Adolescent ; Humans ; Kearns-Sayre Syndrome ; Male

Objective To evaluate the clinical outcomes and report the second-look arthroscopic findings of reconstructed anterior cruciate ligament (ACL) using deep-frozen allograft.Methods Sixty-six patients undergoing ACL reconstruction using deep-frozen allograft in our institute with at least twelve months follow-up from January 2012 to March 2016 were included and received second-look arthroscopy.The patients consisted of 51 males and 15 females with an average age of 30.6 years (range,18 to 55 years) at the time of ACL reconstruction.Knee functions were evaluated by Lysholm score and International Knee Documentation Committee (IKDC) score.Knee stability was evaluated by drawer test,Lachman test and KT-1000 arthrometer.Second-look arthroscopic evaluation was performed in all patients,focused on continuity of the reconstructed ACL,the synovial coverage and subjective tension of the graft,and the prevalence of cyclops-like lesion and other changes after reconstruction procedures.Resuits All patients were followed up for average 18.3 months (range,12 to 36 months).Thirty-one patients underwent second-look arthroscopy from 12 to 18 months,and the other 35 patients underwent second-look arthroscopy from 18 to 36 months after ACL reconstruction.No infection,rejection reaction and other serious complication were reported after operation.The knee range of motion was normal in all cases,except that 10° extension limitation in one case.The Lysholm score significantly improved from preoperative 54.95±9.01 to 12 months postoperatively 86.14±5.86,and the IKDC improved from 54.79±9.12 to 85.11±5.77.Lachman test was positive in 8 cases,but negative in 58 cases postoperatively.KT-1000 arthrometer measurement showed that the side-toside difference significantly improved from preoperative 6.70± 1.24 mm to postoperative 1.52± 1.02 mm.Complete discontinuity occurred in 2 cases of the reconstructed grafts,graft tear in 4 cases.Cyclops-like mass was identified in 2 cases.The overall synovial coverage was slightly better in the patients who were followed up more than 18 months than those less than 18 months.However,there was no significant difference among the groups in the field of graft tension.The patients with taut grafts showed statistically better KT-1000 values (1.14±0.35 mm) than those with lax grafts (2.95±1.38 mm).Conclusion Frozen allograft could be a reasonable choice for ACL reconstruction.However,the graft integration and remodeling could tend to be slow.

Background/Aims: The effect of physical activity on the relationship between dietary fiber intake and constipation has not been comprehensively studied.This study aims to explore the impact of physical activity. Methods: Data were obtained from 3 cycles of the National Health and Nutrition Examination Survey (NHANES) 2005-2010 and included a total of 13 941 participants aged ≥ 20 years. Multiple logistic regression analysis was used to investigate the independent associationbetween dietary fiber and constipation. Interaction analysis was also performed to analyze the relationship between dietary fiber and constipation in different physical activity groups. Results: Among non-active participants, dietary fiber intake did not associate with stool consistency (OR, 1.02; 95% CI, 0.98-1.05; P = 0.407). For physically active participants, 1-gram unit increase in dietary fiber intake reduced the risk of stool consistency by 3% (OR, 0.97; 95% CI, 0.94-0.99; P = 0.020). Moreover, the relationship between dietary fiber intake and stool consistency was significantly different for groups with different levels of physical activity (P interaction = 0.044). However, dietary fiber intake was not related to stool frequency among non-active participants (OR, 0.99; 95% CI, 0.94-1.05; P = 0.767) nor physically active participants (OR, 1.01; 95% CI, 0.97-1.04; P = 0.751). Conclusions Increasing dietary fiber intake was associated with stool consistency-related constipation among physically active participants, but not among non-active participants. However, increasing dietary fiber intake is not significantly associated with stool frequency in different physical activity groups.

OBJECTIVETo evaluate the effect of the combined use of Shenmai Injection (SMI) and enteral nutrition on postoperative fatigue syndrome (POFS) in patients with gastric cancer (GC).

METHODSFifty-eight GC patients were randomized into the parenteral nutrition group (PNG, 19 cases), enteral nutrition group (ENG, 19 cases) and combined treatment group (CTG, 20 cases). The post-operative recovery in patients was observed; patients' conditions of fatigue, mood and sleep were evaluated respectively by visual analogue scale of fatigue, profile of mood states (POMS) and Pittsburgh sleep quality index (PSQI). Meanwhile, nutritional variables, such as serum contents of total protein, albumin, pre-albumin, were measured at different time points: before operation (d0) and the 1st, 5th, and 9th day (d1, d5 and d9) after operation. Immune variables such as subsets of lymphocytes (CD3, CD4, CD8), serum immunoglobulins (IgG, IgM, IgA) were also determined.

RESULTSConditions of recovery, POMS and PSQI were better and the postoperative fatigue reduced more significantly in CTG than those in the other two groups (P < 0.05). On d9, levels of pre-albumin, CD3, CD4, CD4/CD8 in CTG were significantly higher than those in the PNG and ENG (P < 0.05), meantime, levels of albumin and IgA were higher in CTG than those in PNG (P < 0.05).

CONCLUSIONCombined treatment of SMI and enteral nutrition can regulate mood and sleep to some extents, and reduce the postoperative fatigue through improving nutritional status and immune function, thus speeding up the recovery of patients.

Adult ; Aged ; Combined Modality Therapy ; Drug Combinations ; Drugs, Chinese Herbal ; therapeutic use ; Enteral Nutrition ; Fatigue ; therapy ; Female ; Gastrectomy ; methods ; Humans ; Male ; Middle Aged ; Parenteral Nutrition ; Phytotherapy ; Postoperative Complications ; therapy ; Stomach Neoplasms ; surgery

BACKGROUNDHypogammaglobulinemia is common in infant humoral immunodeficiencies and has complicated causes and outcomes. We aimed to determine the clinical manifestations, immunological changes and outcomes of Shanghai infants with hypogammaglobulinemia.

METHODSPatients under 2 years old, having one or more warning signs of primary immunodeficiency disorders, serum immunoglobulin levels below the lower limit of reference range per age, and with normal numbers for lymphocyte subsets, were analyzed and followed up for 2 to 3 years.

RESULTSA total of 91 children (male-to-female ratio: 2.25: 1) participated in the study. Initial clinical presentation was recurrent upper respiratory tract infection (46%), invasive infection (3%), atopic disease (32%). IgA reduction (77%) was prevalent; 34% patients had more than one isotype reduced. During follow-up, 51 of 62 patients (82.25%) had immunoglobulins normalized at the age between 12 - 48 months; these were diagnosed as transient hypogammaglobulinemia of infancy (THI). Long-term follow-up may reveal a diagnosis for the remaining 11 infants with persistent lower immunoglobulin levels, who did not have antibody titers measured. Earlier onset was correlated with higher rates of normalization. More patients were diagnosed with isolated hypogammaglobulinemia in 2006 compared with the previous 4 years (2002 - 2005).

CONCLUSIONSThe awareness of immunodeficiency among pediatricians has been greatly improved. Recurrent otitis media was not a major infection in our patients. THI is a relatively common condition associated with infant hypogammaglobulinemia. In the absence of specific antibody titers, the diagnosis of THI can be confirmed retrospectively with Ig levels normalized in follow-up visits. Therefore, long-term follow-up and frequent re-evaluation of these patients are necessary to distinguish them from true primary immunodeficiency.

Agammaglobulinemia ; epidemiology ; metabolism ; pathology ; Child ; Child, Preschool ; China ; epidemiology ; Female ; Follow-Up Studies ; Humans ; Infant ; Male

OBJECTIVETo observe the effects of ginsenoside Rb1 (GRb1) on the oxidative stress in the skeletal muscles of rats with postoperative fatigue syndrome (POFS) and to study its anti-fatigue mechanisms.

METHODSThe POFS model was established using resection of 70% of mid-small intestine. Ninety-six Sprague-Dawley (SD) rats were screened using grasping test. The rats were randomly divided into the control group, the model group, and the GRb1 treated group (at 10 mg/kg) by the body weight. The maximum grip strength of rats was detected on the 1st, 3rd, 7th, and 10th day after operation, respectively. The contents of malondialdehyde (MDA), the activities of superoxide dismutase (SOD), catalase (CAT), and glutathione peroxidase (GSH-PX) were detected.

RESULTSCompared with the model group, the maximum grip strength was obviously enhanced on the postoperative day 7 and 10 (P < 0. 05), the MDA content obviously decreased on the postoperative day 3 and 7 (P < 0.05), the SOD activity obviously increased in the GRb1 treated group (P < 0.05). There was no obvious change in the activities of CAT and GSH-PX among the three groups at each time point (P > 0.05).

CONCLUSIONGRb1 could reduce the oxidative stress injury in the skeletal muscles, improve the activities of antioxidant enzymes, and enhance the functions of the skeletal muscles in POFS rats, which may be important reasons for fighting against POFS.

Animals ; Catalase ; metabolism ; Fatigue ; etiology ; metabolism ; Ginsenosides ; pharmacology ; Glutathione Peroxidase ; metabolism ; Male ; Malondialdehyde ; analysis ; Muscle, Skeletal ; drug effects ; metabolism ; Oxidative Stress ; drug effects ; Postoperative Period ; Rats ; Rats, Sprague-Dawley ; Superoxide Dismutase ; metabolism

OBJECTIVETo explore the mechanism of postoperative fatigue syndrome(POFS) by detecting the change of central monoamine neurotransmitters in a rat model after major abdominal surgery.

METHODEighty-four rats were randomly divided into fatigue assessment groups (including model group and sham group) and experimental groups (including postoperative day 1, 3, 5, 7, and 14 recovery groups and the corresponding control groups). Postoperative fatigue was evaluated after surgery. The brains were removed thereafter to detect the levels of 5-hydroxytryptamine (5-HT), norepinephrine (NE), dopamine (DA) in the hippocampus, midbrain, hypothalamus by high performance liquid chromatography. Serum free tryptophan (f-Trp) and branched-chain amino acids (BCAA) were measured.

RESULTSThe level of 5-HT increased to the highest at postoperative day 3, but reduced rapidly to the minimum at postoperative day 5, and then gradually recovered to the preoperative level. There was significant difference of 5-HT among experimental groups (P<0.05), also between the postoperative 24 hrs group and control groups (P<0.05). f-Trp and the ratio of f-Trp/BCAA increased in the early postoperative period, reduced to minimum at postoperative day 5. f-Trp was still lower compared to the control group at postoperative day 14, while the ratio of f-Trp/BCAA and BCAA restored to control level. Both of them were significantly different among experimental groups (P<0.05), also between the experimental groups and control groups (P<0.05).

CONCLUSIONChanges of f-Trp, the ratio of f-Trp/BCAA, and central 5-HT may play an important role in the development of POFS.

Abdomen ; surgery ; Amino Acids ; analysis ; Animals ; Fatigue ; blood ; Postoperative Period ; Rats ; Serotonin ; analysis

Objective To investigate the validity of screw-rod system for fixing pelvic fractures by comparing the biomechanical behaviors from using screw-rod system or steel plate for fixing Tile B2 type pelvic fractures. Methods The finite element models of normal pelvis including ligaments, and Tile B2 fractured pelvis fixed by different screw-rod fixations (2 screws at fractured side, 3 screws at fractured side and at healthy side), and steel plate fixation were established. The vertical load (500 N) was applied on the upper terminal plate of the first body of the sacrum to simulate pelvis load during double-leg standing, single-leg standing and sitting. The displacement and stress distributions on normal pelvis and fractured pelvis with screw-rod fixation or with steel plate fixation were compared and analyzed. Results Both the screw-rod system and steel plate could effectively fix the fractured pelvis, and the fixation models showed similar displacement and stress distribution as normal pelvis. The largest displacement of fractured pelvis with 3-screw fixation on the diseased side was smallest under each working condition, and its stress level was also obviously lower than that of the other internal fixation models. During double-leg standing, compared with 2 screws fixation, 3 screws at healthy side fixation, and steel plate fixation, the Von Mises stress for 3 screws at fractured side fixation was reduced by 30.4%, 20.8%, 20.3%; during single-leg standing, the Von Mises stress for 3 screws at fractured side fixation was reduced by 31.8%,25.4%,18.5%; during sitting, the Von Mises stress for 3 screws at fractured side fixation is reduced by -6.5%,28.0%,61.1%,respectively. Conclusions The screw-rod system can fix Tile B2 pelvic fracture effectively, especially for 3-screw fixation on the fractured side. The results can provide the theory basis for clinical treatment of pelvic fracture.