BACKGROUND: Common complication of traditional joint replacement is hip joint dislocation and large head joint implant can effectively solve this problem. OBJECTIVE: To investigate the preliminary efficacy of large head metal-on-metal implants for patients undergoing total hip arthroplasty. DESIGN, TIME AND SETTING: Prospective cohort study. The patients were selected from Department of Joint Surgery, Xinjiang Hospital of Traditional Chinese Medicine between February 2007 and January 2008. PARTICIPANTS: A total of 65 patients (71 hips) undergoing large head metal-on-metal implantation in Xinjiang Hospital of Traditional Chinese Medicine were selected, including 21 females and 44 males with an average age of 54.6 years (ranging 19 to 77 years). Of them, there were 28 cases of necrosis of the femoral head, 24 of hip osteoarthritis, 9 of femoral neck fracture and 4 of acetabular dysplasia. METHODS: According to age, sex, cause of disease and preoperative joint function, the patients were divided into traditional prosthesis (n=30, 33 hips, metal-on-polyethylene implant) and large head M-O-M group (n=35, 38 hips, ASR/XL prosthesis, DePuy, Motech, Warsaw, IN, USA). MAIN OUTCOME MEASURES: The pre and postoperative Harris scores for the hip, range of motion, periprosthetic radiolucency, leg-length inequality and complications were recorded and compared. RESULTS: All patients were followed-up. The traditional group was followed up for 20 months (ranging 13-28 months), and the large head M-O-M group was followed up for 17 months (ranging 10-26 months). The mean Harris score was 89 points (ranging 59-98) in traditional group, and 94 points (ranging 71-100) in large head M-O-M group (P=0.014). The range of motion of hip was improved, and the large head M-O-M group (34?) was superior to traditional group (26?, P=0.004) at 6 months after surgery; the range of motion was improved 27? in traditional group and 37? in large head M-O-M group (P=0.009) over 1 year of follow up. The leg-length inequality was 4 mm (2-11 mm) in large head M-O-M group and 7 mm (5-16 mm) in traditional group (P=0.005). Both groups exhibited periprosthetic radiolucency (≤1 mm, 2 cases in traditional group and 3 cases in large head M-O-M group). One patient in the traditional group suffered dislocation. CONCLUSION: The large head M-on-M implants in total hip arthroplasty has excellent short-term effects on patients compared with traditional prosthesis. They offer the more stability and better restoration of hip articulation function and biomechanical reconstruction.

Professor XIAO Ji-fang, an experienced practitioner of Chinese medicine of Guangxi, is famous for his medical ethics, wide range of studies, comprehensive understanding of the classics, innovation, as well as u nique academic ideas. He focuses on mind-regulating in acupuncture and pulse diagnosis. At the same time, differentiation of syndromes, diseases and meridians are emphasized. The combination of acupuncture and moxibustion and integration of acupuncture and medicine are promoted. He is especially skilled at slow twisting needle insertion, Taiji needling therapy, scalp acupuncture and moxibustion with a herb prepared thread of Zhuang nationality, which all achieve remarkable effects.
Acupuncture Therapy ; history ; China ; History, 20th Century ; Humans ; Moxibustion ; history

Objective To investigate the effect of uvulopalatopharyngoplasty (UPPP) to obstructive sleep apnea hypopnea syndrome (OSAHS) in palients with resistant hypertension (RH).Methods UPPP and modified UPPP were performed on 36 moderate and severe OSAHS patients,who also suffered from RH [ who taking more than three kinds of antihypertensive drugs ( including diuretics ) and still not able to control blood pressure at 140/90 mm Hg (1 mm Hg =0.133 kPa)]. Polysomnography monitoring,ambulatory blood pressure monitoring,apnea hypopnea index ( AHI ),lowest saturation of blood oxygen ( SaO2 ) and the changes of antihypertensive medication dosage were performed to the patients before and 6 months after the surgery.Results Six months after surgery,the total efficiency was 61.1％ (22/36).The AHI median [ 25 quantile; 75 quantile] from 37.5 [26.0; 48.3 ]/h to 9.5 [9.0 ; 21.3 ]/h,the lowest the SaO2 average ( x ± s,the same below ) increased from 0.655 ± 0.114 to 0.860 ± 0.037,the differences were statistically significant (P value ＜ 0.05 ).24 h systolic blood pressure,daytime systolic blood pressure,night contraction,diastolic and mean arterial pressure decreased from ( 160.8 ± 6.8 ),( 170.5±2.5 ),(163.6±10.5),(100.8 ±5.6) and (96.8 ±7.5) mm Hg to (142.5 ±7.3),(150.8 ±7.6),(140.1 ±6.4),(81.8 ± 7.4) and (93.7 ± 2.4) mm Hg,the differences were statistically significant ( P ＜ 0.05 ).The degrees of AHI descent and the average SaO2 improvement were concerned with the degree of systolic blood pressure,diastolic blood pressure decent (r ＞0.80 and r2 ＞0.50).The average numbers of antihypertensive drugs decreased form ( 3.6 ± 0.5 ) to ( 2.9 ± 0.5 ) compared preoperatively and postoperatively,the difference was statistically significant (t =5.537,P ＜ 0.01 ). The use of antihypertensive medication reduced in 23 cases (23/36,63.8％ ) compared preoperatively and postoperatively.Conclusions The blood pressure of the patients with OSAHS and RH dropped significantly after UPPP surgery. Recent follow-up shows that the varieties of antihypertensive drugs taken in these patients are reduced significantly after operation.

OBJECTIVETo investigate the prevalence rates of snoring disease and obstructive sleep apnea-hypopnea syndrome (OSAHS) and their risk factors among truck drivers in Guangzhou, China.

METHODSA questionnaire survey was conducted in 374 truck drivers who were selected from 5 logistics companies in Guangzhou by cluster sampling. Those who had potential snoring disease or OSAHS underwent polysomnographic monitoring at night. The obtained data were analyzed to calculate the prevalence rates of snoring disease and OSAHS and determine the risk factors for OSAHS.

RESULTSA total of 335 subjects completely questionnaires, with a response rate of 90%. Among the 335 subjects, 125 (37.3%) had habitual snoring, and 42 (12.5%) had OSAHS according to the diagnostic criterion (apnea-hypopnea index ≥ 5 times/h). The multiple stepwise regression analysis showed that the risk factors for OSAHS were age, alcohol use, family history of snoring, body mass index, and upper airway abnormality. Of the subjects with grade ≥ 2 snoring and OSAHS, 65.4% often felt sleepy when driving during daytime, and 42% had suffered or nearly suffered traffic accidents due to sleepiness when driving. Moreover, 95.5% (320) of the 335 truck drivers did not consider snoring a disease, and 98% did not think traffic accident might be related to snoring.

CONCLUSIONThe prevalence rates of snoring disease and OSAHS among truck drivers are 37.3% and 12.5%, respectively. Therefore, prevention measures should be established according to the epidemiological characteristics to help the truck drivers realize the hazards of snoring disease and OSAHS, thus minimizing the prevalence and hazards of the diseases.

Adult ; Automobile Driving ; China ; epidemiology ; Female ; Humans ; Male ; Middle Aged ; Prevalence ; Risk Factors ; Sleep Apnea, Obstructive ; epidemiology ; Snoring ; epidemiology ; Surveys and Questionnaires ; Young Adult

Objective To investigate the clinical value of diffusion tensor imaging (DTI) in the evaluation of cerebral infraction. Methods Sixty-nine patients with cerebral infraction confirmed by clinical manifestation and routine MRI and/or CT were analyzed for the signal intensity changes on DTI. The isotropic apparent diffusion coefficient (ADCiso) and fractional anisotropy (FA) of the infracted area were measured and compared with those of the unaffected side. Results Four types of signal intensity changes on DTI were identified. Type Ⅰ changes were found in 8 infraction lesions, where the ADCiso decreased and FA increased, and the infraction lesions showed hypointensity on ADCiso map and hyperintensity on FA map. Type Ⅱ changes, found in 23 lesions, were characterized by decreased ADCiso and FA values, but ADCiso in the peripheral of the lesions decreased and FA increased, and the lesions were shown as isointensity or hypointensity on ADCiso and FA maps with hyperintensity on the peripheral. Type Ⅲ changes (7 lesions) were manifested by decreased ADCiso and FA values and hypointensity on ADCiso and FA maps. Type Ⅳ changes were found in 31 infraction lesions, showing increased ADCiso and decreased FA with corresponding hyperintensity on ADCiso map and hypointensity on FA map. Significant differences were found in the DTI parameters between the infraction lesions and unaffected side (P<0.05). Conclusion DTI for qualitative and quantitative analysis of cerebral infraction better reveals the pathophysiology of the infraction, allows more precise imaging-based staging of the lesion, and provides evidences for more objective diagnosis, treatment, monitoring and prognostic evaluation of the condition.

OBJECTIVETo explore the feasibility of the tissue engineered venous grafts (TEVGs) constructed in vitro based on canine autologous bone marrow-derived endothelial progenitor cells (EPCs) and porcine decellularized aortic scaffolds implanted into the canine inferior vena cava.

METHODSTo draw out a volume of 8 - 12 ml of bone marrow from the canine (n = 8), to culture and expand EPCs in vitro using conditioned medium. After labeled with a red fluorescent dye PKH26-GL, the cells were seeded onto the luminal surface of decellularized porcine scaffolds with single, rotative method for 4 h. Following static culture for 24 - 72 h, the hybrids were implanted to replace autologous canine inferior vena cava about 4 cm long. Meantime one femoral artery-venous shunt about 1 cm long was performed. The non-seeded decellularized scaffolds (n = 4) were performed the same as control. Angiography was performed and the hybrids were explanted for morphology and labeled cells' immuno-fluorescence examinations at postoperative 10 d, 4 weeks and 12 weeks, respectively.

RESULTSThe patent number of experiment (control) group were 7/7 (2/4), 6/6 (2/2) and 4/4 (1/2) at postoperative 10 d, 4 weeks and 12 weeks, respectively. At 12 weeks, tightly confluence endothelial cells which covered the whole inner luminal surface of the explants were detected by immunohistochemistry of factor VIII and scanning electron microscopy, while fibrin-based pseudo-intima was detected on the inner luminal surface of matrix in the solo patent dog from the control group. Meanwhile, fibroblasts and alpha-actin positive cells in the matrices were found by transmission electron microscopy and alpha-actin immunohistochemistry. PKH26-GL labeled EPCs sustained on the luminal surface at a rather proportion accompanied by newly formed endothelial cells. However, the explants in both groups showed partial stenosis.

CONCLUSIONSSuch constructed tissue engineered venous graft based on canine autologous bone marrow-derived endothelial progenitor cells and porcine decellularized aortic matrices is promising and deserve to further improvement and testing.

Actins ; analysis ; Animals ; Blood Vessel Prosthesis ; Blood Vessel Prosthesis Implantation ; Bone Marrow Cells ; cytology ; metabolism ; ultrastructure ; Cells, Cultured ; Dogs ; Endothelial Cells ; cytology ; metabolism ; ultrastructure ; Factor VIII ; analysis ; Feasibility Studies ; Hematopoietic Stem Cell Transplantation ; Immunohistochemistry ; Microscopy, Electron, Scanning ; Microscopy, Electron, Transmission ; Stem Cells ; cytology ; metabolism ; ultrastructure ; Swine ; Tissue Engineering ; methods ; Transplantation, Autologous ; Veins ; Vena Cava, Inferior ; surgery

Objective This study aimed to explore the relationships between residential greenness and cardiometabolic risk factors among rural adults in Xinjiang Uygur Autonomous Region(Xinjiang)and thus provide a theoretical basis and data support for improving the health of residents in this region. Methods We recruited 9,723 adult rural residents from the 51st Regiment of the Third Division of the Xinjiang Production and Construction Corps in September 2016.The normalized difference vegetation index(NDVI)was used to estimate residential greenness.The generalized linear mixed model(GLMM)was used to examine the association between residential greenness and cardiometabolic risk factors. Results Higher residential greenness was associated with lower cardiometabolic risk factor prevalence.After adjustments were made for age,sex,education,and marital status,for each interquartile range(IQR)increase of NDVI500-m,the risk of hypertension was reduced by 10.3%(OR=0.897,95%CI=0.836-0.962),the risk of obesity by 20.5%(OR=0.795,95%CI=0.695-0.910),the risk of type 2 diabetes by 15.1%(OR=0.849,95%CI=0.740-0.974),and the risk of dyslipidemia by 10.5%(OR=0.895,95%CI=0.825-0.971).Risk factor aggregation was reduced by 20.4%(OR=0.796,95%CI=0.716-0.885)for the same.Stratified analysis showed that NDVI500-m was associated more strongly with hypertension,dyslipidemia,and risk factor aggregation among male participants.The association of NDVI500-m with type 2 diabetes was stronger among participants with a higher education level.PM10 and physical activity mediated 1.9%-9.2%of the associations between NDVI500-m and obesity,dyslipidemia,and risk factor aggregation. Conclusion Higher residential greenness has a protective effect against cardiometabolic risk factors among rural residents in Xinjiang.Increasing the area of green space around residences is an effective measure to reduce the burden of cardiometabolic-related diseases among rural residents in Xinjiang.

The genomic characteristics and cellular tropism of a Mangshi virus(MSV)isolated in China were investigated,thereby establishing a robust foundation for further research on the evolution and pathogenicity of MSV.The genome sequence of MSV strain V301/YNJH/2019 was obtained by next-generation sequencing,followed by phylogenetic tree construction and rearrangement assessment using software IQtree,RPD4,and Simplot.Viral proliferation was assessed in C6/36(Aedes albop-ictus),Vero(African green monkey kidney),and BHK(baby hamster kidney)cells.An initial epidemiological investigation of MSV in local cattle and goats was conducted using the serum neutralization test.The genome of MSV strain V301/YNJ H/2019 was 20623 bp in length,encompassing 12 segments of double-stranded RNA(Seg-1 to Seg-12).Sequence analysis confirmed genomic rearrangement of the Seg-1 and Seg-11 sequences,ex-hibiting high similarity to MSV isolated from lake sediment in China in 2022,while Seg-2 to Seg-10 and Seg-12 were most closely related to a MSV strain isolated from mosquitoes in China in 2013.The virus efficiently proliferated and induced sig-nificant cytopathic effects(CPE)in both C6/36 and BHK cells,but limited replication and no observable CPE in Vero cells.No detectable neutralizing antibodies against MSV were detected in 20 goat serum samples collected in Mangshi,while 2 of 20 bo-vine serum samples were positive with neutralizing antibody titers of 1:128 and 1:54.Whole genome sequencing revealed re-assortment events of the V301/YNJH/2019 strain,which is capable of infecting C6/36,BHK,and Vero cells.MSV infection was confirmed in cattle in Mangshi.