OBJECTIVETo investigate the techniques and therapeutic effects of suture anchors for the reconstruction of distal tendo achillis rupture.

METHODSThe clinical data of 16 patients of distal tendo achillis rupture repaired with suture anchors from June 2005 to August 2008 were retrospectively analyzed. Among them, there were 13 males and 3 females with a mean age of 33.5 years (ranged from 17 to 46 years). The postoperative rehabilitation was conducted for every patient. The operation time, position of suture anchor and complications of the surgery were analyzed. The healing of stendo achillis and functional recovery were assessed by Arner-Lindholm standard.

RESULTSAll the patients were followed up for an average of 13.2 months. There were no complications of foreign-body reaction or re-rupture. The average operation time was 35.5 minute. There was no intraoperative injuries of blood vessels, nerves or tendons. A total of 19 suture anchors were used, and only 1 anchor was displaced. The functional recovery of tendo achillis was rated as excellent in 13 cases,good in 2 cases, bad in 1 case. All patients were satisfied with the effects on their current work and life. And no displacement of anchors was found in radiographic films.

CONCLUSIONRepairing of the distal tendo achillis rupture with suture anchors can make operation simple and quick, rigid fixation, less complications, and provide good therapeutic effects.

Adolescent ; Adult ; Female ; Foreign-Body Reaction ; etiology ; Humans ; Male ; Middle Aged ; Reconstructive Surgical Procedures ; instrumentation ; methods ; Retrospective Studies ; Suture Anchors ; Tendon Injuries ; complications ; immunology ; surgery ; Tenodesis ; instrumentation ; methods ; Treatment Outcome ; Young Adult

BACKGROUNDTo evaluate the utility of rabbit ladderlike model of radiation-induced lung injury (RILI) for the future investigation of computed tomography perfusion.

METHODSA total of 72 New Zealand rabbits were randomly divided into two groups: 36 rabbits in the test group were administered 25 Gy of single fractionated radiation to the whole lung of unilateral lung; 36 rabbits in the control group were sham-radiated. All rabbits were subsequently sacrificed at 1, 6, 12, 24, 48, 72 h, and 1, 2, 4, 8,1 6, 24 weeks after radiation, and then six specimens were extracted from the upper, middle and lower fields of the bilateral lungs. The pathological changes in these specimens were observed with light and electron microscopy; the expression of tumor necrosis factor-α (TNF-a) and transforming growth factor-β₁ (TGF-β₁) in local lung tissue was detected by immunohistochemistry.

RESULTS(1) Radiation-induced lung injury occurred in all rabbits in the test group. (2) Expression of TNF-a and TGF-β₁ at 1 h and 48 h after radiation, demonstrated a statistically significant difference between the test and control groups (each P < 0.05). (3) Evaluation by light microscopy demonstrated statistically significant differences between the two groups in the following parameters (each P < 0.05): thickness of alveolar wall, density of pulmonary interstitium area (1 h after radiation), number of fibroblasts and fibrocytes in interstitium (24 h after radiation). The test group metrics also correlated well with the time of postradiation. (4) Evaluation by electron microscopy demonstrated statistically significant differences in the relative amounts of collagen fibers at various time points postradiation in the test group (P < 0.005), with no significant differences in the control group (P > 0.05). At greater than 48 h postradiation the relative amount of collagen fibers in the test groups significantly differ from the control groups (each P < 0.05), correlating well with the time postradiation (r = 0.99318).

CONCLUSIONSA consistent and reliable rabbit model of RILI can be generated in gradient using 25 Gy of high-energy X-ray, which can simulate the development and evolution of RILI.

Animals ; Disease Models, Animal ; Female ; Lung Injury ; diagnostic imaging ; etiology ; metabolism ; Male ; Rabbits ; Radiation Injuries ; diagnostic imaging ; etiology ; metabolism ; Radiography ; Transforming Growth Factor beta1 ; metabolism ; Tumor Necrosis Factor-alpha ; metabolism ; X-Rays

OBJECTIVETo analyze the occurrence of pulmonary thromboembolism (PTE) after surgical procedures to attract more attention to the prevention, diagnosis and treatment of this disease.

METHODSRetrospectively analyze the clinical data of the hospitalized patients with post-surgical PTE from June 2004 to February 2009. The average age of the 45 cases was (60 +/- 16) years old, 35 cases received anticoagulant therapy and 6 cases received thrombolytic therapy, the other 4 cases only received emergency medical treatment. Analyze the data about the surgery category, duration, anaesthetic way, risk factors, clinical symptoms, auxiliary examinations, diagnosis, treatment and turnover of these patients.

RESULTSAmong the total 45 cases of post-surgical PTE, 37 cases (82.2%) occurred within 2 weeks, it accounted for 13.2% (45/341) of the hospitalized PTE patients during that period. PTE was often seen in patients after major surgical operation such as general (35.6%), gynecological (13.3%), orthopedic (13.3%) and chest surgery, especially the surgery related to malignant tumor (57.8%). The average surgical duration was (220 +/- 124) min, 37 cases (82.2%) was given general anaesthesia. The clinical manifestations and auxiliary examinations results of post-surgical PTE were not typical. Thirty-six cases improved after treatment, 9 cases died and the case fatality ratio was 20.0% (9/45).

CONCLUSIONSSurgical procedure is an important risk factor of PTE. The prevention diagnosis and treatment of post-surgical PTE should be paid more attention to.

Adult ; Aged ; Aged, 80 and over ; Female ; Humans ; Male ; Middle Aged ; Postoperative Complications ; diagnosis ; etiology ; therapy ; Prognosis ; Pulmonary Embolism ; diagnosis ; etiology ; therapy ; Retrospective Studies ; Risk Factors

BACKGROUNDPancreatic β cells are susceptible to fatty acid-induced apoptosis. The 17β-estradiol (E2) protects pancreatic β cells from apoptosis, mediated by the estrogen receptor-α (ERα). The mRNA level and promoter activity of leukemia-related protein (LRP) 16 were significantly increased by E2 in ER-α and LRP16 was a co-activator of ER-α. The aim of the study was to assess the effects of LRP16 on fatty acid-induced apoptosis in MIN6 cells.

METHODSCells with over-expressing LRP16 were obtained by lipidosome transfection. Insulin content and glucose-stimulated insulin secretion (GSIS) were examined by radioimmunoassay. Western blotting was applied to detect protein expression. Apoptosis was detected by terminal deoxynucleotidyl transferase dUTP nick end labeling (TUNEL) and flow cytometry. The forkhead boxO1 (FoxO1) subcellular localization was determined by immunocytochemical analysis.

RESULTSMIN6-LRP16 cells with overexpression of LRP16 were successfully established, and protein expression of LRP16 was 2.29-fold of that of control cells (MIN6-3.1, P < 0.05). Insulin content and GSIS in MIN6-LRP16 were substantially increased compared with those in control cells. When cells were stimulated with glucose, increased phosphorylation of extracellular signal-regulated kinase (ERK) 1/2 and serine-threonine kinase (Akt) were observed in MIN6-LRP16. When cells were under palmitate pressure, the TUNEL-positive rate in MIN6-LRP16 was (17.0 ± 0.5)%, while it in MIN6-3.1 was (22.0 ± 0.4)%. In palmitate-treated cells, attenuated Akt phosphorylation was observed, but the attenuation in Akt activity was partially restored in MIN6-LRP16 cells. Meanwhile, nuclear localization of FoxO1 in MIN6-LRP16 was apparently reduced compared with that in control cells.

CONCLUSIONSLRP16 regulated insulin content and GSIS in MIN6 cells by ERK1/2 and Akt activated way. Meanwhile, LRP16 overexpression protected MIN6 cells from fatty acid-induced apoptosis by partially restoring Akt phosphorylation and inhibiting FoxO1 nuclear redistribution. Therefore, LRP16 played important roles not only in insulin content and GSIS but also in the antilipotoxic effect mediated by Akt/FoxO1 signaling.

Animals ; Apoptosis ; drug effects ; Blotting, Western ; Cell Line, Tumor ; Fatty Acids ; pharmacology ; Forkhead Box Protein O1 ; Forkhead Transcription Factors ; genetics ; metabolism ; Mice ; Neoplasm Proteins ; genetics ; metabolism ; Phosphorylation ; drug effects ; Proto-Oncogene Proteins c-akt ; genetics ; metabolism ; Reverse Transcriptase Polymerase Chain Reaction ; Signal Transduction ; drug effects ; genetics

OBJECTIVETo evaluate the safety and accuracy of "funnel technique" in planting thoracic pedicle screws.

METHODSFrom August 2005 to March 2008, a total of 39 patients with at least one thoracic pedicle screw in T1-T10 using "funnel technique" were retrospectively reviewed. Among the patients, 27 patients were male and 14 patients were female, with a mean age of 38.5 years (ranged from 17 to 56 years). One patient was lost follow-up, and other 1 patient was dead before follow-up. The accuracy of screw placement and the complications related to thoracic pedicle screws were analyzed by postoperative CT-scans.

RESULTSAll the patients were followed up ranging from 18 to 30 months, averaged 23.2 months. There were no vascular or viscera complications as well as iatrogenic neurologic injuries. The total number of screws was 208. There was no statistical difference between the percentage of fully contained screws at T1-T4 versus T5-T8 (P = 0.80),T5-T8 versus T9-T10 (P = 0.07), T1-T4 versus T9-T10 (P = 0.06). Twenty-seven screws (13.0%) were misplaced, 14 screws (6.7%) violated lateral cortex of pedicle, 7 screws (3.4%) medially, 5 screws (2.4%) superiorly, 1 screw (0.5%) violated lateral cortex of vertebral body. No violations occurred superiorly or anteriorly. Only 4 screws (1.9%) was a critical perforation.

CONCLUSIONThe "funnel technique" is a simple, safe, accurate and cost-effective technique for pedicle screw placement. It provides even an entry-level surgeon with a safe way to identify and place thoracic pedicle screws.

Adolescent ; Adult ; Bone Screws ; Female ; Humans ; Male ; Middle Aged ; Orthopedic Procedures ; methods ; Retrospective Studies ; Spinal Diseases ; surgery ; Thoracic Vertebrae ; surgery

UNLABELLEDStudy on human case of avian influenza in Guangzhou 2006 without causing human-to-human transmission

OBJECTIVETo explore the possibility of transmission from a human case of avian influenza to his close contacts.

METHODSClose contacts of the human case of avian influenza in Guangzhou 2006 were found out according to the definition and methods publicized by the Ministry of Health, People's Republic of China. Epidemiological investigation and medical observation were carried out. Serum antibodies were tested in some of the close contacts.

RESULTSThe avian influenza patient had never left Guangzhou in the month prior to disease onset. No contact history with dead or diseased poultry was found. A total of 56 close contacts, including his girl friend, relatives, friends and medical staff who had taken care of him, were brought under medical observation for 7 days but none of them showed signs of infection.

CONCLUSIONUnlike SARS, direct contact with patient contracted with avian influenza at the end of incubation period and in the stage of illness through flying droplets, saliva, mucous membrane and skin injuries will not lead to human-to-human transmission, indicating the virus' ability to pass from human to human is limited.

Animals ; China ; Contact Tracing ; Female ; Humans ; Influenza, Human ; transmission ; Male

Objective To explore the association between metabolic syndromes (MS) and carotid atherosclerosis and to estimate the predictive effects of MS under 3 different definitions.Methods A cross-sectional study was conducted in 2 community-based populations in Beijing,in 2008.1266 subjects (598 men,668 women),aged 45-69,were included in the analyses.MS was defined by the criteria of International Diabetes Federation (IDF),the revised NCEPATPm (ATP Ⅲ-R) and "The Guidelines of Dyslipidemia Control for Chinese Adult" ( "Guidelines" ) in 2007.Results The prevalence rates of MS by the 3 criteria were 39.0%,43.3% and 30.9% respectively.The Kappa value for the measure of the agreement between each pair of the 3 definitions were 0.911,0.719 and 0.730 respectively.The intima-media thickness in common carotid artery (CCA-IMT) was significantly higher (P＜0.001) in all MS groups than in non-MS groups,diagnosed with the 3 criteria independent of age,gender,LDL-C,and current smoking status.After adjustment of age,gender,LDL-C,and current smoking status,the classification of MS significantly increased the risk of prevalence of carotid atberosclerotic plaques,compared to the non-MS group.OR value were 1.499 (95% CI:1.157-1.942) for IDF,1.696 (95% CI:1.314-2.189) for NCEP-R,1.763 (95% CI:1.344-2.312) for "Guideline" respectively.Conclusion Our research findings indicated that,when MS were defined with the 3 definitions,prediction on the risk of sub-clinical atberosclerosis would work beyond some of the conventional cardiovascular risk factors such as smoking,LDL-C.There might exist some differences in gender issue on the strength of association between MS when diagnosed by different criteria and carotid plaque.

OBJECTIVE: To investigate the incidence rate of infectious diseases during hospitalization in late preterm infants in Beijing, China, as well as the risk factors for infectious diseases and the effect of breastfeeding on the development of infectious diseases. METHODS: Related data were collected from the late preterm infants who were hospitalized in the neonatal wards of 25 hospitals in Beijing, China, from October 23, 2015 to October 30, 2017. According to the feeding pattern, they were divided into a breastfeeding group and a formula feeding group. The two groups were compared in terms of general status and incidence rate of infectious diseases. A multivariate logistic regression analysis was used to investigate the risk factors for infectious diseases. RESULTS: A total of 1 576 late preterm infants were enrolled, with 153 infants in the breastfeeding group and 1 423 in the formula feeding group. Of all infants, 484 (30.71%) experienced infectious diseases. The breastfeeding group had a significantly lower incidence rate of infectious diseases than the formula feeding group (22.88% vs 31.55%, CONCLUSIONS Breastfeeding can significantly reduce the incidence of infectious diseases and is a protective factor against infectious diseases in late preterm infants. Breastfeeding should therefore be actively promoted for late preterm infants during hospitalization.
Beijing/epidemiology* ; Breast Feeding ; China/epidemiology* ; Communicable Diseases/epidemiology* ; Female ; Hospitalization ; Hospitals ; Humans ; Incidence ; Infant ; Infant, Newborn ; Infant, Premature ; Male ; Pregnancy

Objective: To study the effect of low-to-moderate dose glucocorticoid therapy on viral clearance time in patients with COVID-19. Methods: A total of 72 patients diagnosed with COVID-19 from January 19 to February 17, 2020 at the First Affiliated Hospital, School of Medicine, Zhejiang University were recruited. All patients received oral abidol and/or combined lopinavir/ritonavir, darunavir antiviral, and symptomatic supportive care. Among them, 51 patients received methylprednisolone (0.75-1.50 mg·kg^-1·d^-1) (glucocorticoid treatment group), and 21 patients who did not use glucocorticoid were the control group. The time of stable virologic conversion insputumand the time of radiologic recovery in lungsince onset were compared between the two groups and among the normal patients.The Kruskal-Wallis test or Fisher exact test was used to compare the difference between groups. Results: The median ages of the glucocorticoid group and the control group were 52 [interquartile range (IQR):45, 62] years and 46 (IQR: 32, 56)years, and the differences were significant (P<0.05). The clinical conditions at hospital admission were different between the two groups (P<0.01). There were 52.0% critical ill patients in the glucocorticoid treatment group, compared to that of 71.4% normal patients in the control group. The median times from the onset tostable virologic conversion to negative in the two groups were 15 (IQR:13,20) days and 14 (IQR:12,20) days (P>0.05), and the difference was no statistically significant. The median times from onset to radiologic recovery were 13 (IQR: 11,15) days and 13 (IQR:12,17) days in the two groups, and there was no difference (P>0.05). In ordinary patients, the median timesfrom the onset tostable virologic conversion insputum were no difference (P>0.05), with 13 (IQR:11,18) days in the glucocorticoid group and 13 (IQR:12,15) days in the control group; The median times from onset to radiologic recovery in lungwere also no difference (P>0.05), with 12 (IQR: 10,15)days in the glucocorticoid group and 13 (IQR: 12,17) days inthe control group. Conclusions Low-to-moderate glucocorticoid treatment has no effect on the time of virus clearance in patients with different clinical types of COVID-19. The glucocorticoid is not recommended since no effectiveness on accelerating the improvement of radiologic recovery in lung has been observed.

Objective:To study the effect of low-to-moderate dose glucocorticoid therapy on viral clearance in patients with COVID-19.Methods:A total of 72 patients diagnosed with COVID-19 from January 19 to February 17, 2020 at the First Affiliated Hospital, Zhejiang University School of Medicine were recruited. All patients received oral arbidol and combination of lopinavir/ritonavir or darunavir/cobistitat for antiviral therapy, and symptomatic supportive care. Among them, 51 patients received methylprednisolone (0.75-1.50 mg·kg -1·d -1) (glucocorticoid treatment group), and 21 patients did not use glucocorticoid (control group). The time of virologic negative conversion in sputum and the time of radiologic recovery in lung since onset were compared between the two groups. The Kruskal-Wallis test or Fisher exact test was used to compare the difference between groups. Results:The median ages of the glucocorticoid group and the control group were 52 (45, 62) and 46 (32, 56) years ( χ2=4.365, P<0.05). The clinical conditions at hospital admission were different between the two groups ( P<0.01). The severe cases accounted for 52.0%, while moderate cases in the control group accounted for 71.4%. The median times from the onset to virologic negative conversion in the two groups were 15 (13, 20) and 14 (12, 20) days ( P>0.05). The median times from onset to radiologic recovery were 13 (11, 15) and 13 (12, 17) days in the two groups ( P>0.05). In moderate cases, the median times from the onset to virologic conversion in sputum were 13 (11, 18) days in the glucocorticoid group and 13 (12, 15) days in the control group ( P>0.05). The median times from onset to radiologic recovery in lung were 12 (10, 15) and 13 (12, 17) days, respectively ( P>0.05). Conclusions:Low-to-moderate glucocorticoid treatment has no effect on the time of virus clearance in patients with different clinical types of COVID-19, and also no effect on accelerating radiologic recovery in lung, so it is not recommended.