Objective To investigate the effects of sensorimotor therapy on patients with knee osteoarthritis.Methods Ninety-two patients with knee osteoarthritis were divided into a treatment group and a control group by using random digits table. Both groups received conventional rehabilitation therapy, including knee isometric and isotonic contraction training, ultrashort wave diathermy as well as aerobic exercise. The treatment group was also administered with sensorimotor training, in addition to the conventional training,including the muscle strengthening and control training of quadriceps and hamstring muscle using sling exercise therapy system and on the Thera-band mattress. The visual analogue scale (VAS) for pain, manual muscle testing and knee range of motion as well as the Japanese Orthopedic Association knee function evaluation form were used to evaluate the patients. Results There was no statistic difference between the 2 groups before treatment, with regard to the evaluation parameters used in this study. After 2 months of treatment, both groups improved significantly (P ＜0.05),with the treatment group improved to a significantly greater extent (P ＜0.05). Conclusions Sensorimotor training in addition to the conventional rehabilitation treatment can further relieve the pain of patients with knee osteoarthritis joints arthritis and improve the function of patients with knee osteoarthritis.

Objective To explore the status and influencing factors of surgical site infection (SSI)following lapa-roscopic surgery in patients in department of general surgery,so as to take effective measures to reduce SSI. Methods Active monitoring method was used to survey SSI among 401 patients undergoing laparoscopic surgery from January 1 ,2013 to December 31 ,2013,univariate analysis and multivariate analysis on risk factors for SSI were conducted.Results Of 401 investigated patients,12 (2.99%)developed SSI.Univariate analysis showed that risk factors for SSI in patients with laparoscopic surgery were elderly patients,emergency operation,infected wound,gastrointestinal tract operation,and grade Ⅳof ASA score (all P <0.05 ).Multivariate logistic regression analysis revealed that elderly patients (OR,5.02[95%CI ,1 .38 -30.25]),emergency operation (OR,4.37 [95%CI ,1 .96-28.55]),infected wound (OR,7.27[95%CI ,2.54-25.05]),and gastrointestinal tract operation (OR, 8.13 [95%CI ,1 .38 - 18.33 ])were high risk factors for SSI following laparoscopic surgery (all P < 0.05 ). Conclusion Thereare multiple factors influencing SSI after laparoscopic surgery,diversified prevention and control measures can effectively reduce the incidence of postoperative SSI.

Objective To investigate the expression of T helper type 17 cells (Th17) and cell‐related cytokines ,including interleukin (IL)‐21 ,IL‐22 ,IL‐23 in the peripheral blood of different clinical stages of patients with acute hepatitis B (AHB) .Methods Ten cases of AHB patients were enrolled .The frequency of Th17 cells in the three clinical stages (i .e .acute phase ,convalescent phase and resolved phase) were detected by flow cytometry . IL‐21 , IL‐22 and IL‐23 were measured by enzyme‐linked immunosorbent assay (ELISA) .Control group was composed of ten healthy subjects .The comparison between the two groups was done by t test and the differences among multiple groups were compared by one way ANOVA .Pearson correlation analysis was used for correlation analysis .Results The frequency of Th17 in healthy controls was (0 .68 ± 0 .29)% ,while those in acute phase ,convalescent phase and resolved phase of AHB patients were (18 .22 ± 4 .13)% , (3 .14 ± 1 .90 )% and (3 .31 ± 0 .95 )% , The differences between the two groups were significant (t= 13 .405 ,4 .047 and 8 .342 , respectively ;all P< 0 .01) .The levels of IL‐21 ,IL‐22 and IL‐23 in healthy controls were (42 .00 ± 6 .95) ,(315 .89 ± 96 .16) and (11 .95 ± 6 .95) ng/L ,respectively .Those in acute phase of AHB patients were (575 .39 ± 47 .01) ,(648 .44 ± 47 .12) and (38 .29 ± 4 .68) ng/L ,respectively ,those in convalescent phase were (366 .50 ± 33 .74) ,(405 .04 ± 47 .12) and (25 .10 ± 4 .69) ng/L ,respectively ,while those in resolved phase of AHB patients were (46 .62 ± 8 .28) ,(365 .94 ± 45 .62) and (15 .29 ± 4 .69) ng/L , respectively .Compared with healthy controls ,t values of the levels of IL‐21 in three different phases of AHB patients were 35 .497 ,29 .792 and 1 .354 with P value of <0 .01 ,<0 .01 and 0 .193 ,respectively ;those of IL‐22 were 9 .820 ,2 .632 and 1 .487 with P value of < 0 .01 ,0 .021 and 0 .161 ,respectively ;those of IL‐23 were 9 .944 ,4 .961 and 1 .260 with P values of <0 .01 ,<0 .01 and 0 .226 ,respectively . After comparison of IL‐21 ,IL‐22 and IL‐23 among three different phase of AHB ,F values were 622 .784 , 107 .772 and 60 .743 with all P values less than 0 .01 ,respectively .The levels of IL‐21 ,IL‐22 and IL‐23 were all positively correlated with the serum ALT level in acute phase (r= 0 .655 ,0 .666 and 0 .673 , respectively ;all P<0 .05) .Correlation analysis demonstrated that the frequency of Th17 was positively correlated with the levels of IL‐21 , IL‐22 and IL‐23 in acute phase ( r= 0 .879 ,0 .866 and 0 .879 , respectively ;all P<0 .01) .The frequency of Th17 was positively correlated with the level of IL‐21 in the resolved phase . No correlations between the remaining groups were confirmed . Conclusion The expressions of Th17 and cell‐related cytokines ,including IL‐21 ,IL‐22 and IL‐23 decline with the recovery of A HB .

Objective To investigate the effects of a new sling exercise treatment combined with injections of sodium hyaluronate on the radiographic findings and clinical variables of patients with patellofemoral pain.Methods Seventy patients with patellofemoral pain syndrome were divided into a group which was treated using a new sling exercise therapy combined with injections of sodium hyaluronate (the combined therapy group,n=34) and another which received only sodium hyaluronate injections (the control group,n=36).The patients of both groups were assessed pre-and post-treatment.The clinical assessment modalities were pain scores (using a visual analogue scale,VAS),quadriceps and hamstring strength and range of motion in the active flexion and extension of the knee.Q angles were measured supine and standing.Patellofemor tilt angle and congruence and sulcus angle were determined by CT scanning.Results After 5 weeks the average VAS pain score of the combined therapy group was significantly lower than that of the control group.Muscle strength and range of motion in the combined therapy group were both significantly higher than pro-treatment,the Q angles were significantly smaller,and the congruence and sulcus angles were significantly better.Conclusion Five weeks of practicing the new sling exercise therapy combined with injections of sodium hyaluronate can yield satisfactory clinical and radiologic outcomes in patients with patellofemoral pain syndrome.

Objective To investigate the dynamic changes in the frequencies ofTh17 (CD3+CD8-IL-17+) and regulatory T cells (Treg,CD4+CD25+CD127low) and Th17/Treg ratio in the peripheral blood in patients with acute hepatitis B (AHB),as well as their association with the outcome of AHB.Methods A total of 10 AHB patients were enrolled as observation group,and according to the outcome of AHB,these patients were further divided into acute stage group,early recovery group,and full recovery group.Another 10 healthy subjects who underwent physical examination were enrolled as control group.Flow cytometry was used to measure the frequencies of Th17 and Treg in peripheral blood,and the Th17/Treg ratio was calculated.An automatic biochemical analyzer was used to measure liver function parameters,and RT-PCR was used to measure HBV DNA.An one-way analysis of variance was used for comparison between groups,and the t-test was used for comparison between any two groups.Results Compared with the control group,the acute stage group showed significant increases in the frequencies of Th1 7 and Treg (18.22％±4.13％/6.46％±2.46％ vs 0.68％±0.29％/1.62％±0.18％,P ＜ 0.01) and the Th1 7/Treg ratio (3.37±1.73 vs 0.42±0.20,P ＜ 0.01).Compared with the acute stage group,the early recovery group showed a significant reduction in the frequency of Th 17 (3.14％± 1.90％,P ＜ 0.01),a significant increase in the frequency of Treg (11.73 ％± 1.76％,P ＜ 0.01),and a significant reduction in the Th17/Treg ratio (0.27±0.19,P ＜ 0.01).Compared with the early recovery group,the full recovery group showed a slight increase in the frequency of Th17 (3.31±0.95,P =0.888),a significant reduction in the frequency of Treg (6.83％±1.85％,P ＜ 0.01),but which was significantly higher than that in the control group (P ＜ 0.01),and a slight increase in the Th17/Treg ratio (0.52±0.21,P ＜ 0.05),which showed no significant difference between this group and the control group (P =0.286).In the acute stage ofAHB,HBsAg and HBeAg levels were positively correlated with Th17/Treg ratio (r =0.639,P ＜ 0.05;r =0.633,P ＜ 0.05).Conclusion The dynamic changes in the frequencies of Th17 and Treg and the Th1 7/Treg ratio may be associated with the outcome of AHB.

OBJECTIVE:To systematically review the efficacy and safety of cinacalcet in the treatment of hemodialysis pa-tients with secondary hyperparathyroidism,and provide evidence-based reference for the clinical treatment. METHODS:Retrieved from Medline,Cochrane Library,EMBase and CBM,randomized controlled trials(RCT)about cinacalcet in the treatment of he-modialysis patients with secondary hyperparathyroidism (SHPT) were collected. Meta-analysis was performed by using Rev Man 5.3.5 software after data extract and quality evaluation by Cochrane systematic Rev Man 5.3.5. RESULTS:Totally 7 RCTs were en-rolled,involving 1 987 patients. Results of Meta-analysis showed cinacalcet can significantly reduce the rate of surgical parathyroid-ectomy[RR=0.23,95%CI(0.06,0.89),P=0.03],incidence of fracture[RR=0.26,95%CI(0.12,0.60),P=0.002] and increase the incidences of hypocalcemia[RR=9.81,95%CI(3.92,4.59),P<0.001],nausea[RR=1.97,95%CI(1.58,2.46),P<0.001] and vomit-ing[RR=1.91,95%CI(1.50,2.42),P<0.001],while it showed no significant effect on the the incidence of all-cause mortality and cardiovascular death. CONCLUSIONS:The clinical efficacy of cinacalcet in the treatment of hemodialysis patients with secondary hyperparathyroidism is good,but there are common adverse reactions such as nausea and vomiting,hypocalcemia.

The clinical data of a case of neonatal bacterial meningitis complicated with posterior fossa subdural empyema in the West China Second University Hospital in December 2019 were retrospectively analyzed.The 3-day-old male newborn was admitted for jaundice with decreased intake for 1 day.Examinations on admission showed increased C-reactive protein.The count of karyocytes in cerebrospinal fluid (CSF) significantly increased, which were mainly neutrophils, and pyocytes could be found.The protein content in CSF increased, while that of glucose decreased.Both CSF culture and blood culture detected the presence of Escherichia coli.Enhanced magnetic resonance imaging (MRI) of the head indicated large abnormal signals in bilateral occipital extra-cerebellar spaces.T1-weighted images presented mixed low and high signals, and T2-weighted images presented high signals, and marginal enhancement was observed after enhancement.After 6 weeks of antibiotic treatment using Meropenem combined with Ceftazidime, the CSF index of the newborn patient returned to normal, and the subdural empyema of the posterior fossae subsided.Bacterial meningitis complicated with subdural empyema of posterior fossa is a rare and critical disease of the central nervous system.It is easily misdiagnosed due to the atypical clinical manifestations and early imaging features.The disease requires an adequate course of anti-infective treatment.Surgical removal of the empyema should be performed if the anti-infective treatment is unresponsive.

Objective:To examine the impact of varied surgical treatment strategies on the prognosis of patients with initial resectable gastric cancer liver metastases (IR-GCLM).Methods:This is a retrospective cohort study. Employing a retrospective cohort design, the study selected clinicopathological data from the national multi-center retrospective cohort study database, focusing on 282 patients with IR-GCLM who underwent surgical intervention between January 2010 and December 2019. There were 231 males and 51 males, aging ( M(IQR)) 61 (14) years (range: 27 to 80 years). These patients were stratified into radical and palliative treatment groups based on treatment decisions. Survival curves were generated using the Kaplan-Meier method and distinctions in survival rates were assessed using the Log-rank test. The Cox risk regression model evaluated HR for various factors, controlling for confounders through multivariate analysis to comprehensively evaluate the influence of surgery on the prognosis of IR-GCLM patients. A restricted cubic spline Cox proportional hazard model assessed and delineated intricate associations between measured variables and prognosis. At the same time, the X-tile served as an auxiliary tool to identify critical thresholds in the survival analysis for IR-GCLM patients. Subgroup analysis was then conducted to identify potential beneficiary populations in different surgical treatments. Results:(1) The radical group comprised 118 patients, all undergoing R0 resection or local physical therapy of primary and metastatic lesions. The palliative group comprised 164 patients, with 52 cases undergoing palliative resections for gastric primary tumors and liver metastases, 56 cases undergoing radical resections for gastric primary tumors only, 45 cases undergoing palliative resections for gastric primary tumors, and 11 cases receiving palliative treatments for liver metastases. A statistically significant distinction was observed between the groups regarding the site and the number of liver metastases (both P<0.05). (2) The median overall survival (OS) of the 282 patients was 22.7 months (95% CI: 17.8 to 27.6 months), with 1-year and 3-year OS rates were 65.4% and 35.6%, respectively. The 1-year OS rates for patients in the radical surgical group and palliative surgical group were 68.3% and 63.1%, while the corresponding 3-year OS rates were 42.2% and 29.9%, respectively. A comparison of OS between the two groups showed no statistically significant difference ( P=0.254). Further analysis indicated that patients undergoing palliative gastric cancer resection alone had a significantly worse prognosis compared to other surgical options ( HR=1.98, 95% CI: 1.21 to 3.24, P=0.006). (3) The size of the primary gastric tumor significantly influenced the patients′ prognosis ( HR=2.01, 95% CI: 1.45 to 2.79, P<0.01), with HR showing a progressively increasing trend as tumor size increased. (4) Subgroup analysis indicates that radical treatment may be more effective compared to palliative treatment in the following specific cases: well/moderately differentiated tumors ( HR=2.84, 95% CI 1.49 to 5.41, P=0.001), and patients with liver metastases located in the left lobe of the liver ( HR=2.06, 95% CI 1.19 to 3.57, P=0.010). Conclusions:In patients with IR-GCLM, radical surgery did not produce a significant improvement in the overall prognosis compared to palliative surgery. However, within specific patient subgroups (well/moderately differentiated tumors, and patients with liver metastases located in the left lobe of the liver), radical treatment can significantly improve prognosis compared to palliative approaches.

Objective To explore the causal relationship between family resilience and mental health in military personnel population.Methods A total of 204 military personnel were recruited from an army unit stationed in Western China with cluster convenience sampling.Family Resilience Scale(FRS)and Symptom Checklist 90(SCL-90)were used to survey them twice,in an interval of 4 months.Amos 26.0 was applied to construct a cross-lag model and analyze the data.Results After controlling mental symptoms from the first survey,family resilience in the first measure significantly predicted mental symptoms in the second measure(β=-0.14,P＜0.05).After controlling for family resilience from the first survey,mental symptoms in the first measure significantly predicted family resilience in the second measure(β=-0.13,P＜0.05).Conclusion The relationship between family resilience and mental health is mutually causal in military personnel,and one predicts the other one.Our findings highlight the key dimensions of the relationship between the two.

Objective:To examine the impact of varied surgical treatment strategies on the prognosis of patients with initial resectable gastric cancer liver metastases (IR-GCLM).Methods:This is a retrospective cohort study. Employing a retrospective cohort design, the study selected clinicopathological data from the national multi-center retrospective cohort study database, focusing on 282 patients with IR-GCLM who underwent surgical intervention between January 2010 and December 2019. There were 231 males and 51 males, aging ( M(IQR)) 61 (14) years (range: 27 to 80 years). These patients were stratified into radical and palliative treatment groups based on treatment decisions. Survival curves were generated using the Kaplan-Meier method and distinctions in survival rates were assessed using the Log-rank test. The Cox risk regression model evaluated HR for various factors, controlling for confounders through multivariate analysis to comprehensively evaluate the influence of surgery on the prognosis of IR-GCLM patients. A restricted cubic spline Cox proportional hazard model assessed and delineated intricate associations between measured variables and prognosis. At the same time, the X-tile served as an auxiliary tool to identify critical thresholds in the survival analysis for IR-GCLM patients. Subgroup analysis was then conducted to identify potential beneficiary populations in different surgical treatments. Results:(1) The radical group comprised 118 patients, all undergoing R0 resection or local physical therapy of primary and metastatic lesions. The palliative group comprised 164 patients, with 52 cases undergoing palliative resections for gastric primary tumors and liver metastases, 56 cases undergoing radical resections for gastric primary tumors only, 45 cases undergoing palliative resections for gastric primary tumors, and 11 cases receiving palliative treatments for liver metastases. A statistically significant distinction was observed between the groups regarding the site and the number of liver metastases (both P<0.05). (2) The median overall survival (OS) of the 282 patients was 22.7 months (95% CI: 17.8 to 27.6 months), with 1-year and 3-year OS rates were 65.4% and 35.6%, respectively. The 1-year OS rates for patients in the radical surgical group and palliative surgical group were 68.3% and 63.1%, while the corresponding 3-year OS rates were 42.2% and 29.9%, respectively. A comparison of OS between the two groups showed no statistically significant difference ( P=0.254). Further analysis indicated that patients undergoing palliative gastric cancer resection alone had a significantly worse prognosis compared to other surgical options ( HR=1.98, 95% CI: 1.21 to 3.24, P=0.006). (3) The size of the primary gastric tumor significantly influenced the patients′ prognosis ( HR=2.01, 95% CI: 1.45 to 2.79, P<0.01), with HR showing a progressively increasing trend as tumor size increased. (4) Subgroup analysis indicates that radical treatment may be more effective compared to palliative treatment in the following specific cases: well/moderately differentiated tumors ( HR=2.84, 95% CI 1.49 to 5.41, P=0.001), and patients with liver metastases located in the left lobe of the liver ( HR=2.06, 95% CI 1.19 to 3.57, P=0.010). Conclusions:In patients with IR-GCLM, radical surgery did not produce a significant improvement in the overall prognosis compared to palliative surgery. However, within specific patient subgroups (well/moderately differentiated tumors, and patients with liver metastases located in the left lobe of the liver), radical treatment can significantly improve prognosis compared to palliative approaches.