【Objective】 To monitor the vehicle positioning and temperature of each shipping container during blood transportation by the Internet of Things technology, so as to ensure the blood products for clinical are always within the standard temperature range, and early detect and deal with the temperature runaway during transportation thus realizing the objective and traceable process of blood transportation temperature. 【Methods】 The temperature of each shipping container was collected in real time, and uploaded to the cloud server through the temperature information receiver. The temperature, vehicle positioning and early warning were displayed on the large screen and computer through the cold chain real-time monitoring system platform, and recorded in real time. 【Results】 The comparative validation test of data in 5 months since formal operation showed that the transportation temperature monitoring and recording of the system met the requirements, the handling of abnormal early warning (alarm) was convenient, and the vehicle positioning was accurate. 【Conclusion】 The system achieves real-time monitoring, accuracy and controllability of abnormal disposal, and ensures the blood quality. The blood products with RFID tags can be accurately monitored during transportation.

Triple negative breast cancer (TNBC) has a high degree of malignacy, and a higher incidence among young women. It is prone to early metastasis and chemotherapy tolerance, lacks effective clinical treatment targets, and has a poor prognosis. Many studies have found that androgen receptor (AR) can be highly expressed in TNBC tissues, which is closely related to the prognosis of TNBC. AR has been proved to promote the growth and metastasis of TNBC cells. The clinical data show that the single anti-androgen drug therapy shows the sensitivity to TNBC, and the combination of AR inhibitor and other classic targeted therapy drugs has potential value for the treatment of TNBC. Because AR is a reference indicator for the prognosis of TNBC, the studies on anti-AR therapy in TNBC have attracted considerable attention. This review discusses the therapeutic mechanism and clinical research of anti-AR therapy in TNBC.

Objective: To compare the clinical efficacy of posterior atlantoaxial screw-rod fixation combined with spinous process muscle-vessel complex bone graft or iliac bone graft for atlantoaxial instability. Methods: A retrospective case-control study was conducted to analyze the clinical data of 56 patients with atlantoaxial instability admitted to the Sixth Hospital of Ningbo from September 2014 to October 2016. There were 35 males and 21 females, with the age range from 9 to 59 years [(50.3±3.2)years]. A total of 26 patients were treated with posterior atlantoaxial screw-rod fixation combined with spinous process muscle-vessel complex bone graft (complex group), while 30 patients were treated with iliac bone graft (ilium group). Patients showed different degrees of neck pain and limited neck activity preoperatively. X-ray films and three-dimensional CT examination of the cervical spine were taken before and after operation for evaluating the atlantoaxial reduction, bone graft fusion and internal fixation. The operation time, intraoperative bleeding, bone fusion time, visual analogue scale (VAS), Japanese Orthopaedic Association (JOA) score, atlantodental interval (ADI) and axial symptoms were compared between the two groups, and the complications were recorded. Results: Both groups were followed up for 24-30 months, with an average of 27.4 months. In the complex group and the ilium group, the operation time was (2.21±0.25)hours and (2.72±0.26)hours (P<0.01); the intraoperative blood loss was (227.3±45.4)ml and (277.7±43.4)ml, respectively (P<0.05); the bone fusion time was (6.9±0.5)months and (8.1±1.8)months (P>0.05), respectively. In the complex group, the VAS was (5.45±0.69)points before operation, (2.64±0.51)points at the follow-up one month after operation, (0.91±0.7)points at the follow-up 12 months after operation, and (0.45±0.16)points at the follow-up 24 months after operation; and in the ilium group, the VAS was (5.18±0.75)points, (2.45±0.52)points, (1.27±0.19)points and (0.41±0.18)points correspondingly. In terms of VAS, there were significant differences before and after operation within each group (P<0.01), while there were no significant differences between the two groups at different time points (P>0.05). In the complex group, the JOA score was (10.82±0.35)points before operation, (12.73±0.65)points at the follow-up one month after operation, (15.18±0.61)points at the follow-up 12 months after operation, and (15.64±0.15)points at the follow-up 24 months after operation; and in the ilium group, the JOA score was (10.73±1.19)points, (13.01±0.63)points, (14.73±0.91)points and (15.55±0.51)points correspondingly. In terms of JOA score, there were significant differences between before and after operation within each group (P<0.01), while there were no significant differences between the two groups at different time points (P>0.05). In the complex group, the ADI was (2.28±0.59)mm before operation, (1.83±0.56)mm at the follow-up one month after operation, (1.71±0.56)mm at the follow-up 12 months after operation, and (1.59±0.67)mm at the follow-up 24 months after operation; and in the ilium group, the ADI was (2.23±0.60)mm, (1.80±0.18)mm, (1.67±0.69)mm and (1.62±0.53)mm correspondingly. In terms of ADI, there were significant differences between before and after operation within each group (P<0.01), while there were no significant differences between the two groups at different time points (P>0.05). The axial symptom scores were graded as excellent in 23 patients and good in three patients of the complex group while excellent in 21 patients and good in nine patients in the ilium group (P>0.05). There were no patients with spinal nerve injury caused by pedicle screw placement after operation. One patient in the ilium group had incision errhysis and recovered after dressing change, and other patients had no incision infection. Conclusions For atlantoaxial instability, posterior atlantoaxial screw-rod fixation combined with spinous process muscle-vessel complex bone graft or autogenous iliac bone graft can both achieve satisfactory clinical results. The spinous process-muscle-vascellum complex graft has less operation time and intraoperative bleeding than the autogenous iliac bone graft, which can be a feasible alternative operation.

Objective: To investigate the accuracy and feasibility of individual 3D printing model for pedicle screw placement in treating patients with upper cervical spine fracture. Methods: A retrospective case control study was conducted to analyze the clinical data of 30 patients with upper cervical spine fracture admitted to Ningbo No.6 Hospital from August 2013 to December 2018. There were 19 males and 11 females, aged 45-67 years with an average age of 53.5 years. The 15 patients in the study group were treated with pedicle screw fixation and another 15 patients in the control group were treated with traditional freehand screw fixation. A total of 120 pedicle screws were implanted, with 60 screws in each group. The operation time, intraoperative blood loss, preoperative and postoperative visual analogue score (VAS), Japan Orthopedic Association (JOA) score were recorded. The position and grade of screws were evaluated according to Kawaguchi's evaluation method of screw grade after operation. The patients took monthly reexamination for the first three months after discharge. In the first two months after discharge, the patients took X-ray examination for observation of screw loosening or rupture of internal fixation. At the third month after operation, the patients took CT of cervical spine for observation of bone healing and fusion. Results: The mean follow-up duration was 17.8 months (range, 13-21 months). The study group had shorter operation time (99.13±3.04)minutes compared with the control group (107.00±6.92) minutes (P<0.01). There were no significant differences in intraoperative blood loss, preoperative VAS, JOA scores before operation and 1 year after operation between the two groups (P>0.05), but the VAS in study group was significantly lower than that in control group (P<0.05). In the study group, the VAS score 1 year after operation [(2.3±0.5)points] was lower than that before the operation [(7.7±0.7)points], and the JOA score [(16.8±0.4)points] was significantly higher than that before the operation [(15.9±0.7)points](P<0.01). In the control group, the VAS 1 year after operation [(2.5±0.5)points] was significantly lower than that before operation [(7.5±0.5)points] (P<0.01), and the JOA score [(16.5±0.5)points] was significantly higher than that before operation [(15.9±0.8)points] (P<0.05). In the study group, according to the CT results, there were 28 atlas pedicle screws of grade 0 (93.3%), two of grade 1 (6.7%), 0 of grade 2, 0 of grade 3, and there were 27 axial pedicle screws of grade 0 (90.0%), three of grade 1 (10.0%), 0 of grade 2, and 0 of grade 3. In the control group, there were 25 atlas pedicle screws of grade 0 (83.3%), four of grade 1 (13.3%), one of grade 2 (3.4%), 0 of grade 3, and there were 27 axial pedical screws of grade 0 (90.0%), three of grade 1 (10.0%), 0 of grade 2, and 0 of grade 3. There was no significant difference in the accuracy of pedicle screw placement between the two groups (P>0.05). No serious complications such as spinal cord or vertebral artery injury occurred. At 3 months after operation, CT showed that the fracture of cervical vertebra healed. Conclusion Individualized 3D printed cervical spine model can guide the pedicle screw placement for upper cervical spine fracture, which can shorten the operation time, reduce the postoperative pain of patients, improve the accuracy of screw placement, and reduce the risks related to operation.

Objective: “Food addiction” may be one of the drivers of the obesity epidemic. Bariatric surgery-induced weight loss can significantly alleviate food addiction in overweight or obese people. Appetite regulation is part of the feedback control system for energy balance. The purpose of this study was to investigate the effects of mobile application-based dietary intervention on weight-loss and food addiction in overweight and obese adults. Methods: A total of 101 overweight or obese people aged over 18 years, who were admitted to the obese multidisciplinary clinic of Ningbo First Hospital from August 2015 to January 2018 were enrolled. All subjects received health education and dietary guidance, and submitted their diet log through the weight management application of their smartphone. Over 12 weeks, a dietitian guided and corrected the subjects who did not meet the diet standards. Interviews, physical examinations, laboratory tests, and the Yale Food Addiction Scale Questionnaire survey were administered before and after the intervention (12 weeks) comparing subjects’ weight, food addiction symptom count, and the proportion of food addiction before and after intervention. Statistical analysis of body composition measurements, blood biochemical parameters, and symptom count scores was performed using paired data t-test, McNemar chi-square test, and Fisher’s exact test. Results: A total of 101 overweight and obese subjects were enrolled, including 31 males and 70 females, with an average age of (30.4±7.3) years, mean body mass index of (32.76±4.46) kg/m², and average body weight of (89.95±17.12) kg. The proportion of food addiction was 26.73%. After 12 weeks of dietary intervention with the mobile application, the number of people with food addiction decreased from 27 to 14, the proportion of food addiction decreased by 12.87%, the proportion of symptom counts ≥3 decreased from 41.58% to 19.80%.（χ²=5.17， 11.26, all P <0.01), and the symptom count decreased from 2.25 ±1.61 to 1.50±1.31 (t=3.64, P<0.001). Simultaneously, body weight, BMI, and waist circumference decreased by (6.54±1.03) kg, (2.35±0.36) kg/m², and (6.50±0.86) cm (t=6.36, 5.62 and 3.78, all P<0.001), respectively, compared with those before the intervention. Metabolic indicators such as fasting glucose, insulin resistance index, and LDL-C cholesterol also significantly improved, with a decrease of (0.38±0.10) mmol/L, 1.83±0.46, (0.22±0.75) mmol/L (t=3.67, 3.59, 2.97, all P<0.01). Conclusion The smartphone application-based dietary intervention can effectively improve blood glucose and lipid levels in overweight and obese people, reduce visceral fat accumulation and reduce insulin resistance, and improve the food addiction status of overweight and obese people.

Objective: To observe the clinical effects of free latissimus dorsi myocutaneous flap combined with artificial dermis and split-thickness skin graft in the treatment of degloving injury in lower limbs. Methods: A retrospective observational study was conducted. From December 2017 to December 2020, 8 patients with large skin and soft tissue defect caused by degloving injury in lower extremity were admitted to Ningbo No.6 Hospital, including 5 males and 3 females, aged from 39 to 75 years, with wound area of 25 cm×12 cm-61 cm×34 cm. The free latissimus dorsi myocutaneous flap with latissimus dorsi muscle in the width of 12-15 cm and flap area of 20 cm×8 cm-32 cm×8 cm was used to repair the skin and soft tissue defect of bone/tendon exposure site or functional area. The other defect was repaired with bilayer artificial dermis, and the flap donor site was sutured directly. After the artificial dermis was completely vascularized, the split-thickness skin graft from thigh was excised and extended at a ratio of 1∶2 to 1∶4 and then transplanted to repair the residual wound, and the donor site of skin graft was treated by dressing change. The survival of latissimus dorsi myocutaneous flap, artificial dermis, and split-thickness skin graft after operation was observed, the interval time between artificial dermis transplantation and split-thickness skin graft transplantation was recorded, and the healing of donor site was observed. The appearance and function of operative area were followed up. At the last outpatient follow-up, the sensory recovery of flap was evaluated by British Medical Research Council evaluation criteria, the flap function was evaluated by the comprehensive evaluation standard of flap in Operative Hand Surgery, the scar of lower limb skin graft area and thigh skin donor area was evaluated by Vancouver scar scale, and the patient's satisfaction with the curative effects was asked. Results: The latissimus dorsi myocutaneous flap survived in 6 patients, while the distal tip of latissimus dorsi myocutaneous flap was partially necrotic in 2 patient and was repaired by skin grafting after resection at split-thickness skin grafting. The artificial dermis survived in all 8 patients after transplantation. The split-thickness skin graft survived in 7 patients, while partial necrosis of the split-thickness skin graft occurred in one patient and was repaired by skin grafting again. The interval time between artificial dermis transplantation and split-thickness skin graft transplantation was 15-26 (20±5) d. The donor site of latissimus dorsi myocutaneous flap healed with linear scar after operation, and the thigh skin graft donor site healed with scar after operation. The patients were followed up for 6-18 (12.5±2.3) months. The color and elasticity of the flap were similar to those of the surrounding skin tissue, and the lower limb joint activity returned to normal. There was no increase in linear scar at the back donor site or obvious hypertrophic scar at the thigh donor site. At the last outpatient follow-up, the sensation of the flap recovered to grade S₂ or S₃; 3 cases were excellent, 4 cases were good, and 1 case was fair in flap function; the Vancouver scar scale score of lower limb skin graft area was 4-7 (5.2±0.9), and the Vancouver scar scale score of thigh skin donor area was 1-5 (3.4±0.8). The patients were fairly satisfied with the curative effects. Conclusions: In repairing the large skin and soft tissue defect from degloving injury in lower extremity, to cover the exposed bone/tendon or functional area with latissimus dorsi myocutaneous flap and the residual wound with artificial dermis and extended split-thickness skin graft is accompanied by harvest of small autologous flap and skin graft, good recovery effect of functional area after surgery, and good quality of healing in skin grafted area.
Cicatrix/surgery* ; Degloving Injuries/surgery* ; Dermis/surgery* ; Female ; Humans ; Lower Extremity/surgery* ; Male ; Mammaplasty ; Myocutaneous Flap ; Reconstructive Surgical Procedures ; Skin Transplantation ; Soft Tissue Injuries/surgery* ; Superficial Back Muscles/surgery* ; Treatment Outcome

OBJECTIVETo evaluate the curative effect of arthroscopy-assisted irrigation with different times for the treatment of suppurative knee arthritis in elder patients.

METHODSFrom October 2012 to October 2014, 23 old patients with suppurative knee arthritis were treated with arthroscopic debridement and continuous irrigation. All the patients were randomly divided into two groups:one-week irrigation group (10 cases) and two-week irrigation group(13 cases). The ESR, CRP, recovery time of knee skin temperature, joint rang of motion and knee function were observed to evaluate the therapeutic effects.

RESULTSAll the patients were followed up, and the mean duration was(13.3±2.3) months. No recurrence was observed. The CRP in both groups returned to normal level 2 weeks after operation. The ESR in two-week irrigation group returned to normal level 2 weeks after operation, while in one-week irrigation group it was still at a high level, and returned to normal level 3 weeks after operation; there was a statistical significance between these two groups(<0.05). The recovery time of knee skin temperature after operation in two-week irrigation group was (13.4±1.2) d on average(ranged, 8 to 17 d), which was less than(15.5±1.9) d on average(ranged, 10 to 20 d) in one-week irrigation group (<0.05). The knee joint mobility of all patients 1, 3, 6 months after operation was significantly improved compared with those before surgery(<0.05). The knee joint mobility of patients in two-week irrigation group was better than that in one-week irrigation group at the first month after operation(<0.05);but there were no significant differences between these two groups 3, 6 months after operation. The Lysholm score of all patients 1, 3, 6 months after operation was significantly improved compared with those before surgery(<0.05). The Lysholm score of patients in two-week irrigation group was better than in one-week irrigation group at the first month after operation(<0.05);but there were no significant differences between these two groups 3, 6 months after operation. All the patients had stable knee functions 3 months after operation. According to the Lysholm scale, 3 patients got an excellent result, 6 good and 1 poor in one-week irrigation group 6 months after operation;5 patients got an excellent result, 7 good and 1 poor in two-week irrigation group;there was no significant differences between these two groups.

CONCLUSIONSTreatment of suppurative knee arthritis using arthroscopy has such advantages as minimal invasion and complete debridement, which is helpful to attenuate inflammation and regain knee function. It is suggested that the irrigation should be prolonged for two weeks postoperatively.

OBJECTIVETo compare technique and clinical effect of arthroscopic and conventional sectional therapy for the treatment of ischial tuberosity cyst.

METHODSFrom May 2014 and September 2016, 49 patients with symptomatic ischial tuberosity cyst were randomized divided into arthroscopic group and conventional section group by envelope method. There were 24 patients in arthroscopic group, including 16 males and 8 females aged from 42 to 81years old with an average age of (64.1±9.3) years old;the courses of disease ranged from 2 to 36 months with an average of (17.0±9.1) months;treated with removing cyst wall under arthroscopic and build artificial lacuna around cyst. There were 25 patients in conventional section group, including 11 males and 14 females aged from 47 to 79 years old with an average of (61.2±10.6) years old; the courses of disease ranged from 4 to 36 months with an average of (17.5±8.5) months;treated with cutting off lump with transverse incision. Operative time, blood loss, fluid volume, hospital stays and postoperative complication were observed and compared, VAS score were applied to evaluate pain degree.

RESULTSForty-nine patients were followed up from 6 to 18 months with an average of (11.3±3.3) months. In conventional group, 2 patients occurred incision infection, 1 case reoccurred. All patients in arthroscopic group were healed at stage I. Operative time, blood loss, fluid volume, and hospital stays in arthroscopic group were (54.7±7.7) min, (20.8±3.5) ml, (20.3±5.6) ml, (2.8±0.6) d respectively and better than that of conventional group(71.8±8.8) min, (67.3±12.0) ml, (103.6±20.3) ml, (7.8±2.9) d. Postoperative VAS score in arthroscopic group on the first day, seventh days and first month were 2.6±0.7, 0.5±0.6, 0.3±0.5, and significantly lower than that of conventional group 6.0±0.7, 3.0±1.0, 1.1±1.0 respectively(<0.05). There were no statistical difference in postoperative complications between two groups(>0.05).

CONCLUSIONSCompared with conventional group, arthroscopic for ischial tuberosity cyst has advantages of minimal invasive, less blood loss during perioperative period, less pain degree after surgery, safety and rapid recovery. But arthroscopic skills are needed for surgeons. It should be recommended in clinical practice.

Adult ; Aged ; Aged, 80 and over ; Arthroscopy ; Bone Cysts ; surgery ; Case-Control Studies ; Female ; Humans ; Male ; Middle Aged ; Operative Time ; Pelvic Bones ; pathology ; Postoperative Period ; Prospective Studies ; Treatment Outcome

Astragaloside Ⅳ(AS-Ⅳ) has protective effects against ischemia-reperfusion injury(IRI), but its mechanism of action has not yet been determined. This study aims to investigate the protective effects and mechanism of AS-Ⅳ on H9c2 cardiomyocyte injury induced by hypoxia-reoxygenation(H/R). The H/R model of myocardial cells was established by hypoxic culture for 12 hours and then reoxygenation culture for 8 hours. After AS-Ⅳ treatment, cell viability, the reactive oxygen species(ROS) levels, as well as the content or activity of superoxide dismutase(SOD), malondialdehyde(MDA), interleukin 6(IL-6), and tumor necrosis factor alpha(TNF-α), were measured to evaluate the effect of AS-Ⅳ treatment. The effect of AS-Ⅳ on HO-1 protein expression and nuclear Nrf2 and Bach1 protein expression was determined by Western blot. Finally, siRNA was used to knock down HO-1 gene expression to observe its reversal effect on AS-Ⅳ intervention. The results showed that as compared with the H/R model group, the cell viability was significantly increased(P<0.01), ROS level in the cells, MDA, hs-CRP and TNF-α in cell supernatant and nuclear protein Bach1 expression in the cells were significantly decreased(P<0.01), while SOD content, HO-1 protein expression in cells and expression of nuclear protein Nrf2 were significantly increased(P<0.01) in H/R+AS-Ⅳ group. However, pre-transfection of HO-1 siRNA into H9c2 cells by liposome could partly reverse the above effects of AS-Ⅳ after knocking down the expression of HO-1. This study suggests that AS-Ⅳ has significant protective effect on H/R injury of H9c2 cardiomyocytes, and Nrf2/Bach1/HO-1 signaling pathway may be a key signaling pathway for the effect.
Apoptosis ; Basic-Leucine Zipper Transcription Factors ; metabolism ; Cell Hypoxia ; Cells, Cultured ; Heme Oxygenase-1 ; metabolism ; Humans ; Myocytes, Cardiac ; drug effects ; NF-E2-Related Factor 2 ; metabolism ; Saponins ; pharmacology ; Signal Transduction ; Triterpenes ; pharmacology

OBJECTIVE: To compare clinical efficacy of arthroscopic tenodesis and tenotomy in treating biceps long head tendinitis. METHODS: From January 2015 to January 2017, 40 patients with long head of the biceps tendinitis were randomly divided into tenotomy group (18 patients) and tenodesis group(22 patients). In tenotomy group, there were 6 males and 12 females with an average age of (62.2±6.1) yeas old, and the average course of disease was (8.5±2.2) months; while in tenodesis group, there were 8 males and 14 females with an average age of(60.5±6.3) years old, and the average course of disease was (8.1±2.3) months. Operative time and deformity of Popeye were compared between two groups, VAS score was used to evaluate degree of pain, and UCLA score was used to assess clinical effects before operation, 3, 6 and 12 months after operation. RESULTS: Forty patients were followed up for 12 to 17 months with an average of(14.3±2.1) months. Eight patients occurred Popeye deformity in tenotomy group, and nobody in tenodesis group. There was significant difference between tenotomy group(40.55±7.51) min and tenodesis group(75.33±9.45) min. VAS score after operation at 3, 6 and 12 months were decreased than that of before operation, and VAS score in tenotomy group was lower than that of in tenodesis group at 3 months after operation(<0.05); while there were no difference in VAS score between two groups at 6 and 12 months after operation(>0.05). UCLA score at at 3, 6 and 12 months after operation in tenodesis group were increased than that of before operation, and UCLA score in tenotomy group was lower than that of in tenodesis group at 3 months after operation(<0.05); while there were no difference in UCLA score between two groups at 6 and 12 months after operation(>0.05). According to UCLA score, 5 got excellent results, 10 moderate and 3 poor in tenotomy group, while 8 got excellent results, 12 moderate and 2 poor in tenodesis group, but without difference between two groups(χ² =0.057, =0.81). CONCLUSIONS Both of arthroscopic tenotomy and tenodesis in treating long head of the biceps tendinitis could receive good clinical effects, and early functional outcomes by arthroscopic tenotomy was better than that of tenodesis, but no difference in later period.
Aged ; Arthroscopy ; Female ; Humans ; Male ; Middle Aged ; Rotator Cuff ; Rotator Cuff Injuries ; Tendinopathy ; Tenodesis