To obtain the sound speed data of the right calcaneus of adults in different ages in Guangdong province,we measured the speed of sound of right calcaneus of 224 adults aged 20 to 70 years by the OSTEOSPACE type ultrasound bone densitometry(MEDILINK Company in France) .The results showed that the maximum of the right calcaneus speed of sound occurred at the age of 31-40 years in female(1 591.61?38.14) m/s and 21-30 years in male(1 600.66?30.09) m/s.After the right calcaneus speed of sound reached the maximum,it began to decrease with the age in both male and female.The right calcaneus speed of sound decreased significantly at the age of 41-50 years in male,and at 51-60 years in female.The speed of sound in female at the age of 21-30 years is markedly lower than that in male.The experiment indicates that the speed of sound of right calcaneus decreases with age after reaches the peak.That the speed of sound decreases significantly in male is earlier than that in female.

Objective: To evaluate the efficacy of neoadjuvant chemotherapy combined with cytoreductive surgery and intraperitoneal hyperthermia in the treatment of advanced ovarian cancer. Methods: From June 2014 to April 2017, 72 patients with advanced ovarian cancer who were treated in the Maternal and Child Health Care Hospital of Weihai were selected as the research subjects.According to the digital table method, the patients were randomly divided into two groups, with 36 cases in each group.The control group was treated with neoadjuvant chemotherapy combined with cytoreductive surgery.The observation group was treated with neoadjuvant chemotherapy combined with cytoreductive surgery and intraperitoneal hyperthermic perfusion.After 3 months of chemotherapy, the curative effect was statistically analyzed. Results: The operation time, the amount of ascites and the amount of bleeding in the observation group were significantly less than those in the control group (all P<0.05). There were no statistically significant differences in surgical incision stage I healing rate and the rate of pelvic infection between the two groups (P>0.05). After treatment, the remission rate in the control group was 55.5%(20/36), which was significantly lower than 77.8%(28/36) in the observation group (χ²=4.92, P<0.05). All patients were followed up for 1 year.The recurrence rate of the control group was 33.3%, which was significantly higher than 22.2% of the observation group (χ²=5.71, P<0.05). Conclusion Neoadjuvant chemotherapy combined with cytoreductive surgery and intraperitoneal hyperthermia in the treatment of advanced ovarian cancer is effective and worthy of clinical application.

Adult ; Female ; Fracture Fixation, Internal ; methods ; Fractures, Closed ; surgery ; Humans ; Male ; Manipulation, Orthopedic ; methods ; Middle Aged ; Patella ; injuries

Based on the unique characteristics of medical artificial intelligence （AI） that differ from general medical devices， it was found that the clinical application of medical AI has brought different levels of impacts on the front-end access supervision and regulation， the mid-end informed consent right design， and back-end post-damage liability adjustment. In this regard， it is necessary to appropriately relax the admission review， strengthen the coordination of supervision before and after listing， and simultaneously adjust the comprehensive judgment ideas of “safe and effective” medical AI； clarify the “breadth” of notification and “depth” of disclosure regarding the patients’ informed consent rights； based on current product liability and liability for medical malpractice system， typologically adjust the allocation of liability， while strengthening the supplemental application of medical compulsory liability insurance， so as to enhance the relief of patients’ damage， rationalize risk allocation， and minimize social costs.

Objective To assess the relationship of serum prealbumin level with the severity of acute ischemic stroke (AIS).Methods The clinical data of 2522 AIS patients who were admitted in Peking Union Medical College Hospital from 2000 to 2008 were retrospectively analyzed.The serum prealbumin and hypersensitive C-reactive protein (hs-CRP) levels were evaluated by immunoturbidimetric assay within 24 hours after admission.The AIS severity was evaluated at admission using modified Rankin Scale (mRS).Patients were divided into mild AIS group (mRS score ≤ 3 ) and severe AIS group (mRS score ＞ 3 ).The levels of serum prealbumin and hs-CRP were compared between these two groups,and the relationship between praalbumin and hs-CRP was also analyzed.Results There were 1697 patients in the mild group (average mRS score:1.67) and 825 patients in the severe group ( average mRS score:4.53 ).The severe group had significantly lower prealbumin level [ ( 191.20,82.00)versus (219.18,72.00) mg/L,P =0.000] and higher hs-CRP level [ (6.01,8.22) versus (4.15,6.93) mg/L,P =0.000 ] than the mild group,respectively.Partial regression analysis showed that the stroke severity was negatively correlated with serum prealbumin level (r =-0.115,P =0.000) and positively correlated with hs-CRP level (r =0.098,P =0.000).Serum prealbumin level was inversely correlated with hs-CRP level ( r =- 0.396,P =0.000).Conclusion The prealbumin level is relevant with the severity of AIS and inflammation.

Objective To examine the recurrent ischemic stroke(RIS)in hospitalized patients predicted by Essen Stroke Risk Score(ESRS)and investigate the effect of intensive antiplatelet therapy in patients with high risk of RIS. Methods Retrospective analysis of patients with acute noncardioembolic ischemic stroke consecutively admitted to Peking Union Medical College Hospital(PUMCH)during 2001-2008. All 1008 patients were included in this study, 377 hospitalized in 2001-2002, 315 in 2005 and 316 in 2008. High risk of RIS was defined as ESRS ≥3. The average ESRS score in three groups and percentage of patients with high risk of RIS in each group were calculated. Risk of RIS was evaluated by comparing the average ESRS score in these three groups. Patients with high risk and taking clopidogrel treatment were also evaluated. Results Average ESRS score was 2. 67 ± 1.47,3.55 ± 1.40 and 3.93 ± 1.48(F= 150. 85,P=0.000)in groups of patients hospitalized in 2001-2002, 2005 and 2008 respectively. A significant difference was shown in percentage of high risk patients with ESRS ≥3 in three groups: as 51.64% in 2001-2002,77. 19% in 2005 and 85. 45% in 2008(X2=98.30,P=0. 000),showing a trend of increasing risk of RIS. Except for patients age, rates of having the risk factors in patients increased significantly, including hypertension, diabetes, myocardial infarction, myocardial diseases, smoking,vascular disease and stroke history. Clopidogrel usage has been increasing to 25.63% in 2008, but was far behind high ratio of high risk RIS patients(85.45%). Conclusions This retrospective study showd an increasing trend in RIS risk during 2001-2008. Identifying high risk patients and applying intensified antiplatelet therapy might play an important role in reducing the risk of RIS.

Objective To study the process and mechanism underlying Wallerian degeneration of the central nervous system after stroke.Methods A case suspected of stroke with bilateral symmetrical lesions in middle cerebellar peduncles (MCPs) was described.The etiology of bilateral MCP abnormal signals on MR was analyzed according to the clinical process and neuroanatomy.Results Unilateral paramedian pontine infarction,covering the crossing area of pontocerebellar fibers, would cause bilateral secondary degeneration of MCPs,with hyperintense signals on T2-,Flair and diffusion-weighted images.Conclusions Wallerian degeneration of projecting system is a common sequel after stroke and should not be misdiagnosed as other diseases.

OBJECTIVE: To evaluate the clinical efficacy of warm moxibustion therapy in the recovery of quadriceps muscle strength in patients undergoing total knee arthroplasty (TKA) with analgesia of the femoral nerve block (FNB). METHODS: A total of 174 patients with KOA were randomized into a warm moxibustion group and a rehabilitation group, 87 cases in each group. In the warm moxibustion group, warm moxibustion combined with conventional quadriceps strength training were used. In the rehabilitation group, conventional quadriceps strength training was given. The warm moxibustion was applied at Liangqiu (ST 34) and Zusanli (ST 36), the treatment was given twice a day, 7 days for one course, with a total of 2 courses.The quadriceps muscle strength of the two groups was recorded and compared at 24 h before FNB, 24, 48, 72 and 96 h after surgery, and the resting and exercise VAS pain scores were also recorded at the same time point. And the first time for standing up and the first straight raising time in the two groups were compared, and the occurrence of adverse reactions in the two groups were observed. RESULTS: At 24, 48, 72 and 96 h after FNB, the quadriceps muscle strength in the warm moxibustion group was better than that in the rehabilitation group (<0.05, <0.01). At 72 h and 96 h after FNB, the resting and exercise VAS scores of the warm moxibustion group were lower than those of the rehabilitation group (both <0.001). The average first straight leg raising time in the warm moxibustion group was postoperative (31.03±10.78) h, and the time in the rehabilitation group was postoperative (47.23±15.78) h. The difference was statistically significant (<0.001). The average time of the first time for standing up in the warm moxibustion group was postoperative (25.76±7.00) h, and postoperative (33.12±11.18) h in the rehabilitation group. The difference was also statistically significant (<0.001). No adverse reactions occurred in both groups. CONCLUSION Warm moxibustion combined with conventional quadriceps strength training can improve the symptoms of quadriceps weakness in patients with femoral nerve block after total knee arthroplasty, and accelerate the recovery of joint function, which is superior to conventional quadriceps strength training.
Arthroplasty, Replacement, Knee ; Femoral Nerve ; Humans ; Moxibustion ; Muscle Strength ; Nerve Block ; Pain, Postoperative ; Quadriceps Muscle ; Treatment Outcome

OBJECTIVETo approach the clinical curative effect of treatment of the disease of vertebral column by the arc-track private lock pedicle orthopedics fixation system (ALPF II).

METHODSEighty-six cases were treated by useing ALPF II. The average age of the cases was 36.8 years (range from 18 to 69 years),the male was 39 cases and the female was 37 cases. The results were evaluated and all the cases were followed-up.

RESULTSAll the patients were followed-up for 9 to 30 months. The amelioration of patients nerve function,spinal motion, low back pain and leg pain was 94.1%, 65.9%, 92.1% and 87.4% respectively. The height of anterior and posterior border after operation were improved greatly than that before operation (P < 0.01, P < 0.05). The X-ray films showed that the angle of kyphosis was also improved significantly (P < 0.01).

CONCLUSIONTo treat spinal column disease, ALPF II is a kind of operation safety simple, easy control, reset good, curative effect credibility, the complications little of treatment method.

Adolescent ; Adult ; Aged ; Female ; Humans ; Internal Fixators ; Male ; Middle Aged ; Orthopedic Fixation Devices ; Spinal Diseases ; surgery

Despite recent studies, relatively few are known about the diversity of fungal communities in the deep Atlantic Ocean. In this study, we investigated the diversity of fungal communities in 15 different deep-sea sediments from the South Atlantic Ocean with a culturedependent approach followed by phylogenetic analysis of ITS sequences. A total of 29fungal strains were isolated from the 15 deep-sea sediments. These strains belong to four fungal genera, including Aspergillus, Cladosporium, Penicillium, and Alternaria. Penicillium, accounting for 44.8% of the total fungal isolates, was a dominant genus. The antiaflatoxigenic activity of these deep-sea fungal isolates was studied. Surprisingly, most of the strains showed moderate to strong antiaflatoxigenic activity. Four isolates, belonging to species of Penicillium polonicum, Penicillium chrysogenum, Aspergillus versicolor, and Cladosporium cladosporioides, could completely inhibit not only the mycelial growth of Aspergillus parasiticus mutant strain NFRI-95, but also the aflatoxin production. To our knowledge, this is the first report to investigate the antiaflatoxigenic activity of culturable deep-sea fungi. Our results provide new insights into the community composition of fungi in the deep South Atlantic Ocean. The high proportion of strains that displayed antiaflatoxigenic activity demonstrates that deep-sea fungi from the Atlantic Ocean are valuable resources for mining bioactive compounds.