Traumatic cerebrospinal fluid leakage commonly presents in traumatic brain injury patients, and it may lead to complications such as meningitis, ventriculitis, brain abscess, subdural hematoma or tension pneumocephalus. When misdiagnosed or inappropriately treated, traumatic cerebrospinal fluid leakage may result in severe complications and may be life-threatening. Some traumatic cerebrospinal fluid leakage has concealed manifestations and is prone to misdiagnosis. Due to different sites and mechanisms of trauma and degree of cerebrospinal fluid leak, treatments for traumatic cerebrospinal fluid leakage varies greatly. Hence, the Craniocerebral Trauma Professional Group of Neurosurgery Branch of Chinese Medical Association and the Neurological Injury Professional Group of Trauma Branch of Chinese Medical Association organized relevant experts to formulate the " Chinese expert consensus on the diagnosis and treatment of traumatic cerebrospinal fluid leakage in adults ( version 2023)" based on existing clinical evidence and experience. The consensus consisted of 16 recommendations, covering the leakage diagnosis, localization, treatments, and intracranial infection prevention, so as to standardize the diagnosis and treatment of traumatic cerebrospinal fluid leakage and improve the overall prognosis of the patients.

Objective To investigate the geographic landscape features in Yulong plague natural focus.Methods Four altitudinal gradients (2 400-,2 600-,2 800-,≥3 000 m) were selected as study objects in Yulong plague natural focus from December 2015 to November 2016 to collect and analyze geographic landscape factors (topography and terrain,climate,water areas,vegetation and soil) based on the literatures about this plague focus.Results Yulong plague natural focus was an area with mid-mountain and subalpine topography in northwestern Yunnan Province,and its terrain had the character of lower in the southeast and higher in the northwest.This area belonged to plateau warm temperate monsoon climate of low latitude with an average month temperature 13.6 ℃ from 2005-2016,month air relative humidity averaged 59.4％,and rainfall averaged 884.5 mm a year,which concentrated mostly from June to September.About 98.1％ of the water area in Yulong County was controlled by Chin-sha River.The vegetation and soil were characterized by vertical distribution along with altitude gradients obviously.Conclusion The unique geographical landscape of the plague natural focus in Yulong County is one of important factors affecting the occurrence and epidemic of the plague.

Objective To explore the biomechanical mechanism of non-erosive reflux disease(NERD).MethodsFrom October 4,2014 to September 30,2015,17 NERD patients and 17 healthy controls were recruited from the outpatients department of China-Japan Friendship Hospital.The cross-sectional area(CSA), intra-balloon pressure (IBP)and compliance(Δv/Δp)of each were measured by endoscopy in combination with EndoFlip.ResultsWith the increase of balloon volume,the compliance of gastroesophageal junction in NERD group was significantly higher than that of control group(P<0.01) while the cross sectional area and intra-balloon pressure were similar.Conclusions Increased compliance of the gastroesophageal junction may be involved in the pathogenesis of non-erosive reflux disease.

Objective To determine the intra-and inter-tester reliability of a dynamometer in assessment of knee joint position senses (JPS).Methods Sixteen healthy volunteers (intra-rater N =6,inter-rater N =10) were examined with regard to intra-and inter-tester reliability of knee JPS by using Biodex System 3 dynamometer,measured by passive replication test,with subjects passively returning to the initial positions at 30°,45° and 60° knee flexion.The absolute error (AE) angle was recorded.Both intra-and inter-tester reliability studies involved two testers.Results The intra-tester reliability of the AE were moderate reliable at 30°,45°and 60° knee flexion,and the values of intra-class correlation coefficients (ICC) were 0.728,0.780 and 0.807,respectively.The values of Pearson's correlation coefficients for inter-tester reliability were 0.676,0.610 and 0.705,respectively (P ＜ 0.05).There was no significant difference between the AE values of dominance and non-dominant knees,test and retest,and in the AE values of 30°,45°and 60° knee flexion (P ＞ 0.05).The 95％ confidence upper limits of all subjects' AE values were less than 3°.Conclusion The major findings of this study suggest that the test-retest reliability of the knee JPS were moderate using Biodex System 3 dynamometer,and selecting a target angle of passive replication test can achieve the same purpose in 30° to 60°knee flexion.The clinical significance should be taken into consideration when the AE changes were greater than 3 degrees.

Objective To observe and compare the functional outcomes of early rehabilitation of persons who received primary bilateral or unilateral total knee arthroplasty (TKA).Methods Sixty-eight subjects were divided into a unilateral TKA group (36 cases) and a bilateral TKA group (32cases).All received the same professional rehabilitation program during an average postoperative hospital stay of (15.00 ± 3.71 ) days.At discharge,a visual analogue scale (VAS) was used to rate pain.Active range of motion (AROM) of the involved knee,knee injury and an osteoarthritis outcome score (KOOS) were also assessed.The KOOS and knee society score (KSS) were evaluated at follow-up about 11 months later.Results There was no significant difference between the two groups in any assessment at discharge,nor in the KOOS and KSS-Ⅰ assessments at follow-up.The KOOS of both groups at follow-up had improved significantly compared with that at discharge.The KSS-Ⅱ results in the bilateral group were slightly better than those in the unilateral group at follow-up,and that difference was significant.Conclusions Bilateral TKA patients and unilateral TKA patients had the same clinical outcomes after early postoperative rehabilitation,but the functional outcomes of bilateral TKA patients were better than those of unilateral TKA patients a year later.

ObjectiveTo investigate reproducibility of cardiac MRI for assessment of cardiac morphology and ventricular function in selected normal Chinese Han population.MethodsTwo hundred and sixty-nine normal volunteers underwent cardiac MRI using a 1.5 T MR system.HASTE and steady state free precession imaging were performed with long and short axis images and cine mode through the ventricle with wireless vector cardiac gating.The images were reviewed by two independent observers.The dimensions of cardiac chambers and ventricular function including ejection fraction (EF),end diastolic volume( EDV),end systolic volume (ESV) and myocardial mass were evaluated.The data between male and female were compared by using two-tailed unpaired t test.Results Total imaging time was (15 ± 3 ) min.The anteroposterior diameter of the left atrium was( 2.87 ± 0.77 ) cm,the right atrial diameter perpendicular to the atrial septum was ( 3.61 ± 0.57 ) cm,the end diastolic diameter of the left ventricle was (4.97 ±0.52) cm,the end diastolic diameter of the right ventricle was (2.65 ± 0.48) cm.On the left ventricle,EF was(60.62 ±7.08)％,EDV was (115.37 ±26.71) ml,ESV was (46.02+15.72) ml and LV mass was ( 82.97± 24.03 ) g.On the right ventricle,EF was (47.73 ± 6.50 ) ％,EDV was ( 128.27 ± 32.16 )ml,ESV was (67.7 ± 21.07) ml and RV mass was (48.24 ± 13.42) g.There were no statistically significant differences in LVESV( P =0.144 ),LVEDV index ( P =0.714 ),LVESV index ( P =0.113 ),LVCI ( P =0.199),RVEF ( P =0.296 ) and RV mass ( P =0.093 ),and statistically significant differences in other cardiac parameters between male and female.Conclusion Cardiac MRI can provide useful information about cardiac function and morphology with a high level of reproducibility in normal Chinese Han population.

ObjectiveTo investigate the shoulder-hand syndrome complicated in stroke patients discharged from hospital and effects of intervention for it on motor function.Methods112 stroke patients discharged from hospital were divided into treatment group and control group. The treatment group received intervention to provent and treat the shoulder-hand syndrome. They were assessed with Fugl-Meyer assessment, Barthel index 15 d, 1 month, 3 month, and 6 month after discharged, and the incidence of shoulder-hand syndrome were recorded. ResultsThe scores of Fugl-Meyer Assessment and Barthel Index were significant difference between these 2 groups (P<0.01). The incidence of shoulder-hand syndrome increased with time. ConclusionShoulder-hand syndrome may occur within 6 months after stroke. It is important to develop an effective prevention, treatment and rehabilitation to deal with it.

OBJECTIVETo investigate phytoestrogenic effects of ferulic acid in ER-positive T47D and ER-negative MDA-MB231 cells in culture.

METHODT47D and MDA-MB231 human breast cancer cells were treated with ferulic acid and examined cell proliferation by means of MTT assay. Cell cycle distribution, ERalpha and ERbeta expression were treated by flow cytometer. The pS2 mRNA expressions were detected by real-time fluorescence quantitative PCR.

RESULTThe proliferations were enhanced significantly by treatment with ferulic acid on T47D cells and the proliferation effects were inhibited by adding Faslodex (1 x 10(-8) mol x L(-1)). However, there was no significant difference on the proliferation in MDA-MB-231 cells compared with solvent control group by both treatment with ferulic acid and co-treatment with Faslodex (1 x 10(-8) mol x L(-1)). Ferulic acid stimulated the amount of T47D cells in phase S and proliferation index increased significantly. The effects were inhibited by treatment with Faslodex (1 x 10(-8) mol x L(-1)), and the amount of cells in phase S and proliferation index decreased, the amount of cells in G0/G1 phase increased, cell cycle of T47D was arrested in G0/G1 phase. Ferulic acid up-regulated pS2 mRNA expressions and increased the level of ERalpha protein expression in T47D cells. Ferulic acid did not show remarkable effect to the level of ERbeta protein expression in T47D cells.

CONCLUSIONFerulic acid possessed phytoestrogenic effect by up-regulating pS2 gene expression and the receptor subtype of ERalpha.

Breast Neoplasms ; chemistry ; pathology ; Cell Line, Tumor ; Cell Proliferation ; drug effects ; Coumaric Acids ; pharmacology ; Estrogen Receptor alpha ; analysis ; Estrogen Receptor beta ; analysis ; Female ; Gene Expression Regulation, Neoplastic ; drug effects ; Humans ; RNA, Messenger ; analysis ; Trefoil Factor-1 ; Tumor Suppressor Proteins ; genetics

BACKGROUND: Early rehabilitation following total knee replacement has arisen more attention. The aim of continuous passive joint motion is to recover knee function, prevent anchylosis, accelerate blood and synovia circulation, therefore, enhance tissue repair. OBJECTIVE: To evaluate the efficacy of continuous passive joint motion following total knee replacement. METHODS: Totally 48 patients, who underwent artificial total knee arthroplasty at the Department of Orthopedics, Center Hospital of Minhang District, Shanghai Ruikang Hospital Group and Department of Rehabilitation Medicine, 309~(th) Hospital of Chinese PLA between December 2007 and October 2009 were selected. The patients were randomly divided into the experimental and control groups, with 24 cases in each group. The isometric contraction of qudraceps muscles, combined with physical agent assistant, was performed prior to total knee replacement. Patients in the experimental group was received continuous passive joint motion training at day 2 after operation, with 5°-10°increasing per day. Patients in the control group were treated with conventional methods. The knee functional score, and visual analog scale (VAS) was performed to evaluate knee functions and pains, in addition, perimeter between two legs; and range of motion were measured. RESULTS AND CONCLUSION: The knee functional score, VAS, perimeter between two legs, and range of motion were similar prior to and after total knee replacement (P > 0.05). Compared to the control group, the knee functional score of the experimental group was dramatically increased at days 3 and weeks 2 after operation (P < 0.01), the VAS and perimeter between two legs were significantly declined (P < 0.01), the range of motion was obvious improved after replacement, with greater excellent rate (P < 0.01). There was no deep venous thrombosis or infections. The results demonstrated that early rehabilitation following knee replacement is conductive to easing pain, eliminating swelling, and enhancing knee stability.

OBJECTIVETo explore the phytoestrogenic-like effects of four kinds of Chinese medicine including Radix rehmanniae preparata, Radix Paeoniae Alba, Radix Angelicae Sinensis, Rhizoma Chuanxiong.

METHODSixty immature female SD rats weighting (70 +/- 5) g were randomly divided into six groups: normal control group, positive control group and 4 Chinese medicine groups. The rats in different groups were treated for 4 days. On the fifth day, animals were sacrificed and uteri were separated solely and weighed. The blood was collected, and serum was separated. The effect of the pharmacological serum on proliferation assay with human breast cancer cell line (MCF7) by MTT method. Cell-cycle analyses were carried out with propidium iodide staining by flow cytometer. The expressions of subtypes-estrogen receptor-alpha (ERalpha) were detected by flow cytometry.

RESULTRadix Rehmanniae Preparata, Radix Paeoniae Alba and Radix Angelicae Sinensis could increase the immature rat's uterus wet weight and the ratio of uterus to body weight (P < 0.05). The pharmacological serum of the four kinds of Chinese medicine stimulated proliferation of MCF7 cell respectively compared with normal control group (P < 0.01). The cell cycle was impulsed from G1 to S, DNA synthesizing was inhanced, and PI was also increased. The pharmacological serum of Radix Angelicae Sinensis and Rhizoma Chuanxiong could increase the expressions of (ERalpha) (P < 0.05).

CONCLUSIONRadix Rehmanniae Preparata, Radix Paeoniae Alba and Radix Angelicae sinensis have phytoestrogenic effects. But the data werent consistent with in vitro and in vivo assay of Rhizoma Chuanxiong.

Animals ; Cell Cycle ; drug effects ; Cell Line, Tumor ; Cell Proliferation ; drug effects ; Drugs, Chinese Herbal ; administration & dosage ; Estrogen Receptor alpha ; genetics ; metabolism ; Female ; Phytoestrogens ; administration & dosage ; Random Allocation ; Rats ; Rats, Sprague-Dawley ; Uterus ; cytology ; drug effects ; metabolism