BACKGROUND: Hemorrhagic stroke (HS) is associated with significant disability and mortality. However, the relationship between meteorological factors and hemorrhagic stroke, as well as the potential moderating role of these factors, remains unclear. METHODS: Daily data on HS, air pollution, and meteorological conditions were collected from January 2015 to December 2021 in Ganzhou to analyze the relationship between meteorological factors and HS admissions. This analysis employed a time-stratified case-crossover design in conjunction with a distributional lag nonlinear model. Additionally, a bivariate response surface modelling was utilized to further investigate the interaction between meteorological factors and particulate matter. The study also stratified the analyses by gender and age. To investigate the potential impact of extreme weather conditions on HS, this study defined the 97.5th percentile as representing extremely high weather conditions, while the 2.5th percentile was classified as extremely low. RESULTS: In single-day lags, the risk of admissions for HS was significantly associated with extremely low temperature (lag 1-2 and lag 13-14), extremely low humidity (lag 1 and lag 9-12), and extremely high precipitation (lag 2-7). Females exhibited greater susceptibility to extremely low temperature than males within the single-day lag pattern in the subcomponent layer, with a maximum relative risk (RR) that was 7% higher. In the cumulative lag analysis, the risk of HS admissions was significantly associated with extremely high temperature (lag 0-8∼lag 0-14), extremely low humidity (lag 0-2∼lag 0-14), and extremely high precipitation (lag 0-4∼lag 0-14). Within the cumulative lag day structure of the subcomponent layer, both extremely low and extremely high temperature had a more pronounced effect on females and aged ≥65 years. The risk of HS admissions was positively associated with extremely high barometric pressure in the female subgroups (lag 0-1 and lag 0-2). The highest number of HS admissions occurred when high PM_2.5 concentrations coexisted with low precipitation. CONCLUSIONS Meteorological factors were significantly associated with the risk of hospital admissions for HS. Individuals who were female and aged ≥65 years were found to be more susceptible to these meteorological influences. Additionally, an interaction was observed between airborne particulate matter and meteorological factors. These findings contributed new evidence to the association between meteorological factors and HS.
China/epidemiology* ; Humans ; Female ; Male ; Aged ; Middle Aged ; Cross-Over Studies ; Hospitalization/statistics & numerical data* ; Adult ; Hemorrhagic Stroke/etiology* ; Meteorological Concepts ; Weather ; Particulate Matter/analysis* ; Air Pollution/adverse effects* ; Environmental Exposure/adverse effects* ; Aged, 80 and over ; Young Adult

OBJECTIVE: To investigate the midterm clinical efficacy of medial patellofemoral complex (MPFC) reconstruction for recurrent patellar dislocation with high-grade trochlear dysplasia. METHODS: A retrospective analysis was carried out among adult patients who underwent arthroscopically assisted MPFC reconstruction between January 2014 and December 2020. Dejour classification was evaluated to grade trochlear dysplasia; tibial tubercle-trochlear groove (TT-TG) distance and Insall-Salvati index were measured. Preoperative and postoperative patient-reported outcome measures (PROMs) were compared, including International Knee Documentation Committee (IKDC) score, Kujala score, Lysholm score and Tegner score. Information regarding returning-to-sport rate, re-instability events and complications was collected. Patellar tilt (PT), lateral patellar displacement (LPD) and bisect offset (BSO) ratio were measured based on axial computed tomography before and after surgery to assess the patellofemoral congruence. RESULTS: A total of 46 MPFC reconstructions in 43 patients were enrolled, including 16 male and 27 female. Mean age at surgery was (22.2±7.6) years (range: 14-44 years). Mean follow-up was (49.9±22.6) months (range: 18-102 months). The percentages of Dejour B, C and D dysplasia were 37.0% (17/46), 43.5% (20/46), and 19.6% (9/46), respectively. Mean Insall-Salvati index was 1.2±0.2 (range: 0.85-1.44), and mean TT-TG distance was (19.6±3.5) mm (range: 10.6-28.7 mm). At latest follow-up, there were significant improvements in all PROMs (P < 0.001): IKDC score, from 56.3±15.1 to 86.2±8.1; Kujala score, from 58.9±15.6 to 92.6±5.4; Lysholm score, from 63.7±15.0 to 94.0±5.7; Tegner score, from 3.1±1.4 to 4.7±1.4, and there were no significant differences in the improvements of the scores between the patients with Dejour B, C and D dysplasia. Overall, ninety percent of the patients returned to their preoperative sports level. One patient reported a postoperative subluxation, while no cases of infection, limited range of motion or patella fracture were observed. PT, LPD and BSO ratio were all significant altered (P < 0.001) after MPFC reconstruction. CONCLUSION Arthroscopically assisted MPFC reconstruction yielded satisfactory midterm clinical results for recurrent patellar dislocation with high-grade trochlear dysplasia. No significant differences of improvements in knee function were observed among the three types of high-grade trochlear dysplasia.
Humans ; Patellar Dislocation/surgery* ; Male ; Female ; Adult ; Arthroscopy/methods* ; Retrospective Studies ; Adolescent ; Young Adult ; Patellofemoral Joint/surgery* ; Recurrence ; Plastic Surgery Procedures/methods* ; Patella/surgery* ; Treatment Outcome

To explore the application value of endoscopic ultrasound fine-needle aspiration (EUS-FNA) and endoscopic retrograde cholangiopancreatography (ERCP) in the diagnosis and treatment ofpatients with pancreatic cancer combined with obstructive jaundice.

Population aging trend is taking place in our country,and low back pain is a symptom of neuromuscular diseases of concern in the elderly.Accurately analyzing the disease of low back pain is important for both timely intervention and rehabilitation of patients.As a kind of bioelectrical signal,the acquisition and analysis of lumbar electromyography(EMG)signal is an important direction for the study of low back pain.The study reviews the acquisition of lumbar EMG by different types of sensors,introduces the signal characteristics of needle electrodes,surface electromyography electrodes and array electrodes,describes the use of signal algorithms,points out that wireless sensors and the use of deep learning algorithms are the direction of development,and puts forward prospects for its further development.

The demand for rehabilitation therapists is rising in response to social development, disease spectrum changes and population aging. Under the guidance of the integration of rehabilitation and clinical medicine, Beijing Rehabilitation Hospital has carried out a comprehensive scientific design and practice in the sub-professional training mode for new rehabilitation therapists according to the discipline development and clinical needs, strengthened their training of sub-professional skills, and provided an effective way to standardize the profession admission and specialty advancement.

Objective: “Food addiction” may be one of the drivers of the obesity epidemic. Bariatric surgery-induced weight loss can significantly alleviate food addiction in overweight or obese people. Appetite regulation is part of the feedback control system for energy balance. The purpose of this study was to investigate the effects of mobile application-based dietary intervention on weight-loss and food addiction in overweight and obese adults. Methods: A total of 101 overweight or obese people aged over 18 years, who were admitted to the obese multidisciplinary clinic of Ningbo First Hospital from August 2015 to January 2018 were enrolled. All subjects received health education and dietary guidance, and submitted their diet log through the weight management application of their smartphone. Over 12 weeks, a dietitian guided and corrected the subjects who did not meet the diet standards. Interviews, physical examinations, laboratory tests, and the Yale Food Addiction Scale Questionnaire survey were administered before and after the intervention (12 weeks) comparing subjects’ weight, food addiction symptom count, and the proportion of food addiction before and after intervention. Statistical analysis of body composition measurements, blood biochemical parameters, and symptom count scores was performed using paired data t-test, McNemar chi-square test, and Fisher’s exact test. Results: A total of 101 overweight and obese subjects were enrolled, including 31 males and 70 females, with an average age of (30.4±7.3) years, mean body mass index of (32.76±4.46) kg/m², and average body weight of (89.95±17.12) kg. The proportion of food addiction was 26.73%. After 12 weeks of dietary intervention with the mobile application, the number of people with food addiction decreased from 27 to 14, the proportion of food addiction decreased by 12.87%, the proportion of symptom counts ≥3 decreased from 41.58% to 19.80%.（χ²=5.17， 11.26, all P <0.01), and the symptom count decreased from 2.25 ±1.61 to 1.50±1.31 (t=3.64, P<0.001). Simultaneously, body weight, BMI, and waist circumference decreased by (6.54±1.03) kg, (2.35±0.36) kg/m², and (6.50±0.86) cm (t=6.36, 5.62 and 3.78, all P<0.001), respectively, compared with those before the intervention. Metabolic indicators such as fasting glucose, insulin resistance index, and LDL-C cholesterol also significantly improved, with a decrease of (0.38±0.10) mmol/L, 1.83±0.46, (0.22±0.75) mmol/L (t=3.67, 3.59, 2.97, all P<0.01). Conclusion The smartphone application-based dietary intervention can effectively improve blood glucose and lipid levels in overweight and obese people, reduce visceral fat accumulation and reduce insulin resistance, and improve the food addiction status of overweight and obese people.

Tertiary rehabilitation hospitals should not only serve patients with systemic and specialized rehabilitations but also have capabilities in diagnosis/treatment,and even emergency responses.This paper introduced an integrated care mode at a rehabilitation hospital,in practicing in-depth and phased integration of clinical service and rehabilitation.Phase 1 (March 2015-March 2016) witnessed the "two-way" model,with coexisting rehabilitation pathway and clinical pathway.The second phase,from April 2016 to September 2017,witnessed the integrated care mode in which clinicians and physiatrists jointly took care of patients.A comparison between the same period of 2016 with data of 2015,and that of 2017 with data of 2016,found average length of stay was shortened by 0.5 day and 3.6 days respectively,the drug ratio fell by 4.63％ and 8.47％ respectively;the rehabilitation effective percentage was increased from 95.2％ to 98.0％.The percentage of cure or improvement for primary diseases was over 97％.The integrated care mode by both clinicians and physiatrists can shorten the length of stay,lower the drug ratio,raise medical efficiency,and encourage a more reasonable ratio of medical expenses.

Objective: To explore the effects of microRNA-34a on regulating silent information regulator 1 (SIRT1) and influence of SIRT1 on myocardial damage of rats with severe burns at early stage. Methods: (1) Twenty-four Sprague-Dawley (SD) rats were divided into sham injury (SI) group, simple burns (SB) group and SIRT1 agonist (SA) group according to the random number table (the same grouping method below), with 8 rats in each group. Rats in groups SB and SA were inflicted with 30% total body surface area full-thickness scald (hereinafter referred to as burns) on the back, and rats in group SI were sham injuried on the back. Immediately after injury, rats in groups SI and SB were intraperitoneally injected with normal saline of 50 mL/kg, and rats in group SA were intraperitoneally injected with normal saline of 50 mL/kg and 1 mg/mL resveratrol of 50 mg/kg. At 6 h post injury, abdominal aortic blood was collected to make serum and myocardial tissue of rats was collected. (2) Myocardial cells of twelve neonatal SD rats were collected and divided into microRNA-34a mimic control (MMC) group, microRNA-34a mimic (MM) group, microRNA-34a inhibitor control (MIC) group, and microRNA-34a inhibitor (MI) group, which were respectively transfected with gene sequences of mimic control, mimic, inhibitor control, and inhibitor of microRNA-34a. The microRNA-34a expression level and protein expression level of SIRT1 in myocardial cells were respectively detected by real-time fluorescence quantitative reverse transcription polymerase chain reaction (RT-PCR) and Western blotting. Another batch of myocardial cells were divided into microRNA-34a inhibitor control+ burn serum (MCB) group, microRNA-34a inhibitor+ burn serum (MB) group, and microRNA-34a inhibitor+ burn serum + EX527 (MBE) group. Myocardial cells in group MCB were transfected with gene sequence of inhibitor control, and myocardial cells in the later groups were transfected with gene sequence of inhibitor of microRNA-34a. After transfection of 48 h, myocardial cells in group MBE were cultured in Dulbecco′s modified Eagle′s medium (DMEM) solution for 6 hours, with serum in group SB of volume fraction of 10% and final amount-of-substance concentration of 1 mol/L, and myocardial cells in the other 2 groups were cultured in DMEM solution with serum from rats of group SB of volume fraction of 10%. The protein expression levels of myocardial cells of SIRT1, cleaved-caspase-3, and Bax were detected by Western blotting. (3) Myocardial tissue from (1) was collected to detect expression levels of microRNA-34a and mRNA of SIRT1 in groups SI and SB by real-time fluorescence quantitative RT-PCR. Morphology of myocardial tissue of rats in groups SI, SB, and SA was observed with biological image navigator. The mRNA expression levels of interleukin 1β (IL-1β) and tumor necrosis factor (TNF-α) of rats in groups SI, SB, and SA were detected by real-time fluorescence quantitative RT-PCR. The expression levels of cleaved-caspase-3, and Bax of myocardial tissue of rats in groups SI, SB, and SA were detected by Western blotting. Data were processed with one-way analysis of variance and least-significant difference test. Results: (1) After transfection of 48 h, the expression level of microRNA-34a of myocardial cells in group MM was 4.67±0.92, significantly higher than 1.03±0.04 in group MMC (P<0.01); the protein expression level of SIRT1 of myocardial cells in group MM was 0.35±0.06, significantly lower than 1.12±0.11 in group MMC (P<0.01). After transfection of 48 h, the expression level of microRNA-34a of myocardial cells in group MI was 0.26±0.07, significantly lower than 1.33±0.07 in group MIC (P<0.01); the protein expression level of SIRT1 of myocardial cells in group MIC was 1.12±0.16, significantly lower than 1.74±0.34 in group MI (P<0.01). At 6 h after culture, compared with those in group MCB, the SIRT1 protein expression level of myocardial cells in group MB was significantly increased (P<0.05), while cleaved-caspase-3 and Bax protein expression levels of myocardial cells in group MB were significantly decreased (P<0.05). Compared with those in group MB, the SIRT1 protein expression level of myocardial cells in group MBE was with no significantly statistical difference (P>0.05), and cleaved-caspase-3 and Bax protein expression levels were significantly increased (P<0.05). (2) At 6 h post injury, compared with that in group SI, the microRNA-34a expression level of myocardial tissue in group SB was significantly increased (P<0.01), and the mRNA expression level of SIRT1 of myocardial tissue in group SB was significantly decreased (P<0.01). At 6 h post injury, myocardial cells in group SI arranged neatly with normal nucleus and no inflammatory cells infiltration; myocardial cells in group SB arranged disorderly, with no abnormal nucleus, and obvious inflammatory cells infiltration; myocardial cells in group SA arranged neatly, with normal nucleus and little inflammatory cells infiltration. At 6 h post injury, compared with those in group SB, the mRNA expression levels of IL-1β and TNF-α, and the protein expression levels of cleaved-caspase-3 and Bax of myocardial tissue in groups SI and SA were significantly decreased (P<0.01). Conclusions The microRNA-34a expression level of myocardial tissue of rats with severe burns at early stage increases, which decreases the expression level of SIRT1, and increases the expression levels of IL-1β, TNF-α, cleaved-caspase-3 and Bax, leading to obvious myocardial damage. Activation of SIRT1 can alleviate myocardial damage of rats with severe burns at early stage through decreasing expression levels of IL-1β, TNF-α, cleaved-caspase-3, and Bax.

Objective To compare the early analgesic effects of continuous femoral nerve block analgesia (CFNB) and patient controlled intravenous analgesia (PCIA) and their effects on functional recovery after total knee arthroplasty.Methods Retrospective analysis was conducted on 60 ASA Ⅰ and ASA Ⅱ patients with unilateral total knee arthroplasty in our hospital from January 2014 to January 2015.The patients were divided into two groups,CFBN group (treatment group) and PCIA group (control group),with 30 patients in each group.VAS scores of postoperative ipsilateral knee resting and movement pain,range of postoperative knee joint motion (ROM),muscle strength of femoral quadriceps,incidence rates of adverse reaction within 7 days after operation,HSS score 3 months before and after the operation,and discharge time were observed.Results Postoperative VIS score in CFNB group was lower than that in PCIA group.ROM and muscle strength of femoral quadriceps in CFBN group were better than those in PCIA group on day 1,2,3,5,and 7 after the operation.Postoperative adverse reaction rate within 7 days in PCIA group was significantly higher than that in CFNB group.HSS score three months after the operation in CFNB group was higher than that in PCIA group.Discharge time of CFNB group was significantly earlier than that of PCIA group (P＜0.05).Conclusion Compared with PCIA analgesia,CFNB analgesia shows better analgesic effect.It can alleviate early knee joint pain after TKA,increase joint motion,significantly shorten the hospitalization time,promote joint exercises which are effective in functional rehabilitation,and decrease the incidence of adverse reactions like nausea and vomiting.

Objective To estimate the effect of low molecular weight heparin (LMWH) combined with conventional treatment on patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD).Methods Literature on randomized control trials( RCTs) with AECOPD treated by LMWH combined with conventional methods was collected in PubMed.The studies were selected according to inclusive and exclusive criteria.The data were extracted,the quality was assessed, and meta-analysis was conducted with RevMan 5.2 software.Results There were twelve RCTs including 879 patients with AECOPD in the current study.The results of meta-analysis showed that:①LMWH could obviously improve PaO2 and PaCO2 of patients with AECOPD as compared with the control group.②There was no statistically significant difference between the LMWH-treated group and control group in the improvement of FEV1 or hematocrit.Conclusion LMWH can significantly improve arterial blood gas analysis in AECOPD, but does not improve FEV1 or hematocrit.