OBJECTIVETo study the effect of acupuncture on the immune function of sepsis patients.

METHODSNinety sepsis patients were assigned to the control group, the thymosin a1 group, and the acupuncture treatment group according to random digit table, 30 patients in each group. Patients in the control group were treated according to the guideline of Surviving Sepsis Campaign (SSC). Patients in the control group received routine treatment. Those in the thymosin alpha1 group additionally received subdermal injection of thymosin alpha1 (1.6 mg), once per day for 6 successive days. Needling at related points such as Zusanli (ST36), Yanglingquan (GB34), Neiguan (PC6), Guanyuan (RN4), and so on, was performed in patients of the acupuncture treatment group, once per day for 6 successive days. T cell subgroups (CD3+, CD4+, CD8+, CD4+ /CD8+) and immunoglobulin levels (IgG, IgA, IgM) were detected. The length of ICU hospital stay, hospital readmission rate, and 28-day mortality were compared among the three groups.

RESULTSAfter six days of treatment, CD3+, CD4+, CD8+, IgG, IgA, IgM, and CD4+ /CD8+ ratio of three groups were all significantly increased (P < 0.01). Of them, CD3+, CD4+, CD8+, IgG, IgA, and IgM increased more significantly in the thymosin alpha1 group and the acupuncture treatment group (P < 0.01). Compared with the control group, the ICU hospitalization length was significantly shortened, the hospital readmission rate and the 28-day mortality were lower in the thymosin alpha1 group and the acupuncture treatment group (P < 0.05, P < 0.01). There was no statistical difference in each index between the thymosin alpha1 group and the acupuncture treatment group (P > 0.05).

CONCLUSIONAcupuncture could adjust the immune function of sepsis patients, improve their immunological indicators and prognoses.

Acupuncture Therapy ; CD4-CD8 Ratio ; Humans ; Length of Stay ; Prognosis ; Sepsis ; diagnosis ; immunology ; therapy ; T-Lymphocyte Subsets ; Thymosin ; analogs & derivatives

Objective To increase the awareness of autoimmune pancreatitis (AIP) and correct diagnosis rate of AIP by investigating radiologic characteristic of AIP and small pancreatic cancers.Methods The clinical data and radiologic imaging of 24 AIP patients who met the Asia diagnostic criteria of AIP in 2008 and 25 cases of pathologically condirmed small pancreatic cancer were retrospectively reviewed.All imaging findings were reviewed,especially on the shape,enhancement patterns of mass,pancreatic ducts,peripancreatic and extra-pancreatic manifestations. Chi-square test and Fisher test were used for statistical analysis.ResultsThe imaging signs,including location of masses,distal pancreatic atrophy,enhancing mass during portal phase,truncated duct sign of pancreatic duct,capsule-like rim and renal involvement,was significantly different between AIP and small pancreatic cancer ( x2 =9.010,10.506,15.488,8.688,6.292 and 4.966 respectively,P ＜0.05 ).But only two signs,distal pancreatic atrophy and enhancing mass during arterial and portal phase,were statistically different between local AIP and small pancreatic cancer (P ＜0.05).ConclusionsThe typical imaging features of diffuse AIP is distinct and helpful for the differential diagnosis of AIP from small pancreatic carcinoma,but there is limited value in the differential diagnosis between local AIP and small pancreatic cancer.

Objective To evaluate the characteristics and efficacy of microscope-assisted bilateral decompression via unilateral approach for the treatment of lumbar stenosis. Methods From June 2007 to June 2010, Sixty case lumbar stenosis with bilateral decompression were treated via unilateral approach under microscopy. Patients were followed up from 6 to 24 months, average (12 ± 4.7) months. Results The pain level of each patient was assessed both before and after the opeartion, using a visual analogue scale (VAS). Intermittent claudication was completely relieved in 57 out of 60 cases, moderately relieved in 3 cases. VAS score decreased from pre-operational 9.08 ± 0.76 to post-operational 2.33 ± 1.43, and there was significantly difference between them. There was no recurrent case during the whole follow-up. Conclusion Bilateral decompression via unilateral approach under microscope is proved to be an effective and safe procedure for the treatment of lumbar stenosis, and have the advantages of minimal invasion, less pain, quick recovery, better effect, little influence on the spinal stability.

Etiology of adolescent idiopathic scoliosis (MS),a complicated three-dimensional spinal deformity with early-onset,receives continuous attention but remains unclear.To gain an insight into AIS pathogenesis,this review searched PubMed database up to June 2019,using key words or medical subject headings terms including "adolescent idiopathic scoliosis," "scoliosis," "pathogenesis,etiology," "generics,mesenchymal stem cells," and their combinations,summarized existing literatures and categorized the theories or hypothesis into nine aspects.These aspects include bone marrow mesenchymal stem cell studies,genetic studies,tissue analysis,spine biomechanics measurements,neurologic analysis,hormone studies,biochemical analysis,environmental factor analysis,and lifestyle explorations.These categories could be a guidance for further etiology or treatment researches to gain inspiration.

OBJECTIVEAccidents are an important cause of childhood injury. It is hypothesized that safety education programs can reduce accidents in primary school-aged children. This study aimed to determine whether child and parent safety education programs can decrease the incidence of accidental injury in children when compared with controls.

METHODSThe study population (aged 7-13 years) were recruited from four local primary schools, and randomly assigned into an Intervention or a Control group. The Intervention group received child and parent safety education and was taught injury prevention strategies. The Control group received no injury prevention education or intervention. The incidence of accidental injury was compared between the two groups.

RESULTSIn the first year after intervention the incidence of accidental injury was 262 cases in the Intervention group (8.26%) and 234 cases (8.67%) in the Control group (P > 0.05). In the second year after intervention, however, the incidence of accidental injury was significantly less in the Intervention group (211 cases, 6.54%) compared with the Control group (229 cases, 8.63%) (P < 0.01).

CONCLUSIONSInjury prevention strategies and child and parent safety education can reduce risks of accidental injury in children.

Accident Prevention ; methods ; Adolescent ; Child ; Female ; Humans ; Male ; Parents ; Safety ; Wounds and Injuries ; prevention & control

OBJECTIVETo observe the preventive effect of rats' serum containing Buyang Huanwu Decoction (BYHWD) on cultured cardiomyocyte apoptosis of neonatal rat induced by means of 24 hrs hypoxia and 4 hrs reoxygenation, and to investigate its mechanism concerned with nitric oxide (NO).

METHODSMyocyte apoptosis was detected by flow cytometry and ELISA with Annexin V-PI double labeled method. The lactate dehydrogenase (LDH) releasing level was measured with ultraviolet spectrophotometer. The NO concentration was determined by modified Yu method and the concentration of thiobarbituric acid response substance (TBARS) was tested by Ohkawa method.

RESULTSBYHWD contained rats' serum could significantly prevent cardiomyocyte from apoptosis induced by hypoxia and reoxygenation. After hypoxia-reoxygenation, the NO, LDH and TBARS levels in the supernatant of cultured liquid treated with BYHWD were significantly lower than those in non-treated cultured liquid, the effect of BYHWD was dose-dependent.

CONCLUSIONBYHWD can prevent cardiomyocytes from apoptosis induced by hypoxia and reoxygenation, its mechanism might be related with oxygen free radical and NO scavenging produced during the hypoxia-reoxygenation process.

Animals ; Animals, Newborn ; Apoptosis ; drug effects ; Cell Hypoxia ; Cells, Cultured ; Drugs, Chinese Herbal ; pharmacology ; Myocytes, Cardiac ; cytology ; drug effects ; Nitric Oxide ; metabolism ; Oxygen ; pharmacology ; Phytotherapy ; Rats ; Rats, Wistar

Objective To assess the effects of suction drainage versus nondrainage on the post-operative rehabilitation of patients receiving primary bilateral total knee arthroplasties (TKA).
Methods A prospective study including 40 patients was conducted. These patients were diagnosed with osteoarthritis and underwent primary bilateral TKA between October 2007 and September 2009 with the same operation team. A suction drainage was placed by randomization in only one knee for each patient, while the other knee as self-control. Pain visual analogue scale score, extremity swelling, wound healing, range of motion and incidence of early post-operative complications between the drained and nondrained group were compared statistically.
Results Each patient was followed up for 12 months. Placing drainage did not relieve the pain, extremity swelling, ecchymosis, or reduce the incidence of early complications (all P>0.05).
Conclusions Suction drainage in TKA does not exhibit substantial advantages in promoting post-operative rehabilitation after unsophisticated TKA, compared with nondrainage. On the other hand, it might complicate the surgical operation, and increase the incidence of post-operative hemorrhage and retrograde infection.Thus we do not recommend suction drainage in unsophisticatedTKA.

OBJECTIVETo investigate the gene expression and potential functions of transforming growth factor-beta1 in osteophyte development.

METHODSA total of 25 specimens were obtained from individuals undergoing total knee arthroplasty due to severe primary osteoarthritis. Tissue samples were embedded in paraffin wax and made into sections. Hematoxylin and eosin and toluidine blue stainings were performed. The expressions of collagen I, IIa, IIb, and X were detected by immunohistochemistry. Based on the histomorphology of cellularity and matrix abundance, the glycosaminoglycans content, and the differential expressions of collagen I, IIa, IIb, and X, the osteophytic tissues were classified. For each different type of osteophyte, expressions of transforming growth factor-beta1 were detected by immunohistochemistry and in situ hybridization, and results were analyzed using the image analysis system.

RESULTSFive different types of osteophytes were identified as type I, type II, type III, type IV, and type V. Transforming growth factor-beta1 mRNA was more and intensely expressed in chondrocytes of type II and III osteophytes, and was less in other types of osteophytes. The difference was significant (P<0.05, P<0.01).

CONCLUSIONTransforming growth factor-beta1 mRNA is mainly expressed in early-mid stages of osteophytes and may play an important role in promoting the proliferation and differentiation of chondrocytes in the early stages of osteophyte development.

Chondrocytes ; metabolism ; pathology ; Humans ; Osteoarthritis, Knee ; metabolism ; pathology ; Osteophyte ; metabolism ; pathology ; RNA, Messenger ; biosynthesis ; Transforming Growth Factor beta1 ; biosynthesis ; genetics

Spinal instrumentation is a common method for the treatment of spinal disorders, but it can lead to the changes of spine biomechanics. Because of the stress changes, accelerated degeneration of the adjacent segment may occur as time goes by, namely adjacent segment disease. The accelerated degeneration can lead to secondary spinal stenosis, articulated joint degeneration, acquired spondylolisthesis, and spine instability, and some patients may have to receive surgery again. In recent years, the researchers gradually recognized the importance of this disease, and began to investigate its pathogenesis and management.
Humans ; Joint Instability ; etiology ; prevention & control ; Postoperative Complications ; diagnosis ; prevention & control ; Spinal Diseases ; surgery ; Spinal Fusion ; adverse effects ; instrumentation ; Spinal Stenosis ; etiology ; prevention & control ; Spondylolisthesis ; etiology ; prevention & control

OBJECTIVETo evaluate the short-term clinical and radiographic results of modular fully porous-coated stem in revision operation of total hip arthroplasty.

METHODSFrom May 2001 to November 2002, ten cases with twelve hips received revision total hip arthroplasty using modular Profemur R with fully porous-coated stem. There were three males and seven females and the average age was 54.2 years (35 to approximately 71 years). The reasons for revision operation included aseptic loosing in eleven hips and septic loosing in one hip. All the patients were evaluated radiographically and clinically. Radiographic evaluation included the classification of bone loss, leg discrepancy, offset and antiversion before and after revision and bone in-growth postoperatively. Clinical evaluation were based on Harris score system.

RESULTSThe average follow-up period is 13.5 months (range: 6 to approximately 24 months). Leg discrepancy from more than 2 cm in six cases were restored to less than 1 cm postoperatively. Femoral offset, antiversion angle and neck-shaft angle were also restored to normal limitation. All the patients were allowed to full weight-bearing 3 to approximately 5 months later and pain relief occurred in all involved hips. At the last follow-up, bone in-growth occurred in eleven hips and solid fibrous fixation only in one case. Harris score was improved from a mean of 25 to 72. Complications mainly consisted of femoral shaft fracture in three cases but no infection or dislocation was found postoperatively.

CONCLUSIONSSatisfactory results of short-term radiographic and clinical follow-up can be achieved using modular fully porous-coated stem for revision total hip arthroplasty.

Adult ; Aged ; Arthroplasty, Replacement, Hip ; methods ; Bone Cements ; Cementation ; Coated Materials, Biocompatible ; therapeutic use ; Female ; Follow-Up Studies ; Hip Joint ; diagnostic imaging ; Hip Prosthesis ; Humans ; Male ; Middle Aged ; Prosthesis Failure ; Radiography ; Reoperation