OBJECTIVETo assess the efficacy of Yishen Jiejing Decoction (YJD) in treating poststroke shoulder-hand syndrome (SHS) patients of yin deficiency yang hyperactivity with blood stasis stagnation collaterals syndrome.

METHODSTotally 60 SHS patients of yin deficiency yang hyperactivity with blood stasis stagnation collaterals syndrome were randomly assigned to two groups, the treatment group and the control group, 30 cases in each group. Conventional rehabilitation training and therapeutics were applied in all patients. Besides, patients in the treatment group took 50 mL YJD, twice a day. One month without interruption consisted of one course of treatment. The curative effects of each group were evaluated respectively before treatment and at one month after treatment. The neurologic impairment, TCM syndrome, and the improvement of upper limbs movement were assessed by the neurologic impairment integral, scoring for TCM syndrome diagnostics, Fugl-Meyer Assessment (U-FMA). Adverse reactions were observed at the same time.

RESULTSThe effective rate of stroke was 86.67% and the effective rate of SHS was 90.00% in the treatment group, higher than those of the control group (P < 0.05). Both groups got improvement in neurologic impairment, stroke induced blood stasis syndrome, yin deficiency yang hyperactivity syndrome, and the improvement of upper limbs movement after treatment (all P < 0.05). Besides, all the improvement was obviously superior in the treatment group (P < 0. 05). No adverse reaction occurred during the course of treatment.

CONCLUSIONThe curative effect of YJD combined with conventional rehabilitation training was confirmative and superior to the control group.

Aged ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Humans ; Male ; Middle Aged ; Reflex Sympathetic Dystrophy ; drug therapy ; etiology ; rehabilitation ; Stroke ; complications ; Treatment Outcome ; Yin Deficiency ; drug therapy ; Yin-Yang

Prostate cancer, bladder cancer, and rectal cancer are common malignancies in the male pelvis. The incidence rate of erectile dysfunction (ED) following radical prostatectomy, cystectomy or rectal cancer surgery is about 25% - 100%. The main cause of post-surgery ED is mainly attributed to injury of neurovascular bundles, which may lead to reduced oxygenation in and fibrosis of the penile tissue. Early penile rehabilitation after surgery can improve or restore the erectile function of the patients. This article focuses on penile rehabilitation after radical pelvic surgery.
Cystectomy ; Erectile Dysfunction ; etiology ; rehabilitation ; Humans ; Male ; Pelvic Neoplasms ; surgery ; Penile Erection ; Penis ; Postoperative Complications ; rehabilitation ; Postoperative Period ; Prostatectomy ; adverse effects ; Prostatic Neoplasms ; surgery ; Rectal Neoplasms ; surgery ; Urinary Bladder Neoplasms ; surgery

Background and purpose:Radiotherapy is the main method to manage head and neck tumors.About half of the patients with malignant tumor in head and neck could obtain long term survival through radiotherapy or other therapy combined with radiotherapy.However,it is necessary to clinically detect whether carotid stenosis is a major sequela of head and neck irradiation,especially in long term survivors such as patients with nasopharyngeal carcinoma.We analyzed this injury and the degree of carotid stenosis,and its related factors to provide information to reduce and delay the incidence of this injury.Methods:We analyzed the degree of arterial stenosis of the nasopharyngeal carcinoma patients who received radiotherapy and had survived more than three years in Cancer Hospital Fudan University,compared with newly diagnosed as nasopharyngeal carcinoma before radiotherapy.The degree of carotid artery injury was observed and the clinical factors which affect its occurrence and development.All patients were low differentiated squamous cell carcinoma confirmed by pathology.All patients were examined with color doppler ultrasound to detect the carotid artery.The main end points were the diameter of carotid artery,the peak systolic and end diastolic velocities.Results:Arterial stenosis was more common in the reserch group than the control group(80% vs 20%,P＜0.001).The common and internal carotid arteries were most commonly involved(70% vs 20%,P＜0.001;6313% vs 10%,P＜0.001),followed by the external carotid artery(30% vs 3.3%,P=0.015).Significant stenosis was only found in the research group,common carotid arteries 36.7%,internal carotid arteries 23.3%,external carotid arteries10%.Conclusion:This study showed that radiation could cause significant carotid stenosis in nasopharyngeal carcinoma patients who had received radiotherapy more than 3 years previously.Carotid stenosis developed more frequently in the common carotid artery and intemal carotid artery on the side that had received radiotherapy.

Objective To explore the efficacy of foreskin-deglove and shaft-fix procedure combined with Z-plasty of penis and scrotum skin in the treatment of concealed penis. Methods Fifty-eight patients diagnosed as concealed penis were included in the study.All of them underwent the foreskin-deglove and shaft-fix procedure.Foreskin was degloved from 5 mm to 10 mm proximal to corona deep to the root,and bilateral tunica albuginea at this level was sutured to suprapubic scarpas' fascia.Z plasty of penis and scrotum skin was applied to cover penile shaft. Results After follow-up for 6 to 12 months,there was no recurrent retraction of the penile shaft,and all the patients were satisfied with the appearance of penis after plastic surgery.Edema of prepuce occurred in 2 patients,and completely regressed in 2 to 3 months.There was no incision scar hyperplasy,and the function of urination and erection were normal. Conclusion Foreskin-deglove and shaft-fix procedure combined with Z-plasty of penis and scrotum skin can resolve pathologic problems of concealed penis and has favourable aesthetic results with less complications.It is easy to perform and is an ideal procedure in the treatment of concealed penis.

Objective To assess the current status of knowledge, attitude and practice (KAP) towards antibiotic use among community residents in Hangzhou, and to explore the correlations among them. Methods A total of 449 permanent residents in Hangzhou were randomly selected using a multistage stratified random sampling method. Self-reported data on basic demographic factors, and relevant KAP information were collected by the questionnaire survey. Differences in KAP scores according to each demographic factor were assessed by the t test or ANOVA test, and AMOS 21.0 was used for the path analysis. Results Scores for knowledge, attitude and practice regarding antibiotic use were (6.17±2.45), (6.45±0.99) and (6.21±1.02) respectively. Results of the path analysis showed that education level and age had effects on the knowledge (coefficients: 0.57 and -0.38 respectively) . Age, gender and knowledge had effects on the attitude (coefficients: -0.27, 0.12 和 0.02 respectively), and attitudes, gender, monthly income and the level of education had effects on the practice (coefficients: 0.48、 0.37、 0.06 and 0.02 respectively) . Conclusion Community residents in Hangzhou lack relevant knowledge, and there are some irrational attitudes and practices regarding antibiotic use. There is a correlation between knowledge and attitudes, as well as between attitudes and practices, but the knowledge and practices are not correlated.

OBJECTIVETo study therapeutic effects between hook plate fixation and modified Weaver-Dunn surgery for the treatment of acromioclavicular joint dislocation.

METHODSForty patients with fresh acromioclavicular joint dislocations of type III according to Rockwood classification were reviewed. All the patients were divided into two groups: hook plate fixation group and modified surgery group. There were 20 patients in hook plate fixation group, including 13 males and 7 females, with an average age of (37.45 +/- 14.29) years old; 12 patients had injuries in the left and 8 patients had injuries in the right; preoperative Constant-Murley score was 40.75 +/- 10.40. And there were 20 patients in modified surgery group,including 11 males and 9 females, with an average age of (41.65 +/- 14.83) years old; 11 patients had injuries in the left and 9 patients had injuries in the right; preoperative Constant-Murley score was 42.75 +/- 8.18. The Lazzcano standard, Constant-Murley score and imaging changes were used to evaluate shoulder joint function before and after surgery.

RESULTSAll the patients were followed up,and the duration ranged from 7 to 32 months,with an average of 24 months. According to Lazzcano evaluation, 16 patients got an excellent result,3 good and 1 poor in modified surgery group with no re-dislocation, and 1 patient had pain more than middle degree; while in hook plate fixation group, 9 patients got an excellent result, 7 good and 4 poor, 1 patient had re-dislocation, and 3 patients got pain more than middle degree. The therapeutic effects of modified surgery group were better than those of hook plate fixation group. Constant-Murley scores:preoperative 42.75 +/- 8.18 vs 93.40 +/- 4.04 at the latest follow-up in modified surgery group; preoperative 40.75 +/- 10.40 vs postoperative 88.40 +/- 4.81 and 92.05 +/- 4.49 at the latest follow-up in hook plate fixation group. The postoperative scores all improved compared to preoperative scores in two groups. And there was no statistical difference of scores at the latest follow-up between two groups.

CONCLUSIONThe surgery of allograft tendon transplantation combined with anchor fixation to strengthen coracoclavicular ligament, as well as part transposition of acromiocoracoid ligament and resection at the distal part of clavicle may got safety fixation and less postoperative complications compared with hook plate internal fixation.

Acromioclavicular Joint ; injuries ; Adolescent ; Adult ; Bone Plates ; Case-Control Studies ; Clavicle ; surgery ; Female ; Follow-Up Studies ; Humans ; Joint Dislocations ; surgery ; Male ; Middle Aged ; Orthopedic Procedures ; instrumentation ; Treatment Outcome ; Young Adult

Objective To examine the clinical manifestations and pulmonary radiological features in patients with triphosgene poisoning.Methods Clinical manifestations,laboratory tests and CT scans were analyzed retrospectively in 17 patients with triphosgene poisoning.We focused on the severity,development and repair of pulmonary impairment.Results Plain film and CT scans in five mild cases demonstrated bilateral scattered pulmonary patchy shadows.Of 12 cases with moderate to severe diseases,three showed bilateral multiple pulmonary patchy shadows and nodules with confluence of part of the lesions on plain film and CT scans;bilateral lungs were involved in nine cases with imaging findings of bilateral disseminated pulmonary round or ovary nodules with different size,ill-defined and partly-confluent patchy shadows and thickening of both interlobular septum and the wall of bronchus.Of clinical interests,imaging findings were closely correlated with clinical course and laboratory results.Conclusion Radiological examinations with plain films and CT scans could reveal the severity,evolvement of pulmonary edema in patients with triphosgene poisoning,and these are of clinical benefit in the early management and prognostic evaluation of patients with triphosgene poisoning.

Objective To observe the expression of Bcl-2,Bax and proliferating cell nuclear antigen(PCNA) in liver of rats with hepatic fibrosis and the effects of transforming growth factor (TGF)-?1 vaccine on them.Methods Thirty healthy male Sprague-Dawley rats were assigned into 3 groups,named healthy control group(n=10),hepatic fibrosis group(n=10) and TGF-?1 vaccine treated group(n=10).The animal model with hepatic fibrosis was established by injecting solution dimethylnitrosamine (DMN) into abdominal cavity with concentration as 0.5% and dose as 0.2 mL/ 100 g.In TGF-?1 vaccine treated group,every rat was not only injected with DMN but also 150?g TGF-?1 vaccine protein.On the 42nd day,all rats were sacrificed.Then the blood and the liver tis- sues were collected.The expression levels of Bcl-2,Bax and PCNA in liver tissues were detected by S -P immunohistochemistry and observed by routine pathological evaluation.Alanine aminotransferase (ALT),aspartate aminotransferase(AST) and albumin(Alb) were determined by auto biochemical analytical tool.Serum levels of hyaluronic acid (HA),laminin(LN) were detected by radioimmunoas- say (RIA).Results The expression of Bax,which promoted apoptosis,directly correlated with pathological grade in liver of rats,while the expression of Bcl-2 and Bcl-2/Bax,which protected a gainst apoptosis,inversely correlated with pathological grade in liver of rats.The expression levels of TGF-?1 and Bax in healthy control group were significantly lower than those of fibrosis group,how ever,the expression levels of Bcl-2 were comparable between these two groups.As compared with fi- brosis group,the expression of TGF-?1 was significantly lower while the expression of Bcl-2 was sig nificantly higher in TGF-?1 vaccine treated group.However,the expression of Bax was comparable between these two groups.The expression level of PCNA of fibrosis group was significantly higher than that of healthy control group but dramatically lower than that of TGF-?1 vaccine treated group (Both P

OBJECTIVETo compare the clinical effects of interlocking intramedullary nail and micro-invasive internal fixation with plate for the treatment of multiple segmental tibiofibular fractures.

METHODSThe clinical data of 39 patients with multiple segmental tibiofibular fractures received treatment from January 2010 to June 2013 were retrospectively analyzed. In the 39 patients, 18 cases were treated by the interlocking intramedullary nail (intramedullary nail group), there were 12 males and 6 females with the mean age of (40.6 ± 9.7) years old (ranged, 24 to 60 years);7 cases were type C2.1, 11 were type C2.2 according to the AO classification. The other 21 cases were treated by micro-invasive internal fixation with plate(plate group), there were 13 males and 8 females with the mean age of (41.7 ± 8.1) years old (ranged, 22 to 52 years), 7 cases were type C2.1, 13 were type C2.2, 1 was type C2.3. Preoperative preparation time, operation time, intraoperative blood loss, postoperative complications, fracture healing time were compared between two groups. Johner-Wruhs evaluation criteria was used to evaluate the clinical effect at last follow-up.

RESULTSAll the patients were followed up from 10 to 28 months with an average of 15.2 months. Operative time, intraoperative blood loss in intramedullary nail group were (62.1 ± 5.8) min, (70.9 ± 7.1) ml, respectively; in plate group were (64.3 ± 7.7) min, (74.1 ± 8.5) ml,respectively. There was no significant difference in operation time and intraoperative blood loss between two groups (P > 0.05). However, preoperative preparation time, fracture healing time in intramedullary nail group were (5.3 ± 0.7) days, (11.1 ± 1.9) months, in plate group were (7.1 ± 0.8) days, (14.1 ± 2.2) months, respectively. No postoperative complications were found in intramedullary nail group, and five cases developed with complications in plate group. There was significant difference in preoperative preparation time, postoperative complications and fracture healing time between two groups (P < 0.05). According to Johner-Wruhs criteria at last follow-up, 11 cases got excellent results, 4 good, 3 fair in intramedullary nail group; 11 excellent, 5 good, 2 poor in plate group.

CONCLUSIONInterlocking intramedullary nail has advantages of shorter preoperative preparation time, less postoperative complications and faster fracture healing time in treating multiple segmental tibiofibular fractures. But the application scope of interlocking intramedullary nail was inferior to micro-invasive internal fixation with plate , and its indications should be strictly controlled.

Adult ; Bone Plates ; Case-Control Studies ; Female ; Fibula ; injuries ; surgery ; Fracture Fixation, Internal ; instrumentation ; Fracture Fixation, Intramedullary ; methods ; Fracture Healing ; Humans ; Male ; Middle Aged ; Operative Time ; Retrospective Studies ; Tibial Fractures ; surgery

Objective To validate the hypothesis that the phenotype reversion occurs in the smooth muscle cells in the corpus cavernosum of hypertensive rats with selenium food and explore selenium′s impact on erectile function. Methods 25 14-week-old male spontaneously hypertensive rates (SHR) were divided into 2 groups (SHR-ED-Se group n = 8 and SHR-ED-N group n = 9). SHR-ED-Se rats were fed with selenium diet, SHR-ED-N rats and WKY rats with normal diet. And 10 syngeneic normotensive rats (WKY) were used as control group. All rats were killed after 4-week feeding. Immunohistochemical staining and color image analysis system were used to observe expression of α-actin, desmin and osteopontin (OPN) in rats corpus cavernosum of different group. Results 2 SHR-ED-N rats died. Expression of α-actin of smooth muscle in corpus cavernosum in SHR-ED-N group was the lowest in all groups (P = 0.000), so did erection frequency (P < 0.05). Expression of OPN in SHR-ED-N is the highest (P = 0.000). No significant difference existed in expression of desmin in all group (P > 0.05). Conclusions Phenotype modulation of smooth muscle in corpus cavernosum of SHR rats can be reversed by selenium which means the smooth cells can transform from synthetic phenotype into the contractile phenotype, resulting ultimately in improving erectile function.