Objective To study the correlation between patellar stability and keen clinical manifestation in adults with Kaschin-Beck disease (KBD).Methods Through a cross-sectional study in September 2016,one hundred and forty-three adult patients with KBD were asked to accept a digital radiographic X-ray (DR) which included positive and lateral slices of knee joint and axis slice of patellar.Meanwhile,every patient must undergo a Lysholm function evaluation for knee joint and morphological measurement on the DR film which included Insall index,lateral patellofemoral angle,sulcus angle,congruence angle,lateral migrating ratio of patella,and patellofemoral index.Then,the regression equation was built and the correlation analysis was made with multiple linear regression test.Results One hundred and forty-three patients' average scores of Insall index,lateral patellofemoral angle,sulcus angle,congruence angle,lateral migrating ratio of patella,patellofemoral index and Lysholm score were 1.10 ± 0.17,(14.49 ± 1.47)°,(138.08 ± 3.86)°,(11.55 ± 2.17)°,(1.34 ± 0.13)％,1.18 ±0.10,and (62.96 ± 6.11) scores.By multiple linear regression test,Insall index (X1),congruence angle (X4),lateral migrating ratio of patella (X5),and patellofemoral index (X6) were selected to enter into the equation;while,lateral patellofemoral angle and sulcus angle were rejected.The multiple linear regression equation was as follows:Y =17.529 + 15.232X5 + 0.950X4 + 15.957X6-4.224X1.The adjusted determination coefficient (R2) of the equation was 0.559.Those indexes which were selected to enter into the equation were ranked from big to small based on the impact on Lysholm as follow:congruence angle,lateral migrating ratio of patella,patellofemoral index,and Insall index.Among them,Lysholm score had a negative correlation with Insall index.Through variance analysis,F valve was 46.642,and P ＜ 0.05,which meant the fitted equation had statistical significance.Conclusion There is significant correlation between the patellar stability and knee Lysholm scoring in adult with KBD,which is reflected with the following parameters from big to small in turn:patellofemoral index,lateral migrating ratio of patella,congruence angle and Insall index.

Objective To study the correlation of patellar stability with age ,knee Kellgren-Lawrence grading and patellar Wiberg typing of adults with Kaschin-Beck disease (KBD) .Methods Through cross-sectional study , we asked 143 adult patients with KBD from several villages in Gansu Province to receive digital radiographic x-ray (DR) which included lateral slice of knee joint and axis slice of patellar .Meanwhile ,each patient had to undergo patellar stability measurement on the DR film which included some indexes such as Insall index , lateral patellofemoral angle ,sulcus angle ,congruence angle ,lateral migrating ratio of patella ,and patellofemoral index . Then ,all the participants were divided into four groups based on the patella Wiberg typing and three groups based on KBD clinical grading .Last ,we analyzed the correlation of patellar stability with patellar Wiberg typing ,clinical KBD grading ,and Kellgren-Lawrence grading of the patients by Spearman test .Results ① By ANOVA test on the patella Wiberg typing ,lateral patellofemoral angle decreased with increased level of patella Wiberg typing ,but congruence angle ,lateral migrating ratio of patella ,and patellofemoral index were increased with increased level of patella Wiberg typing . P values of the six indexes were all <0 .05 ,which indicated that these differences between groups were significant .By ANOVA test on the KBD clinical grading ,lateral patellofemoral angle decreased with increased level of KBD clinical grading ,but congruence angle ,lateral migrating ratio of patella ,sulcus angle ,and patellofemoral index increased with increased level of KBD clinical grading .Besides that P value of Insall index was>0 .05 , P value of the other five indexes were all <0 .05 ,which indicated these differences between groups were significant .② Spearman test :a strong correlation lay between Wiberg patellar typing and other indexes including age ,lateral patellofemoral angle ,congruence angle ,lateral migrating ratio of patella ,and patellofemoral index ( R=0 .684 ,0 .752 ,0 .582 ,0 .533 ,0 .735 , P< 0 .05) .However ,there was no correlation between Wiberg patellar typing and K-L photographical grading (R=0 .030 ,P>0 .05) .K-L grading was strongly correlated with age (R=0 .782 , P< 0 .05 ) , weakly correlated with lateral migrating ratio of patella ( R = 0 .104 , P> 0 .05 ) , but not correlated with the others ( R < 0 .1 , P> 0 .05 ) . Age was strongly correlated with K-L grading and lateral patellofemoral angle (R=0 .782 ,0 .506 ,P<0 .05) ,moderately correlated with congruence angle ,lateral migrating ratio of patella ,and patellofemoral index (R=0 .403 ,0 .361 ,0 .475 , P< 0 .05) ,but not correlated with Wiberg typing ,sulcus angle ,or Insall index ( R=0 .024 ,0 .074 ,0 .053 , P>0 .05) .Conclusion Patellar Wiberg typing is the key factor which influences latellar stability ;age has a limited influence ,while K-L grading does not affect patellar stability .

OBJECTIVETo compare the clinical efficiency of two strategy in the treatment of secondary common bile duct stones: laparoscopic cholecystectomy with transcytotic common bile duct exploration (LC + LTCBDE), or laparoscopic cholecystectomy after endoscopic sphincterotomy (EST + LC).

METHODSAccording to the screening standard, 88 patients with secondary bile duct stones (43 cases in LC + LTCBDE group, 45 cases in EST + LC group) who were treated from June 2005 to November 2007 were analyzed retrospectively. The achievement ratio, complications, average hospital stay and cost between two groups were compared. And all patients were followed up.

RESULTSThere were no significant differences on achievement ratio and complications between two groups (P > 0.05). The LC + LTCBDE group has significantly shorter hospital stay and lower cost (P < 0.05). There were no recurrence in 1 year.

CONCLUSIONSLTCBDE is a promising strategy which has more advantages in the minimal invasive treatment of secondary common bile duct stones.

Aged ; Cholecystectomy, Laparoscopic ; Choledocholithiasis ; surgery ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Minimally Invasive Surgical Procedures ; methods ; Prognosis ; Retrospective Studies ; Sphincterotomy, Endoscopic ; Treatment Outcome

BACKGROUNDWe undertook a randomized controlled trial to ascertain if single-incision laparoscopic cholecystectomy (SILC) was more beneficial for reducing postoperative pain than traditional laparoscopic cholecystectomy (TLC). Moreover, the influencing factors of SILC were analyzed.

METHODSA total of 552 patients with symptomatic gallstones or polyps were allocated randomly to undergo SILC (n = 138) or TLC (n = 414). Data on postoperative pain score, operative time, complications, procedure conversion, and hospital costs were collected. After a 6-month follow-up, all data were analyzed using the intention-to-treat principle.

RESULTSAmong SILC group, 4 (2.9%) cases required conversion to TLC. Mean operative time of SILC was significantly longer than that of TLC (58.97 ± 21.56 vs. 43.38 ± 19.02 min, P < 0.001). The two groups showed no significant differences in analgesic dose, duration of hospital stay, or cost. Median pain scores were similar between the two groups 7 days after surgery, but SILC-treated patients had a significantly lower median pain score 6 h after surgery (10-point scale: 3 [2, 4] vs. 4 [3, 5], P = 0.009). Importantly, subgroup analyses of operative time for SILC showed that a longer operative time was associated with greater prevalence of pain score >5 (≥100 min: 5/7 patients vs. <40 min, 3/16 patients, P = 0.015).

CONCLUSIONSThe primary benefit of SILC appears to be slightly less pain immediately after surgery. Surgeon training seems to be important because the shorter operative time for SILC may elicit less pain immediately after surgery.

Adolescent ; Adult ; Aged ; Cholecystectomy, Laparoscopic ; adverse effects ; Female ; Gallstones ; surgery ; Humans ; Male ; Middle Aged ; Operative Time ; Pain Measurement ; Pain, Postoperative ; diagnosis ; Polyps ; surgery ; Prospective Studies ; Treatment Outcome ; Young Adult

Bias ; Humans ; Pain Measurement ; Pain, Postoperative

Adult ; Bone Marrow Transplantation ; Humans ; Male ; Pancreas ; pathology ; Pancreatic Neoplasms ; diagnosis ; secondary ; surgery ; Precursor Cell Lymphoblastic Leukemia-Lymphoma ; complications ; diagnosis ; physiopathology

To study the relationship between tau hyperphosphorylation and the function of glutamate transporter okadaic acid (OA), a protein phosphatase inhibitor, 20 ng in a 0.5 microl volume, was injected into the frontal cortex of rat brain and immunostaining was used to observe the phosphorylation of tau protein and the expression of excitatory amino acid transporter 1 (EAAT1) in the brain following the injection. The results showed that (1) the neurons in the center of the injection region displayed cytoplasmic shrinkage, swelling, nuclear pyknosis, and dislocation at the early stage, and necrosis appeared 3 d after the injection. However, most neurons in the peri-injected areas showed normal morphological characters with immuno positive reaction for AT8, a tau phosphorylated marker; (2) morphological analysis showed that tau hyperphosphorylation caused by OA treatment was mainly observed in the axons and dendrites of neuronal cells at 6 h in the cell body at 1 d, which brought about dystrophic neurites and neurofibrillary tangle (NFT)-like pathological changes; (3) the induction of glutamate transporter EAAT1 was observed in the involved areas corresponding to that with AT8 immunopositive staining, and the number of EAAT1-positive staining cells markedly increased at 12 h (P<0.01), peaked at 1 d (P<0.001), then decreased at 3 d following the injection. Combined with a confocal laser scanning microscopic analysis, double fluorescent immunostaining showed that EAAT1 positive staining appeared in neurons as well as astrocytes in the peri-injected areas of the frontal cortex. These results demonstrate that OA increases glutamate transporter EAAT1 expression in neurons while it induces tau hyperphosphorylation. However, the mechanism and significance of the induction of glutamate transporter EAAT1 expression remain to be further elucidated.
Animals ; Astrocytes ; drug effects ; metabolism ; Axons ; drug effects ; metabolism ; Brain ; cytology ; Dendrites ; drug effects ; metabolism ; Excitatory Amino Acid Transporter 1 ; metabolism ; Neurofibrillary Tangles ; pathology ; Neurons ; drug effects ; metabolism ; Okadaic Acid ; pharmacology ; Phosphorylation ; Rats ; tau Proteins ; metabolism

AIMTo study the chemical constituents of Selaginella tamariscina (Beauv.) Spring.

METHODSVarious chromatographic techniques were used to separate and purify the chemical constituents. Their physico-chemical properties and spectral data were used to elucidate the structures.

RESULTSFour compounds were isolated from the n-BuOH fraction of the water-extracts. Their structures were identified as 1-hydroxy-2-[2-hydroxy-3-methoxy-5-(1-hydroxyethyl)-phenyl]-3-(4-hydroxy-3,5-dimethoxy)-propane-1-O-beta-D-glucopyranoside (tamariscinoside B, I), adenosine (II), guanosine (III), arbutin (IV).

CONCLUSIONTamariscinoside B (I) is a new compound, while the others were isolated from Selaginella for the first time.

Adenosine ; chemistry ; isolation & purification ; Arbutin ; chemistry ; isolation & purification ; Glucosides ; chemistry ; isolation & purification ; Guanosine ; chemistry ; isolation & purification ; Molecular Conformation ; Molecular Structure ; Plants, Medicinal ; chemistry ; Selaginellaceae ; chemistry

AIMTo study the chemical constituents of Selaginella tamariscina (Beauv.) Spring.

METHODSThe compounds were isolated and purified by macroporous adsorption resin, Sephadex LH-20 and silica gel column chromatography and identified on the basis of their physicochemical and spectral data.

RESULTSFour compounds were obtained from the n-BuOH fraction of 70% acetone extracts. Their structures were elucidated as (7S, 8R)-7, 8-dihydro-7-(4-hydroxy-3,5-dimethoxyphenyl)-8-hydroxymethyl-[1'-( 7'-hydroxyethyl)-5' methoxyl] benzofuran-4-O-beta-D-glucopyranoside (tamariscinoside C, I), D-mannitol (II), tyrosine (II), shikimic acid (IV).

CONCLUSIONCompound I is a new compound, compounds II and III were obtained from the genius for the first time, compound IV was yielded from the plant for the first time.

Benzofurans ; chemistry ; isolation & purification ; Mannitol ; chemistry ; isolation & purification ; Molecular Conformation ; Molecular Structure ; Monosaccharides ; chemistry ; isolation & purification ; Plants, Medicinal ; chemistry ; Selaginellaceae ; chemistry ; Shikimic Acid ; chemistry ; isolation & purification ; Tyrosine ; chemistry ; isolation & purification

Objective To improve the patients' satisfaction to the nursing work through implementing the humanistic concern in nursing work. Methods We held some activities to provide the humanistic concern in nursing work, developed the educations to improve the professional quality of the nurses, constructed the criterion of civilized srvice, and strengthened the construction of nursing culture in the service demonstration ward. Meanwhile, we intensified the service ideas to create the harmonious patient-nurse relationships, the harmonious working settings, the harmonious treatment surroundings and the harmonious humanistic environment. Results The whole quality of the nurses was improved. especially the consciousness of active service. The relationship between nurses and patients was more harmonious, and the nursing quality and the degree of patients' satisfaction were elevated. Conclusions to implement the humanistic concern in nursing work is not only the base of building the harmonious relationships between patients and nurses. but also the guarantee of elevating the nursing quality and the degree of patients' satisfaction.