PHIs.The self-developed ques-tionnaire was used to survey the availability of glucose-lowering drugs in PHIs.Patients' medication adherence was assessed by four self-reported questions,and was classified as either adherent or non-adherent.Descriptive statistics was used to analyze the availability of glucose-lowering drugs in PHIs and the medication adherence among the T2DM patients.Multilevel logistic regression models were used to explore the relationship between the availability of glucose-lowering drugs in PHIs and patients' medication adherence.Results:A total of 1866 T2DM patients prescribed with at least one glucose-lowering drug were included in analysis.Among them,58.5％ patients followed their antidiabetic treatment well.In village-level PHIs,the pa-tient's adherence rate was lower than in township-level PHIs (55.9％ vs.61.1％,P ＜ 0.05).Among the 68 PHIs,average (2.53±0.97) glucose-lowering products (generic names) were available,which in village-level PHIs were less than in township-level PHIs (2.47 vs.3.17,P ＜ 0.05).And the number of available glucose-lowering products in PHIs was associated with the adherence of T2DM patients.Conclusion:Poor availability of glucose-lowering products was found in PHIs in Shandong.The availability of glucose-lowering products in PHIs was positively associated with patients' medication adherence,and could be enhanced to improve the control of diabetes in primary care settings.

Objective:To explore the performance of the commonly used whole blood C-reactive protein (CRP) detection systems and give related recommendation on the performance requirements of detection systems.Methods:A total of 7 540 venous blood samples from 26 maternal, child and children′s hospitals were collected to conduct this multi-center study on the analytical performance of 5 commonly used whole blood CRP detection systems from March to April in 2019. The blank check, carryover, repeatability, intermediate precision, linearity, sample stability, influence of hematocrit/triglyceride/bilirubin, comparison with SIEMENS specific protein analyzer and trueness were evaluated. The 5 systems included BC-5390CRP autohematology analyzer, AstepPLUS specific protein analyzer, Ottoman-1000 Automated Specific Protein POCT Workstation, i-CHROMA Immunofluorometer equipment Reader and Orion QuikRead go detecting instrument. The 5 systems were labeled as a, b, c, d and e randomly.Results:Within the 5 systems, all values of blank check were less than 1.00 mg/L, the carryovers were lower than 1.00%. The repeatability of different ranges of CRP concentrations including 3.00-10.00, 10.00-30.00 and>30.00 mg/L were less than 10.00%, 6.00% and 5.00%, respectively, and the intermediate precision was less than 10.00%. The linearity correlation coefficients of the 5 systems were all above 0.975, while the slope was within 0.950-1.050. Whole blood samples were stable within 72 hours both at room temperature (18-25 ℃) and refrigerated temperature (2-8 ℃). The CRP results were rarely influenced by high triglyceride or bilirubin, except for the immmunoturbidimetric test based on microparticles coated with anti-human CRP F(ab) 2 fragments. When triglyceride was less than 15.46 mmol/L, the deviation of CRP was less than 10.00%. When bilirubin was less than 345.47 μmol/L, the deviation of CRP was less than 10.00%. CRP was more susceptible to Hct on the systems without Hct correction. The deviation of CRP between different Hct dilution concentration and 40% dilution concentration can reach as high as 67.48%. The correlation coefficients ( r) of 5 systems were all more than 0.975 in the range of 0-300.00 mg/L compared with Siemens specific protein analyzer. All systems passed the trueness verification using the samples with specified values of 12.89 and 30.60 mg/L. Conclusion:The performance of 5 systems can basically meet the clinical needs, but it is suggested that the whole blood CRP detection system without automatic Hct correction should be modified manually.