Objectives To identify the mainstream studies and their development trends in health management research, and enable domestic scholars and institutions in their decision making to select strategic research fields and their discipline development on health management. Methods Co-citation cluster analysis of high-frequency citations, combined with co-word cluster analysis of high-frequency of MeSH terms were used to discover research focuses. This was followed by statistical analysis of the content of each cluster, and demonstration of the research trends through citation and subject strategic diagrams. Results Eight hot sub-fields have been identified both before and after 2002, which include both cross and separate topics. Conclusion With a multi-disciplinary characteristic, health management has not yet developed into a mature and stable research field; Health management involves the whole management process of healthcare services; Mental health management, chronic disease management and its primary health care service are all constant hotspots of studies. Health literacy is an area deserving greater attention in health management; Health management should interact with health insurance,making it part of the medical insurance system.

OBJECTIVETo investigate the effect of augmentative locking compression plate combined with bone graft in treating aseptic femoral shaft nonunion after intramedullary nailing.

METHODSTwenty-one cases with aseptic femoral shaft nonunion after intramedullary nailing from January 2007 to January 2013 were treated,including 18 males and 3 females with a mean age of 37.7 years (ranged from 23 to 64 years). The mean period of nonunion after surgery was 23.9 months (ranged from 9 to 62 months). According to Weber-Cech classification,10 of those 21 cases were hypertrophic nonunion,7 were atrophic, and 4 had oligotrophic fracture nonunion. All patients retained the original intramedullary nail, and applied with augmentation plating of 6 to 8 holes locking compression plate, unicortical fixation with 2 to 3 locking screws in the proximal or distal end, with simultaneous autologous iliac bone grafting. After treatment,all patients were allowed to partial weight-bearing until full weight-bearing according to the radiological results. All patients were followed up and were evaluated with clinical and imaging results.

RESULTSAll patients were followed up from 8 to 24 months, averaged (13.5±3.5) months,which showed clinical union at 4 to 8 months, averaged (6.0±1.0) months and radiological solid union at 7 to 12 months, averaged (9.1±1.5) months. No such complications as infection,hardware loosening or breaking were found.

CONCLUSIONAugmentative locking compression plate(LCP) combined with bone graft for aseptic femoral shaft nonunion after intramedullary nail has a satisfied clinical efficacy. It's an useful and simple method.

Adult ; Bone Nails ; adverse effects ; Bone Plates ; Bone Transplantation ; Female ; Femoral Fractures ; complications ; surgery ; Follow-Up Studies ; Fracture Fixation, Intramedullary ; adverse effects ; Fractures, Ununited ; complications ; surgery ; Humans ; Male ; Middle Aged ; Postoperative Complications ; etiology ; surgery ; Treatment Outcome ; Young Adult

OBJECTIVETo study effects of body mass index (BMI) on postoperative outcome in patients with osteoarthritis after total knee arthroplasty (TKA).

METHODSThe data of 148 patients with osteoarthritis who underwent TKA from June 2006 to May 2009 in our hospital and had complete follow-up data were analyzed restrospectively, including 29 males and 119 females, ranging in age from 39 to 89 years old, with an average age of 71.2 years old. According to BMI classification standard, all the patients were divided into 4 groups: non-obese group (BMI ≤ 25.0 kg/m2), had 38 patients (45 knees), including 9 males and 29 females, with a mean age of (70.0 ± 8.2) years old; overweight group (BMI 25.1 to 27.0 kg/m2), had 40 patients (48 knees), including 10 males and 30 females, with a mean age of (72.6 ± 7.4) years old; obesity group (BMI 27.1 to 30.0 kg/ m2), had 30 patients (43 knees), including 7 males and 30 females, with a mean age of (70.4 ± 6.0) years old; morbidly obesity group (BMI > 30.0 kg/m2), 33 patients (39 knees), including 3 males and 30 females, with a mean age of (71.7 ± 6.4) years old. The index such as Knee Society Score (KSS), anterior knee pain and patella cartilage damage during surgery were recorded before surgery and at the time of follow-up.

RESULTSPostoperative KSS increased significantly compared to preoperative KSS, and the good rate reached to 97.1%. In the knee score, preoperative KSS and postoperative KSS had no significant differences among the four groups (preoperative P = -0.789; postoperative P = 0.133). However, compared with other groups, obesity group got the lowest preoperative function score (preoperative P = 0.036; postoperative P = 0.225). While the incidence of anterior knee pain was 9.7% (17/175), including 14 grade I and 3 grade II. There were no significant differences in incidence of anterior knee pain among four groups (χ2 = 0.764, P = 0.862). The average BMI of the patients with anterior knee pain was (27.4 ± 3.6) kg/m2, while the others' BMI was (27.5 ± 4.4) kg/m2. There was no statistically difference between two groups (t = -0.061, P = 0.951). There were no significant differences in patella cartilage damage among groups (χ2 = 7.070, P = 0.314).

CONCLUSIONThe KSS increases in all the different groups. Those patients get the benefit from TKA, and the obese patients can receive a similar postoperative outcome as the non-obese ones.

Adult ; Aged ; Aged, 80 and over ; Arthroplasty, Replacement, Knee ; Body Mass Index ; Female ; Humans ; Male ; Middle Aged ; Osteoarthritis ; physiopathology ; surgery ; Retrospective Studies ; Treatment Outcome

BACKGROUNDTyrosine kinase signaling cascades play a critical role in the pathogenesis of allergic airway inflammation. Sunitinib, a multitargeted receptor tyrosine kinase inhibitor, has been reported to exert potent immunoregulatory, anti-inflammatory and anti-fibrosis effects. We investigated whether sunitinib could suppress the progression of airway inflammation, airway hyperresponsiveness (AHR), and airway remodeling in a murine model of chronic asthma.

METHODSOvalbumin (OVA)-sensitized mice were chronically challenged with aerosolized OVA for 8 weeks. Some mice were intragastrically administered with sunitinib (40 mg/kg) daily during the period of OVA challenge. Twelve hours after the last OVA challenge, mice were evaluated for the development of airway inflammation, AHR and airway remodeling. The levels of total serum immunoglobulin E (IgE) and Th2 cytokines (interleukin (IL)-4 and IL-13) in bronchoalveolar lavage fluid (BALF) were measured by ELISA. The expression of phosphorylated c-kit protein in the lungs was detected by immunoprecipitation/Western blotting (IP/WB) analysis.

RESULTSSunitinib significantly inhibited eosinophilic airway inflammation, persistent AHR and airway remodeling in chronic experimental asthma. It reduced levels of total serum IgE and BALF Th2 cytokines and also lowered the expression of phosphorylated c-kit protein in remodelled airways.

CONCLUSIONSSunitinib may inhibit the development of airway inflammation, AHR and airway remodeling. It is potentially beneficial to the prevention or treatment of asthma.

Angiogenesis Inhibitors ; pharmacology ; Animals ; Asthma ; chemically induced ; drug therapy ; immunology ; Blotting, Western ; Bronchial Hyperreactivity ; chemically induced ; immunology ; Bronchoalveolar Lavage Fluid ; chemistry ; Female ; Immunoglobulin E ; blood ; Immunohistochemistry ; Immunoprecipitation ; In Vitro Techniques ; Indoles ; pharmacology ; Inflammation ; chemically induced ; immunology ; Interleukin-13 ; metabolism ; Interleukin-4 ; metabolism ; Lung ; drug effects ; immunology ; metabolism ; Mice ; Mice, Inbred BALB C ; Ovalbumin ; pharmacology ; Proto-Oncogene Proteins c-kit ; metabolism ; Pyrroles ; pharmacology

OBJECTIVETo investigate the clinical effect of Devine's technique with free skin grafting in the treatment of concealed penis with prepuce deficit.

METHODSThis study included 7 children with concealed penis, aged 6 - 15 (mean 8.6) years, 6 of them treated by circumcision previously. All the patients underwent Devine's operation to resect the inelasticity sarcolemma and lengthen the penis. The length of prepuce deficit ranged from 2 to 4 cm. Intermediate split thickness skin grafts of the corresponding length were taken from the femoribus internus to wrap up the tunica albuginea penis, followed by the procedures of saturation, encapsulation and fixation.

RESULTSSurgery time ranged from 70 to 120 minutes, averaging 90.5 minutes. The penis was prolonged about 2 - 4 cm after surgery. A 6-month follow-up revealed desirable penile appearance and normal penile erection.

CONCLUSIONDevine's technique with free skin grafting from the femoribus internus is an ideal treatment for concealed penis with prepuce deficit.

Adolescent ; Child ; Foreskin ; abnormalities ; surgery ; Humans ; Male ; Penis ; abnormalities ; surgery ; Skin Transplantation ; Surgery, Plastic ; methods ; Surgical Flaps

Enhanced recovery after cesarean (ERAC) delivery is an evidence-based, multi-disciplinary approach throughout pre-, intra-, post-operative period. The ultimate goal of ERAC is to enhance recovery and improve the maternal and neonatal outcomes. This review highlights the role of anesthesiologist in ERAC protocols. This review provided a general introduction of ERAC including the purposes and the essential elements of ERAC protocols. The tool used for evaluating the quality of ERAC (ObsQoR-11) was discussed. The role of anesthesiologist in ERAC should cover the areas including management of peri-operative hypotension, prevention and treatment of intra- and post-operative nausea and vomiting, prevention of hypothermia and multi-modal peri-operative pain management, and active pre-operative management of unplanned conversion of labor analgesia to cesarean delivery anesthesia. Although some concerns still remain, ERAC implementation should not be delayed. Regular assessment and process improvement should be imbedded into the protocol. Further high-quality studies are warranted to demonstrate the effectiveness and efficacy of the ERAC protocol.

OBJECTIVETo study the gene expression of Notch1 and Jagged1 in children with acute leukemia (AL) and their possible roles in the pathogenesis of AL.

METHODSMononuclear cells from bone marrow or peripheral blood of 47 children with AL and 20 controls (normal children or children with nonmalignant hematologic disease) were collected from February 2009 to July 2011. A two-step method to semi-quantitative reverse transcription-polymerase chain reaction (RT-PCR) was used to detect the gene expression of Notch1 and Jagged1. Of the 47 children with AL, there were 26 cases of B-ALL, 6 cases of T-ALL and 15 cases of AML.

RESULTSThe positive expression rate of Notch1 in the ALL and AML groups was higher than in the control group (P<0.05). The expression level of Notch1 in T-ALL children was higher than in B-ALL children (P<0.01). The positive expression rate of Jagged1 in the ALL and AML groups was not significantly different from the control group, however, the expression level of Jagged1 in the ALL and AML groups was higher than in the control group (P<0.05).

CONCLUSIONSThere are significant differences in the gene expression of Notch1 between children with different types of ALL, and a higher expression of Notch1 relates to T-ALL. The activation of Notch1 signal is common in children with AL. The abnormal gene expression of Notch1 in children with AML shows the role of Notch1 in AML. The gene expression of Jagged1 in children with ALL or AML is abnormal, and this needs to be confirmed by further research.

Acute Disease ; Adolescent ; Calcium-Binding Proteins ; genetics ; Child ; Child, Preschool ; Female ; Gene Expression Regulation, Neoplastic ; Humans ; Infant ; Intercellular Signaling Peptides and Proteins ; genetics ; Jagged-1 Protein ; Leukemia ; metabolism ; Leukemia, Myeloid, Acute ; metabolism ; Leukemia-Lymphoma, Adult T-Cell ; metabolism ; Male ; Membrane Proteins ; genetics ; Receptor, Notch1 ; genetics ; metabolism ; Reverse Transcriptase Polymerase Chain Reaction ; Serrate-Jagged Proteins ; Signal Transduction

OBJECTIVETo investigate the clinical and pathological features, diagnosis and treatment of cystic lymphangioma of the spermatic cord.

METHODSOne case of cystic lymphangioma of the spermatic cord in a 71-year-old patient was retrospectively analyzed and the relevant literature was reviewed.

RESULTSThe patient, presented with spermatic cord hydrocele, was treated by local excision of the tumor, which was pathologically diagnosed as cystic lymphangioma. No relapse was found during a 3-month follow-up after the operation.

CONCLUSIONLymphangioma of the spermatic cord is a benign tumor. Preoperation ultrasonography and CT are important for determining the location and nature of lymphangioma. Surgical excision is an effective option for the treatment of cystic lymphangioma of the spermatic cord.

Aged ; Genital Neoplasms, Male ; diagnosis ; surgery ; Humans ; Lymphangioma, Cystic ; diagnosis ; surgery ; Male ; Retrospective Studies ; Spermatic Cord ; pathology ; Treatment Outcome

OBJECTIVETo investigate the direct electrochemical behaviors of matrine (MT), oxymatrine (OMT), sophoridine (SR) and oxysophoridine (OSR) at a glassy carbon electrode in a physiological medium, and to determine the contents of commercial MT and SR pharmaceutical products were determined.

METHODTheir electrochemical behaviors and contents in 0.15 mol x L(-1) NaCl aqueous solutions were obtained by cyclic voltammetry (CV) and square wave voltammetry (SWV) methods.

RESULTThe electrochemical experimental results show that the two totally irreversible oxidation peaks for both MT and SR were observed, which potential values are 0.81 V and 0.92 V, and the electrode reaction processes were diffusion-controlled. But for both OMT and OSR, they have no oxidation peaks observed in the same condition as well. The linear range of the concentration of MT and SR and the contents in their products were obtained by SWV.

CONCLUSIONThe research results can be applied in determination of the contents of commercial MT and SR pharmaceutical products.

Alkaloids ; analysis ; chemistry ; Carbon ; Electrochemistry ; methods ; Electrodes ; Oxidation-Reduction ; Plants, Medicinal ; chemistry ; Quinolizines ; analysis ; chemistry ; Reproducibility of Results ; Sophora ; chemistry

Objective:To investigate the relationship between double mutations of myosin heavy chain gene (MYH6) p.Gly743Arg and p.Glu1389Lys and the cardiac phenotype.Methods:Patients carrying double mutations in the MYH6 gene p.Gly743Arg and p.Glu1389Lys were screened from 52 unrelated left ventricular hypertrophy (LVH) who were admitted to the Second Hospital of Chongqing Medical University from 2015 to 2020, and the genetic testing of peripheral blood of patients by second-generation whole-exome sequencing assay technology and genomic DNA of their family members Sanger sequencing was performed to validate the genomic DNA of the family members. The cardiac phenotype was evaluated by electrocardiogram, coronary computed tomography angiography (CTA), echocardiography, and cardiac magnetic resonance imaging (MRI) as adjuncts.Results:All whole-exome gene were detected in 52 unrelated patients with LVH, of which 1 patient (1.9%) had double mutations in MYH6 gene p.Gly743Arg and p.Glu1389Lys (proband). Two members of the maternal line of this patient carried p.Glu1389Lys mutation, but there was no obvious clinical phenotype. Two members of the paternal line carried p.Gly743Arg mutation and had obvious clinical phenotype of bradycardia, but there was no LVH. The male proband, aged 21 years old, presented with LVH and sinus bradycardia but no coronary artery stenosis on CTA before treatment, MRI showed that the left ventricular end diastolic diameter was 58 mm. After treatment with angiotensin receptor-enkephalinase inhibitor (ARNI), electrocardiogram showed that the heart rate increased significantly (from 43 bpm to 72 bpm). Echocardiography showed that the left ventricular end diastolic diameter decreased significantly (from 60 mm to 49 mm).Conclusions:The p.Glu1389Lys mutation of the MYH6 gene may not manifest the phenotype of heart disease. MYH6 gene p.Gly743Arg mutation may be manifested asymptomatic sinus bradycardia, but there is no LVH phenotype. The cardiac disease phenotype caused by the double mutations of p.Gly743Arg and p.Glu1389Lys in the MYH6 gene is more obvious. Asymptomatic LVH and sinus bradycardia can appear in adolescence, but the LVH phenotype can be reversed in a short period of time after ARNI treatment.