OBJECTIVETo explore the improvement of hand motion function,spasm and self-care ability of daily life for stroke patients treated with floating-needle combined with rehabilitation training.

METHODSEighty hand spasm patients of post-stroke within one year after stroke were randomly divided into an observation group and a control group, 40 cases in each one. In the two groups, rehabilitation was adopted for eight weeks,once a day,40 min one time. In the observation group, based on the above treatment and according to muscle fascia trigger point, 2~3 points in both the internal and external sides of forearm were treated with floating-needle. The positive or passive flexion and extension of wrist and knuckle till the relief of spasm hand was combined. The floating-needle therapy was given for eight weeks, on the first three days once a day and later once every other day. Modified Ashworth Scale(MAS), activity of daily life(ADL, Barthel index) scores and Fugl-Meyer(FMA) scores were used to assess the spasm hand degree,activity of daily life and hand motion function before and after 7-day, 14-day and 8-week treatment.

RESULTSAfter 7-day, 14-day and 8-week treatment, MAS scores were apparently lower than those before treatment in the two groups(all P<0. 05), and Barthel scores and FMA scores were obviously higher than those before-treatment(all P<0. 05). After 14-day and 8-week treatment, FMA scores in the observation group were markedly higher than those in the control group(both P<0. 05).

CONCLUSIONFloating-needle therapy combined with rehabilitation training and simple rehabilitation training could both improve hand spasm degree, hand function and activity of daily life of post-stroke patients, but floating-needle therapy combined with rehabilitation training is superior to simple rehabilitation training for the improvement of hand function.

Acupuncture Therapy ; instrumentation ; methods ; Adult ; Aged ; Combined Modality Therapy ; Female ; Hand ; physiopathology ; Humans ; Male ; Middle Aged ; Needles ; Range of Motion, Articular ; Recovery of Function ; Stroke ; therapy ; Stroke Rehabilitation ; Treatment Outcome

This study evaluated the effects of early treatment with β-adrenergic blocker metoprolol on ventricular remodeling and function after acute myocardial infarction (AMI) by using high frequency ultrasound. The relationship between the efficacy and the expression level of cardiac myocardial inflammatory cytokine was examined in rats. The rat model of AMI was induced by ligating the left anterior descending artery. The surviving rats were randomly assigned to two experimental groups: MI control (MI) group and MI metoprolol (MI-B) group, with the rats undergoing sham operation serving as normal control (Sham). MI-B group was given metoprolol for 4 weeks (refer to the CCS-2 protocol) and the other two groups received equal volume of saline via intragastric (i.g.) administration. The ventricular remodeling and function were evaluated by high frequency ultrasound 4 weeks after the treatment. Then all rats were sacrificed for pathological examination and immunohistochemistrical detection of inflammatory cytokines, including IL-1β, IL-6, IL-10 and TNF-α. Compared with the MI group, the left ventricular end-systolic dimension, end-diastolic dimension, end-systolic volume and end-diastolic volume of the MI-B group were significantly decreased (P<0.01), while the left ventricular anterior wall end-diastolic thickness, ejection fraction and fractional shortening were obviously increased (P<0.01). The conspicuous improvement in the left ventricular morphology and function was coincident with the markedly reduced TNF-α and IL-1β expression and the increased IL-10 expression. We are led to conclude that early metoprolol treatment for AMI can regulate myocardial inflammatory cytokine expression to improve cardiac function and the underlying mechanism might be that it decreases the level of pro-inflammatory cytokines and increases the level of its anti-inflammatory counterparts in cardiac myocytes. Our study also showed that echocardiography is a useful technique for the structural and functional assessment of left ventricle after acute myocardial infarction.

Objective To evaluate the effects of combination of dexmedetomidine and mild hypothermia on global cerebral ischemia-reperfusion (I/R) injury in neonatal rats.Methods Ninety-six neonatal Sprague-Dawley rats,aged 6-7 days,weighing 18-22 g,were randomly divided into 4 groups (n=24 each) using a random number table:I/R group,mild hypothermia group (group H),dexmedetomidine group (group D) and combination of dexmedetomidine and mild hypothermia group (group DH).Global cerebral ischemia was induced in rats anaesthetized with chloral hydrate by bilateral common carotid artery clamping (for 15 min) combined with hypotension followed by reperfusion.Dexmedetomidine 75 pg/kg was given intraperitoneally at 30 min before ischemia in D and DH groups,while the equal volume of normal saline was given in I/R and H groups.The temperature in the temporal muscle was maintained at 36.7-37.2℃ in I/R and D groups,and at 34.8-35.3℃ in H and DH groups.At 12,24 and 72 h of reperfusion,8 rats were randomly chosen in each group,and neurological deficit score (NDS) was determined.The animals were then sacrificed,and their brains were removed for determination of myeloperoxidase (MPO) activity (by spectrophotometry) and contents of tumor necrosis factor-alpha (TNF-α) and interleukin-6 (IL-6) in brain tissues (using ELISA).Results Compared with I/R group,the NDS,MPO activity and contents of TNF-α and IL-6 were significantly decreased in the other three groups.The NDS,MPO activity and contents of TNF-α and IL-6 were significantly lower in DH group than in H or D group.Conclusion Dexmedetomidine can optimize cerebral protection providedby mild hypothermia against global cerebral I/R injury through inhibiting inflammatory responses in brain tissues of neonatal rats.

Objective To evaluate the effects of an optimized resuscitation bundle on prognosis of emergency patients with septic shock.Methods 65 patients with septic shock,admitted into emergency intensive care unit (ICU),were randomly divided into the treatment group(treated by an optimized resuscitation bundle)and the control group(treated by surviving sepsis campaign classics methods)by using random number table.The scores of sepsis-related organ failure assessment(SOFA) scores,the vasoactive agent application times,the mechanical ventilation times,the stay days of ICU,and 28-day mortality of the two groups were observed and compared.Results 3,7 day after erollment the SOFA score of the treatment group was (9.1 ± 2.5) points,(8.2 ± 2.8) points,respectively,which was lower than that of the control group[(10.1 ± 3.3) points,(9.5 ± 3.1) points] at the same time(t =4.52,3.99,all P ＜ 0.05) ; 8-day mortality rate of the treatment group was 28.1％,which was lower than that of the control group (48.5％) (x2 =12.84,P ＜ 0.05).Conclusion Application of an early optimized resuscitation bundle can significantly improve the prognosis of emergency patients with septic shock.

Objective To summarize diagnostic methods and surgical management experience of penetrating chest trauma . Methods The clinical data of 603 patients in our department during the past 10 years were analyzed retrospectively in respects of features of injury ,diagnostic methods ,surgical management and outcome ,etc .Results Location of the wounds :the wounds on the left anterior chest wall had 151 cases ,on the left posterior chest wall 134 cases ,on the right anterior chest 137 cases ,on the right posterior chest 108 cases ,on the bilateral chest 22 cases ,on the root of the neck 35 cases ,on the upper abdome 16 cases .In 453 ca‐ses examined by CT ,96 .03% of these cases were found to be abnormal .In 252 cases examined by X ray ,71 .03% of these cases were found to be abnormal .166 underwent thoracotomy ,26 underwent VATS(Video assisted Thoracoscopic Surgery ) .411 under‐went non operative management .583 were cured ,76 cases developed complications .20 were died .Conclusion Multi spiral CT is a rapidly and accurate diagnostic method to penetrating chest trauma .Incision of thoracotomy is employed according to the lethal damage and the most serious injury organ .

This study evaluated the effects of early treatment with β-adrenergic blocker metoprolol on ventricular remodeling and function after acute myocardial infarction (AMI) by using high frequency ultrasound. The relationship between the efficacy and the expression level of cardiac myocardial inflammatory cytokine was examined in rats. The rat model of AMI was induced by ligating the left anterior descending artery. The surviving rats were randomly assigned to two experimental groups: MI control (MI) group and MI metoprolol (MI-B) group, with the rats undergoing sham operation serving as normal control (Sham). MI-B group was given metoprolol for 4 weeks (refer to the CCS-2 protocol) and the other two groups received equal volume of saline via intragastric (i.g.) administration. The ventricular remodeling and function were evaluated by high frequency ultrasound 4 weeks after the treatment. Then all rats were sacrificed for pathological examination and immunohistochemistrical detection of inflammatory cytokines, including IL-1β, IL-6, IL-10 and TNF-α. Compared with the MI group, the left ventricular end-systolic dimension, end-diastolic dimension, end-systolic volume and end-diastolic volume of the MI-B group were significantly decreased (P<0.01), while the left ventricular anterior wall end-diastolic thickness, ejection fraction and fractional shortening were obviously increased (P<0.01). The conspicuous improvement in the left ventricular morphology and function was coincident with the markedly reduced TNF-α and IL-1β expression and the increased IL-10 expression. We are led to conclude that early metoprolol treatment for AMI can regulate myocardial inflammatory cytokine expression to improve cardiac function and the underlying mechanism might be that it decreases the level of pro-inflammatory cytokines and increases the level of its anti-inflammatory counterparts in cardiac myocytes. Our study also showed that echocardiography is a useful technique for the structural and functional assessment of left ventricle after acute myocardial infarction.
Animals ; Cytokines ; metabolism ; Inflammation ; drug therapy ; metabolism ; Male ; Metoprolol ; pharmacology ; Myocardial Infarction ; drug therapy ; Myocardium ; metabolism ; Rats ; Rats, Sprague-Dawley ; Ultrasonography ; methods

OBJECTIVE: To explore clinical effect of repairing anterior talofibular ligament with knot-free anchors under total ankle arthroscopy in treating chronic lateral ankle instability. METHODS: From April 2018 to August 2021, 24 patients with chronic lateral ankle instability were treated with knot-free anchors under total ankle arthroscopy to repair anterior talofibular ligament, including 16 males and 8 females, aged from 22 to 42 years old with an average of(28.6±5.8) years old;the time from injury to opertaion ranged from 6 to 10 months with an average of(7.7±1.3) months. Preoperative and postoperative American Orhopaedic Foot and Ankle Society (AOFAS) score, visual analogue scale (VAS), talar tilt, anterior talar translation(ATT) were recorded and compared. RESULTS: All patients were followed up from 10 to 12 months with an average of (10.2±1.14) months. Incision were healed at stageⅠ, and no infection, nerve injury and lateral ankle instability occurred. AOFAS score improved from(52.79±8.96) before opertaion to (93.00± 4.01) at 6 months after operation, 23 patients got excellent result and 1 good;VAS decreased from (5.50±0.98) before opertaion to (1.04±0.80) at 6 months after operation(P<0.05);talar tilt decreased from(9.16±2.09)° to (3.10±1.72)° at 3 months after operation(P<0.05);ATT decreased from(8.80±2.55) mm to (2.98±1.97) mm at 3 months after operation(P<0.05). Twenty-four patients drawer test and varus-valgus rotation wer negative. CONCLUSION Repairing anterior talofibular ligament with knot-free anchors under total ankle arthroscopy for the treatment of chronic lateral ankle instability has advantages of less trauma, less complications safe and reliable, and good recovery of ankle joint function.
Female ; Male ; Humans ; Young Adult ; Adult ; Ankle Joint/surgery* ; Ankle ; Arthroscopy ; Lateral Ligament, Ankle/surgery* ; Joint Instability/surgery*

OBJECTIVETo investigate the clinical effect of a new bundle-to-bundle suturing method for acute Achilles tendon rupture.

METHODSFrom April 2013 to January 2015, 15 patients with acute Achilles tendon rupture were treated with a new bundle-to-bundle suturing method including 12 males and 3 females with an average age of 37.5 years old ranging from 27 to 56 years old. All of them were immobilized by cast for 6 weeks on the underlying limbs, and were educated for a rehabilitation training during the follow-up.

RESULTSAll the patients were followed up for 9 to 17.5 months with an average of 13.5 months. According to the American Ankle Surgery Association (AOFAS), ankle and foot score was 93.3±3.5 at 6 months after operation. All patients got incomplete weight-bearing at 1.6 months on average after the operation, and back to primary work position 4.7 months later on average. All the wounds got primary healing. No incisional infection, necrosis of incisional marginal necrosis, rupture of the Achilles tendon, and gastrocnemius injury occurred.

CONCLUSIONSThe surgical treatment of acute Achilles tendon rupture with bundle-to-bundle suturing method has advantages of mini-invasion, a low rate of incision problems and quick function recovery, and was valuable spread in clinic.

Objective:To analyze the health literacy level among medical staff and its influencing factors.Methods:Using the convenient sampling method, the in-service medical staff from four medical institutions (Shanghai Pudong New Area People′s Hospital, Shanghai Pudong New Area Zhoupu Hospital, Shanghai Tenth People′s Hospital Chongming Branch, and Shanghai Jing′an District Zhabei Central Hospital) were administered with a national residents′ health literacy questionnaire uniformly compiled by the China Health Education Center, and an electronic questionnaire independently compiled in combination with professional characteristics of the medical staff. The survey period was January 5-17, 2021. The contents of the questionnaire included basic information regarding gender, age, education, and professional title. Respondents were also asked whether they had chronic diseases, and three aspects of health literacy for basic knowledge and concepts, healthy lifestyle and behavior and health skills covering six other types of health problems including scientific outlook on health, infectious disease prevention and control literacy, chronic disease prevention and control. Safety and first aid literacy, basic medical literacy, health information literacy were also assessed. The total score for the questionnaire was 100 points. Respondents with a score of 80 or more were considered to have a competent health literacy. A total of 870 questionnaires were distributed, excluding incomplete ones, 826 valid questionnaires were used for analysis. Logistic regression was used to analyze factors influencing the health literacy among medical staff.Results:The overall health literacy level of medical staff was 64.0%, with 79.7% of respondents indicating that they had basic knowledge and concepts, 70.8% indicating that they practiced healthy lifestyles and behaviors, and 33.5% showed proficiencies in terms of health skills. From high to low, the health literacy levels for the six types of health problems were safety and first aid literacy (80.5%), scientific outlook on health (76.4%), infectious disease prevention and control literacy (60.2%), chronic disease prevention and control literacy (70.9%), basic medical literacy (52.7%), and health information literacy (50.2%). The results of a multivariate logistic regression analysis showed that physical condition, a lifestyle harmful to one′s health, highest educational background, and a professional title in the previous year were the independent influencing factors related to health literacy ( P<0.05). Conclusion:Levels of health skills, basic medical literacy, and health information literacy among medical staff are low, and physical condition in the previous year, lifestyle, professional title, and education are important factors influencing the level of health literacy among medical staff.

Dexmedetomidine displays multiple mechanisms of neuroprotection in ameliorating ischemic brain injury. In this study, we explored the beneficial effects of dexmedetomidine on blood-brain barrier (BBB) integrity and neuroinflammation in cerebral ischemia/reperfusion injury. Sprague-Dawley rats were subjected to middle cerebral artery occlusion (MCAO) for 1.5 h and reperfusion for 24 h to establish a rat model of cerebral ischemia/reperfusion injury. Dexmedetomidine (9 µg/kg) was administered to rats 30 min after MCAO through intravenous injection, and SB203580 (a p38 MAPK inhibitor, 200 µg/kg) was injected intraperitoneally 30 min before MCAO. Brain damages were evaluated by 2,3,5-triphenyltetrazolium chloride staining, hematoxylin-eosin staining, Nissl staining, and brain water content assessment. BBB permeability was examined by Evans blue staining. Expression levels of claudin-5, zonula occludens-1, occludin, and matrix metalloproteinase-9 (MMP-9) as well as M1/M2 phenotypes-associated markers were assessed using immunofluorescence, RT-qPCR, Western blotting, and gelatin zymography. Enzyme-linked immunosorbent assay was used to examine inflammatory cytokine levels. We found that dexmedetomidine or SB203580 attenuated infarct volume, brain edema, BBB permeability, and neuroinflammation, and promoted M2 microglial polarization after cerebral ischemia/reperfusion injury. Increased MMP-9 activity by ischemia/reperfusion injury was inhibited by dexmedetomidine or SB203580. Dexmedetomidine inhibited the activation of the ERK, JNK, and p38 MAPK pathways. Moreover, activation of JNK or p38 MAPK reversed the protective effects of dexmedetomidine against ischemic brain injury. Overall, dexmedetomidine ameliorated brain injury by alleviating BBB permeability and promoting M2 polarization in experimental cerebral ischemia/reperfusion injury model by inhibiting the activation of JNK and p38 MAPK pathways.