Objective To evaluate the effect of home-based care alongside with health promotion on Wechat towards disabled centenarians, to provide the basis for improving the home and community based care towards the oldest old. Methods A total of 158 indigious centenarians in Hainan were surveyed and 78 of them who were considered disabled by Barthel criteria were selected and then divided into intervention group (with health education on Wechat platform and nursing visit) and control group (with nursing care handbook) by the serial number of them. The living quality,incidence of adverse health events and positive feeling of family care givers of two group were evaluated and compared after 6 months intervention. Results After 6 months of home- care intervention, significant statistical differences in incidence of adverse health events were found between intervention group and control group, which compromise falls (2 cases vs. 13 cases, χ2 = 8.91, P = 0.00), pain (1 case vs. 17 cases, χ2 = 17.28, P =0.00) and constipation (6 cases vs. 15 cases, χ2 = 4.75, P = 0.03). When it came to positive feeling of care givers, the scores of intervention groupwere (33.44±3.72), (36.46±4.06) points, control groupwere (28.10± 3.25), (28.15±3.15) points, significant differences were found at 3rd and 6th month′s follow-up between two groups, which t value represent 4.955 (P=0.00) and 10.142 (P=0.00), respectively. It also suggested that the differences in living quality of the elderly were statistical significant when refered to discomfortble or pain scored 1.58±0.50 and 2.37±0.63 (t=-6.154,P=0.00), and anxiety or depression scored1.73±0.64 and 2.32 ± 0.70 (t=- 3.889,P=0.00). Conclusions Health education on Wechat platform with nursing visit can enhance the effect of home- based care by improving the living quality, incidence of adverse health events of the elderly and positive feeling of family care givers.

BACKGROUND:Antedor canulated screw has been considered an ideal method to treat odontoid fracture.OBJECTIVE:To compare the biomechanical properties of different anterior screws.DESIGN,TIME AND SETTING:A randomized contrast study was performed at the Biomechanics Laboratory of Southern Medical University from March to September 2006.MATERIALS:Double-thread canulated screws and single-thread canulated screws were made of titanium alloy and provided by Shuangyang Medical Apparatus Co.,Ltd.,Suzhou.METHODS:A total of head-neck complexes (C0-C3) which were collected from 20 corpses were maintained in formaldehyde for less than 3 months;thereafter,the muscles and ligaments were removed to obtain the axis specimens so as to make type Ⅱ odontoid fracture models.The fracture samples were individually treated with double-thread and single-thread canulated screws,with 10 samples for each group.MAIN OUTCOME MEASURES:The shear stiffness and the maximum resistance of the two kinds of screw were tested in this study.RESULTS:The shear stiffness of the double-thread screw group was significantly higher than the single-thread screw group (P＜0.01 );however,there was no significant different in the maximum resistance between the two groups (P＞0.05).CONCLUSION:Double-thread canulated screws have a strong biomechanical stability for treating odontoid fracture;therefore,the first choice of the internal fixation should be double-thread canuiated screws for patients with osteoporosis or those who are susceptible to expanded screw pathway during surgical procedures.

BACKGROUND:Whether controling of post-injury inflammatory response combined with neural stem cel (NSC) transplantation can improve the curative efficacy for spinal cord injury stil remains unclear. OBJECTIVE:To investigate the repair of spinal cord tissue, myelin regeneration, axon regeneration, motor function recovery and the possible mechanism after early application of tumor necrosis factor α antagonist (Etanercept) combined with tyrosine kinase C (TrkC) gene-modified NSC transplantation. METHODS:TrkC-overexpressed NSCs (TrkC-NSCs) were constructed by lentiviral transfection technique. The rat models of spinal cord transection injury were prepared, and then subjected to Etanercept combined with TrkC-NSCs transplantation. The number of neurons and neuroregeneration after injury were measured by Nissl's staining, immunofluorescence and western blot. The rat motor function was detected by Basso Beattie Bresnahan score and evoked potential. The myelin regeneration was detected by electron microscopy and toluidine blue staining. RESULTS AND CONCLUSION:Compared with the other groups, the Etanercept combined with TrkC-NSCs transplantation group had more survived anterior horn motor neurons at 28 days after injury, more myelin-encapsulated axons, higher Basso Beattie Bresnahan score, greater amplitude of the evoked potentials, and relatively shorter latency (alP < 0.05). These findings indicate that early application of tumor necrosis factor-α antagonist combined with TrkC-NSCs transplantation after spinal cord injury in rats can effectively promote myelin regeneration, axon regeneration, and further promote motor function recovery.

OBJECTIVETo study the bone marrow mesenchymal stem cells (MSC) settled in rats after small intestinal transplantation.

METHODSBone marrow MSCs were taken from 1-month male Lewis rats, isolated and cultured by density gradient centrifugation and differential adherent culture. The surface antigens (CD29, CD90, CD34 and CD45) of MSC were identified by flow cytometry. Final concentration of 5 μg/L CFSE was used to mark the third generation of MSCs. Adult male inbred line F344 rats were used as donor and adult male Lewis rats as acceptor. A heterotopic intestinal transplant rat model was established by F344 to Lewis. Labeled MSCs were injected into model rats through vena dorsalis penis after operation. Tissues at postoperative 7-day were collected for frozen pathology to reveal the location of transplanted MSCs under fluorescence microscope.

RESULTSMSCs were successfully isolated from rat bone marrow. The average positive expression rates of surface antigens CD29, CD90, CD34 and CD45 were 96.48%, 99.77%, 2.41% and 1.39% respectively. MSCs were successfully and effectively marked with CFSE. Seven days after operation, a large number of green fluorescence could be observed in transplanted intestine, spleen and thymus. Autograft intestinal tissues only showed trace fluorescence, and the heart, liver and lung tissue basically did not present the green fluorescence.

CONCLUSIONBone marrow MSCs can settle in transplanted small intestine of rat.

Objective:To assess the clinical outcome of the novel computer assisted reduction malarplasty using angled double L-shaped osteotomies.Methods:Retrospective analysis of the 35 female patients who received reduction malarplasty surgery during June 2014 to April 2019 was conducted. Patients were divided into the conventional surgery group (9 cases) and the computer assisted surgery group (26 cases) based on their personal will. For the conventional surgery group, the zygomatic arch was repositioned inwardly after L-shaped osteotomy, and was rigidly fixed with miniplates and screws. The computer assisted reduction malarplasty was as follows: computer assisted angled double L-shaped osteotomies with surgical guide was performed intraorally, and the pre-bent titanium was used to setback the resected zygoma bone, which was then fixed with titanium miniplates and screws. Operation time, patients’ satisfaction (3-month follow-up) and postoperative complications (asymmetry and bone nonunion) were recorded and assessed. CT scans were performed to compare the preoperative design and 3-month postoperative follow-up for the computer assisted patient group. For statistical analysis, independent sample t test was used to analyze operation time of the 2 groups and chi-square test was used to analyze the data of patients’ satisfaction and asymmetry occurrence. P<0.05 was considered as statistically significant. Results:The mean operation time was (85.1 ± 17.8) min during computer assisted surgery versus (62.2±11.7) min during conventional surgery. The difference between the two groups was statistically significant ( t=3.53, P=0.020). Neither group showed noticeable resected bone shifting or soft tissue drooping. One patient in the conventional surgery group had bone nonunion on the right zygoma and partial absorption of the left zygomatic bone. The incidence of asymmetry in the computer-assisted group was 3.8% (1/26, surgical correction was not required), and 33.3% in the conventional surgery group (3/9, one patient required surgical correction). There was a statistically significant difference between the two groups ( χ2=6.179, P=0.046). Patients’ satisfaction in the computer-assisted group was 100% (26/26), and 78% (7/9) in the conventional surgery group ( χ2=7.929, P=0.019). Comparisons between the postoperative CT and preoperative simulation CT images showed that the position deviation of the resected bones was (0.21 ± 0.19) mm. Conclusions:In the present study, improved precision of zygomatic bone resection and bone setback was achieved in reduction malarplasty by using the angled double L-shaped osteotomies with computer assistance. Moreover, complication occurrences (asymmetry, bone nonunion etc.) were significantly decreased. Also, patients’ expectation was better achieved with this method.

Objective To analyze the qualified rate of the fiducial markers during 3D-printing co-planar template assisted CT-guided implantation in stereotactic body radiation therapy by CyberKnife,and to explore the cause of the unavailable markers in order to provide the reference for the fiducial implantation,treatment planning and radiotherapy delivery.Methods From March to December 2017,a total of 52 cases were planned to stereotactic body radiation therapy(SBRT) using CyberKnife by fiducial tracking,and the fiducial markers were implanted based on CT-guided 3D-printing co-planar template,including 22 in lung,12 in liver,5 in mediastinal lymph node,8 in retroperitoneal lymph node,3 in pancreas,each in celiac and pelvic lymph nodes,respectively.Except 7 cases not fit for CyberKnife treatment,45 cases finished the treatment of CyberKnife,but there were 3 cases changed to spine tracking due to unqualified fiducial markers.The number of fiducial markers used and the qualified rate of fiducial markers were analyzed,and the cause of unqualified fiducial markers was studied.Results A total of 131 fiducial markers were impanted into 42 cases who finally received the treatment of CyberKnife by fiducial tracking,including 85 fiducial markers qualified (64.89％) and 46 fiducial markers unqualified (35.11％).The main causes of the unqualified fiducial markers varied,including outrange of rigidity error(26.08％),fiducial markers unavailable(41.31％),and other (32.61％).Conclusions The 3D-printing co-planar template assisted CT-guided implantation could reduce the number of puncture needles used,help to decrease the risk of puncture and trauma and the incidence of complications after the fiducial markers implantation.However,the fiducial markers implanted by this way would be abandoned by a variety of causes and should be taken into account before the fiducial markers implantation.

Retina is composed of a heterogeneous population of cell types, each with a unique biological function. Even if the same type of cells, due to genetic heterogeneity will lead to cell function differences. In the past, traditional molecular biological methods cannot resolve variations in their functional roles that arise from these differences, and some cells are difficult to define due to the lack of specific molecular markers or the scarcity of numbers, which hindered the understanding and research of these cells. With the development of biotechnology, single-cell RNA sequencing can analyze and resolve differences in single-cell transcriptome expression profiles, characterize intracellular population heterogeneity, identify new and rare cell subtypes, and more definitely define the characteristics of each cell type. It clarifies the origin, function, and variations in cell phenotypes. Other attributes include pinpointing both disease-related characteristics of cell subtypes and specific differential gene expression patterns, to deepen our understanding of the causes and progression of diseases, as well as to aid clinical diagnosis and targeted therapy.

Objective:To compare the efficacy of lateral elbow dislocation approach with non-dislocation approach for open reduction and internal fixation of distal humeral coronal fracture.Methods:A retrospective cohort study was used to analyze the clinical data of 26 patients with distal humeral coronal fracture admitted to Qilu Hospital (Qingdao) of Shandong University from January 2018 to October 2021, including 10 males and 16 females, aged 15-80 years [(51.6±4.9)years]. According to Dubberley classification, there were 10 patients with type 2A, 5 with type 2B, 6 with type 3A and 5 with type 3B. Overall, 12 patients were operated via lateral elbow dislocation approach (dislocation approach group) and 14 via lateral elbow non-dislocation approach (non-dislocation approach group). The operation time, intraoperative bleeding volume, incision healing, three-dimensional CT assessment of the reduction within one week after surgery (separation or step>2 mm as poor), Mayo elbow performance score (MEPS) at 3 months after surgery and fracture healing at the last follow-up were recorded in both groups. Complications were also compared between the two groups.Results:All patients were followed up for 3-18 months [(10.5±3.3)months]. The operation time was (146.9±15.5)minutes in dislocation approach and (122.7±11.1)minutes in non-dislocation approach group ( P>0.05). The intraoperative bleeding volume was (113.3±9.7)ml in dislocation approach and (112.9±10.1)ml in non-dislocation approach group ( P>0.05). All incisions healed uneventfully in stage I. All patients had good reduction in dislocation group, while only 7 patients had good reduction and the other 7 patients presented a separation or step>2 mm in non-dislocation group ( P<0.05). The MEPS was (90.0±1.4)points in dislocation approach group at 3 months after surgery, including 9 patients being rated as excellent and 3 good, with the excellent and good rate of 100%. In constrast, the MEPS was (78.9±2.9)points in non-dislocation approach group at 3 months after surgery, including 5 patients being rated as excellent, 4 good, 4 fair and 1 poor, with the excellent and good rate of 64.3% ( P<0.05). All fractures were healed at the last follow-up. In non-dislocation approach group, osteoarthritis occurred in 7 patients, including 3 with screw protrusion, 2 with heterotopic ossification and 2 of advanced age with osteophyte formation around the joint. In dislocation approach group, osteoarthritis occurred only in 2 patients of advanced age, showing osteophyte formation around the elbow joint, with no screw cutting or heterotopic ossification. Conclusion:For distal humeral coronal fracture, the lateral elbow dislocation approach is able to provide complete exposure of the articular surface, obtain anatomic reduction, restore elbow function and reduce complications when compared with the non-dislocation approach.

OBJECTIVETo report on clinical, genetic and molecular characterization of two Chinese families with Leber's hereditary optic neuropathy.

METHODSOphthalmological examinations have revealed variable severity and age at onset of visual loss among the probands and other matrilineal relatives of both families. The entire mitochondrial genome of the two probands was amplified with PCR in 24 overlapping fragments using sets of oligonucleotide primers.

RESULTSThe ophthalmological examinations showed that penetrance was 12.5% and 30.0% respectively in the two families. Sequence analysis of the complete mitochondrial genomes in these pedigrees has identified unreported homoplasmic T8821G mutation in the ATPase 6 gene and distinct sets of polymorphisms belonging to haplogroups M10a. The T8821G mutation has occurred at the extremely conserved nucleotide (conventional position 99) of the ATPase6. Thus, this mutation may alter structural formation of ATPase6, thereby leading to failure in the synthesis of ATP involved in visual impairment.

CONCLUSIONAbove observations have suggested that the ATPase6 T8821G mutation may be involved in the pathogenesis of optic neuropathy in these families.

Adolescent ; Asian Continental Ancestry Group ; genetics ; Base Sequence ; China ; DNA, Mitochondrial ; genetics ; Female ; Humans ; Male ; Mitochondrial Proton-Translocating ATPases ; genetics ; Molecular Sequence Data ; Optic Atrophy, Hereditary, Leber ; enzymology ; genetics ; Pedigree ; Point Mutation ; Young Adult

Objective To investigate the Activity of Daily life (ADL) among individuals aged 100 and above,in Hainan.Methods From June 2014 to December 2016,a community-based cross-sectional study was conducted among individuals aged 100 and over in Hainan province.Data regarding basic information,ADL,prevalence of major age-related diseases was collected in this population.Loss of ADL among these centenarians was described and its determinants examined.Results The prevalence of ADL loss in centenarian population was 72.5％,with the top four items of ADL loss as stair-climbing (79.0％),moving (59.1％),walking (44.3％) and using toilet (41.3％).Results showed that tea consumption,good both on vision and audition were possible protective factors for the functions of ADL.Low level of education and vitamin D deficiency seemed as risk factors for the slowing-down of ADL (P＜0.05).Conclusions The prevalence of ADL loss among centenarians appeared relatively high.Years of education,tea consumption,degrees of vision,audition and vitamin D deficiency were possible risk factors responsible for the ADL loss in this centenarian population.