Objective To observe the difference in treament of thoracolumbar vertebral bodies fractures be- tween AF nail and Dick nail.Methods From March 1998 to March 2007,85 cases of thoracolumbar vertebral bod- ies fractures were followed up.20 cases were fixed with Dick nail,and 65 cases with AF nail.Results The mean,fol- low-up period was 12 months.By comparison of the operating rime,bleeding amount,the recovery rate of vertebral height,the reduction of Cobb angle and capacity of vertebral canal,AF nail was much better than Dick nail.But there was no marked difference in the recover of nerve function.Conclusion AF nail has more power to reduce vertebral height and is easier to set than Dick nail.It will be worthy of more and wider application in basic level hospitals.

ObjectiveTo evaluate the adverse events occurred during tumour necrosis factor (TNF)-αblocker treatment in Chinese Han population patients with ankylosing spondylitis (AS).MethodsThis study had enrolled 369 Chinese Han population patients with ankylosing spondylitis.They all received TNF-αblocker treatment in the hospital.All 1011 administration were recorded in total.All of them were evaluated for adverse events 2 hours after injection,126 of them had received long-term TNF-α blocker injection,and they were followed-up at week 8,12,52,104.Mild immediate adverse events and long-term adverse events were all counted.SPSS 10.0 software package was used for Fisher's exact test.ResultsThree hundred and sixty-nine patients had 1011 administrations in total,652 had received rhTNFR:Fc,316 had infliximab,21had etanercept,22 had adalimumab injections.Adverse events 2 hours after injection were:17 (2.6％) for rhTNFR:Fc,12 (3.8％) for infliximab,0 for etanercept,1 (4.5％) for adalimumab.Twenty adverse events were mild(12 for rhTNFR:Fc,9 for infliximab),5 events were moderate(3 for rhTNFR:Fc,1 for infliximab,1 for adalimumab),4 events were severe(2 for rhTNFR:Fc,2 for infliximab).The frequency of adverse events were comparable between rhTNFR:Fc and Infliximab injection in immediate adverse reactions (P=0.31).One hundred and twenty-six (69 rhTNFR:Fc,57 infliximab) patients had long-term usage,and were followed-up at week 8,12,52,104,39 patients had adverse reactions:20 (51.3％) for rhTNFR:Fc,19(48.7％) for infliximab.Thirty-seven patients had infectious events(94.9％ ),1 neurological event(2.6％),and 1 patient had tuberculosis relapse (2.6％).Outcomes were comparable with rhTNFR:Fc and infliximab in long-term usage(P=0.69).ConclusionAttention should be paid to the above events in Chinese Han patients with ankylosing spondylitis who were treated with TNF-α blocker treatment.Special attention should be paid to those patients who are in their third or fourth injection.The occurrence of immediate reaction or long-term adverse events between rhTNFR:Fc and infliximab are comparable.

OBJECTIVETo objectively assess the clinical efficacy and safety of a new Pulian Ointment (, NPLO) in treating psoriasis of blood-heat syndrome of Chinese medicine.

METHODSA total of 108 patients with psoriasis of blood-heat syndrome were equally assigned, using a randomizing digital table, to the test group treated externally with NPLO and the control group treated with placebo; the medication was done using a singleblinded method twice a day. Meanwhile, all patients received by oral intake a conventional Chinese decoction for clearing heat and cooling blood; the therapeutic course was 4 weeks for both groups. The therapeutic efficacy, changes in the Psoriasis Area and Severity Index (PASI) score and various aspects of the lesion, including scaly eruption, erythema, infiltration, size, score of itching as well as adverse reactions were observed.

RESULTSThe trial was completed in 100 patients, 51 in the test group and 49 in the control group. The remarkably effective rate was 45.10% and the total effective rate was 84.31% in the test group, which were significantly higher than those in the control group, 12.24% and 51.02%, respectively, showing a significant difference between groups (P<0.01). The test group also showed better effects in the improvement of the PASI score of the lesions and scores on erythema, infiltration, size of lesion as well as itching. No adverse event was found in either group.

CONCLUSIONNPLO is a Chinese remedy for the external treatment of psoriasis of the blood-heat syndrome with a reliable therapeutic efficacy and good safety.

Adult ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Humans ; Male ; Middle Aged ; Ointments ; Psoriasis ; drug therapy ; Syndrome

Objective:To conduct a qualitative analysis of the operating room service demands of patients undergoing foraminal endoscopic surgery based on the Kano model, and the influence of satisfaction on each demand was calculated to provide a basis for the development of targeted improvement strategies.Methods:A cross-sectional study method was adopted to select 510 patients from the Affiliated Hospital of Qingdao University with foraminal endoscopic surgery from January 2022 to June 2023 by convenient sampling method. Kano two-factor questionnaire was compiled from five dimensions of surgical environment needs, information and knowledge needs, surgical safety needs, surgical nursing quality needs, emotional support needs and psychological needs for investigation, and the attribute classification of needs was determined. The service demand importance-satisfaction matrix of patients undergoing foraminoscopic surgery was drawn.Results:Finally, 472 patients were enrolled. with 217 males and 255 females, aged (57.78 ± 12.61) years old. Among the 42 operating room service needs of patients undergoing foraminal endoscopic surgery, 12 were attractive attributes (28.57%), 7 were expected attributes (16.67%), 17 were necessary attributes (40.48%), and 6 were indifferent attributes (14.29%). The importance-satisfaction matrix shows that there were 2 improvement needs for the first best, 2 improvement needs for the middle best and 15 improvement needs for the second best.Conclusions:Kano model can clearly define the demand attributes of patients undergoing local anesthesia foraminal endoscopic surgery and the influence on their satisfaction, effectively guide the priority improvement sequence of demands, and facilitate managers to scientifically and accurately improve surgical patient satisfaction.

AIM To explore the clinical effects of San'ao Decoction combined with salbutamol on patients with cough variant asthma.METHODS Eighty patients were randomly assigned into control group(40 cases)for 3-month administration of salbutamol,and observation group(40 cases)for 3-month administration of both San'ao Decoction and mifepristone.The changes in clinical efficacy,TCM syndrome scores,serum MMP-9,VEGF and sex hormones(E2,FSH,PRL)and incidence of adverse reactions were detected.The changes in clinical efficacy,EOS,SIgG4,TIgE,Eotaxin,NKA,LTD4,IL-27,SP,R5-R20,Fres,R5,Zrs,PEF diurnal variation rate,FEF25,PEF,ACT score,PAQLQ score,recurrence rate and incidence of adverse reactions were detected.RESULTS The observation group demonstrated higher total effective rate than the control group(P<0.05),along with lower recurrence rate(P<0.05).After the treatment,the two groups displayed decreased EOS,TIgE,Eotaxin,NKA,LTD4,SP,R5-R20,Fres,R5,Zrs and PEF diurnal variation rate(P<0.05),and increased SIgG4,IL-27,FEF25,PEF,ACT score,PAQLQ score(P<0.05),especially for the observation group(P<0.05).No significant difference in incidence of adverse reactions was found between the two groups(P>0.05).CONCLUSION For the patients with cough variant asthma,San'ao Decoction combined with salbutamol can improve EOS,TIgE,Eotaxin,SIgG4 levels and airway resistance indices,lung function indices,regulate neurogenic mediators,alleviate airway inflammation injury,enhance life quality,and reduce recurrence rate.

Objective To investigate the therapeutic effect of Huangqi Xuming Decoction for Alzheimer's disease(AD)patients with spleen and kidney deficiency syndrome and to explore its possible mechanism.Methods A total of 134 patients with AD of spleen and kidney deficiency type were randomly divided into observation group and control group,with 67 cases in each group.The control group was treated with routine western medicine,and the observation group was treated with Huangqi Xuming Decoction on the basis of treatment for the control group.The course of treatment for the two groups covered 12 weeks.The changes of traditional Chinese medicine(TCM)syndrome score,Mini-Mental State Examination(MMSE)score,Alzheimer's Disease Assessment Scale-Cognitive Subscale(ADAS-Cog)score and serum levels of 5-hydroxytryptamine(5-HT),norepinephrine(NE),brain-derived neurotrophic factor(BDNF),superoxide dismutase(SOD),interleukin-6(IL-6)and hypersensitive C-reactive protein(Hs-CRP)in the two groups before and after treatment were observed.After treatment,the clinical efficacy of the two groups was evaluated.Results(1)After 12 weeks of treatment,the total effective rate of the observation group was 89.55％(60/67)and that of the control group was 71.64％(48/67),and the intergroup comparison(tested by chi-square test)showed that the efficacy of the observation group was significantly superior to that of the control group(P＜0.05).(2)After treatment,the MMSE scores of the patients in the two groups were higher(P＜0.05)and the TCM syndrome scores and ADAS-Cog scores were lower than those before treatment(P＜0.05).The intergroup comparison showed that the increase of the MMSE scores and the decrease of the TCM syndrome scores and ADAS-Cog scores in the observation group were significantly superior to those in the control group(P＜0.05).(3)After treatment,the serum 5-HT,NE,BDNF,and SOD levels of the two groups were higher(P＜0.05)and serum IL-6 and Hs-CRP levels were lower than those before treatment(P＜0.05).The intergroup comparison showed that the increase of serum 5-HT,NE,BDNF,and SOD levels and the decrease of serum IL-6 and Hs-CRP levels in the observation group were significantly superior to those in the control group(P＜0.05).Conclusion For patients with AD of spleen and kidney deficiency type,the application of Huangqi Xuming Decoction based on the conventional western medicine treatment is helpful to relieving the inflammatory response,regulating the imbalance of oxidative stress,promoting the improvement of the patients'abilities of daily living,and enhancing the clinical efficacy.

Objective:To develop a scientific, objective and quantifiable operating room operation cooperation quality evaluation scale based on the Service Quality Model, so as to continuously improve the quality of surgical cooperation.Methods:The initial item pool was compiled through a literature search. The Delphi method was used to conduct 2 rounds of letter consultation among 20 experts in China, and finally the Operating Room Operation Cooperation Quality Evaluation Scale was formed. Using the convenient sampling method, a survey of 280 surgeons in a Class Ⅲ Grade A hospital in Qingdao was conducted in January 2020, and the reliability and validity of the scale were tested. A total of 280 questionnaires were issued and 263 valid questionnaires were returned. The effective recovery rate was 93.9%.Results:The Operating Room Operation Cooperation Quality Evaluation Scale was divided into the Expectation Scale and the Perception Scale, which included 5 first-level indicators, 16 second-level indicators and 51 third-level indicators. The cumulative variance contribution rates of the 5 common factors extracted from the Expectation Scale and the Perception Scale were 73.22% and 72.87%, respectively. The content validity index at the item level was 0.900 to 1.000, the content validity index at the scale level was 0.824, and the average content validity index at the scale level was 0.990. The test-retest reliability of the Expectation Scale and Perception Scale were respectively 0.952 and 0.949, the Cronbach's α coefficients were respectively 0.892 and 0.905, and Cronbach's α coefficients of each dimension were all greater than 0.800.Conclusions:The Operating Room Operation Cooperation Quality Evaluation Scale based on the Service Quality Model is scientific, objective and quantifiable, which has good reliability and validity and can be used to evaluate the Operating Room cooperation quality.

AIMTo study the effect of curcumin on the expression of prostate specific antigen (PSA).

METHODSAXSYM system-chemical luciferase method was used to examine the content of PSA in prostate cancer cell lines, LNCap after treated with different doses of curcumin. pGL3-PSA luciferase expression vector, containing 640 bp DNA of PSA gene 5' promoter region was constructed and transfected into LNCap cell with lipofectin. Through detecting the activity of luciferase, the effect of curcumin on the promoter of PSA was studied. Western blotting was used to detect expression of androgen receptor (AR) in LNCap cell with different concentrations of curcumin.

RESULTSThe expression of PSA was inhibited and activity of luciferase was reduced by curcumin. There was also significant difference in AR expression as shown by Western blotting experiment after treatment of different doses of curcumin.

CONCLUSIONThrough inhibiting AR expression, curcumin reduced the function of PSA promoter and inhibited PSA protein expression.

Antineoplastic Agents ; pharmacology ; Cell Line, Tumor ; Curcumin ; pharmacology ; Humans ; Luciferases ; metabolism ; Male ; Promoter Regions, Genetic ; drug effects ; Prostate-Specific Antigen ; genetics ; metabolism ; Prostatic Neoplasms ; immunology ; metabolism ; pathology ; Receptors, Androgen ; metabolism

Objective:To examine the expression of programmed cell death 1 (PD-1) and its ligand (PD-L1) in epithelial ovarian cancer (EOC) tissues, and investigate the correlation among their expression, clinicopathological features and prognosis.Methods:The specimens of 180 patients with EOC treated in the First Affiliated Hospital of Dalian Medical University from October 2002 to December 2013 were confirmed by pathological examination. The pathological tissue specimens of subtypes ，included 120 cases of serous carcinoma, 30 cases of mucinous carcinoma, 20 cases of endometrioid carcinoma, and 20 cases of clear cell carcinoma. The normal paracancerous tissues of 50 cases randomly selected from the 180 patients as control group. Immunohistochemical SP method was used to detect the expressions of both PD-1 and PD-L1 in epithelial ovarian cancer tissues, and the relationships among their expressions,the clinicopathological parameters and prognosis were respectively analyzed.Results:（1） PD-1 was expressed in lymphocytes infiltrated in EOC tissues, and PD-L1 was expressed in the cell membranes of cancer tissues. In all EOC cases, 33 cases (18.3%, 33/180) of both PD-1 and PD-L1 were highly expressed, and only 1 (2.0%, 1/50) of control group showed high expression. There was statistically significant difference between two groups ( P<0.01). (2) Among the four subtypes tissue specimens of EOC, the high expression rate of PD-1 was 25.0% (30/120) for serous carcinoma, 3/15 for endometrioid carcinoma, 0 (0/30) for mucinous carcinoma, and 0 (0/15) for clear cell carcinoma. The high expression rate of PD-L1 was 23.3% (28/120) for serous carcinoma, 3.3% (1/30) for mucinous carcinoma, 2/15 for endometrioid carcinoma, and 2/15 for clear cell carcinoma. Both PD-1 and PD-L1 expressions in the four sub-types of tissue specimens were significantly different ( P<0.05). The high expression rate of both PD-1 and PD-L1 was 9.2% (8/87) in the early stage and 26.9% (25/93) in the late stage. There was a statistically significant difference between the two groups ( P<0.01). Similarly, the expression of both PD-1 and PD-L1 were significantly higher in the cases of high-grade EOC （type Ⅱ） than those of low-grade （type Ⅰ） and in the cases of EOC distributed bilaterally than that distributed unilaterally, and there were statistically significant differences ( P<0.05). (3) The Kaplan-Meier survival analysis showed that the survival time were respectively 35 and 36 months in the cases with high expressions of both PD-1 and PD-L1, and the survival time were the same as 61 months in the cases with low expression of both PD-1 and PD-L1, and the comparison was statistically significant ( P<0.05). Conclusions:The expression levels of PD-1 and PD-L1 in EOC tissues are higher than those in adjacent tissues, especially in serous carcinomas. The expression of both PD-1 and PD-L1 is higher in specimens of the patients with advanced stages. The results showed that the high expression of both PD-1 and PD-L1 is an indicator of poor prognosis of patients suffering from EOC.

OBJECTIVETo improve clinicians' ability of diagnosing testicular torsion.

METHODSWe reviewed the data of a case of testicular torsion that resulted in necrosis because of delayed presentation and repeated misdiagnosis, and analyzed its anatomic features, clinical manifestations, ultrasound results, the causes of misdiagnosis and relevant literature.

RESULTSThe patient presented 5 hours after the onset of symptoms, complaining of severe paroxysmal pain in the lower left abdomen, accompanied with nausea and vomiting, and was twice misdiagnosed as having enterospasm or ureteral calculus at two different hospitals. Fifteen hours later, surgical exploration revealed an about 900-degree testicular torsion in the spermatic cord, which necessitated orchiectomy for non viability of the testis. Postoperative pathological examination confirmed testicular necrosis and diffused hemorrhage in the testis and epididymis.

CONCLUSIONTimely presentation, correct diagnosis and proper treatment are keys to saving the affected testis. Color Doppler ultrasound is an ideal option for the definite diagnosis of acute scrotal diseases, and it offers a valuable guidance for related surgery as well.

Adult ; Diagnostic Errors ; Humans ; Male ; Necrosis ; Spermatic Cord Torsion ; diagnosis ; Testis ; pathology