BACKGROUNDInfection and aseptic loosening are common complications of total elbow arthroplasty (TEA) and often require revision surgery. However, bone defects, along with other complications, bring an extra difficulty to the second surgery, especially for patients with a massive bone defect in the proximal ulna. Several methods including allograft or autograft have been introduced into practice, but none sufficiently solves these problems.

METHODSWe conducted a new surgical method for patients with a massive ulnar bone defect needing revision TEA. During revision arthroplasty, the ulnar prosthesis was inserted into the radius as a salvage procedure. Four consecutive patients received revision arthroplasty with this method between 2013 and 2016. Patients' data were collected to evaluate the clinical outcome.

RESULTSAll patients had a Grade III ulnar bone defect. At the last follow-up session, all patients reported a painless, functional elbow joint. Three patients suffered from a periprosthetic infection that was completely cured using the two-stage method. No major complications, including infection, aseptic loosening, or wound problems were found. One patient had a transient ulnar neuritis, and another had a transient radial neuritis. Both patients had full recovery at the last follow-up session.

CONCLUSIONSInserting an ulnar prosthesis into the radius is a novel procedure for patients with a massive bone defect due to infection or aseptic loosening. It is a safe, quick, and effective treatment with a promising short-term outcome. This method should be provided as a salvage procedure for patients with a nonreconstructable ulnar bone defect.

Arthroplasty, Replacement ; methods ; Elbow ; surgery ; Female ; Humans ; Male ; Middle Aged ; Prostheses and Implants ; Radius ; surgery ; Range of Motion, Articular ; Reoperation ; methods ; Retrospective Studies ; Treatment Outcome ; Ulna ; surgery

OBJECTIVETo investigate associations between health-promoting lifestyle and suboptimal health status (SHS) in the population of Guangdong province.

METHODSA cross-sectional survey was conducted in a clustered sample of 24 159 individuals aged 12-80 years from 2012 to 2013. Health-promoting lifestyle was assessed via the Health-Promoting Lifestyle Profile (HPLP-II), and SHS was evaluated using the medical examination report and Sub-health Measurement Scale V1.0 (SHMS V1.0).

RESULTSOf the 24159 participants, subjects with SHS (46.0%) and disease status (35.2%) accounted for a much higher percentage than healthy subjects (18.8%). Regression analyses revealed a significant association between health status and healthy lifestyle (P<0.001). Unhealthy lifestyle was an important risk factor for SHS and disease, especially the former. Compared with the participants with a healthy lifestyle (minimal exposure), after demographic adjustment, subjects with a 'poor' lifestyle (maximal exposure) were at a 43 times higher risk of developing SHS (OR: 42.825, 95% CI: 30.567-59.997), those with a general lifestyle were at a 21 times higher risk of SHS (OR: 21.072, 95%CI: 17.258-25.729), and those with a suboptimal lifestyle had a 4 times higher risk (OR: 4.085, 95%CI: 3.352-4.979). In the general population, the major risk factors for SHS included poor stress management, poor self-actualization, inactive exercise and poor interpersonal relationship.

CONCLUSIONs Unhealthy lifestyles are significantly related to an increased risk of SHS. Intervention of unhealthy lifestyles, controlling the risk factors of SHS, and rigorous management of the time window of SHS are necessary to promote the heath status.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Child ; Cross-Sectional Studies ; Health Promotion ; Health Status ; Humans ; Life Style ; Middle Aged ; Regression Analysis ; Risk Factors ; Young Adult

OBJECTIVE: To study the damaging effect of nano-neodymium oxide( Nano-Nd_2O_3) on rat adrenal pheochromocytoma cell PC12. METHODS: PC12 cells in the logarithmic growth phase were divided into control group and 7 drug treatment groups. The control group was not treated with Nano-Nd_2O_3. The drug treatment groups were treated with 7 different dosing with the final mass concentrations of 3. 13,6. 25,12. 50,25. 00,50. 00,75. 00,100. 00 mg/L of NanoNd_2O_3 for 24 hours,then the follow-up selected experimental concentration were 3. 13,6. 25,12. 50,25. 00,50. 00 and75. 00 mg/L. The CCK-8 essay was used to detect the cell viability. The levels of glutathione( GSH) and superoxide dismutase( SOD) in the cells were measured by enzyme-linked immunosorbent assay. The expression of B cell lymphoma-2( Bcl-2),Bcl-2 associated X protein( Bax) and Caspase-3 protein were detected by Western blot. RESULTS: The survival rate,GSH level and Bcl-2/Bax ratio of PC12 cells decreased with the increase of the Nano-Nd_2O_3 dose,and showed doseresponse relationship( P < 0. 01). The SOD activity of PC12 cells in Nano-Nd_2O_3 group of 12. 50,25. 00,50. 00 and75. 00 mg/L were lower than that of control group( P < 0. 05). The ratio of Caspase-3/β-actin in PC12 cells was higher than that in control group( P < 0. 05). In the range of 0. 00-25. 00 mg/L of Nano-Nd_2O_3,with the increase of NanoNd_2O_3 dose,the ratio of Caspase-3/β-actin in PC12 cells increased gradually,and showed a dose-response relationship( P < 0. 01). CONCLUSION: Nano-Nd_2O_3 can induce oxidative stress in PC12 cells,leading to the decrease of Bcl-2/Bax ratio,activate Caspase-3 expression,and than inhibits cell proliferation in a dose-dependent manner.

Objective To explore epidemic characteristics of the coexistence of common chronic diseases among community residents in Jiading District, Shanghai, and to provide a basis for comprehensive prevention and control of chronic diseases in the community. Methods A multi-stage stratified cluster random sampling method was adopted in the present study, and residents over 20 years old in three selected streets (towns) were investigated. SPSS statistical software was used to analyze the data, and χ² test was used to compare the difference between groups. Results Among the respondents, 24.80% had no chronic diseases and 75.20% had various chronic diseases. The top ten most common diseases were hypertension (37.82%), fatty liver (30.10%), chronic gastritis (18.11%), hyperlipidemia (14.51%), thyroid disease (8.85%), diabetes mellitus (8.65%), renal cyst (8.12%), chronic bronchitis (7.62%), kidney stone (6.97%) and gout (5.75%). The prevalence increased with age. Chronic diseases existed in the form of multiple diseases, and the prevalence rates of two, three, four, five, six and more chronic diseases at the same time were respectively 19.78%, 13.07%, 7.90%, 4.11% and 4.09%. The most common comorbid diseases were hypertension, hyperlipidemia and diabetes combined with other chronic diseases. Conclusion The prevalence of chronic diseases in residents in Jiading District was very high. Most of the residents suffered from multiple chronic diseases in which hypertension, hyperlipidemia and diabetes were the common basis. The comprehensive prevention and control of chronic diseases in the community should be strengthened.

China/epidemiology* ; Humans ; Mycobacterium Infections, Nontuberculous/microbiology* ; Nontuberculous Mycobacteria/classification* ; Transients and Migrants

OBJECTIVE: To investigate the toxic effects of nano-sized neodymium oxide( nano-Nd_2O_3) on the central nervous system in mice. METHODS: Specific pathogen free female ICR mice were randomly divided into control group,lowdose group and high-dose group,with 12 rats in each group. The mice in low-dose group and high-dose group were treated with nano-Nd_2O_3 by nasal drip method at 80 and 160 mg/( kg·d) body weight for 30 days,while the mice in the control group were given 0. 9% sodium chloride solution. The water maze experiment and jump platform experiment were used to evaluate learning and memory ability. Hippocampus was examined using Hematoxylin-Eosin( HE) staining and glial fibrillary acidic protein( GFAP) immunohistochemical staining. The level of malondialdehyde( MDA) and the activity of total superoxide dismutase( T-SOD) in brain tissue were detected by microplate reader. RESULTS: The escape latency increased and the step down latency decreased in the low-dose group and high-dose group compared with the control group(P < 0. 05). No obvious pathological changes were observed by HE staining in brain hippocampus. Immunohistochemistry staining showed that the expression of GFAP protein in the hippocampal astrocytes of the low-and high-dose groups was higher than that in the control group,especially in the high-dose group,when compared with the control group. The MDA level increased and the T-SOD activity decreased in the low-and high-dose groups compared with the control group( P <0. 05). CONCLUSION: nano-Nd2 O3 can reduce the learning and memory ability of mice and increased GFAP expression in hippocampal astrocytes. The mechanism may be related to oxidative stress.

Chrysosplenium nudicaule,Tibetan name " Yajima",is recorded as an effective medicine for the treatment of liver and gallbladder diseases by Tibetan Pharmacopoeia published in the past dynasties,but its traditional efficacy has not yet been investigated by means of modern pharmacological research methods. In this paper,the protective effect of extract of C. nudicaule(ECN) on liver injury in mice was observed by using the mice model of intrahepatic cholestasis(IC) induced by α-naphthyl isothiocyanate(ANIT) and the possible mechanism by which ECN work as the therapeutic agent was discussed. The results showed that the serum levels of AST,ALT,ALP,DBIL,TBIL and TBA of the model mice were notably reduced in dose-dependent manner(P<0. 01,P<0. 05). The activity of SOD and GSH-Px in the liver homogenate of mice was increased,while the content of MDA was decreased(P<0. 01,P<0. 05).Pathological examination of liver in mice showed that ECN could improve the pathological changes of liver tissue in mice. The mRNA expression level of genes related to bile acid metabolism were detected by RT-PCR and the results suggested that ECN could significantly increase the expression of genes such as BSEP,FXR and MRP2(P<0. 01,P<0. 05),meanwhile significantly reduce the expression of CYP7 A1(P<0. 01,P<0. 05). These results confirmed the protective effect of ECN on intrahepatic cholestasis-induced liver injury in mice,and indicated that the mechanism may be related to activating FXR and its target genes,reducing bile acid synthesis and increasing bile acid excretion. This study provides a modern pharmacological basis for the clinical application of Yajima in Tibetan medicine.
Animals ; Cholestasis, Intrahepatic ; chemically induced ; drug therapy ; Liver ; Medicine, Tibetan Traditional ; Mice ; Plant Preparations ; pharmacology ; Saxifragaceae ; chemistry

Rats ; Animals ; RNA, Long Noncoding/genetics* ; RNA, Messenger/genetics* ; Microwaves ; Transcriptome ; Hippocampus

Objective: To observe the incidence and treatment of radiation rectal injury complicated with anxiety, depression and somatic symptom disorder. Methods: A cross-sectional survey research method was carried out. Patients with radiation rectal injury managed by members of the editorial board of Chinese Journal of Gastrointestinal Surgery were the subjects of investigation. The inclusion criteria of the survey subjects: (1) patients suffered from pelvic tumors and received pelvic radiotherapy; (2) colonoscopy showed inflammatory reaction or ulcer in the rectum. Exclusion criteria: (1) patient had a history of psycho-somatic disease before radiotherapy; (2) patient was unable to use a smart phone, unable to read and understand the questions in the questionnaire displayed on the phone; (3) patient refused to sign an informed consent form. According to the SOMA self-rating scale, PHQ-15 self-rating scale, GAD-7 and PHQ-9 self-rating scale, the electronic questionnaire of "Psychological Survey of Radiation Proctitis" was designed. The questionnaire was sent to patients with radiation rectal injury managed by the committee through the WeChat group. Observational indicators: (1) radiation rectal injury symptom assessment: using SOMA self-rating scale, radiation rectal injury symptom classification: mild group (≤3 points), moderate group (4-6 points) and severe group (> 6 points); (2) incidence of anxiety, depression and physical disorder: using GAD-7, PHQ-9 and PHQ-15 self-rating scales respectively for assessment; (3) correlation of radiation rectal injury symptom grading with anxiety, depression, and somatic symptom disorder. Results: Seventy-one qualified questionnaires were collected, of which 41 (56.9%) were from Guangzhou. Among the 71 patients, 6 were males and 65 were females; the mean age was (55.7±9.3) years old and 48 patients (67.6%) were less than 60 years old; the median confirmed duration of radiation rectal injury was 2.0 (1.0, 5.0) years. (1) Evaluation of symptoms of radiation rectal injury: 18 cases of mild (25.4%), 27 cases of moderate (38.0%), and 26 cases of severe (36.6%). (2) Incidence of anxiety, depression and somatic disorder: 12 patients (16.9%) without comorbidities; 59 patients (83.1%) with anxiety, depression, or somatic disorder, of whom 2 patients only had anxiety, 1 patient only had depression, 9 only had somatic disorder, 2 had anxiety plus depression, 4 had anxiety plus somatic disorder, 2 had depression plus somatic disorder, and 40 had all three symptoms. (3) correlation of radiation rectal injury grading with anxiety, depression, and somatic symptom disorder: as compared to patients in mild group and moderate group, those in severe group had higher severity of anxiety and somatic symptom disorder (Z=-2.143, P=0.032; Z=-2.045, P=0.041), while there was no statistically significant difference of depression between mild group and moderate group (Z=-1.176, P=0.240). Pearson correlation analysis revealed that radiation rectal injury symptom score was positively correlated with anxiety (r=0.300, P=0.013), depression (r=0.287, P=0.015) and somatic symptom disorder (r=0.344, P=0.003). Conclusions: The incidence of anxiety, depression, and somatic symptom disorder in patients with radiation rectal injury is extremely high. It is necessary to strengthen the diagnosis and treatment of somatic symptom disorder, so as to alleviate the symptoms of patients with pelvic perineum pain and improve the quality of life.
Aged ; Anxiety ; Cross-Sectional Studies ; Depression ; Female ; Humans ; Male ; Middle Aged ; Quality of Life ; Rectum ; Surveys and Questionnaires