No abstract available.
Catheter Ablation* ; Thyroid Gland* ; Ultrasonography

Irreducible dislocation of the elbow is an uncommon event. We present the case of a posterolateral elbow dislocation after a fall injury in a 67-year-old woman. A closed reduction performed in the emergency department was unsuccessful since the limited passive range of motion resulted in difficulty to perform longitudinal traction and flexion. Computed tomography images showed that the posterolateral aspect of the capitellum was impacted by the tip of the coronoid process, thus appearing similar to the Hill-Sachs lesion in the humeral head. Subsequent open reduction of the elbow revealed the dislocation to be irreducible since the tip of the coronoid process had wedged into a triangular Hill-Sachs-like lesion in the capitellum. The joint was reduced by providing distal traction on the forearm, and main fragments were disengaged using digital pressure. At the 3-month follow-up, the patient reported no dislocations, and had an acceptable range of motion. Thus, we propose that to avoid iatrogenic injury to the joint or other nearby structures, irreducible dislocations should not be subjected to repeated manipulation.
Aged ; Dislocations ; Elbow ; Emergency Service, Hospital ; Female ; Follow-Up Studies ; Forearm ; Humans ; Humeral Head ; Joints ; Range of Motion, Articular ; Traction

OBJECTIVETo explore the efficacy on knee osteoarthritis (KOA) treated with different acupuncture methods at different stages.

METHODSOne hundred and eighty cases of KOA were divided into stagnation stage, fascia cramp stage and tendon lesion stage according to the condition of disease, 60 cases in each stage. Each stage was randomized into a staging treatment group and an electroacupuncture (EA) group, 30 cases in each one. In the staging treatment group, acupuncture at the tendon points of meridians and electric thermal needling method were adopted for the cases at the stagnation stage; the small needle-knife therapy and bleeding method were used for the cases at the fascia cramp stage; and the electric thermal therapy with thick silver needles was applied for the cases at the tendon lesion stage. In the EA group, EA was applied for the cases of all the three stages at Liangqiu (ST 34), Xuehai (SP 10), Yanglingquan (GB 34), etc.

RESULTSThe total effective rate was 96.1% (87/90) in the staging treatment group and was 91.1% (82/90) in the EA group, without significant difference in comparison (P > 0.05). The controlled and remarkably effective rate (88.9%, 80/90) in the staging treatment group was higher apparently than (62.2%, 56/90) in the EA group (P < 0.001). And in the EA group, with the disease progression and the further disease stages, the controlled and remarkably effective rate was reduced. After treatment, the scores of symptoms and signs were decreased in both groups (both P < 0.001), the improvement in the staging treatment group was superior to that in the EA group (P < 0.001).

CONCLUSIONThe different acupuncture methods at the three stages improve obviously the clinical effect and are highly targeted. The mechanism of the three stages on "meridian muscle region pathology" and the treatment based on the disease stages can be the effective approach to KOA.

Acupuncture Points ; Acupuncture Therapy ; Adult ; Aged ; Disease Progression ; Female ; Humans ; Male ; Middle Aged ; Osteoarthritis, Knee ; pathology ; therapy

BACKGROUND: Eczema is the most common skin problem among children in Hong Kong. Previous studies have highlighted that the quality of life of the families of children with eczema influences the effects of eczema interventions. However, the Chinese version of the Family Dermatology Life Quality Index (C-FDLQI), a tool for measuring the quality of life of the families of children with eczema, has not yet been validated. OBJECTIVE: This study examined the psychometric properties of the C-FDLQI among parents and caregivers of children with eczema in Hong Kong. METHODS: This study evaluated the internal consistency, test-retest reliability and structural validity of the C-FDLQI and its convergent validity by examining its correlations with the SCORing Atopic Dermatitis (SCORAD) and the Cantonese version of the Children’s Dermatology Life Quality Index (C-CDLQI) among 147 Chinese parents/caregivers of children with varying degrees of eczema.
Asian Continental Ancestry Group ; Caregivers ; Child ; Dermatitis, Atopic ; Dermatology ; Eczema ; Hong Kong ; Humans ; Parents ; Psychometrics ; Quality of Life ; Reproducibility of Results ; Semantics ; Skin

Objective To investigate the changes of cognitive impairment and its correlated factors in patients with first acute cerebral ischemic stroke.Methods Five hundred and sixty-eighty patients,admitted to our hospital from July 2010 to June 2011 and met the diagnostic criteria of first acute cerebral ischemic stroke,were chosen in our study; neuropsychological evaluation was conducted within 1 week of acute cerebral ischemic stroke.The comprehensive neuropsychological evaluation battery included mini-mental state examination (MMSE),Digit span,Mattis dementia scale,Rey complex figure test,stroop test,World Health Organization and University of California-Los Angeles auditory verbal learning test,semantic category verbal fluency test and clock drawing test,which contained tests for memory,attention,executive function,information processing capability,visuospatial and visuo constructive functions.Gender,age,histories of hypertension and smoking,and levels of blood pressure,random blood glucose,fasting blood glucose and 2-hour postprandial blood glucose,cholesterin,triglyceride,low density lipoprotein-C (LDL-C) and high density lipoprotein-C (HDL-C) were noted and the relations between cognitive function and both blood sugar and blood lipid levels were analyzed.Results (1) The abnormal rates of these patients in MMSE,Mattis dementia scale,attention deficit disorder,immediate logical memory disorder,delayed logical memory disorder,instant auditory memory disorder,delayed auditory memory disorder,visual memory disorder,executive function disorder,information processing disorder,and visuospatial and visuo constructive disorder were 78.2％,72.5％,26.5％,56.3％,60.9％,74.6％,98.2％,83.8％,62.7％,4.9％ and 77.7％,respectively.In patients with different blood glucose levels,significant differences were found on scores of MMSE,Mattis dementia scale,attention scale (P＜ 0.05); furthermore,the scores ofMMSE,Mattis dementia scale,attention scale in patients with impaired fasting glucose were obviously lower as compared with those in other groups (P＜0.05).The scale of above cognitive domains showed no significant difference in patients with different types of hyperlipidemias (P＞0.05); the scores of execution ability and visual space structure capability in patients with HDL-C were higher than those in normal density lipoprotein-C and LDL-C (P＜0.05),and the higher level of density lipoprotein-C,the higher scores of visual space structure capability (P＜0.05).Logistic regression analysis found that the total MMSE scores were associated with gender,age,and levels of fasting blood glucose and 2-hour postprandial blood glucose; the independent risk factors of executive function were gender,age and HDL-C level; the ability of memory was correlated with age and HDL-C level.Visuospatial and visuo constructive function was associated with gender,age and mRS scores; the information processing ability was only correlated with HDL-C level.Conclusion In patients with acute cerebral ischemic stroke,the cognitive impairment is extensive and severe,with a prevalence of about 75％,mainly having disorders in memory,executive ability,spatial structure; glucose levels,especially impaired fasting glucose level show most obvious influence in cognitive impairment;HDL-C level helps keep normal cognitive function; age,gender,HDL-C level are the most important factors of cognitive function.

Adolescent ; Adult ; Aged ; Blood Banks ; legislation & jurisprudence ; Blood Donors ; legislation & jurisprudence ; Child ; Female ; Hepatitis C ; epidemiology ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Young Adult

Objective: To quantitatively assess the pulmonary vasculature using non-contrast computed tomography (CT) in patients with chronic thromboembolic pulmonary hypertension (CTEPH) pre- and post-treatment and correlate CT-based parameters with right heart catheterization (RHC) hemodynamic and clinical parameters. Materials and Methods: A total of 30 patients with CTEPH (mean age, 57.9 years; 53% female) who received multimodal treatment, including riociguat for ≥ 16 weeks with or without balloon pulmonary angioplasty and underwent both noncontrast CT for pulmonary vasculature analysis and RHC pre- and post-treatment were included. The radiographic analysis included subpleural perfusion parameters, including blood volume in small vessels with a cross-sectional area ≤ 5 mm 2 (BV5) and total blood vessel volume (TBV) in the lungs. The RHC parameters included mean pulmonary artery pressure (mPAP), pulmonary vascular resistance (PVR), and cardiac index (CI). Clinical parameters included the World Health Organization (WHO) functional class and 6-minute walking distance (6MWD). Results: The number, area, and density of the subpleural small vessels increased after treatment by 35.7% (P < 0.001), 13.3% (P = 0.028), and 39.3% (P < 0.001), respectively. The blood volume shifted from larger to smaller vessels, as indicated by an 11.3% increase in the BV5/TBV ratio (P = 0.042). The BV5/TBV ratio was negatively correlated with PVR (r = -0.26; P = 0.035) and positively correlated with CI (r = 0.33; P = 0.009). The percent change across treatment in the BV5/TBV ratio correlated with the percent change in mPAP (r = -0.56; P = 0.001), PVR (r = -0.64; P < 0.001), and CI (r = 0.28; P = 0.049).Furthermore, the BV5/TBV ratio was inversely associated with the WHO functional classes I–IV (P = 0.004) and positively associated with 6MWD (P = 0.013). Conclusion Non-contrast CT measures could quantitatively assess changes in the pulmonary vasculature in response to treatment and were correlated with hemodynamic and clinical parameters.

Neuropathic pain is one of the common complications of diabetes. Tetrahydropalmatine(THP) is a main active component of Corydalis Rhizoma with excellent anti-inflammatory and pain-alleviating properties. This study aims to investigate the therapeutic effect of THP on diabetic neuropathic pain(DNP) and the underlying mechanism. High-fat and high-sugar diet(4 weeks) and streptozotocin(STZ, 35 mg·kg~(-1), single intraperitoneal injection) were employed to induce type-2 DNP in rats. Moreover, lipopolysaccharide(LPS) was used to induce the activation of BV2 microglia in vitro to establish an inflammatory cellular model. Fasting blood glucose(FBG) was measured by a blood glucose meter. Mechanical withdrawal threshold(MWT) was assessed with von Frey filaments, and thermal withdrawal latency(TWL) with hot plate apparatus. The protein expression levels of OX42, inducible nitric oxide synthase(iNOS), CD206, p38, and p-p38 were determined by Western blot, the fluorescence expression levels of OX42 and p-p38 in the dorsal horn of the rat spinal cord by immunofluorescence, the mRNA content of p38 and OX42 in rat spinal cord tissue by qRT-PCR, and levels of nitric oxide(NO), interleukin-1β(IL-1β), interleukin-6(IL-6), tumor necrosis factor-α(TNF-α), interleukin-10(IL-10), and serum fasting insulin(FINS) by enzyme-linked immunosorbent assay(ELISA). RESULTS:: showed that the mo-del group demonstrated significant decrease in MWT and TWL, with pain symptoms. THP significantly improved the MWT and TWL of DNP rats, inhibited the activation of microglia and p38 MAPK signaling pathway in rat spinal cord, and ameliorated its inflammatory response. Meanwhile, THP promoted the change of LPS-induced BV2 microglia from the pro-inflammatory M1 phenotype to the anti-inflammatory M2 phenotype, suppressed the activation of the p38 MAPK signaling pathway, decreased the expression levels of inflammatory factors NO, IL-1β, IL-6, and TNF-α, and increased the expression level of anti-inflammatory factor IL-10. The findings suggested that THP can significantly ameliorate the pain symptoms of DNP rats possibly by inhibiting the inflammatory response caused by M1 polarization of microglia via the p38 MAPK pathway.
Animals ; Berberine Alkaloids ; Blood Glucose/metabolism* ; Diabetes Mellitus ; Diabetic Neuropathies/genetics* ; Interleukin-10 ; Interleukin-6/metabolism* ; Lipopolysaccharides/pharmacology* ; Microglia ; Neuralgia/metabolism* ; Rats ; Rats, Sprague-Dawley ; Signal Transduction ; Spinal Cord/metabolism* ; Streptozocin/therapeutic use* ; Tumor Necrosis Factor-alpha/metabolism* ; p38 Mitogen-Activated Protein Kinases/metabolism*

Objective: To evaluate the short-and mid-term efficacy of pediatric kidney transplantation and the risk factors for kidney graft and recipient. Methods: The baseline data and postoperative complications of pediatric donors and recipients of 284 kidney transplants were retrospectively analyzed in the Department of Kidney Transplantation in the First Affiliated Hospital of Zhengzhou University from August 2010 to May 2021 and all subjects were followed up until December 31, 2021. According to the survival status of donors and recipients, they were divided into the graft-loss group and the graft-survival group, and the recipient death group and survival group, respectively. Univariate comparison between groups was performed by Log-rank test, and Cox proportional risk model was used to explore the independent risk factors for the graft and recipient survival. Results: Among the 284 children recipients, 184 cases (64.8%) were male and 100 cases(35.2%) were female, and 19 cases (6.7%) were living relative donor renal transplantation, 19 cases (6.7%) were preemptive transplantation, and 8 cases were secondary transplantation. The age of 284 recipients at the time of transplantation was 13.0 (9.0, 15.0) years, among whom 29 cases aged 0-6 years, 96 cases aged 7-11 years old, and 159 cases aged 12-18 years. The 1, 3, and 5 year survival rates were 92.3%, 88.9% and 84.8% for the kidney grafts, and were 97.1%, 95.6% and 94.4% for the recipients, respectively. Multivariate analysis showed postoperative acute rejection (HR=3.14, 95%CI 1.38-7.15, P=0.006) and perioperative vascular complications (HR=4.73, 95%CI 2.03-11.06, P<0.001) were independent risk factors for the survival of kidney graft. Postoperative infection (HR=14.23, 95%CI 3.45-58.72, P<0.001) was an independent risk factor for the postoperative mortality of recipients. Conclusions: Pediatric kidney transplantation shows a good short-and mid-term prognosis. Postoperative acute rejection and perioperative vascular complications are the risk factors for the survival of kidney graft, and postoperative infection is the risk factor affecting the survival of recipient.
Child ; Female ; Graft Rejection ; Graft Survival ; Humans ; Kidney Transplantation/adverse effects* ; Living Donors ; Male ; Postoperative Complications ; Prognosis ; Retrospective Studies ; Risk Factors