·AIM:To determine the effect of anterior-posterior joint surgery on choroidal thickness in patients with proliferative diabetic retinopathy (PDR). · METHODS: A retrospective, case - control study enrolled 60 eyes of 60 patients with PDR diagnosed at Qingdao Municipal Hospital. The patients, who had conditions that warranted anterior - posterior joint surgery,were divided into a clinically significant macular edema group (PDR/CSME+;31 patients,31 eyes) and a non-CSME group (PDR/CSME-;29 patients,29 eyes). Twenty-seven eyes of 27 normal patients were included in the control group. All affected eyes underwent anterior - posterior joint surgery. After surgery, the subfoveal choroidal thickness (SFCT), and the nasal choroidal thickness (NCT) and temporal choroidal thickness (TCT), which were obtained at a distance of 1500μ m from the fovea in the nasal and temporal directions, respectively, were measured in the control and PDR groups by enhanced depth imaging spectral domain optical coherence tomography (EDI-SDOCT) at 1wk,1,3, and 6mo after surgery. Changes in choroidal thickness after anterior - posterior joint surgery were compared between the groups. ·RESULTS:The SFCT,NCT,and TCT were significantly thicker at 1mo than at 1wk, 3, and 6mo after surgery in the PDR/CSME+ and PDR/CSME- groups(P<0.05). The SFCT, NCT, and TCT were significantly thinner at 6mo than at 1wk,1,and 3mo after surgery in the PDR/CSME+and PDR/CSME- groups(P<0.05). The SFCT,NCT,and TCT in the PDR/CSME+ and PDR/CSME- groups at 1wk, 1, and 3mo after surgery were significantly thicker than those in the control group (all P<0.05), but the SFCT, NCT, and TCT at 6mo after surgery showed no significant difference compared with the control group (all P>0.05). There was no significant difference in the SFCT,NCT, or TCT at 1wk, 1, 3, or 6mo between the PDR/CSME+ and PDR/CSME- groups (P>0.05). ·CONCLUSION:The choroidal thickness of PDR patients increases within 1mo after surgery, and decreased after 1mo,but is not significantly different between the control group and the PDR groups at 6mo after surgery. Whether PDR is associated with CSME has no effect on the choroidal thickness after surgery.

BACKGROUND:It is important to maintain the height of joint line in total knee arthroplasty or renovation. Foreign scholars have reported the parameters of the distance from different landmarks to knee joint line, but there is stil a lack of relevant data for Chinese people. OBJECTIVE:To explore the relationships of the knee anatomic landmarks and joint line in normal Chinese, thereby providing clinical evidence for primary total knee replacement and knee renovation. METHODS:Totaly 746 normal knee joints of 409 healthy volunteers from North China and Southwest China were randomly enroled, including 214 males and 195 females, with a mean age of 37.7 years. CT scan was used to reconstruct the three-dimensional knee joint, and the distance between the anatomic landmarks and the joint line was measured using Mimics software. RESULTS AND CONCLUSION:The distance from the center of femoral medial sulcus to the joint line was (25.72±2.52) mm. The distance from the center of lateral femoral condyle prominence to the joint line was (26.30±2.65) mm. The distance from the adduction muscle tubercle to the joint line was (44.60±4.32) mm. The distance from the peak of the tibial tubercle to the joint line was (21.50±3.57) mm. These parameters in male group were significantly higher than those in female group (P < 0.05). In conclusion, these findings provide anatomic evidence for the recovery of joint line in knee replacement or renovation; the variability of the distance from the center of femoral medial sulcus, lateral femoral condyle prominence and adductor tubercle to the joint line is smaler, and therefore, these landmarks have more reference values in total knee arthroplasty.

OBJECTIVETo study the qi deficiency syndrome distribution and quality of life (QOL) of patients with advanced non-small cell lung cancer (NSCLC).

METHODSA questionnaire survey was conducted in 120 patients with advanced NSCLC using the QOL scale "Functional Assessment of Cancer Therapy" (FACT-L) (Version 4.0). Meanwhile, syndrome typing was performed. On the basis of results of syndrome typing, patients of different syndrome types were grouped and compared, thus studying the distribution of advanced NSCLC patients of qi deficiency syndrome and qi deficiency syndrome correlated QOL features.

RESULTSQi deficiency, blood stasis, yin deficiency, phlegm and dampness dominated in syndrome types of the 120 patients with advanced NSCLC. Of syndrome types accounting for larger ratios in 112 patients, pure qi deficiency syndrome accounted for 30.36% (34 cases), qi deficiency and blood stasis syndrome for 18. 75% (21 cases), both qi and yin deficiency syndrome for 10. 71% (12 cases). There was no correlation between the appearance of qi deficiency syndrome and patients' age, sex, pathological typing (adenocarcinoma/squamous carcinoma), or the disease duration. NSCLC patients in phase IV were mostly complicated with qi deficiency syndrome (P<0.05). Scores of physical states, emotional states, functional states, and total scores in the FACT-L scale were lower in those complicated with qi deficiency syndrome (89 cases) than in those without complicated qi deficiency syndrome (31 cases), showing statistical difference (P<0.01, P<0.05). The scores of the lung cancer specific module (additional concerns) in the FACT-L scale showed statistical difference, sequenced as qi deficiency and blood stasis syndrome > pure qi deficiency syndrome > both qi and yin deficiency syndrome (P<0.05).

CONCLUSIONSQi deficiency syndrome is the main syndrome of advanced NSCLC. The QOL of advanced NSCLC patients complicated with qi deficiency syndrome was poorer than those without complicated qi deficiency syndrome. Besides, along with the aggravation of qi deficiency syndrome, the QOL decreased somewhat. It suggested that symptomatic treatment of qi deficiency syndrome could improve advanced NSCLC patients' QOL.

Adult ; Aged ; Aged, 80 and over ; Carcinoma, Non-Small-Cell Lung ; diagnosis ; psychology ; Female ; Humans ; Lung Neoplasms ; diagnosis ; psychology ; Male ; Medicine, Chinese Traditional ; Middle Aged ; Quality of Life ; Surveys and Questionnaires ; Yin Deficiency ; diagnosis

Objective To investigate the expression of neural-nitric oxide synthase (nNOS) in renal clear cell carcinoma and its clinical significance.Methods The expression of nNOS mRNA in 533 samples of TCGA database was analyzed with Student t test,and statistical analysis was performed to assess the relationship between nNOS expression and clinical prognosis with Kapla-Meier test.Western blot analysis of nNOS protein expression in 10 cases of clear cell renal cell carcinoma(ccRCC) from department of urology of Wuhan union hospital with student t test.Results The mRNA levels of nNOS in 72 cases of ccRCC in tumor tissues and adjacent tissues and were 2.99 ± 0.28 and-1.57 ± 0.17,it is significantly lower than those in adjacent tissues (P ＜ 0.01).The mRNA levels of nNOS in 533 cases of ccRCC,in tumor tissues and adjacent tissues and were 2.99 ± 0.28 and-1.76 ± 0.05,it is significantly lower than those in adjacent tissues (P ＜ 0.01).A total of 533 sample studies showed a low correlation between nNOS expression and clinical T stage,T1-1.59 ±0.08,T2-1.96 ±0.13,T3-1.90 ±0.09,T4-2.38 ±0.28 (P =0.0029) and -1.63 ±0.06 and-2.16 ± 0.13 between non-metastasis and no-metastasis (P =0.0009),and-1.57 ± 0.08 and-2.03 ± 0.11 between non-recurrence and recurrence (P =0.008).Survival analysis showed that the overall survival time were (40.3 ± 5.6) months and (48.3 ± 5.7) months in lower and higher nNOS expression,and disease free survival time were (37.1 ± 2.1) months and (40.3 ± 5.6) months in lower and higher nNOS expression,both with shorter time in low expression of nNOS (P ＜ 0.01).nNOS proteins were 1.02 ± 0.16 and 0.61 ± 0.1 1 in tumor tissues and adjacent tissues with significantly lower expression(P＜0.05).Conclusions The mRNA and protein of nNOS are lower in ccRCC with a poor prognosis of ccRCC.

Objective To investigate the absorption mechanism of Bio-chanin A ( BCA) and PEGylated BCA loaded nanostructured lipid carri-ers ( PEG -BCA -NLC ) across Caco -2 cell model.Methods Caco-2 cell monolayer model was used to explore the uptake , transport and impact factors of BCA and PEG -BCA-NLC.Drug concentration was measured by HPLC and the apparent permeability coefficients ( Papp ) were calculated.Results The main mechanism of BCA and PEG-BCA-NLC across Caco -2 monolayer model was passive diffu-sion.But under the same time , lower uptake of drug in Caco -2 cells was observed at PEG -BCA -NLC group comparing to that at BCA group.The absorption and the apparent permeability coefficient of BCA in Caco-2 cells monolayer were increased when combined with verapam-il.The Papp (AP→BL) increased and Papp (BL→PL) reduced, but the uptake content was much lower than BCA solution.Conclusion Ab-sorption process of PEG -BCA-NLC in Caco-2 cells monolayer met the characteristics of passive diffusion.However , the PEG-BCA-NLC may not significantly improve the absorption of BCA in intestinal epithelial.

OBJECTIVETo evaluate the clinical outcome of surgical treatment of the posterior dislocation of the elbow with coroniod and radial head fractures.

METHODSFrom January 2004 to March 2009, 9 patients with terrible triad of the elbow were reviewed. There were 7 males and 2 females (4 left elbows and 5 right elbows), with an average age of 41.2 years, ranged from 21 to 67 years. The radial head fractures were classified according to the Schatzker-Tile criteria: 4 patients had the fractures of type I, 3 patients had type II and 2 patients had type III. The ulnar coronoid fractures were classified according to the Regan-Morrey criteria: 2 patients had the fractures of type I, 5 patients had type II and 2 patients had type III. The general approach was used to repair the damaged structures sequentially from deep to superficial, through coronoid, anterior capsule, radial head, and lateral ligament complex to common extensor origin. If there was valgus instability in the elbow after the operation, the medial collateral ligament should be repaired with nonabsorption sutures. The plaster was applied for 7 to 10 days with elbow flexion in 90 degrees and the forearm in full pronation. Unrestricted motions and rehabilitation began at the 8th week after operation. Recovery of regular occupation depended on the degree of physical activity required, and it typically took 3 months for heavy physical laborers to return to work.

RESULTSAll the patients were followed up from 6 months to 5 years, with a mean duration of (31 +/- 6) months. At the 3rd month after operation, the mean rang of motion in flexion and extension of the elbow was (102 +/- 3) degrees (ranged from 80 degrees to 110 degrees), and the mean range of motion in pronation and supination of the forearm was (135 +/- 6) degrees (100 degrees to 150 degrees). According to the criteria of the Mayo scoreing system, the results were excellent in 5 cases, good in 3 cases, and fair in 1 case. Three patients had heterotopic ossification at the 6th month after operation. Among them, 2 patients had no effects on elbow function and were not treated, 1 patient had effects on flexion-extension of the elbow and was treated with resection of heterotopic ossification through lateral approach combined with early rehabilitation, the MEP score of the patient improved from fair to good.

CONCLUSIONThe key points for treating the terrible triad of the elbow are to restore the elbow normal anatomy and early rehabilitation to avoid the elbow stiff.

Adult ; Aged ; Elbow Joint ; injuries ; physiopathology ; Female ; Humans ; Joint Dislocations ; complications ; physiopathology ; surgery ; Male ; Middle Aged ; Radius Fractures ; complications ; physiopathology ; surgery ; Ulna Fractures ; complications ; physiopathology ; surgery

BACKGROUNDThis is a prospective clinical study based on a large sample gathered from multiple centers in China, subordinating to 10th Five-Year Plan of National Science & Technology Progression. We analyzed the high-risk factors inducing hypertensive disorders in pregnancy (HDP) and estimated the potential effect of anti-oxidants administration, including vitamin C (VC), vitamin E (VE) and Salvia Miltiorrhiza L (SML), a Chinese herb medicine, in amelioration of the high-risk factors in pregnancy.

METHODSFrom April 2005 to July 2006, 4814 pregnant women from 24 national wide cooperative hospitals were involved in this prospective research. The participants were randomly divided into two groups: 1607 cases were in anti-oxidants group with administration of vitamins and SML; 3207 cases were in control group without any medicine given. Every participant was under monitoring for the morbidity of HDP and the high-risk factors were investigated in HDP cases in each group.

RESULTS(1) The morbidity of HDP was 3.55% in anti-oxidants group vs. 4.18% in control group. No statistical difference existed between the two groups (P > 0.05). (2) In anti-oxidants group, the HDP morbidities among three subgroups: VC + VE + SML, VC + VE and SML only, were 5.51%, 3.05% and 5% respectively. It showed no statistical difference among three remedies (P > 0.05). (3) The related index of factors affecting HDP showed in intensity sequence as follows: family HDP history > profession > education level > age > body weight. The incidence of HDP in normal population was 3.51%, and the incidence of HDP in high-risk pregnant women (family HDP history, heavy physical labor, low education level (middle school and below), age ≥ 40, body mass index ≥ 24) was 5.84%, which was obviously higher than that in normal population (P < 0.01). In anti-oxidants group, the probability of HDP in women with high-risk factors was 3.81%, which was obviously lower than that in control group with high-risk factors at 7.14% (P < 0.01). (4) In control group, the morbidity of HDP in women with family HDP history (especially with sisters'), heavy physical labor, middle school and below, age ≥ 35 was: 50.00%, 15.22%, 6.33%, 26.28% and 5.75%, respectively, and that in anti-oxidants group was 0, 7.69%, 3.74%, 9.27% and 2.67%, respectively, which was obviously lower than that in control group.

CONCLUSIONSThe high-risk factors prone to induce HDP included: family history of HDP, heavy physical labor, low education level, aging and obesity. No impressive effect of anti-oxidants application was found in preventing HDP in general population but the remedy demonstrated positive effect on preventing HDP in pregnant women with high-risk factors.

Adolescent ; Adult ; Age Factors ; Antioxidants ; therapeutic use ; Body Weight ; Female ; Humans ; Hypertension ; drug therapy ; physiopathology ; Logistic Models ; Pregnancy ; Pregnancy Complications ; drug therapy ; Prospective Studies ; Risk Factors ; Young Adult

[Objective] To investigate the HIV infection status and behavioral characteristics of men who have sex with men (MSM) over the age of 50 in Taizhou during 2010-2017 HIV sentinel surveillance, analyze the related factors of HIV infection, and provide basis for developing targeted intervention strategies. [Methods] HIV sentinel surveillance data from 2010 to 2017 in Taizhou was used to analyze the demographic characteristics, HIV awareness, and sexual behaviors of MSM over the age of 50. Also, HIV infection status and related factors were analyzed by multivariate regression analysis. [Results]A total of 334 MSM aged over 50 were surveyed by HIV sentinel surveillance in 2010-2017, and the HIV positive rate was 14.1％. The average age of the 334 MSM was (59.6 ± 7.2) years, and those with junior high school education and below accounted for 76.0％, with awareness of AIDS knowledge being 85.6％. And78.7％ of them had anal sex with men in the past 6 months. Among them, 30.4％ used condoms each time. And 4.8％ of them had commercial sex with men and 37.1％ had sex with women in the past 6months. Multivariate analysis showed that syphilis-positiveness was a risk factor for HIV infection and awareness of HIV-related knowledge proved to be a protective factor for HIV infection. [Conclusion] The MSM over 50 years old in Taizhou has a high rate of HIV-positiveness and high-risk behaviors exist. It is imperative to strengthen dynamic HIV surveillance for this population and behavioral intervention to reduce HIV related risky behavior.

Aim To explore the effect and mechanism of antioxidant peptide AOP1 on repair of skin burn wound healing in mice.Methods Fluorescence probe DCFH-DA was used to detect the changes of intracellular reactive oxygen species (ROS).Cell proliferation and migration assay were used to detect AOP1 toxicity and its effect on wound healing.Moreover,the skin scald wound was made on the shaved dorsum of the anesthetized mice with a 1.0 cm diameter brass cylinder heated in a water bath at 80 ℃ for 2 min and pressed against the rat skin for 10 s.The effects of AOP1 on the healing of skin burns were observed by HE and Masson staining and the contents of MDA and the activity of SOD in skin tissues were measured.Results The antioxidant peptide AOP1 could significantly reduce the number of ROS in HaCaT and L929 cells,and promote cell migration and proliferation.Compared with the untreated group,the skin healing time of AOP1 group was short,the healing rate was high,the area of scab was small,and inflammation and the content of MDA in burned tissue significantly decreased.The effect of AOP1 on healing of burn wound healing was also confirmed by HE and Masson staining.Conclusion It is suggested that the antioxidant peptide AOP1 with natural activity may promote the healing of skin burns by reducing the oxidative stress caused by burns.

Objective To discuss family environment and parent's education pattern of violent online games addictive disorder in junior middle school students. Methods From August to December at 2008,6000 students were randomly drown from 8 junior middle schools in Dalian. All subjects were investigated with the self-made internet game survey form and the Chen internet addiction scale (CLAS). 149(2.5% ) internet game addicts were screen out from 6000 students, and then were divided into the violence and entertainment game addicted group (66 students in per group, and the male 55, female 11). No-game group 66 students were matched according tothe sex and the age. All subjects were evaluated with Egma Minnen av Bardndosnauppforstran ( EMBU) and Moss's Family Environment Scale of Chinese version. Results Lower mother's understand and warm were observed in violence internet online game addictive student group than other two groups( (46. 37 ± 13. 93,49. 80 ± 7.13,53. 16 ± 14. 89) , F = 4.88, P<0.01) ,and the mother understand and warm were remarkably lower in the violence online game addictive group than the non-game addicted group(P<0.01) ,and mothers rejection and the denial are obviously higher in entertainment online game addictive group than the non-game group(P = 0. 038). In family environment survey results suggested there were significant different during the 3 groups (F1-3 = 13. 99, 12.24,10.56; P<0.05)in emotion expression(4. 74 ± 1. 32,6. 06 ± 1. 97,5. 80 ± 1. 11) ,and conflict (5. 57 ± 1.85,5.28 ± 1.41,3.63 ± 1.50) .independence (3.96 ± 1. 87,4.56 ± 1.84,4.63 ± 1. 85). In the violence online game addictive group, emotion expression was lower than other two groups (P<0. 01) ,the conflict score was higher than other two groups (P<0.01). The controlling was lower than other two groups ( all P<0. 01) ; family function and total score are lower in online game addictive groups than other groups (P<0. 01, P<0. 05). Conclusion -Lower emotion expression,higher conflict,lacks of mother's love and warm,and lower controlling are found in violence online game addictive junior middle school students.