OBJECTIVE: To explore influence of external factors of wind, cold and dampness on clinical symptoms in knee osteoarthritis (KOA) patients with different constitutions of traditional Chinese medicine. METHODS: A cross-sectional stratified study was performed to select 108 patients with GradeⅡKOA in Kellgren & Lawrence (K-L) classification, including 22 males and 86 females, aged from 47 to 75 years old with an average of (60.7±6.0) years old;body mass index(BMI) ranged from 17.87 to 31.22 kg·m^-2 with an average of (23.80±2.86) kg·m^-2. According to Classification and Judgment of TCM Physique (ZYYXH/T157-2009), the types of TCM physique were determined and divided into 4 layers according to the deficiency and actual physique. Among them, there were 24 patients without biased physique, 12 males and 12 females, aged from 51 to 73 years old with an average of(62.8±6.0) years old, BMI ranged from 17.87 to 31.14 kg·m^-2 with an average of (24.32±3.25) kg·m-2;there were 46 patients with virtual bias constitution, including 7 males and 39 females, aged from 47 to 70 years old with an average of (60.0±5.8) years old, BMI ranged from 19.38 to 31.22 kg·m^-2 with an average of(23.42±2.97) kg·m^-2;There were 26 patients with solid bias constitution, including 2 males and 24 females, aged from 48 to 75 years old with an average of (60.4±5.8) years old, BMI ranged from 21.16 to 30.76 kg·m^-2 with an average of (24.15±2.33) kg·m^-2;there were 9 patients with special constitution, 1 male and 8 female, aged from 53 to 75 years old with an average of (59.8±7.5) years old, BMI ranged from 19.26 to 26.67 kg·m^-2 with an average of (23.79±2.49) kg·m^-2. Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) was used to evaluate severity of clinical symptoms. The wind-cold-dampness external factor score was calculated through the questionnaire of wind-cold-dampness syndrome scale to evaluate degree of influence of wind-cold-dampness external factor. Pearson correlation analysis and partial correlation analysis were used to calculate the correlation coefficient between severity of external factors affecting wind, cold and dampness and severity of clinical symptoms in patients with different TCM constitution stratification. RESULTS: There was no statistical significance between total score of wind-cold-dampness and WOMAC score in patients with no biased constitution and special condition. Total wind-cold-dampness score of patients with virtual biased constitution was positively correlated with WOMAC stiffness score (r=0.327, P=0.032), and total wind-cold-dampness score of patients with solid biased constitution was positively correlated with WOMAC pain score (r=0.561, P=0.005) and WOMAC overall score (r=0.446, P=0.033). After further adjusting for the interaction of external factors of wind-cold-dampness, there was no statistical significance between wind-cold-dampness scores and WOMAC scores in patients with solid biased constitution. The score of dampness and pathogenic factors was positively correlated with WOMAC stiffness score (r=0.414, P=0.007). CONCLUSION The external factors of wind-cold dampness have different effects on the clinical symptoms of KOA patients with different TCM constitutions. Compared with other constitutions, the rigid symptoms of patients with asthenic biased constitutions are more susceptible to dampness pathogenic factors.
Aged ; Female ; Humans ; Male ; Middle Aged ; Cross-Sectional Studies ; Medicine, Chinese Traditional ; Osteoarthritis, Knee ; Syndrome ; Wind ; Cold Temperature

With the increasing detection rate of early upper gastric cancer and adenocarcinoma of esophagogastric junction, the safety of proximal gastrectomy with clear indications has been verified, and function-preserving proximal gastrectomy has been widely used. However, proximal gastrectomy destructs the normal anatomical structure of esophagogastric junction, resulting in severe postoperative gastroesophageal reflux symptoms and seriously affecting the quality of life. Among various anti-reflux surgery methods, reconstruction of "cardiac valve" has always been the focus of relevant scholars because its similarity with the mechanism of normal anti-reflux. After years of development, evolution and optimization, the designed seromuscular flap anastomosis includes tunnel muscle flap anastomosis, Hatafuku valvuloplasty, single muscle flap anastomosis and double muscle flap anastomosis. The double muscle flap anastomosis has become a research hotspot because it shows good anti-reflux effect in clinical application. This paper reviews the history, research status and hot issues of seromuscular flap anastomosis of esophageal remnant stomach at home and abroad.
Anastomosis, Surgical/methods* ; Esophagogastric Junction/surgery* ; Gastrectomy/methods* ; Gastroesophageal Reflux/surgery* ; Humans ; Quality of Life ; Stomach Neoplasms/surgery*

OBJECTIVE: To assess changes of nutritional status by comprehensive nutrition assessment including nutritional risk screening, dietary assessment, blood biochemical index, and body composition in acute leukemia patients who had undergone chemotherapy. METHODS: A total of 169 patients with acute leukemia treated at The First Affiliated Hospital of Soochow University from June 2018 to August 2019 were recruited for this study. Before and after chemotherapy, the NRS-2002 and PG-SGA scales, dietary intake, blood biochemical index and body composition were evaluated to compare the changes of nutritional status. RESULTS: NRS-2002 score and PG-SGA score after chemotherapy were significantly increased than those before chemotherapy (P<0.001). Many patients had insufficient nutritional intake during chemotherapy, and the dietary intake score of patients with induction chemotherapy was significantly lower than that of patients with consolidation chemotherapy (P=0.043). The results of multivariate analysis showed that induction chemotherapy was the independent risk factor for the increase of PG-SGA scores and the decrease of dietary intake (all P<0.05). After chemotherapy, the white blood cell count, hemoglobin, and platelet count were significantly decreased (P<0.001), the prealbumin was significantly increased (P<0.001), and the blood glucose was increased (P=0.04), but albumin was not significantly changed. The weight, body mass index, fat-free mass, skeletal muscle mass and intracellular water were all significantly decreased (P<0.001), and visceral fat area was increased significantly after chemotherapy (P<0.05), especially in newly-diagnosed acute lymphoblastic leukemia patients after the induction of chemotherapy. CONCLUSION The nutritional status of patients with acute leukemia has undergone significant changes after chemotherapy. A single indicator has limited significance for nutritional status assessment. Comprehensive assessment of nutritional status by multiple tools is worthy of clinical application.
Acute Disease ; Humans ; Induction Chemotherapy/methods* ; Leukemia, Myeloid, Acute/drug therapy* ; Nutrition Assessment ; Nutritional Status ; Precursor Cell Lymphoblastic Leukemia-Lymphoma/drug therapy*

The quality control and standardization of procedures in radical gastrectomy for gastric cancer, especially the standardized processing of specimens after radical gastrectomy for gastric cancer, is very important. It is not only the basis of accurate pathological staging, but also the evidence of surgical quality and the original data of clinical research, which plays a pivotal role. The examination and classification of lymph nodes, specimens processing records, and data uploading and archiving after radical gastrectomy for gastric cancer are indispensable. It is necessary for surgeons to participate in the processing of surgical specimens. This article will combine the current research status and progress at home and abroad to review the standardized processing of specimens after radical gastrectomy for gastric cancer.
Gastrectomy ; Humans ; Lymph Node Excision ; Lymphatic Metastasis ; Neoplasm Staging ; Stomach Neoplasms/surgery*

Immune-mediated inflammatory injury is an important feature of the disease aggravation of hepatitis B virus-related acute-on-chronic liver failure (ACLF). Toll-like receptors (TLRs) have been shown previously to play a pivotal role in the activation of innate immunity. The purpose of this study was to characterize the TLR4 expression in peripheral blood mononuclear cells (PBMCs) of ACLF patients and its possible role in the disease aggravation. Twelve healthy subjects, 15 chronic HBV-infected (CHB) patients and 15 ACLF patients were enrolled in this study. The TLR4 expression in PBMCs and T cells of all subjects was examined by real-time PCR and flow cytometry. The correlation of TLR4 expression on T cells with the markers of disease aggravation was evaluated in ACLF patients. The ability of TLR4 ligands stimulation to induce inflammatory cytokine production in ACLF patients was analyzed by flow cytometry. The results showed that TLR4 mRNA level was upregulated in PBMCs of ACLF patients compared to that in the healthy subjects and the CHB patients. Specifically, the expression of TLR4 on CD4(+) and CD8(+) T cells of PBMCs was significantly increased in ACLF patients. The TLR4 levels on CD4(+) and CD8(+) T cells were positively correlated with serum total bilirubin (TBIL), direct bilirubin (DBIL), international normalized ratio (INR) levels and white blood cells (WBCs), and negatively correlated with serum albumin (ALB) levels in the HBV-infected patients, indicating TLR4 pathway may play a role in the disease aggravation of ACLF. In vitro TLR4 ligand stimulation on PBMCs of ACLF patients induced a strong TNF-α production by CD4(+) T cells, which was also positively correlated with the serum markers for liver injury severity. It was concluded that TLR4 expression is upregulated on T cells in PBMCs, which is associated with the aggravation of ACLF.
Adult ; End Stage Liver Disease ; metabolism ; virology ; Female ; Hepatitis B virus ; pathogenicity ; Humans ; Male ; Middle Aged ; Monocytes ; metabolism ; RNA, Messenger ; genetics ; T-Lymphocytes ; metabolism ; Toll-Like Receptor 4 ; genetics ; metabolism ; Up-Regulation

OBJECTIVETo explore the clinical classification method of keloids and providing a thread for the treatment of keloids.

METHODSTo summarize the 600 cases of keloid patients we accepted and diagnosed from November 2004 to October 2012, and filling in keloid patients information sheet, recording the keloids form by photographs, analyzing the treatment, putting forward the classification method of keloids in clinic.

RESULTSAccording to the position and quantity that keloids grow, the keloid patients are divided into four major categories:one in single site, one in each site, more than one in single site and more than one in each site; According to the area and thickness of keloids, the keloid single lesion is divided into four subclasses: type of small area and thin, type of small area and thick, type of large areas and thin,type of large areas and thick; According to the number of lesions, keloid multiple lesions is divided into two subgenera: isolated multiple and dispersion multiple, different kinds of keloids suit different methods of treatment.

CONCLUSIONThe clinical classification method of keloids can be used to provide thought for the treatment of keloids, and have a good application value.

Humans ; Keloid ; classification ; pathology ; therapy

In a prospective study, 42 048 adults residing in Zhongshan City, Guangdong, China, were followed for 16 years, and 171 of them developed nasopharyngeal carcinoma (NPC). Although Epstein-Barr virus (EBV) antibody levels of the cohort fluctuated, the antibody levels of 93% of the patients with NPC were raised and maintained at high levels for up to 10 years prior to diagnosis. This suggests that the serologic window affords an opportunity to monitor tumor progression during the preclinical stage of NPC development, facilitating early NPC detection. We reviewed the clinical records of the 171 patients with NPC in the prospective study to assess the efficacy of early NPC detection by serologic screening and clinical examination. Of the 171 patients, 51 had Stage I tumor (44 were among the 73 patients detected by clinical examination and 7 were among the 98 patients presented to outpatient department). Initial serologic screening predicted 58 (95.1%) of the 61 patients detected within 2 years. The risk of the screened population (58/3093) raised 13 times relative to cohort (61/42 048) during this period. Clinical examination detected all the 58 predicted cases, and 35 (60.3%) of which were diagnosed with Stage I tumor. The serologic prediction rate fell to 33.6% (37/110) 2 to 16 years after screening. The proportion of cases detected by clinical examination fell to 40.5% (15/37). The proportion of Stage I tumors among the cases detected by clinical examination during both periods remained at about 60%. We concluded that early detection of NPC can be accomplished by repeated serologic screening to maintain high prediction rates and by promptly examining screened subjects to detect tumors before the symptoms develop.
Adult ; Aged ; Antibodies, Viral ; blood ; Antigens, Viral ; immunology ; Capsid Proteins ; immunology ; Carcinoma, Squamous Cell ; blood ; diagnosis ; pathology ; Chemotherapy, Adjuvant ; Cohort Studies ; Early Detection of Cancer ; methods ; Female ; Herpesvirus 4, Human ; immunology ; Humans ; Male ; Middle Aged ; Nasopharyngeal Neoplasms ; blood ; diagnosis ; pathology ; Neoplasm Metastasis ; Neoplasm Recurrence, Local ; Neoplasm Staging ; Remission Induction ; Survival Rate

OBJECTIVETo observe the expression of Runx2 in osteoblasts in response to centrifugation in vitro and discuss the function of bone morphogenetic protein (BMP) signal transduction pathway in this course.

METHODSCells were divided into four groups, group A, B, C and D, pretreated with DMEM containing 10% fetal bovine serum, 10% fetal bovine serum, 100 ng x mL(-1) Noggin and 100 ng x mL(-1) Noggin for 24 hours separately. 271 x g centrifugation was loaded for 5 min to these groups except group A and C, other conditions were the same. The total RNA of each group were extracted, and reversed transcription to cDNA after 30 min. The expression of Runx2 in response to centrifugation in vitro was analyzed by quantitative real time PCR.

RESULTSThe expression of Runx2 mRNA in group B was significantly higher than that in group A (P < 0.05). The expression of Runx2 mRNA in group D was significantly lower than that in group B (P < 0.05). There was no statistically significant difference among group A, C, D (P = 0.692).

CONCLUSIONBMP signal transduction pathway plays an important role in the response of osteoblasts to mechanical stimulations. It may also play a central role in the cascade information dissemination of osteoblasts.

Bone Morphogenetic Protein 2 ; Bone Morphogenetic Proteins ; Cell Differentiation ; Centrifugation ; Core Binding Factor Alpha 1 Subunit ; Gene Expression Regulation ; Humans ; In Vitro Techniques ; Osteoblasts ; RNA, Messenger ; Signal Transduction

Objective To assess the endemic trend of Kaschin-Beck disease in Tibet and to provide scientific basis for prevention and etiology study of the disease. Methods A questionnaire designed by us was administered to 905 participants who were from Lhundrop county, Medro Gongkar county of Lhasa municipality and Sangri county of Lhoka region in July to November, 2007. The Kashin-Beck disease diagnostic criteria(GB 16003-1995) was used for clinical diagnosis, and children 5 to 14 years old were taken right wrist X-ray film for diagnosis.Results One hundred and forty-four genealogies were recruited in this study. The interview and clinical examination were done to 905 persons, 208 persons were detected with Kaschin-Beck disease, and the detectable rate was 22.98%(208/905). The numbers of patients with degrees Ⅰ , Ⅱ and Ⅲ of Kaschin-Beck disease were 148, 43 and 17, respectively, with proportion of 71.15%(148/208), 20.67%(43/208) and 8.17%(17/208) out of all patients, respectively. The detectable rates of Kaschin-Beck disease were 29.73% (102/343) and 18.86%(106/562), respectively in Lhasa and Lhoka district, and the difference between this two districts was statistically significant(x2= 15.257, P＜ 0.01) . A total of 368 males and 537 females were recruited in this study, the detectable rates of male and female with Kaschin-Beck disease were 19.29% (71/368) and 25.51% (137/537), respectively,and the difference between male and female was statistically significant (x2 = 5.372, P ＜ 0.01) . In this study most patient were between 31 to 70 years old, the patients with degrees Ⅱ or Ⅲ of Kaschin-Beck disease were mostly above 40 years old. There were only 5 patients who were less and equal 20 years old in chinical diagnosis. The Xray positive detectable rate of children between 5 to 14 years old was 6.85% (10/146). Conclusions The condition of Kashin-Beck disease area is relatively stable in these two regions in recent years, and shows a downward trend. However, there are still positive child cases diagnosed by X-ray, which should arouse the attention of the relevant departments to further strengthen the implementation of control measures.

Objective To understand the situation of the hepatitis B virus infection in Suining,Sichuan, and to evaluate the results of promoting the hepatitis B vaccine immunization strategy in the neonatal after 1992. Methods A multi-stage stratified random sampling method was adopted, and selected the counties according to administrative region and the economic level. A township (street offices) was randomly selected from each county, in each township selected randomly a village. The family as the unit carried out a questionnaire for 1-59 year old group, and collected blood to detect the HBsAg,anti-HBs and anti-HBc by ELISA. Results A total of 1468 human serum were collected for detect; The positive rate of HBsAg among the crowd was 14.78%, the positive rate of anti-HBs was 39.17%, the infection rate of HBV was 72.68%. HBsAg positive rate of the upper age group was 30 to 34-year-old group (27.59%) and the lowest was 0-4-year-old group (2. 06% ); HBV infection rate was the highest 55-59-year-old group (93.13%) and the lowest was 5-9 year-old group (44. 2%), there were differences in the sex, age,occupation and geographic prevalence rate of HBV infection signs. Conclusion In Suining, Sichuan region, people HBV infection was high, the crowd HBsAg-positive rate was still higher than the national average, but the epidemiological characteristics of hepatitis B among the crowd had changed, to promote the use of hepatitis B vaccine had dramatically reduced the target population ( ≤ 14 year-olds) in HBsAgpositive rate and HBV infection.