Objective To assess the safety of living environment by the elderly, further clarify the relevant factors of the elderly fall in the living environment. Methods The self- made assessment form of fall-related factors of living environment for elderly patients was used to survey 1 076 elderly. Likert five grades score was used for each item, and the higher score demonstrated the safer living environment. Results In the assessment of the safety of living environment, the indoor physical environment (3.94 points), home furniture safety (3.66 points) score was better;home ground and the channel (3.32 points) and outdoor activities places (3.57 points) score was lower. Scores of home′s ground and channel, furniture safety, indoor physical environment and living environment of urban elderly were (23.56 ± 6.49), (44.52 ± 7.72), (11.93 ± 2.49), (105.03 ± 17.82) points, which were better than (22.46 ± 6.39), (42.73 ± 7.95), (11.53 ± 2.39), (101.55 ± 18.15) points of rural elderly (t=2.471-3.495, P <0.05). Conclusions The indoor physical environment, home furniture safety got higher scores, and the scores of ground-channel environment and outdoor activities places were relatively lower. Scores of the safety of living environment in urban are better than in rural. It suggests the elderly living environment need to reduce the incidence of falls.

AIM: To investigate the effect of compound rhubarb preparation (Kintop) in preventing obesity in rats and its probable mechanism involved. METHODS: Twenty-six newborn SD rats were randomly grouped as rhubarb preparation plus high-energy forage group( n= 8), high-energy forage control group( n= 8) and ordinary forage control group( n= 10). The rats in rhubarb preparation plus high-energy forage group and high-energy forage control group were fed with high-energy forage and those in ordinary forage control group were fed with ordinary forage. The rats in rhubarb preparation plus high-energy forage group were administered by compound rhubarb preparation (40 mg?100 g -1 body weight?d -1 ) from 9th to 17th week. The dynamic changes in body weight, celiac fat weight and adipocytes size were measured. Immunohistochemical analysis of leptin in celiac adipocytes (ABC method) and measurement of serum leptin level (RID method) were performed. RESULTS: The body weight and the wet weights of celiac fat were lower, their adipocytes were smaller and immunohistochemical stainings of leptin were weaker in rhubarb preparation plus high-energy forage group than those in high-energy forage control group. There was an obvious positive correlation between the expression of leptin and celiac fat tissue weight( r= 0.8663, P

Objective· To investigate whether vitamin E could reverse the disruptive effects of bisphenol A (BPA) on steroidogenesis and to explore the optimal vitamin E concentration.Methods· Rat primary granulosa cells were extracted and exposed to BPA (0,0.01,0.1,1,10,100 μmol/L).After 48 h of incubation,culture medium was collected and estradiol (E2) and progesterone (P4) were measured using ELISA kits.Then,granulosa cells were incubated with 5 μmol/L(average concentration in follicular fluid) or 25 μmol/L (high concentration in follicular fluid) vitamin E (α-tocopherol) or vitamin E (5 μmol/Lor 25 μmol/L) plus BPA (10 μmol/L or 100 μmol/L) for 48h,E2 and P4 were measured.Results· BPA at 10 μmol/L and 100 μmol/L suppressed E2 and P4 production in a dose-dependent manner (P＜0.05).Vitamin E at 25 μmol/L significantly increased E2 and P4 levels by (44.89±15.18) ％ and (43.33±8.82) ％(P＜0.05),respectively.Coincubation of the granulosa cells with BPA and vitamin E (5 μmol/L or 25 μmol/L) restored the productions of E2 and P4,which were not significantly different from the control group (P＞0.05).Conclusion· Vitamin E (5 μmol/L/25 μmol/L) could reverse BPA-induced reduction in steroid hormone production in rat ovary granulosa cells,and the antagonistic effect of 25 μmol/L vitamin E was more obvious than that of 5 μmol/L vitamin E.

Objective To observe the effect of multidisciplinary rehabilitation on activity of daily living (ADL) and injured nerve function of old stroke patients.Methods 78 old stroke patients were randomly divided into the simple rehabilitation group (36 cases) and multidisciplinary rehabilitation group (42 cases). The patients of the simple rehabilitation group were treated with Bobath method only, those of the multidisciplinary rehabilitation group were added with acupuncture and Chinese herbs. The treatment course of two groups was 6 weeks. All patients in two groups were assessed with Modified Brathel Index (MBI) for ADL before treatment and every week after treatment and the evaluation of National Institute of Health Stroke Scale (NIHSS) was also performed for injured nerve function at same times.Results After 3 weeks treatment, the scores of MBI and NIHSS of all patients improved, but there was no significant difference compared with that before treatment ( P>0.05). After 6 weeks treatment, the NIHSS scores of the patients in the multidisciplinary rehabilitation group was significant superior to that before treatment ( P<0.05), the MBI scores was also superior to that before treatment ( P<0.01); while, the NIHSS and MBI scores of the patients in the simple rehabilitation group also improved compared with that before treatment, but no significant difference ( P>0.05).Conclusion Both multidisciplinary rehabilitation and simple rehabilitation are all effect on ADL and injured nerve function of old stroke patients, but the effect of multidisciplinary rehabilitation is superior to that of simple rehabilitation (using Bobath method only).

ObjectiveTo observe the effects of comprehensive rehabilitation therapy and simple rehabilitation therapy on old acute stroke patients.Methods72 old acute stroke patients were randomly divided into 2 groups: the simple rehabilitation group (n=32) treated with Bobath therapy only, the comprehensive rehabilitation group (n=40) added with acupuncture and Chinese herbs besides Bobath therapy. The courses of two groups were all 6 weeks. The scores of NIHSS (The US NIK Stroke Scale) and activities of daily living (ADL) of patients of two groups were assessed every week.ResultsAfter 3 weeks, scores of NIHSS and ADL of patients in both groups improved, but there were no significant differences between two groups and in each group compared with before. After 6 weeks, there were significant differences in the simple rehabilitation group (P<0.05) and in the comprehensive rehabilitation group (P<0.01), but there was no difference between two groups.ConclusionComprehensive rehabilitation therapy and simple rehabilitation therapy are also effect on old acute stroke patients; there isn't difference on effects of two therapies.

Objective To evaluate the effect of point-of-care hemoglobin/hematocrit (POC HGB/HCT) devices and intraoperative blood salvage on the amount of perioperative allogeneic blood transfusion and blood conservation in clinical practice.Methods A total of 46 378 medical records of 22 selected hospitals were reviewed. The volume of allogeneic red blood cell and plasma, number of patients transfused, number of intraoperative autologous blood salvage, total volume of autologous blood transfusion, and amount of surgery in the year of 2011 and 2013 were tracked. Paired t-test was used in intra-group comparison, while t-test of two isolated samples carried out in inter-group comparison. P<0.05 was defined as statistically significant difference.Results In the hospitals where POC HGB/HCT device was used (n=9), the average allogeneic blood transfusion volume per 100 surgical cases in 2013 was significantly lower than that in 2011 (39.86±20.20 vs. 30.49±17.50 Units, t=3.522, P=0.008). In the hospitals without POC HGB/HCT meter, the index was not significantly different between 2013 and 2011. The average allogeneic blood transfusion volume was significantly reduced in 2013 than in 2011 in the hospitals where intraoperative autologous blood salvage ratio [autologous transfusion volume/(autologous transfusion volume+allogeneic transfusion volume)] was increased (n=12, t=2.290, P=0.042). No significant difference of the above index was found in the hospitals whose autologous transfusion ratio did not grow.Conclusion Intraoperative usage of POC HGB/HCT devices and increasing autologous transfusion ratio could reduce perioperative allogeneic blood transfusion.

Adult ; Foot Diseases ; diagnostic imaging ; Humans ; Male ; Melorheostosis ; diagnostic imaging ; Radiography ; X-Rays

Objective To discuss the combined value of gray-scale ultrasound ( GSUS) and contrast-enhanced ultrasound (CEUS) in the diagnosis of benign and malignant thyroid lesions and to explore the optimal diagnostic point of scoring method .Methods Ultrasound images of 178 thyroid lesions confirmed by pathology were synthetically reviewed by scoring 5 GSUS indicators including shape , orientation, interior echogenicity, halo sign, microcalcification and 6 CEUS indicators including relative arrival time of microbubbles in the periphery and interior, peak periphery and interior echogenicity, peripheral ring-enhancement, and homogeneity of enhancement .One positive indicator scored one point .The optimal diagnostic points and their clinical value were explored according to ROC curves .Results Scores of GSUS, CEUS and the combination of GSUS and CEUS were significantly different (Z =10.188,9.843,10.705,all P <0.001). Areas under ROC curves of GSUS, CEUS and the combination of GSUS and CEUS were 0.936, 0.919 and 0.964, respectively.Three or more positive GSUS indicators of five in a thyroid lesion predicted that the thyroid lesion was malignant , with the sensitivity of 79.6% and the specificity of 91.2%.Two or more positive CEUS indicators of six in a thyroid lesion predicted that the thyroid lesion was malignant , with the sensitivity of 91.8% and the specificity of 81.2%.Five or more positive GSUS and CEUS indicators of eleven in a thyroid lesion predicted that the thyroid lesion was malignant , with the sensitivity of 93.6%and the specificity of 92.3%.The areas under the ROC curve of GSUS and CEUS were 0.936 and 0.919.The area under the ROC curve of the combination of GSUS and CEUS was 0.964, larger than the areas under the GSUS ROC curve and the CEUS ROC curve.Conclusion Ultrasound is valuable in the differential diagnosis of benign and malignant thyroid lesions , and the combination of GSUS and CEUS is the most valuable with 5 points as the optimal diagnostic scoring method .

Altitude ; Exercise/physiology* ; Heart Rate/physiology* ; Humans ; Lung ; Respiration

Objective To study the outcomes of autologous osteo-periosteal cylinder graft transplantation for Hepple V osteochondral lesions of the talus (OLT) with large subchondral cyst.Methods The data of 27 consecutive patients of OLT with subchondral cyst was retrospectively analyzed who were treated by autologous osteo-periosteal cylinder graft transplantation from October 2007 to September 2011.There were 26 males and 1 female with an average age of 35.8 years (range,22-53 years).Visual analogue score (VAS) for pain during daily activities,the American Orthopaedic Foot and Ankle Society (AOFAS) ankle and hindfoot score,and subjective satisfaction were investigated.The plain radiographs,magnetic resonance imaging (MRI) of the ankle,and second look arthroscopy were analyzed.Results All the 26 patients were followed up for 22.4 months.At the last follow-up,the VAS score decreased from 5.4±1.0 points preoperatively to 0.8±0.8 points postoperatively,and the mean (50％) AOFAS score improved from 73.9±3.1 points preoperatively to 93.0±6.5 points postoperatively.In 26 cases,the radiolucent area of cysts disappeared on plain radiographs.The mean magnetic resonance observation of cartilage repair tissue (MOCART) score was 57.2,though small subchondral bone cyst was still found in 3 cases on postoperative MRI.The mean (50％) ICRS arthroscopic score of cartilage repair was 9.2 points according to second look arthroscopy of 18 cases.There were 16 cases receiving excellent effect,8 good and 2 fair.The excellent and good rate was 92.3％ (24/26).There were no major complications.Conclusion Autologous osteo-periosteal cylinder graft transplantation could repair the osteochondral defects.It yields satisfactory results,and is suitable for treating OLT with large subchondral cyst.