ObjectiveTo observe the effect of early rehabilitation on patients with severe closed traumatic brain injury in intensive care unite (ICU).Methods118 patients with severe closed traumatic brain injury were divided randomly into the treatment group and control group with 59 cases in each group. The patients of control group recieved respiration rehabilitation, bedsore prevention and urinary system nursing; while the patients of treatment group added with motor and cognitive rehabilitation. Scores of Glasgow coma scale (GCS), Fugl-Mayer assessment (FMA), mini-mental status examination (MMSE), disability rating scale (DRS) and activities of daily living (ADL) of all patients were recorded before and after treatment.ResultsThe scores of GCS, FMA (upper limbs), ADL and DRS of the treatment group patients were significantly difference with that of the control group after treatment (P<0.05). The MMSE scores of two groups had no significantly difference after treatment (P>0.05).ConclusionEarly rehabilitation on the patients of severe closed traumatic brain injury in ICU can improve brain function and reduce the disability rating scale. The improvement of cognitive ability is not obviously in a shot period.

OBJECTIVE: To investigate the outcome of lateral femoral notch (LFN) after early anterior cruciate ligament (ACL) reconstruction and evaluate the recovery of knee joint function after the operation. METHODS: The clinical data of 32 patients who underwent early ACL reconstruction from December 2015 to December 2019 were retrospectively analyzed. The study included 18 males and 14 females, aged 16 to 54 years old, with an average age of (25.39±2.82) years. The body mass index (BMI) of the patients ranged from 20 to 30 kg/cm2, with an average of (26.15±3.09) kg/cm². Among them, 6 cases were caused by traffic accidents, 19 by exercise, and 7 by the crush of heavy objects. MRI of all patients showed LFN depth was more than 1.5 mm after injury, and no intervention for LFN was performed during surgery. Preoperative and postoperative depth, area, and volume of LFN defects were observed by MRI data. International Cartilage Repair Society (ICRS) score, Lysholm score, Tegner activity levels, and knee injury and osteoarthritis outcome score (KOOS) were analyzed before and after the operation. RESULTS: All patients were followed up from 2 to 6 years with an average of (3.28±1.12) years. There was no significant difference in the defect depth of LFN from (2.31±0.67) mm before the operation to (2.53±0.50) mm at follow-up (P=0.136). The defect area of LFN was decreased from (207.55±81.01)mm² to (171.36±52.69)mm² (P=0.038), and the defect volume of LFN was decreased from (426.32±176.54) mm³ to (340.86±151.54)mm³ (P=0.042). The ICRS score increased from (1.51±0.34) to (2.92±0.33) (P<0.001), the Lysholm score increased from (35.37±10.54) to (94.46±8.45) (P<0.001), and the Tegner motor score increased from (3.45±0.94) to (7.56±1.28), which was significantly higher than that of the preoperative data (P<0.001). The KOOS score of the final follow-up was 90.42±16.35. CONCLUSION With the increase of recovery time after anterior cruciate ligament reconstruction, the defect area and volume of LFN decreased gradually, but the defect depth remained unchanged. The knee joint function of the patients significantly improved. The cartilage of the LFN defect improved, but the repair effect was not good.
Male ; Female ; Humans ; Young Adult ; Adult ; Adolescent ; Middle Aged ; Anterior Cruciate Ligament Injuries/surgery* ; Retrospective Studies ; Magnetic Resonance Imaging ; Anterior Cruciate Ligament Reconstruction ; Femur/surgery* ; Treatment Outcome ; Knee Joint/surgery*

Objective To evaluate the effect of oral roxithromyein on lung function in chronic obstructive pulmonary disease (COPD) and analyse the probable mechanism. Methods Fifty patients with COPD were divided randomly into treatment group (25 eases) and control group (25 eases). The control group was treated with base therapy, and the treatment group was treated with oral roxithromycin beside base therapy, 0.15 g, twice one day for one year. Then the changes of peripheral blood neutrophil and lung function was observed before and after treatment, and the times of acute exacerbation were statistically analyzed.Results There was significant difference in the changes of peripheral blood neutrophil in treatment group (P<0.05). The ratio of forced expiratory volume in one second and forced vital capacity (FEV_1/FVC),FEV_1% pred, peak expiratory flow, maximal vital volume had no obvious change in treatment group (P>0.05), but had obvious decrease in control group (P<0.05 ). There was significant difference in the changes of lung function in two groups(P<0.05 ). The times of acute exacerbation were 10(40%) in treatment group and 19 (76%) in control group, and the times of need to be in hospital were 6 (24%) and 13 (52%)respectively. There were significant difference (P<0.05). Conclusion Long-term oral roxithromyein can protect the lung function of COPD patients, the probable mechanism is that roxithromyein inhibit the neutrophil's function.

Objective To study the correlation between the expression of activator protein-1 (c-Fos/c-Jun) mRNA and gingival inflammation,so as to discuss the pathogenesis of periodontitis.Methods The gingival tissues were divided into three groups according to the gingival index (GI),including GI=0 group (control group,14 cases),GI=1 group (15 cases) and GI=2 group (11 cases).The total RNA in each gingival tissue was extracted,and cDNA was synthesized by reverse transcription synthesis.The expressions of c-Fos and c-Jun mRNA in healthy gingival tissue (GI=0 group) were detected by reverse transcription-polymerase chain reaction.The levels of c-Fos and c-Jun mRNA in all the groups were detected by real-time quantitative PCR.Results Both c-Fos and c-Jun mRNA was expressed in healthy gingival tissues.The levels of c-Fos and c-Jun mRNA in GI=1 group was 15.58±9.19 and 3.47± 1.77,respectively,which was significantly higher than 1.31±1.03 and 1.32±0.94 in GI=0 group,and the differences were statistically significant (all P＜0.05).The level of c-Fos mRNA in GI=2 group was 3.01±1.48,which was lower than that in GI=1 group (P＜0.05) and higher than that in GI=0 group (P＜0.05).The level of c-Jun mRNA in GI=2 group was 1.48±0.65,which was lower than that in GI=1 group,and had no significant difference with GI=0 group (P＞ 0.05).Conclusions Activator protein-1 (c-Fos/c-Jun) is associated with the degree of gingival inflammation,suggesting that it is involved in the occurrence and development of gingival inflammation.

OBJECTIVETo investigate the incidence of erectile dysfunction (ED) in men with lower urinary tract symptoms (LUTS) and the correlation between LUTS and ED.

METHODSWe enrolled 1 000 men aged 40 - 80 years with regular sex partners, evaluated their erectile function using IIEF-5, and investigated LUTS among them by International Prostate Symptom Score (IPSS). We studied the relationship between ED and LUTS by univariate conditional Logistic regression analysis.

RESULTSLUTS were found in 42.81% of the men investigated (426/995), and ED in 76.18% of the subjects (758/995) and 82.16% of those with LUTS (350/426). Logistic regression analysis revealed a significant relation of ED with aging and LUTS (P < 0.01).

CONCLUSIONThe The incidence of ED is high in men with LUTS and increases with aging and the severity of LUTS.

Adult ; Aged ; Aged, 80 and over ; Erectile Dysfunction ; epidemiology ; physiopathology ; Humans ; Lower Urinary Tract Symptoms ; epidemiology ; Male ; Middle Aged ; Penile Erection ; Prevalence ; Risk Factors

OBJECTIVETo improve early diagnosis rate and reduce the incidence rate of colorectal cancer, through the application of optimized sequential screening scheme for colorectal neoplasm in general population.

METHODSQuantitative risk assessment by questionnaires survey and fecal occult blood test (FOBT) were used to proceed preliminary screening among people aged 40 to 74. Electronic colonoscopy was applied to examine the whole colon and rectum among identified high-risk subjects. The detected cases received treatment for colorectal cancer, adenomatous polyps or non-adenomatous polyps. The early diagnosis rate and incidence rate of colorectal cancer were evaluated and compared with those before screening.

RESULTWith application of optimized sequential screening schemes, various types of colorectal lesions were detected in 1 117 subjects, including 69 cases of colorectal cancer, 701 cases of colorectal adenoma and 211 cases of advanced adenoma. The early diagnosis rate of colorectal cancer was increased by 58.19%, and its incidence rate also decreased significantly.

CONCLUSIONThe optimized sequential screening scheme is simple, economical, efficient in colorectal cancer screening of general population.

Adult ; Aged ; Colonoscopy ; Colorectal Neoplasms ; diagnosis ; Early Detection of Cancer ; Humans ; Incidence ; Mass Screening ; methods ; Middle Aged ; Occult Blood ; Risk Assessment ; Surveys and Questionnaires

OBJECTIVETo compare the age-specific detection rates of colorectal neoplasms by colonoscopic screening among high-risk population in rural area and to provide evidence for determining the initial age in the colorectal cancer screening.

METHODSThe age-specific detection rates of colorectal cancers and adenomas, and the proportion of detected cases in each age group after screening by the optimized sequential colorectal cancer screening program in Jiashan County, Zhejiang Province, were analyzed.

RESULTSMass screening with the optimized sequential colorectal cancer screening program in Jiashan was conducted and 8867 colonoscopic examinations were performed. A total of 1811 individuals with at least one colorectal neoplastic lesion were found. Among them, there were 92 (1.04%) colorectal cancer patients, 1164 (13.13%) patients with at least one adenoma and 377 (4.25%) patients with at least one advanced adenoma. The detection rate of colorectal neoplastic lesions for the age group 40 - 44 was considerably lower than that in the age group 45 - 49. Hypothetically, to increase the initial age to 45-years for the optimized sequential colorectal cancer screening program would yield a 7.84% increase in the detection rate of total colorectal neoplastic lesions, 13.46% increase in the detection rate of colorectal cancer, 8.76% increase in the detection rate of adenoma, 12.24% increase in the detection rate of advanced adenoma and 19.64% lower in the cost of initial screening, 13.30% lower in the cost of colonoscopic screening.

CONCLUSIONSAmong the high-risk population aged 40 to 74, the detection rates of colorectal cancer and adenoma are increasing with the increase of age, the detection rates of colorectal cancer and adenoma as well as proportion of detected cases in the 40 - 44 age group are considerably lower. To increase the initial age to 45 for colorectal cancer screening in rural area of China is reasonable.

Adenoma ; diagnosis ; epidemiology ; pathology ; Adult ; Age Distribution ; Aged ; Carcinoma ; diagnosis ; epidemiology ; pathology ; China ; epidemiology ; Colitis, Ulcerative ; diagnosis ; epidemiology ; pathology ; Colonic Polyps ; diagnosis ; epidemiology ; pathology ; Colonoscopy ; Colorectal Neoplasms ; diagnosis ; epidemiology ; pathology ; Female ; Humans ; Incidence ; Male ; Mass Screening ; methods ; Middle Aged ; Risk ; Rural Population ; Surveys and Questionnaires

Objective To explore the effect of extracellular regulated protein kinases (ERK) signaling pathway on early brain injury and autophagy of nerve cell in hippocampus area in rats with subarachnoid hemorrhage (SAH). Methods Forty-eight adult male Sprague-Daw-ley rats were randomly divided into sham group, SAH group, SAH+dimethyl sulfoxide (DMSO) group and SAH+U0126 group, with 12 rats in each group. The SAH model was established with puncture of internal carotid artery. The SAH+U0126 group was injected with U0126 0.05 mg/kg;the sham group and SAH group were injected with normal saline, and the SAH+DMSO group was injected with DMSO 30 min-utes before modeling. They were sacrificed 24 hours after modeling. The brain water content was measured with wet and dry method. The morphology changes of neural cells in hippocampus CA1 were observed by HE staining. The expression of phosphorylation ERK (p-ERK), Beclin-1 and LC3-Ⅱwere detected with immunohistochemical method and Western blotting. Results Compared with the sham group, the brain water content increased (P<0.05), the number of survival neurons decreased (P<0.05), the expression of p-ERK, Beclin-1 and LC3-Ⅱincreased in SAH group (P<0.05). Compared with SAH group, the brain water content increased, the number of survival neurons decreased (P<0.05), the expression of p-ERK, Beclin-1 and LC3-Ⅱ decreased in SAH+U0126 group (P<0.05); and no significant difference was found in SAH+DMSO group (P>0.05). Conclusion The activation of ERK signaling pathway may alleviate early brain injury after SAH by regulation of autophagy.

ABSTRACT:Objective To explore role of U0126,the specific inhibitor of ERK signaling pathway,in early brain injury (EBI)and the autophagy of nerve cells in hippocampus area in subarachnoid hemorrhage (SAH). Methods A total of 48 male adult SD rats were randomly divided into control group,SAH group,DMSO+SAH group,and U0126+SAH group,with 12 in each.We established SAH rat model by the puncture of internal carotid artery.The same amount of saline water,DMSO and U0126 solution of 0.5 mL per rat was injected respectively into the rats of different groups 30 min before modeling.The rats were killed at 24 h.To measure brain water content by Wet and dry method after 24 h,the morphological changes of hippocampus CA1 neural cells were observed by microscopy;the expression levels of ERK,Beclin-1 and LC3 were detected by using immunohistochemical method. Results Compared with that in sham group,brain water content increased obviously in SAH model group.The density of surviving neurons in SAH group was significantly lower than that in control group (P<0 .0 5 ).ERK signaling pathway was activated obviously,the expressions of Beclin 1 and LC3-Ⅱ were significantly higher than those in control group (P<0.05).Compared with SAH model group,in U0126 group brain water content increased obviously.Compared with those in SAH group,the density of surviving neurons was significantly lower (P<0.05), ERK signaling pathway was suppressed,the expressions of Beclin-1 and LC3-Ⅱ were significantly lower (P<0.05). Conclusion The U0126,the ERK signaling pathway inhibitor,can inhibit neuron autophagy and increase EBR of SAH.

Objective : To estimate the risk threshold of route index（RI）and mosq-ovitrap index（MOI）based on Breteau index（BI）,as supplements for dengue fever risk monitoring in specific habitats. Methods : Two towns and two streets were selected from nine towns（streets）in Jiashan County,and then one village（community）was selected from each of them as a Aedes albopictus monitoring site. The BI,RI and MOI were employed at the same time and area from April to October in the year 2018. Linear regression models were built with RI,MOI and BI to calculate the dengue risk threshold of RI and MOI according to BI. Results : The linear regression model of BI（X）and RI（Y）was Y=0.145+0.662X（P<0.05）,of BI（X）and MOI（Y）was Y=3.423+0.524X（P<0.05）. If BI=5（having risk of transmission of dengue fever）,then RI=3.455（95%CI：1.717-5.198）,MOI=6.043（95%CI：-0.327-12.417）. If BI=10（having risk of outbreak）,then RI=6.765（95%CI：5.018-8.518）,MOI=8.663（95%CI：2.260-15.071）. If BI=20（having risk of epidemic）,then RI=13.385（95%CI：11.326-15.453）,MOI=13.903（95%CI：6.352-21.461）. Conclusion The dengue fever risk threshold of RI estimated by BI had a narrow 95%CI and could be applied for dengue fever risk assessment,while the risk threshold of MOI had a wide 95%CI and the application value needed further study.