Eleven cases of arthroscopic ankle arthrodesis were reviewed. Average age of patients was 59 years, 4 male and 7 female. Underlying diseases were osteoarthritis in 7 cases, rheumatoid arthritis in 3 cases and one post-traumatic arthritis. At the mean follow up of 15 months, fusion rate was 100%, mean time to complete union was 9.5 weeks. There were no complications such as nonunion, infection and skin problems. All patients stayed at the hospital just overnight after the surgery. Patients satisfaction was high and the functional clinical grade was excellent in 9 patients, good in 1 patient and fair in 1 patient. We concluded that arthroscopic technique was a simple and effective method for ankle arthrodesis in the selected patients and had significant advantages over the open technique.
Ankle* ; Arthritis ; Arthritis, Rheumatoid ; Arthrodesis* ; Arthroscopy ; Female ; Follow-Up Studies ; Humans ; Male ; Osteoarthritis ; Skin

Objective To explore the impact of maternal hepatitis B (HBV) virus infection status on the vaccination effect of the offspring. Methods Eighty-six pairs of HBV-infected mothers and newborns who were treated in Dalian Sixth People<sup>'sup>s Hospital from 2017 to 2019 were selected as the research subjects. According to the strength of the hepatitis B vaccine response, all patients were divided into two groups, the observation group (none or weak response) and the control group (strong response). Hepatitis B virus infection was compared between the mothers of the two groups, and multivariate logistic regression was used to analyze the influencing factors of vaccination effect of the offspring. Results The positive rate of HBV DNA in mothers of the observation group was higher than that in the control group. HBV DNA was mainly at high load and HBeAg was at low level. The HBV DNA of the control group was mainly at low load, while the distribution of HBeAg was close. The difference was statistically significant (P < 0.05). HBV infection pattern in the observation group was <sup>"sup>HBsAg(+), HBeAg(+), anti-HBc(+)<sup>"sup> in 14 cases (51.85%), <sup>"sup>HBsAg(+), anti-HBe(+), anti- HBc(+)<sup>"sup> in 11 cases (40.74%) , while there were 27 cases (45.76%), 25 cases (42.37%), and 7 cases (11.86%), respectively, in the control group. The difference was statistically significant (P<0.05). Multivariate logisitic regression analysis showed that HBV DNA positivity, HBV DNA high load, HBeAg positivity, and low HBeAg levels were risk factors for weak response of the offspring vaccination. Conclusion HBV DNA positivity, high HBV DNA load, HBeAg positivity, and low HBeAg levels in HBV-infected mothers were risk factors for weak response of the offspring to vaccines, which should be paid attention to in clinic.

No abstract available.
Child* ; Humans ; Liver Diseases* ; Liver* ; Prospective Studies*

OBJECTIVES: This study aims to investigate the effectiveness of an internet-based anger management program for school-aged children. METHODS: Forty-eight elementary school students took part in an anger management training program; subsequently, participants, their parents, and their teachers answered questionnaires assessing the participants' anger, aggressiveness, and other emotional/behavioral problems, pre- and post-training. RESULTS: At the post-training self-assessment, the participants showed significant reductions in their "anger-out" tendencies and physical aggressiveness. In addition, the effects of the program on "anger-out" tendencies, aggressiveness, anger and peer relational problem were found to be more significant in participants who reported depressive symptoms. Teachers rated the participants' peer-relational problems as having decreased after the training. CONCLUSION: The proposed internet-based anger management program had a significant effect on the school-aged children's abilities to control their anger.
Anger* ; Child* ; Depression ; Education ; Humans ; Parents ; Self-Assessment ; Violence* ; Surveys and Questionnaires

PURPOSE: The efficacy of 20-gauge and 23-gauge vitrectomy system was investigated in primary vitrectomy for rhegmatogenous retinal detachment. METHODS: Eyes that underwent primary vitrectomy without scleral buckling for the treatment of rhegmatogenous retinal detachment were followed up at least 6 months and were reviewed retrospectively. Anatomic results, functional outcomes, operation time and complications were compared between 20-gauge and 23-gauge groups. RESULTS: Among 59 eyes of 59 patients, the 20-gauge group had 29 eyes of 29 patients and 23-gauge group had 30 eyes of 30 patients. Anatomic success after a single operation was obtained in 23 eyes (79.3%) of the 20-gauge group and 28 eyes (93.3%) of the 23-gauge group. Recurrence occurred in 6 eyes (20.7%) in the 20-gauge and in 2 eyes (6.6%) in the 23-gauge group. Retinal reattachment in all of these eyes was obtained through reoperation. Visual acuity improved logMAR 0.2 or more in 19 eyes (65.5%) of the 20-gauge group and 20 eyes (66.7%) of the 23 gauge group (p=0.153, 0.215). The average operation time of the 23-gauge group was 80.2 minutes, which was significantly shorter than the 94.8 minutes of the 20-gauge group (p=0.008). Transient ocular hypertension and progression of lens opacity were the most common complications in the both groups. CONCLUSIONS: Twenty-three-gauge transconjuctival sutureless vitrectomy achieved outcomes comparable with 20-gauge vitrectomy, with significantly shorter operation time in repair of rhegmatogenous retinal detachment. It is considered as a viable alternative to 20-gauge vitrectomy in selected cases.
Cataract ; Eye ; Humans ; Ocular Hypertension ; Recurrence ; Reoperation ; Retinal Detachment ; Retinaldehyde ; Retrospective Studies ; Scleral Buckling ; Visual Acuity ; Vitrectomy

PURPOSE: To compare the changes in corneal topography between 23 gauge (G) pars plana vitrectomy (PPV) and 20 G PPV. METHODS: Forty-three eyes of 42 patients who underwent PPV were divided into 2 groups: 20G PPV (Group I, n=18) and 23 G PPV (Group II, n=25). Both groups were followed up over 3 months postoperatively. ORBSCAN II was performed to compare the corneal topographic change of 20 G PPV and 23 G PPV. RESULTS: In a 5 mm zone, significant postoperative change in the mean corneal surface cylinder was found between the 1st day and the 1st month in Group I, while no significant change was found in Group II. Postoperatively, the increase in the mean corneal surface cylinder in Group I was significantly higher than in Group II between the 1st day and the 1st month. Clinically significant astigmatism, induced by surgery, was found only in Group I one week after the operation. In a 3 mm zone, there was no significant change in the mean corneal surface cylinder in both groups postoperatively. The difference in the mean corneal surface cylinder between the 2 groups at the postoperative periods showed no significant change. Surgically induced astigmatism was significantly higher in Group I than in Group II between the 1st day and the 1st month postoperatively. CONCLUSIONS: PPV with the 23 G system is a sutureless transconjunctival surgery, which appears to be more effective due to insignificant corneal surface and astigmatic changes in the early postoperative period.
Astigmatism ; Corneal Topography ; Eye ; Humans ; Postoperative Period ; Vitrectomy

There are some controversies on the mechanism of the lumbar disc degeneration and disc prolapse. But,it is clear that many factors are related to the disc degeneration. Configurations of the lower lumbar and lumbosacral spine have long been proposed as one of the important factors of disc degeneration in these areas. To look for the configurational risk factors and the probability of disc degeneration by the combinations of these factors, we analyzed simple radiographs and MRI of 73 patients who complaints of low back pain and are between 20 years and 39 years of age. We performed chi-square test and multivariate logistic regression analysis: L4-5 disc degeneration and L5-Sl disc degeneration as dependent variables and lumbar lordosis, sacral inclination, height of intercrest line, transitional vertebra and facet joint asymmetry as independent variables. We could not find any of these variables significantly related to the L4-5 intervertebral disc degeneration. For L5-S1 disc degeneration, only the presence of transitional vertebra was signicantly related. When there is no transitional vertebra, the probability of disc degeneration is 9 times(8.889) as large as that of presence of transitional vertebra. The probability of L4-5 disc degeneration without the degeneration of L5-S1 is 3 times as large as that of degeneration of both of L4-5 and L5-S1 disc in case of the presence of transitional vertebra.
Animals ; Humans ; Intervertebral Disc Degeneration* ; Logistic Models ; Lordosis ; Low Back Pain ; Magnetic Resonance Imaging ; Prolapse ; Risk Factors ; Spine* ; Zygapophyseal Joint

Graft-versus-host disease (GVHD) is a fatal complication that occurs after allogeneic hematopoietic stem cell transplantation. To understand the dynamics of CD4 and CD8 T cell production of IFN-gamma and IL-17 during GVHD progression, we established a GVHD model by transplanting T cell-depleted bone marrow (TCD-BM) and purified T cells from B6 mice into irradiated BALB.B, creating an MHC-matched but minor histocompatibility (H) antigen-mismatched transplantation (B6 --> BALB.B GVHD). Transplantation-induced GVHD was confirmed by the presence of the appropriate compositional changes in the T cell compartments and innate immune cells in the blood and the systemic secretion of inflammatory cytokines. Using this B6 --> BALB.B GVHD model, we showed that the production of IFN-gamma and IL-17 by CD4 T cells preceded that by CD8 T cells in the spleen, mesenteric lymph node, liver, and lung in the BALB.B GVHD host, and Th1 differentiation predated Th17 differentiation in all organs during GVHD progression. Such changes in cytokine production were based on changes in cytokine gene expression by the T cells at different time points during GVHD development. These results demonstrate that both IFN-gamma and IL-17 are produced by CD4 and CD8 T cells but with different kinetics during GVHD progression.
Animals ; Bone Marrow ; Cytokines ; Gene Expression ; Graft vs Host Disease* ; Hematopoietic Stem Cell Transplantation ; Histocompatibility ; Interleukin-17* ; Kinetics* ; Liver ; Lung ; Lymph Nodes ; Mice ; Spleen ; T-Lymphocytes*

Diabetic neuropathy (DN) is the most common and disabling complication of diabetes that may lead to foot ulcers and limb amputations. Despite widespread awareness of DN, the only effective treatments are glucose control and pain management. A growing body of evidence suggests that DN is characterized by reduction of vascularity in peripheral nerves and deficiency in neurotrophic and angiogenic factors. Previous studies have tried to introduce neurotrophic or angiogenic factors in the form of protein or gene for therapy, but the effect was not significant. Recent studies have shown that bone marrow (BM)-derived stem or progenitor cells have favorable effects on the repair of cardiovascular diseases. Since these BM-derived stem or progenitor cells contain various angiogenic and neurotrophic factors, these cells have been attempted for treating experimental DN, and turned out to be effective for reversing various manifestations of experimental DN. These evidences suggest that cell therapy, affecting both vascular and neural components, can represent a novel therapeutic option for treatment of clinical DN.
Adult ; Amputation ; Angiogenesis Inducing Agents ; Bone Marrow ; Cardiovascular Diseases ; Diabetic Neuropathies ; Extremities ; Foot Ulcer ; Glucose ; Humans ; Nerve Growth Factors ; Pain Management ; Peripheral Nerves ; Stem Cells ; Tissue Therapy

PURPOSE:The effect of preoperative intravitreal bevacizumab (Avastin(R)) injection was investigated in primary vitrectomy for severe proliferative diabetic retinopathy. METHODS: Eyes that underwent vitectomy for proliferative diabetic retinopathy were followed up at least 6 months and were reviewed retrospectively. The authors reviewed functional outcomes, complications, and operation time between preoperative bevacizumab injection (group I) and non-injection groups(group II). RESULTS: Among 93 eyes of 87 patients, the injection group consisted of 44 eyes of 41 patients and the non-injection gauge group consisted of 49 eyes of 46 patients. The mean interval between injection and vitrectomy was 5.8 days. Final visual acuity significantly improved as compared to preoperative visual acuity, and group I showed better visual acuity than group II (p=0.008). Visual acuity improved logMAR 0.2 or more in 36 eyes in group I and 43 eyes in group II (p=0.167). The average duration of postoperative vitreous hemorrhage was 1.02 days in group I, and 4.02 days in group II (p=0.2.08). Recurrence of vitreous hemorrhage was not observed in group I or in 2 eyes of group II (p=0.274). Epiretinal membrane occurred in 2 eyes of group I, and in 9 eyes of group II (p=0.031). Only a single eye in group I had neovascular glaucoma after vitrectomy (p=0.527). The operation time of group I was 64.8 minutes, which was significantly shorter than 78.1 minutes of group II (p=0.018). CONCLUSIONS: Intravitreal bevacizumab injection before vitrectomy in proliferative diabetic retinopathy facilitated removal of the fibrovascular membrane, and leads to less postoperative complications and better functional outcomes. Intravitreal bevacizumab injection before vitrectomy can be considered as an effective preoperative adjuvant.
Antibodies, Monoclonal, Humanized ; Diabetic Retinopathy ; Epiretinal Membrane ; Eye ; Glaucoma, Neovascular ; Humans ; Membranes ; Postoperative Complications ; Recurrence ; Retrospective Studies ; Visual Acuity ; Vitrectomy ; Vitreous Hemorrhage ; Bevacizumab