Objective To evaluate the correlation between the Waters classification based on shoulder CT or MRI scan and passive shoulder external rotational angle before operation in the glenohumeral joint deformity caused by shoulder internal rotational contracture secondary brachial plexus birth palsy.Methods 33 patients suffered the shoulder internal rotational contracture secondary brachial plexus birth palsy (Tassin classification Ⅱ 19, Ⅲ 13, Ⅳ 1) including 12 girls and 21 boys, ranging from 10 months to 16 years old with an average of 4.5 years old, underwent either CT or MR examination in shoulder joint. The retroversion of the glenoid (glenoscapular angle) and the ratio of humeral head posterior subluxation were measured on the CT or MRI images according to the method described by Friedman. The deformity of glenohumeral joint was classificated according to the Waters criteria, while the passive shoulder external rotational angle was measured at neutral position in involved shoulder joint. The correlation between the external rotation and the deformity was analysed. Results 33 cases with shoulder internal rotational contracture secondary brachial plexus birth palsy were evaluated according to the Waters criteria. 4 cases were classified as typeⅠdeformity, 4 cases as typeⅡ, 7 cases as type Ⅲ, 6 cases as type Ⅳ; 5 cases as typeⅤ; 7 case as type Ⅵ. The type of glenohumeral deformity was significantly associated with the limited range of passive external rotation of the shoulder joint. Conclusion The Waters classification of the glenohumeral deformity according to the Waters criteria can accurately demonstrated the deformity of the glenohumeral joint caused by shoulder internal rotational contracture secondary to brachial plexus birth palsy.

The neuroretinal injuries of diabetic retinopathy (DR) include retinal neuronal damage and reactive gliosis,both of which are induced by hyperglycemia and presented as early features of DR.They promote to develop mutually and accelerate the progression of DR.The molecular mechanisms study of neuronal damage mainly focuses on the alterations of extracellular environment and related signaling pathways,include inflammation,oxidative stress,endoplasmic reticulum stress,the formation of advanced glycation end products,glutamate toxicity and so on.These alterations mainly result in neuronal apoptosis and autophagy.The damaged neurons activate the glial cells with apparent changes in morphology,cell counts and the level of intracellular protein expression.In non-proliferative DR,glial cells are moderately hypertrophic and slightly increased in numbers.In proliferative DR,there is a significant rise in glial cell number with enhanced level of inflammatory factors and vascular active substances which lead a further neuronal damage.Signaling pathways of extracellular signal-regulated kinase 1/2,c-Fos and p38 mitogen-activated protein kinase are associated with their activation.Researches on the molecular mechanisms and signaling pathways of the DR will promote controlling the DR progression at the cellular level.

Objective To investigate the life quality changes and influencing factors of acute coronary syn -drome after stent implantation .Methods 100 cases with acute coronary syndrome received stent implantation were selected .SF-36 life quality questionnaire was used to survey the patients′life quality before operation and 6 months af-ter operation,and the life quality changes and influence factors were analyzed .Results 6 months after operation,the physical activity ,mental health ,social activities ,physical pain ,physical function ,physical role ,energy and health score of the patients were higher than before operation (P<0.05).According to Logistic regression analysis ,female,type 2 diabetes,underwent percutaneous coronary intervention ,ST-T segment elevation myocardial infarction were the im-portant factors affecting patients′recovery(P<0.05).Conclusion 6 months after stent implantation,the life quality of the patients with acute coronary syndrome were improved obviously;the female and underwent percutaneous coro-nary intervention have positive influence on patients′recovery,while type 2 diabetes,ST-T segment elevation myocar-dial infarction affect patients′recovery in negative way .

Objective To investigate the occurrence, prevention and management of surgical complication of contralateral C7 nerve root transfer through the prespinal route to repair the brachial plexus nerve root avulsion injury. Methods From Feb. 2002 to Aug. 2009, 425 patients were performed the contralateral C7 nerve root transfer through the prespinal route with this procedure. There were 379 males and 46 females,with the average age of 21 years (range, 3 months to 56 years). The contralateral C7 nerve root was sectioned at the distal of the middle trunk in 15 cases, at the distal of the anterior and posterior division in 410 patients. The surgical complications related to the health C7 nerve root section and the make of tunnel through the prespinal route and others were analyzed retrospectively. Results The incidence rate of complication was 5.2%(22/425). The surgical complications related to the make of prespinal route including 2 cases had the severe bleeding during the operation because of vertebral artery injury; transitory laryrecurrent nerve palsy occurred in 5 cases, the pain and numbness occurred on the donor upper limber in 4 cases when the patients swallowed. The complications related to the section of contralateral C7 nerve root including the extension of finger and thumb was dysfunction in 5 patients after the operation, 3 cases had the severely pain on the health upper limber, Horner's sign occurred on donor side in 2 children suffered birth palsy, and C6 nerve root was mistaken sectioned as C7 in 1 case. Other serious perioperative complication including the thromboses of the cerebral trunk occurred in 1 case 42 hours postoperative and died in hospital 38 days after the operation. Conclusion The procedure of contralateral C7 nerve root transfer through the prespinal route is safe. The effective method to prevent this complication occurrence is to expose the origin segment of vertebral artery when making prespinal route.

Objective: To investigate the effects of different doses of aerobic exercise on the microvascular function of habitually sedentary college students. Methods: A total of 69 students from Hubei Minzu University were recruited and divided into sports group A, sports group B and control group, with 23 students in each group (12 boys and 11 girls). The exercise group received 12 weeks of aerobic exercise intervention, in which group A exercised 1-2 times a week, group B exercised≥3 times a week, and the control group did not carry out any systematic sports. Microvascular response, Transcutaneous partial pressure of oxygen(TcpO 2), Nitric oxide, Nitric oxide synthase (NOS) and En dothelin-1 (ET-1) were measured before and after the test. Results: After the test, the microvascular reactivity showed group and time interaction( P <0.01), in which exercise group B was greater than that of control group and exercise group A ( P <0.01). There was no significant difference between exercise group A and control group ( P >0.05), but the percutaneous partial pressure of oxygen ( P =0.53) had no time interaction with other groups; NO( F =6.32) and NOS( F =7.91) had group and time interaction, in which exercise group B was greater than control group and exercise group A ( P <0.01), and there was no significant difference between exercise group A and control group ( P >0.05). Conclusion There is a "dose effect" relationship between aerobic exercise and microcirculatory blood perfusion and endogenous NO. Continuous aerobic exercise ≥3 times a week for 12 weeks improved microcirculatory blood perfusion and promoted endogenous NO production in sedentary college students, but doing aerobic exercise for 1-2 times a week had no significant effect on microcirculatory blood perfusion and endogenous NO.

Objective: To investigate the relationship between physical activity (PA) and the risk of incident hypertension among population in rural areas of China. Methods: The Community Intervention of Metabolic Syndrome in China & Chinese Family Health Study (CIMIC) was conducted in 2007-2008. Data on PA, smoking, drinking, blood pressure and other variables were obtained at baseline. Then the follow-up study of incident hypertension was performed during 2012-2015. A total of 41 457 participants aged ≥18 years and free from hypertension at baseline were included in the final analyses. PA was calculated as metabolic equivalent (MET) for each participant. Cox proportional hazard models were used to explore the relationship of PA with incident hypertension according to the quartiles of PA. Results: A total of 6 780 participants developed hypertension during an average follow up of 5.8 years. The annual incidence of hypertension was 2.80%. Compared to participants in the first quartile of PA, HR (95%CI) of incident hypertension decreased with the level of PA of 0.92 (0.86, 0.99), 0.72 (0.67, 0.77) and 0.70 (0.65, 0.75) for the 2^nd, 3^rd and 4^th quartile, respectively (P_trend<0.001). In subgroup analyses, compared to the first quartile, hazards of hypertension among normotensive participants (systolic blood pressure less than 120 mmHg (1 mmHg=0.133 kPa) and diastolic blood pressure less than 80 mm Hg) in the 2^nd, 3^rd and 4^th quartile were 0.82 (0.70, 0.95), 0.73 (0.63, 0.85) and 0.78 (0.67, 0.90), respectively (P_trend=0.002). Among participants with prehypertension (systolic blood pressure from 120 to 139 mmHg and/or diastolic blood pressure from 80 to 89 mmHg), similar trend for the relationship of PA and incident hypertension was also found with HR (95%CI) of 0.94 (0.87, 1.01), 0.71 (0.65, 0.77) and 0.66 (0.61, 0.71) for the 2^nd, 3^rd and 4^th quartile, respectively (P_trend<0.001). Conclusion There was linear trend association between PA and incident hypertension. Increased PA in daily life may be a protective factor against hypertension.

OBJECTIVETo compare the difference in the therapeutic effect on post-infectious cough differentiated as wind-cold retention in the lung between the combined therapy of scraping anddecoction and the simple application ofdecoction.

METHODSEighty patients were randomized into a combined therapy group and a Chinese herbal medicine group, 40 cases in each one. In the Chinese herbal medicine group, the oral administration ofdecoction was used. The main ingredients included,,,,,,,, etc., one dose a day, twice a day. In the combined therapy group, on the basis of the treatment as the Chinese herbal medicine group, scraping therapy was added and applied to the bladder meridian of foot-, the lung meridian of hand-, the conception vessel and the governor vessel, focusing on Tiantu (CV 22), Baihui (GV 20), Dazhui (GV 14), Feishu (BL 13), Fengmen (BL 12), Taiyuan (LU 9), Lieque (LU 7) and Fengchi (GB 20), once a week and one-week treatment as one session. Totally, the continuous two sessions were required in the two groups. The cough symptom score, cough remission time, relapse, TCM syndrome score, the score of Leicester cough questionnaire (LCQ), SP concentration in the supernatant of the induced sputum before and after treatment as well as clinical efficacy were observed in the two groups.

RESULTSThe cough symptom score, TCM symptom score and SP concentration in the supernatant of the induced sputum were all apparently reduced after treatment in the patients of the two groups (all<0.01). The scores in the combined therapy group were reduced in the higher amplitude as compared with those in the Chinese herbal medicine group (all<0.01). The total effective rate was 95.0% (38/40) in the combined therapy group, better than 87.5% (35/40) in the Chinese herbal medicine group (<0.05). Regarding the cough remission time and relapse rate, the results in the combined therapy group were better than those in the Chinese herbal medicine group[(5.3±1.2) d vs (7.4±1.5) d,<0.01; 0% (0/19) vs 62.5% (5/8),<0.01]. The scoreo of LCQ was all apparently improved in the patients of the two groups (both<0.01), and the score in the combined therapy group was higher than that in the Chinese herbal medicine group (<0.01).

CONCLUSIONSScraping therapy combined withdecoction and the simple application ofdecoction all relieve the symptoms of post-infectious cough and improves the living quality. The therapeutic effects of the combined therapy are superior to the oral administration ofdecoction.

From 1987 to 2017, cardiovascular disease (CVD) had been ranking the first cause of death in Suzhou, and the mortality rate showed an upward trend annual percentage changes (APC=0.62%, P=0.001), while the standardized mortality rate showed a downward trend (APC=-2.65%, P<0.001). The probability of premature death of CVD declined consistently from 7.06% in 1987 to 2.00% in 2017 (APC=-4.45%, P<0.001). When the life expectancy was set at 70, the potential years of life lost rate (PYLLR) decreased from 6.35‰ in 1987 to 3.30‰ in 2017, and the standardized PYLLR decreased from 7.30‰ to 2.68‰. When the life expectancy was set at 75, the PYLLR decreased from 10.12‰ to 5.19‰, and the standardized PYLLR decreased from 11.44‰ to 3.88‰. With the increase of years, all PYLLR and standardized PYLLR showed a significantly downward trend (APC=-2.51%--3.89%, P<0.001).