Objective:To analyze the efficacy of arthroscopic release of the lateral patellofemoral retinaculum (LPR) combined with medial patellofemoral ligament (MPFL) compression for the treatment of moderate to severe patellofemoral arthritis.Methods:A prospective study method was used to select 101 patients with moderate to severe patellofemoral arthritis who were admitted to the Jinzhou Medical University Shanghai Fengxian District Central Hospital from January 2021 to December 2023. They were randomly divided into group A (50 cases, LPR release surgery under knee arthroscopy) and group B (51 cases, LPR release surgery combined with MPFL compression surgery under knee arthroscopy). Perioperative indexes, pain degree of patellofemoral joint, patellofemoral trajectory correction, knee joint function and patellofemoral joint function were compared between the two groups before and 6 months after surgery.Results:During the study period, both group A and group B were excluded or separated, and ultimately 47 and 49 patients were enrolled in group A and group B, respectively. The operation time of group B was longer than that of group A: (35.27 ± 3.09) min vs. (25.64 ± 2.66) min, with statistically significant differences ( P<0.05). Six months after surgery, both groups experienced a reduction in pain, with group B being milder than group A: no pain 75.51% (37/49) vs. 44.68% (21/47), mild pain 24.49% (12/49) vs. 38.30% (18/47), moderate pain 0 vs. 14.89% (7/47), and severe pain 0 vs. 2.13% (1/47). The difference was statistically significant ( P<0.05). Six months after surgery, the patellofemoral adaptation angle, patellofemoral tilt angle, and patellofemoral lateral displacement distance in both groups decreased, and group B was smaller than group A: (8.02 ± 1.62)° vs. (10.35 ± 1.54)°, (8.71 ± 1.08)° vs. (10.85 ± 0.75)°, 1.00 (1.00, 1.00) mm vs. 1.00 (1.00, 1.00) mm, with statistically significant differences ( P<0.05). Both groups showed an increase in Lysholm knee score scale and patellar Kujala score, with group B being higher than group A: (89.92 ± 4.02) points vs. (84.21 ± 5.65) points and (89.18 ± 2.57) points vs. (87.40 ± 3.38) points, with statistically significant differences ( P<0.05). Conclusions:Arthroscopic release of LPR combined with MPFL compression surgery is more effective in treating moderate to severe patellofemoral arthritis than arthroscopic release of LPR. It can improve the correction of patellofemoral trajectory, reduce pain, and facilitate the recovery of knee and patellar joint function.

Objective:To analyze the efficacy of arthroscopic release of the lateral patellofemoral retinaculum (LPR) combined with medial patellofemoral ligament (MPFL) compression for the treatment of moderate to severe patellofemoral arthritis.Methods:A prospective study method was used to select 101 patients with moderate to severe patellofemoral arthritis who were admitted to the Jinzhou Medical University Shanghai Fengxian District Central Hospital from January 2021 to December 2023. They were randomly divided into group A (50 cases, LPR release surgery under knee arthroscopy) and group B (51 cases, LPR release surgery combined with MPFL compression surgery under knee arthroscopy). Perioperative indexes, pain degree of patellofemoral joint, patellofemoral trajectory correction, knee joint function and patellofemoral joint function were compared between the two groups before and 6 months after surgery.Results:During the study period, both group A and group B were excluded or separated, and ultimately 47 and 49 patients were enrolled in group A and group B, respectively. The operation time of group B was longer than that of group A: (35.27 ± 3.09) min vs. (25.64 ± 2.66) min, with statistically significant differences ( P<0.05). Six months after surgery, both groups experienced a reduction in pain, with group B being milder than group A: no pain 75.51% (37/49) vs. 44.68% (21/47), mild pain 24.49% (12/49) vs. 38.30% (18/47), moderate pain 0 vs. 14.89% (7/47), and severe pain 0 vs. 2.13% (1/47). The difference was statistically significant ( P<0.05). Six months after surgery, the patellofemoral adaptation angle, patellofemoral tilt angle, and patellofemoral lateral displacement distance in both groups decreased, and group B was smaller than group A: (8.02 ± 1.62)° vs. (10.35 ± 1.54)°, (8.71 ± 1.08)° vs. (10.85 ± 0.75)°, 1.00 (1.00, 1.00) mm vs. 1.00 (1.00, 1.00) mm, with statistically significant differences ( P<0.05). Both groups showed an increase in Lysholm knee score scale and patellar Kujala score, with group B being higher than group A: (89.92 ± 4.02) points vs. (84.21 ± 5.65) points and (89.18 ± 2.57) points vs. (87.40 ± 3.38) points, with statistically significant differences ( P<0.05). Conclusions:Arthroscopic release of LPR combined with MPFL compression surgery is more effective in treating moderate to severe patellofemoral arthritis than arthroscopic release of LPR. It can improve the correction of patellofemoral trajectory, reduce pain, and facilitate the recovery of knee and patellar joint function.

BACKGROUND/OBJECTIVES: Previous research has shown maternal betaine supplementation alleviates fetal-derived hepatic steatosis. Therefore, this study examined the anti-inflammatory effect of maternal betaine intake in offspring mice and its mechanism.MATERIALS/METHODS: Female C57BL/6J mice and their offspring were randomly divided into 3 groups according to the treatment received during gestation and lactation: control diet (CD), fatty liver disease (FLD), and fatty liver disease + 1% betaine (FLD-BET). The FLD group was given a high-fat diet and streptozotocin (HFD + STZ), and the FLD-BET group was treated with HFD + STZ + 1% betaine. After weaning, the offspring mice were given a normal diet for 5 weeks and then dissected to measure the relevant indexes. RESULTS: Compared to the CD group, the offspring mice in the FLD group revealed obvious hepatic steatosis and increased serum levels of alanine aminotransferase, interleukin (IL)-6, and tumor necrosis factor (TNF)-α; maternal betaine supplementation reversed these changes. The hepatic mRNA expression levels of IL-6, IL-18, and Caspase-1 were significantly higher in the FLD group than in the CD group. Maternal betaine supplementation reduced the expression of IL-1β, IL-6, IL-18, and apoptosis-associated speck-like protein containing C-terminal caspase recruitment domain (ASC). Maternal betaine supplementation also reversed the increasing protein expressions of nitric oxide dioxygenase-like receptor family pyrin domain containing 3 (NLRP3), ASC, Caspase-1, IL-1β, and IL-18 in offspring mice exposed to HFD + STZ. Maternal betaine supplementation decreased the homocysteine (Hcy) and s-adenosine homocysteine (SAH) levels significantly in the livers. Furthermore, the hepatic Hcy concentrations showed significant inverse relationships with the mRNA expression of TNF-α, NLRP3, ASC, and IL-18. The hepatic SAH concentration was inversely associated with the IL-1β mRNA expression. CONCLUSIONS The lipotropic and anti-inflammatory effect of maternal betaine supplementation may be associated with the inhibition of NLRP3 inflammasome in the livers of the offspring mice.

Objective To evaluate the effect of dexmedetomidine on Toll-like receptor 4 ( TLR4)/myeloid differentiation factor 88 ( MyD88)/nuclear factor Kappa B ( NF-κB) signaling pathway in the pe-ripheral blood mononuclear cells of elderly patients with diabetes mellitus undergoing lower extremity surger-y. Methods Forty elderly patients of both sexes with type 2 diabetes mellitus, aged 65-80 yr, with body mass index of 18. 5-27. 9 kg/m2 , of American Society of Anesthesiologists physical status Ⅱ or Ⅲ, with New York Heart Association Ⅰ or Ⅱ, undergoing lower extremity surgery with tourniquets under general anesthesia, were divided into 2 groups ( n=20 each) by using a random number table method: control group ( group C) and dexmedetomidine group ( group D) . Combined intravenous-inhalational anesthesia was applied. Dexmedetomidine was infused over 15 min in a dose of 1μg/kg after induction of anesthesia, fol-lowed by a continuous infusion of 0. 5 μg·kg-1 ·h-1 until the end of surgery in group D, while the equal volume of normal saline was given instead of dexmedetomidine in group C. Before using the the tourniquet and at 15 min, 1 h and 24 h after loosing the tourniquet, arterial blood samples were collected for determi-nation of the expression of TLR4, NF-κB and MyD88 in peripheral blood mononuclear cells and concentra-tions of tumor necrosis factor-alpha ( TNF-α) , interleukin-1β ( IL-1β) , cardiac troponin I ( cTnI ) and creatine kinase-MB ( CK-MB) in plasma. Results Compared with group C, the expression of TLR4, NF-κB and MyD88 in peripheral blood mononuclear cells was significantly down-regulated, and the concentra-tions of TNF-α, IL-1β, cTnI and CK-MB in plasma were decreased at each time point after loosing the tourniquet in group D ( P＜0. 05) . Conclusion The mechanism by which dexmedetomidine reduces myo-cardial damage may be related to inhibiting TLR4/MyD88/NF-κB signaling pathway and reducing systemic inflammatory responses in elderly patients with diabetes mellitus undergoing lower extremity surgery.

OBJECTIVE:To study the protective effects and the mechanism of Rabdosia serra water extract(RWE)on hepatic fibrosis(HF)induced by carbon tetrachloride(CCl4)in rats. METHODS:Sixty male SD rats were randomly divided into normal group,model group,colchicine group(0.12 mg/kg),and RWE low-dose,medium-dose and high-dose groups(4,8,16 g/kg,by crude drug),with 10 rats in each group. Except for intraperitoneal injection of olive oil for normal group,other groups were given 40% CCl4olive oil solution intraperitoneally to induce HF model. Since the first day of modeling,each treatment group was given relevant medicine (10 mL/kg) intragastrically, while normal group and model group were given constant volume of water intragastrically,once a day,for consecutive 6 weeks. After medication,biochemical process or ELISA were used to determine the contents of ALT,AST,HA,LN,PCⅢ and Ⅳ-C in serum,the activities or contents of SOD,GSH-Px,MDA,TNF-α,IL-6 and IL-1β in liver tissue. Pathological changes of liver tissue in rats were observed by HE staining. The expression of α-SMA and TGF-β1 in liver tissue were detected by Western blot. RESULTS:Compared with normal group,the contents of ALT,AST,LN,HA,PCⅢ and Ⅳ-C in serum,the contents of MDA,TNF-α,IL-6 and IL-1β in liver tissue were all increased significantly in model group (P＜0.01);the activities of SOD and GSH-Px in liver tissue were decreased significantly(P＜0.01). Liver fibrosis was obvious, and the relative expression of α-SMA and TGF-β 1were increased significantly (P＜0.01). Compared with model group,the contents of ALT,AST,HA,LN,PCⅢ and Ⅳ-C in serum as well as the contents of MDA,TNF-α and IL-6 in liver tissue in colchicines group and RWE groups,the contents of IL-1 β in liver tissue of rats in colchicines group,RWE medium-dose and high-dose groups were all decreased significantly (P＜0.05 or P＜0.01). The activities of SOD and GSH-Px in liver tissue of rats were increased significantly in colchicines group and RWE groups(P＜0.05 or P＜0.01). The fibrosis degree of liver tissue was significantly reduced, while the relative expression of α-SMA and TGF-β 1decreased significantly (P＜0.01). CONCLUSIONS:RWE can protect CCl4-induced HF model rats,the mechanism of which may be associated with regulating lipid metabolism,relieving liver lipid peroxidation injury and anti-oxidative stress response,inhibiting the release of inflammatory factors and the expression of TGF-β1.

Objective To compare the quality of life at baseline and at 3 months after coronary artery bypass grafting(CABG) and investigate the related risk factors. Methods The prospective study included 121 consecutive patients reaching inclusion criteria and undergoing CABG between June 2009 and May 2016. Health status survey was measured with short form-36(SF-36)at baseline and at 3 months after CAGB. Change of quality of life and influencing factors and quality of life were analyzed. Results Eight domains including physical functioning ,role-physical ,bodily pain,general health,vitality,social functioning,role-emotional and mental health and two component summaries including physical component summary(PCS)and mental component summary (MCS)of SF-36 were significantly improved at 3 months following CAGB(all P<0.01). Moreover,advanced age, women,diabetes mellitus,assisted ventilation time,hospital stay and use of t-PA were relative to the PCS after CAGB. Conclusions The findings demonstrate quality of life is significantly improved at 3 months post CAGB. Advanced age,underlying disease,serious disease,women and lower PCS score prior to CAGB are linked with low PCS after CAGB.

Objective To evaluate the efficacy of dexmedetomidine for improvement of postoperative analgesia with sufentanil in pediatric patients with a large area of burn after tangential excision and skin grafting.Methods Forty-two pediatric patients of both sexes with a large area of burn,of American Society of Anesthesiologists physical status Ⅱ or Ⅲ,aged 2-10 yr,weighing 13-36 kg,scheduled for elective tangential excision and skin grafting under combined propofol-remifentanil-sevoflurane anesthesia,were randomly divided into 2 groups (n=21 each) using a random number table:sufentanil group (group Suf) and dexmedetomidine plus sufentanil group (group Dex-Suf).The patient-controlled intravenous analgesia (PCIA) was used for postoperative analgesia.PCIA solution contained sufentanil 2 μg/kg and granisetron 100 μg/kg in 100 ml of normal saline in group Suf,and contained dexmedetomidine 2.5 μg/kg,sufentanil 1.5 μg/kg,and granisetron 100 μg/kg in 100 ml of normal saline in group Dex-Suf.The PCA pump was set up with a 0.5 ml bolus dose,a 15 min lockout interval and background infusion at a rate of 2 ml/h after a loading dose of sufentanil 0.1 μg/kg.When Faces Pain Scale score＞2,sufentanil 0.1 μg/kg was injected intravenously as rescue analgesic.The consumption of sufentanil was recorded within 48 h after operation.Ramsay sedation scores at static and dynamic (during dressing changes) conditions were assessed after operation.The parents' satisfaction,requirement for rescue analgesics and incidence of adverse reactions such as agitation,nausea and vomiting were recorded after operation.Results Compared with group Suf,Ramsay sedation scores at static and dynamic conditions and patients' satisfaction scores were significantly increased,and the consumption of sufentanil,requirement for rescue analgesics and incidence of agitation,nausea and vomiting were significantly decreased after operation in group Dex-Suf (P＜0.05).Conclusion Dexmedetomidine significantly improves postoperative intravenous analgesia with sufentanil in the pediatric patients with a large area of burn after tangential excision and skin grafting,and combination of dexmedetomidine and sufentanil is recommended for this type of pediatric patients.

Objective To observe the clinical efficacy of acupuncture plus Chinese medicinal fumigation in treating chronic pelvic inflammatory disease (CPID).Method Totally 120 CPID patients were randomized into group A, group B and group C, 40 cases in each group. Group A was intervened by acupuncture plus Chinese medicinal fumigation, group B was by dry acupuncture treatment, while group C was by Chinese medicinal fumigation alone. After 3 treatment courses, the clinical efficacies were observed, and the relapse rates among the cured cases in 8 months after the whole treatment were compared among the 3 groups.Result The total effective rate and recovery rate were respectively 95.0% and 70.0% in group A, versus 82.5% and 45.0% in group B, and 57.5% and 32.5% in group C, and the total effective rate and recovery rate in group A were significantly different from that in group B and group C (P<0.05). The treatment duration for the recovered cases in group A was significantly different from that in group B and C (P<0.05). The relapse rate in the recovered cases in the 8-month follow-up was 10.7% in group A, versus 44.4% in group B and 53.8% in group C, and the relapse rate in group A was markedly lower than that in group B and C (P<0.05).Conclusion Acupuncture plus Chinese medicinal fumigation is an effective method in treating CPID, and its advantages include content efficacy, short treatment duration, and low relapse rate, etc.

Objective To study the effect of health education on compliance of patients undergoing anticoagulant therapy after cardiac valve replacement? Methods One hundred and six patients undergoing anticoagulant therapy after cardiac valve replacement received enhanced health education after cardiac valve replacement? A self-designed questionnaire was used to investigate their treatment compliance and mastery of related knowledge pre-and postoperatively? Result The mastery of the knowledge related to anticoagulant therapy and the compliance were significantly improved compared to pre-health education(bothP < 0?05)? Conclusion The health education may improve the recognition of anti-coagulant therapy as well as compliance of patients?

Objective To investigate the effects of the routine needle-withdrawing method and improved needle-withdrawing method? Methods One hundred patients undergoing intravenous transfusion were randomized into the control group and the improvement group (255 times of transfusion ), with 50 cases in each group: the former was treated with routine needle-withdrawing method and the latter with the improved method? Complications after needle-withdruing were compared between the two groups? Result The rates of pains, subcutaneous bleeding or bleeding at the puncture points in the improvement group were all significantly lower than those of the control group (P<0?001)? Conclusion The improved needle-withdrawing method is effective in reducing the rate of post-withdrawal complications and improve the safety of intravenous transfusion?