Objective: To compare the efficacy of different treatment protocols in treating transient synovitis of the hip (TSH) in children and to optimize the clinical treatment strategy for this condition. Methods: Ninety kids with TSH were divided into a control group, a chiropractic group and a chiropractic plus foot bath group using the random number table method, with 30 cases in each group. The control group was treated with conventional traction; the chiropractic group was given chiropractic treatment based on the control group; the chiropractic plus foot bath group was given Chinese medicine foot bath based on the chiropractic group. Traction and foot bath were conducted once daily while chiropractic was done once every other day, all with 14 d as a treatment course for a total of two courses. Changes in the visual analog scale (VAS) score and range of motion (ROM) of the hip joint in the three groups were observed, and the efficacy was compared. Results: The total effective rate was 93.3％ in the chiropractic plus foot bath group, versus 76.7％ in the chiropractic group and 66.7％ in the control group, and the total effective rate was notably higher in the chiropractic plus foot bath group than in the other two groups (both P<0.05). Respectively after the first and second treatment course, the VAS score decreased significantly in each of the three groups compared with that before treatment (all P<0.01), and the ROM of the hip joint in flexion increased significantly (all P<0.01). After two treatment courses, the VAS score was lower in the chiropractic plus foot bath group than in the other two groups (both P<0.05), and its ROM of the hip joint in flexion was larger than that in the other two groups (both P<0.05). Conclusion: Based on traction, chiropractic plus Chinese medicine foot bath can effectively reduce pain and improve motor function of the hip joint in treating TSH.

The hotspots and frontiers in studies on medical information education were identified with key words cluster algorithm and burst words detection algorithm by making use of CiteSpaceⅢwith 540 papers on medical in-formation education published in core journals of medical information education from 2007 to 2016 as sample data, which showed that the 7 hotspots and frontiers in studies on medical information education from 2007 to 2016 in medical information education field of China and can thus provide support for keeping abreast of its development trend and working out its development strategies.

OBJECTIVETo build three-dimensional (3-D) visible model for surgical treatment of infection of fascial spaces of hand.

METHODSSerial thin cross-sections (0.2 mm) of hand were made by cryomicrotome, and the thin cross-sections of metacarpal parts were observed. A personal computer was employed to reconstruct 3-D model of metacarpal fascial space.

RESULTSThe shapes, locations and adjacent relations of the mid-palmar space, thenar space and metacarpal bones were displayed clearly from computerized 3-D model, which could be the cross-reference of the cross-sections expediently.

CONCLUSIONThe computerized 3-D reconstruction of metacarpal fascial spaces can provide some guidance for surgical treatment of infection and other diseases of metacarpal fascial spaces.

Anatomy, Cross-Sectional ; Hand ; anatomy & histology ; Humans ; Image Processing, Computer-Assisted ; Imaging, Three-Dimensional

[Objective]To analyze the short-term (24 h) and long-term (3 months) effects of thrombolysis in patients with acute cerebral infarction and its influencing factors.[Methods]Fifty-three patients with acute ischemic stroke,admitted to our hospital fiom January 2006 to December 201 i,were treated with urokinase (UK);the effects were observed by NIHSS and Modified Rankin Scale (mRS).Influencing factors were analyzed by Stepwise logistic regression.[Results] Twenty-eight patients had good outcome (52.8％) 24 h after thrombolytic therapy;multivariate logistic regression indicated that gender,interval between onset and receiving thrombolytic therapy,and fibrinogen level before thrombolytic therapy were the independent predictors of good outcome (P=0.007,0.017 and 0.001,respectively).Forty patients (75.4％) had good outcome 3 months after thrombolytic therapy;multivariate logistic regression indicated that the scores of NIHSS before thrombolysis and 24-h thrombolytic effect were the independent predictors of good outcome (both P=0.002).[Conclusion] Risk factors associated with short- and long-term thrombolytic effects might be different,which needs us make a difference in clinical work.

OBJECTIVETo provide detailed information of corona mortis for ilioinguinal approach as an anterior approach to the acetabulum and pelvis.

METHODSThe course, branches and distribution of the vascular connection between the obturator system and the external iliac or inferior epigastric systems located over the superior pubic ramus were observed on 50 hemipelvises with intact soft tissues.

RESULTSDuring the dissections, 72% of the cadaveric sides had at least one communicating vessel between the obturator system and the external iliac or inferior epigastric systems on the superior pubic ramus. The average diameter of the connecting vessel was 2.6 mm (range, 2.0-4.2 mm). It coursed over the superior pubic ramus or iliopubic eminence vertically to enter the obturator foramen and exit the pelvis. The average distance from pubic symphysis to the vascular connections between the obturator and external iliac systems was 52 mm (range, 38-68 mm).

CONCLUSIONSVascular connections between the obturator system and the external iliac or inferior epigastric systems were found over the superior pubic ramus with a high incidence. They are prone to damage during the ilioinguinal approach as an anterior approach to the acetabulum and pelvis. Thus, corona mortis located over the superior pubic ramus deserves great attention during the ilioinguinal approach.

Adult ; Aged ; Epigastric Arteries ; anatomy & histology ; Female ; Humans ; Iliac Vein ; anatomy & histology ; Male ; Middle Aged ; Obturator Nerve ; anatomy & histology ; Pelvis ; blood supply ; Pubic Symphysis ; blood supply

BACKGROUND:Studies have shown that bioactive molecules or polypeptides grafted onto the surface of polyethylene glycol (PEG) hydrogels can improve PEG bioactivities.OBJECTIVE:To manufacture PEG hydrogels capable of auto-recruiting growth factor beta1 (TGF-β1) and to study its biocompatibility. METHODS:Pure PEG hydrogels (group A), PEG hydrogels grafted on a cell adhesion peptide RGD peptides (group B), PEG hydrogels grafted with auto-recruited TGF-β1 peptide sensitive polypeptide HSNGLPL (group C), PEG hydrogels grafted with both RGD and HSNGLPL polypeptides (group D) were prepared. Contract angle of the hydrogel was detected in each group. Human bone mesenchymal stem cells were seeded onto four kinds of hydrogels. After cells attached, scanning electron microscope and LIVE/DEAD staining were done to observe cell-hydrogel compounds. Human bone marrow mesenchymal stem cells were co-cultured with ordinary culture medium (control) or four kinds of hydrogels for 1, 3, 5, 7 days, and the cell proliferation was detected by cell counting kit-8 assay. The four kinds of hydrogels were put into 24-well culture plates with addition of PBS containing TGF-β1, and 1 hour later, immunofluorescence staining was done. RESULTS AND CONCLUSION:(1) The contact angles of groups A and C were larger than those of groups B and D. (2) Under the scanning electron microscope, groups A and C had little cells attached on the hydrogel surface, but there were many cells on the hydrogel surface in groups B and D. (3) LIVE/DEAD staining showed groups A and C had little living cells, and conversely groups B and D had many living cells. (4) The results of cell counting kit-8 demonstrated that as the incubation time went on, cell proliferation activity of five different groups increased with no difference at the same time point. (5) Findings from the immunofluorescence staining showed that groups A and B had very weak fluorescence, while groups C and D had stronger green fluorescence. In conclusion, PEG hydrogels grafted with RGD and HSNGLPL polypeptides can auto-recruit TGF-β1, and have good biocompatibility.

0.05)in the former part of the surgery that was before the beginning of the surgery via anterior route.But in group B,only propofol for sedation was used for the patients during the latter part of the surgery via the anterior route or while the nerve plexus was blocked; during this time in group A,the addition of fentanyl and vecuronium were still intermittently necessary to maintain the general anesthesia.The duration between the completion of surgery and the recovery of spontaneous breathing,times for initial conscious reaction such as opening the eyes following an order, extubation and from extubation to complete recovery were significantly shorter in group B than those in group A(all P

Objective To evaluate the value of transesophageal echocardiography (TEE) in transthoracic minimally invasive device closure of ventricular septal defect(VSD).Methods A total of 164 cases of VSD were recruited as candidates to receive transthoracic minimally invasive device closure between January 2007 and October 2010,including 138 perimembranous VSDs,3 muscular VSDs and 23 supracristal VSDs.Among these groups,85 male patients were included.Four-champer view,five-champer view,left ventricular long-axis view,short-axis view and right ventricular inflow view were detected to evaluate the availability of device closure.Results A total of 152 cases(92.7%)were successfully closed with a device.All the patients were followed up more than 3 months arranged with a standard protocol.No complete atrioventricular block (CAVB) or associated valvular complications were observed.Three of the five cases with traced residual shunt after device closure closed spontaneously.Conclusion TEE plays an important role in transthoracic minimally invasive device closure of ventricular septal defect,which has been proved by the good follow-up results without CAVB and associated valvular complications.

OBJECTIVETo evaluate the safety and feasibility of laparoscopic cylindrical abdominoperineal resection.

METHODSSix patients with rectal adenocarcinoma within 3 cm above the anal verge underwent laparoscopic cylindrical abdominoperineal resection. Transabdominal levator transaction was performed laparoscopically, with no position change during the perineal operation. Pelvic reconstruction was achieved using human acellular dermal matrix mesh in 3 patients.

RESULTSAll the procedures were successfully performed without any intraoperative complications, laparoscopy-associated complications, or conversion to the open approach. The mean operation time was 186.7 minutes and intraoperative blood loss was 101.7 ml. All the specimens had a cylindrical shape with levator muscles attached to the mesorectum and circumferential margins were all negative. No adverse incidence followed the pelvic reconstruction using human acellular dermal matrix mesh.

CONCLUSIONSLaparoscopic transabdominal transection of the levator muscles without position change and pelvic floor reconstruction with human acellular dermal matrix mesh is feasible. This procedure simplifies cylindrical abdominoperineal resection which is aggressively invasive and technically complicated. The oncologic outcomes are acceptable and complications are less.

Abdomen ; surgery ; Aged ; Anal Canal ; surgery ; Female ; Follow-Up Studies ; Humans ; Laparoscopy ; methods ; Male ; Middle Aged ; Pelvis ; surgery ; Perineum ; surgery ; Reconstructive Surgical Procedures ; methods ; Rectal Neoplasms ; surgery ; Treatment Outcome

A novel mucoadhesive microcapsule with drug-resin complex core loaded with berberine hydrochloride (BH) was developed and optimized. Drug-ion exchange resin (IER) complex was prepared by static method which stirring IER in drug solution at certain conditions. The influences of different IERs, different temperature, pH values and concentrations of drug solution on the drug loading were investigated. IER complex was coated by emulsion-solvent evaporation method. The coating fluid formulation was optimized using central composite design-response surface methodology, where the ratio between Carbopol 934 and IER (X1), the ratio between Eudragit and IER (X2) and the ratio between Eudragit RL and RS (X3) were taken as independent variables. Time of cumulative release 85% (Y1) and percentage of gastric retention (Y2) were taken as response variables. Drug loading achieved a high level and more drug available in the condition of IER (IRP 88), 37 degrees C, pH 5 and 1.0 mg x mL(-1) drug solution. When X1 = 0.75, X2 = 0.9, X3 = 0.6, the time of cumulative release reached 85% at 300 min, the highest percentage of gastric retention in the range of this experiment were procured.
Acrylates ; chemistry ; Animals ; Berberine ; administration & dosage ; pharmacokinetics ; Capsules ; Delayed-Action Preparations ; Drug Compounding ; methods ; Drug Delivery Systems ; Emulsions ; Gastric Mucosa ; metabolism ; Hydrogen-Ion Concentration ; Ion Exchange Resins ; chemistry ; Male ; Polymers ; chemistry ; Rats ; Rats, Sprague-Dawley ; Temperature