ObjectiveTo investigate the application of intraoperative Computed Tomograph (CT) using in surgery for complex acetabular fractures.MethodsFrom June 2008 to December 2010,14 patients (9 males,5 females; with the mean age of 45.1 years; range,28-62 years) with complex acetabular fractures were operated using intraoperative CT.Preoperative radiotherapy and CT scan were adopted to evaluate the fractures.Three dimensional reconstruction based on CT scan was used to mimic surgery.The surgery approach and the type of internal fixators were noted.Intraoperative C-arm and CT scan were used to evaluate the fractures reduction respectively.Decision of additional reduction was made by surgeons according to above mentioned methods respectively and the results were noted.Comparing to preoperative design,the change of surgery plan were noted.Overall time,frequency and radiation dose of intraoperative CT scan were also noted.ResultsAll patients in this study received average 2.7 times of intraoperative CT scan.Mean time of CT scan was 40.4 min and the overall dose of radiation was 47.2 mGy.Decision of additional reduction was made in 3 cases according to C-arm radiography and 4 cases according to CT scan (above mentioned 3 cases were included).The change of surgery plan was made in one case.In postoperative radiography evaluation according to Matta's score system,anatomical reduction were achieved in 8 cases,imperfect reduction in 3 cases and poor reduction in 3 cases.ConclusionIntraoperative CT scan increases the radiation time and dose of patients dramatically.When used to evaluate fracture reduction intraoperatively,it can't take the advantage of traditional C-arm radiography.When delicate preoperative plan is made with radiography and three dimensional reconstruction based on CT data,the efficiency of intraoperative CT scan for complex acetabular fractures are to be discussed.

Abstract: Objective To evaluate the key quality control and protective performance test of Halcyon medical linear accelerator. Methods WS 674-2020Specification for Testing of Quality Control in Medical Linear Accelerator（ According to the hereinafter WS 674-2020） ， referred to and the manufacturer´s manual the performance of the first Halcyon medical linear accelerator in Results ， ， Hunan Province was tested. The results showed that all ten indicators of the accelerator including dose deviation ， ， （ ， ， ， - repeatability linearity daily stability and symmetry the results were 0.10% 0.03% 0.04% 0.50% and 100.50% 100.80% ）， - - respectively met the requirements of WS 674 2020. The results of manufacturer quality control indicators such as dose rate ， ， stability in beam gantry rotation isocenter and mechanical position accuracy megavolt image parameters and cone beam computer tomography image parameters met the requirements of the manufacturer´s regulations. Due to the special structure and ， - ： function of the accelerator it is difficult to detect the parameter required by WS 674 2020 as below the radiation leakage - ， ， ， ， outside the M zone the uniformity the indicators related to the light field the offset of the radiation beam axis the zero scale Conclusion - position of the rotating motion scale and others. It is difficult to carry out complete testing according to WS 6742020 for Halcyon medical linear accelerator and it is urgent for the state to issue relevant testing standards to standardize and strengthen the quality control testing of various accelerators.

OBJECTIVETo investigate the effect of pulsed electromagnetic fields (PEMs) on inducing osteoclastic like cell (OLC) formation changes and apoptosis in ovariectomized (OVX) rats bone marrow culture in vitro.

METHODSThirty healthy three-month-old female Wistar rats were either sham-operated (Sham) or ovariectomized (OVX) and randomly divided into three groups: group A (OVX + PEMs, 18 rats), group B (OVX, 6 rats) and group C (Sham, 6 rats); group A was again randomly divided into three groups: A1, A2, A3. The frequencies adopted were 1.5, 2, 75 Hz and 30 minutes for once a day. All rats were fed with normal diet for 3 months, then the bone marrow of all rats were cultured, 2 days later, group A cells (including group A1, A2, A3) were collected and exposed to different frequencies PEMs for 2 weeks (30 min/day). In order to observe the changes of osteoclasts and count their numbers, cells were taken for Wright Giemsa staining, tartrate-resistance acid phosphatase (TRAP) staining and Hoechst 33258 staining.

RESULTSTRAP staining results indicated the number of OLC in group C was the least, then was group A2, A3, A1, B. The number of OLC in group B was remarkably increased (P < 0.01; vs group C, A2). The number of OLC in group B was significantly increased (P < 0.05; vs group A1, A3). Hoechst 33258 staining results indicated the number of apoptosis of OLC in group C was more than other groups, which of group C, A2 was significantly increased (P < 0.05; vs group B).

CONCLUSIONPEMs had decreased the formation of OLC and increased the number of apoptosis of OLC in ovariectomized (OVX) rats bone marrow culture in vitro, the effects of 2 Hz was the best. PEMs would be a new way of osteoporosis therapy.

Acid Phosphatase ; metabolism ; Animals ; Apoptosis ; radiation effects ; Bone Marrow Cells ; cytology ; enzymology ; radiation effects ; Cells, Cultured ; Electromagnetic Fields ; Female ; Isoenzymes ; metabolism ; Osteoclasts ; cytology ; enzymology ; radiation effects ; Ovariectomy ; Random Allocation ; Rats ; Rats, Sprague-Dawley ; Rats, Wistar ; Tartrate-Resistant Acid Phosphatase

Objective To explore the changes of serum amyloid A (SAA) level and its clinical significance in patients with post-stroke depression (PSD). Methods One hundred and sixty-four patients with acute ischemic stroke, admitted to our hospital from January 2016 to June 2017 were assessed with Hamilton Depression Scale-17 (HAMD-17) to evaluate the depression degrees, and accordingly, they were divided into PSD group (n=57) and non-PSD group (n=107). Healthy volunteers who were examined in the corresponding period were selected as healthy control group (n=50). The SAA level was determined with ELISA in subjects of the 3 groups. Clinical data were collected; single factor analysis and multivariate Logistic regression analysis were performed to select the risk factors of PSD. Results The SAA level in PSD group ([18.85±5.25] mg/L) was significantly higher than that in the non-PSD group ([15.25±5.75] mg/L) and healthy control group ([7.65±4.50] mg/L, P<0.05); that in the non-PSD group was significantly higher than that in the healthy control group (P<0.05). Single factor analysis showed that differences in education level, introversion, economic status, living alone, marital status, National Institutes of Health Stroke Scale (NIHSS) scores≥9 at admission, complications, and proportion of key area infarction (frontal lobe and basal ganglia) had statistical significance between PSD group and non-PSD group (P<0.05). Multivariate Logistic regression analysis showed that introversion, poor economic status, living alone, NIHSS scores≥9, infarction of key areas, and elevation of SAA level (OR=1.545, P=0.035, 95％ CI: 1.257-1.898) were independent risk factors for PSD (P<0.05). Conclusion SAA used as one of the detection biomarkers has great significance in early diagnosis, intervention and clinical prevention for PSD.

BACKGROUNDPeri-strut low-intensity area (PLIA) is a typical image pattern of neointima detected by optical coherence tomography (OCT) after stent implantation. However, few studies evaluated the predictors and prognosis of the PLIA; therefore, we aimed to explore the genesis and prognosis of PLIA detected by OCT in this study.

METHODSPatients presenting neointimal hyperplasia documented by OCT reexamination after percutaneous coronary intervention were prospectively included from 2009 to 2011. Peri-strut intensity was analyzed and classified into two patterns: Low-intensity and high-intensity. Clinical characteristics were analyzed to assess their contribution to peri-strut intensity patterns. Follow-up were performed in patients who did not receive revascularization during OCT reexamination, and the prognosis of the patients was evaluated.

RESULTSThere were 128 patients underwent OCT reexamination after stent implantation included in the study. PLIA was detected in 22 (17.2%) patients. The incidence of PLIA was positively correlated with serum triglyceride (odds ratio [OR]: 2.11, 95% confidence interval [CI]: 1.14-3.90, P = 0.017), low-density lipoprotein (OR: 2.61, 95% CI: 1.22-5.66, P = 0.015), history of cerebrovascular disease (OR: 101.11, 95% CI: 6.54-1562.13, P < 0.001), and initial clinical presentation of acute coronary syndrome (ACS, OR: 18.77, 95% CI: 2.73-128.83, P = 0.003) while negatively correlated with stent implantation time (OR: 0.57, 95% CI: 0.33-0.98, P = 0.043). The median follow-up was longer than 3.8 years. Major adverse cardiovascular events (MACEs) occurred in 7 (7.3%) patients while showed no correlation with PLIA. A total of 17 (17.7%) patients experienced unstable angina (UA) and showed significant correlation with PLIA (hazard ratio: 6.16, 95% CI: 1.25-30.33, P = 0.025).

CONCLUSIONSPLIA detected by OCT was positively correlated with higher serum lipid level, history of cerebrovascular disease and initial presentation of ACS, and negatively correlated with stent implantation time. Patients with PLIA were more likely to have UA than those with high-intensity while no significant difference was found in MACEs.

Acute Coronary Syndrome ; blood ; pathology ; physiopathology ; Aged ; Angina, Unstable ; blood ; pathology ; physiopathology ; Cross-Sectional Studies ; Female ; Humans ; Lipoproteins, LDL ; blood ; Male ; Middle Aged ; Neointima ; blood ; pathology ; physiopathology ; Prospective Studies ; Tomography, Optical Coherence ; methods ; Triglycerides ; blood

OBJECTIVETo evaluate wound healing after types of pancreaticojejunostomy.

METHODSAfter resection of the pancreatic head, 38 domestic piglets were divided into two groups according to the types of anastomoses: group I: binding pancreaticojejunostomy, a new technique designed and advocated by professor Peng Shuyou; group II: end-to-end pancreaticojejunal invagination. Anastomotic strength in vivo and histopathological findings were assessed on operative day and postoperative day 5 and 10.

RESULTSBursting pressure was 139.7 +/- 8.0, 178.7 +/- 9.7 and 268.8 +/- 12.8 mm Hg in group I on day 0, 5 and 10, whereas 67.3 +/- 7.9, 96.2 +/- 10.4 and 130.6 +/- 9.3 mm Hg in group II. The gain on day 0 to 5 and 5 to 10 was 27.9% and 50.5% in group I and 42.9% and 35.7% in group II, respectively. A significant difference was observed between group I and group II, and between 5 and 10 day after anastomoses (P < 0.01). Breaking strength was 4.5 +/- 0.4, 6.6 +/- 0.4 and 10.0 +/- 0.6 N in group I on day 0, 5 and 10 and 4.6 +/- 0.6, 5.8 +/- 0.5 and 7.1 +/- 0.6 N in group II. Although a similar value was shown in both types of anastomoses on day 0, a rapider gain was demonstrated on day 0 to 5 and 5 to 10 in group I (44.8% and 52.9%) than in group II (25.4% and 22.0%). A significant difference was found on day 5 and 10 between the two types of anastomoses (P < 0.05 and P < 0.01). Anastomotic site was well repaired by connective tissue and the cut surface of pancreatic stump was covered by mucosal epithelium in group I on day 10, but the cut surface was incompletely repaired by granulation tissue and no, regeneration of the epithelium was found in group II.

CONCLUSIONAnastomotic strength of binding pancreaticojejunostomy was stronger than end-to-end pancreaticojejunal invagination and the healing was better and rapid.

Anastomosis, Surgical ; methods ; Animals ; Female ; Male ; Pancreaticojejunostomy ; methods ; Swine ; Wound Healing

Objective: To investigate the short- and long-term effects of triple acupuncture at the Qugu acupoint as an adjunctive therapy on type-Ⅲ chronic prostatitis / chronic pelvic pain syndrome (CP/CPPS). METHODS: We equally randomized 90 CP/CPPS patients into a control and a treatment group, both treated with Levofloxacin Mesylate Tablets (0.5 g, tid) + Terazosin Hydrochloride Capsules (2 mg qd) for 4 weeks, while the latter group by triple acupuncture at the Qugu acupoint as an adjunctive therapy twice a week at the same time. Then, we followed up all the patients for 4 weeks, recorded the cases, time and rate of recurrence, obtained the scores in National Institutes of Health Chronic Prostatitis Symptom Index (NIH-CPSI), quality of life (QoL) and Zung Depression Scale (ZDS), and compared them between the two groups of patients. RESULTS: Compared with the controls, the patients of the treatment group showed significantly decreased NIH-CPSI scores in pain (8.6 ± 2.12 vs 6.2 ± 2.25, P <0.05), micturition (5.8 ± 1.22 vs 3.1 ± 1.10, P <0.05), and QoL (6.0 ± 1.33 vs 3.4 ± 1.71, P <0.05) and ZDS score as well (43.9 ± 4.53 vs 33.6 ± 3.20, P <0.01). The recurrence rate was markedly lower while the recurrence time remarkably longer in the treatment than in the control group (15.56 vs 35.56% and ［20.0 ± 2.72］ vs ［12.5 ± 3.47］ d, P <0.05). CONCLUSIONS As an adjunctive therapy, triple acupuncture at the Qugu acupoint can evidently ameliorate the clinical symptoms, enhance the curative effect of antibacterials, reduce the recurrence rate, and prolong the recurrence time in the treatment of CP/CPPS.
Acupuncture Points ; Acupuncture Therapy ; methods ; Anti-Bacterial Agents ; therapeutic use ; Chronic Disease ; Chronic Pain ; therapy ; Combined Modality Therapy ; Drug Therapy, Combination ; methods ; Humans ; Levofloxacin ; therapeutic use ; Male ; Pelvic Pain ; therapy ; Prazosin ; analogs & derivatives ; therapeutic use ; Prostatitis ; therapy ; Quality of Life ; Recurrence ; Syndrome ; United States ; Urological Agents ; therapeutic use

Objective: To investigate the clinical therapeutic effects of Yijingfang, a Chinese medicinal liquid, on asthenospermia. METHODS: We randomly divided 450 asthenospermia patients into a treatment group (n = 300) and a control group (n = 150), the former treated with Yijingfang once half a dose, bid, and the latter with Wuziyanzong Pills (9 g, bid) + L-carnitine oral liquid (10 ml, bid), both for 3 months. Before and at 1, 2, and 3 months after medication, we compared the semen volume, sperm concentration, percentages of progressively motile sperm (PMS) and total motile sperm (TMS), and semen liquefaction time between the two groups of patients. RESULTS: No statistically significant difference was observed in the semen parameters between the treatment and control groups before medication (P >0.05). In comparison with the baseline, the treatment group showed significant differences at 1, 2, and 3 months after medication in sperm concentration (［35.96 ± 8.50］ vs ［49.66 ± 10.91］, ［55.21 ± 11.46］, ［74.90 ± 13.07］ ×10⁶/ml, P <0.01), PMS (［19.72 ± 2.06］ vs ［23.81 ± 2.56］, ［26.12 ± 2.34］, and ［32.17 ± 1.62］ %, P <0.01) and TMS (［28.86 ± 2.70］ vs ［34.17 ± 3.43］, ［36.59 ± 3.36］, and ［47.08 ± 2.97］ %, P <0.01), but not in the semen volume (［3.35 ± 0.99］ vs ［3.15 ± 1.06］, ［3.12 ± 0.90］, and ［3.27 ± 0.78］ ml, P >0.05) or semen liquefaction time (［32.31 ± 8.15］ vs ［31.68 ± 3.14］, ［30.38 ± 3.44］, and ［30.86 ± 2.42］ min, P >0.05); the control group exhibited similar results at the three time points in sperm concentration (［36.85 ± 6.88］ vs ［40.53 ± 8.32］, ［47.51 ± 12.73］, and ［56.14 ± 11.98］ ×10⁶/ml, P <0.01), PMS (［20.26 ± 2.73］ vs ［25.17 ± 2.64］, ［27.23 ± 2.25］, and ［31.89±2.27］ %, P <0.01), and TMS (［30.03 ± 2.67］ vs ［33.89±2.26］, ［37.38±4.79］, and ［40.35±3.06］ %, P <0.01), but not in the semen volume (［3.03 ± 1.09］ vs ［3.16±1.78］, ［3.15±0.96］, and ［3.12±0.65］ ml, P >0.05) or semen liquefaction time (［30.25 ± 5.20］ vs ［29.36±4.25］, ［28.21±3.26］, and ［28.33±3.59］ min, P >0.05). There were statistically significant differences between the treatment and control groups in the increase rates of sperm concentration and TMS after medication (P <0.01) but not in that of PMS (P >0.05). CONCLUSIONS Yijingfang is an effective drug for the treatment of asthenospermia, which can regulate the spermatogenesis, increase the percentage of PMS, and improve the total sperm motility of the patients.
Asthenozoospermia ; drug therapy ; Carnitine ; therapeutic use ; Drugs, Chinese Herbal ; therapeutic use ; Humans ; Male ; Semen ; Sperm Count ; Sperm Motility ; drug effects ; physiology ; Spermatogenesis ; drug effects

To discuss the synergistic mechanism of compatible use of two medicinal herbs,Panax notoginseng and Bletilla striata, an HPLC was established to determine two ginseng saponins (20S)-ginseng saponin Rg₃ and ginseng saponin Rh₄ contained in single decoction of Panax notoginseng as well as in compound decoction of Panax notoginseng and Bletillastriata in different compatibility ratio (1∶0.5, 1∶1, 1∶2), followed by analyzing the impact of amount of notoginsenosides after compatibility. As a result, compared with the single decoction of Panax notoginseng, the contents of ginseng saponin Rg₃ and ginseng saponin Rh₄ in the compound decoction of Panax notoginseng and Bletillastriata were on the rise as the increasement of the amount of Bletillastriata. The contents of the notoginsengsaponin R₁, ginseng saponin Rg₁ and ginseng saponin Rb₁ of Panax notoginseng single decoction were significantly decreased after compatibility. Therefore, after compatibility, it was more easy to produce (20S)-ginseng saponin Rg₃ and ginseng saponin Rh₄.This study can extend to a method of preparation of (20S)-ginseng saponin Rg₃ and ginseng saponin Rh₄. Furthermore, after compatibility, two ginseng saponins which had lipase inhibitory effect were both increased significantly, indicating that the compatibility of these two herb medicines may have effect on losing weight.

To prepare Cinnamomi Ramulus pieces standard decoction and establish its quality standard, provide quality reference for formula granules and other clinic non-traditional forms of medicines, and lay a foundation for standard decoction research for the pieces containing essential oil. 14 batches of Cinnamomi Ramulus pieces with different quality were collected from market and their extraction process was further improved based on the preparation principle of standard decoction to prepare the standard decoction of Cinnamomi Ramulus pieces. Then its transfer rate of Cinnamaldehyde, dry extract rate and pH value were calculated to evaluate its process stability; and a method for chromatographic fingerprint and content determination was also established. Results revealed that the dry extract rate for standard decoction of Cinnamomi Ramulus pieces was from 6.06%-8.95%, with an average value of 7.18%; the transfer rate of cinnamaldehyde was at the range of 29.6%-54.3%, with an average of 43.2%; and the pH value was at the range of 4.33-4.82. The fingerprint similarities between 14 batches of standard decoction of Cinnmomi Rammulus pieces and reference fingerprint were all>0.9. The established method for standard decoction was stable and its quality standard was perfect, suitable for evaluating the quality of standard decoction of Cinnanomi Ramulus pieces.