OBJECTIVE: To explore the effectiveness of arthroscopic release of elbow joint assisted by medial small incision ulnar nerve release in the treatment of non-traumatic elbow stiffness. METHODS: The clinical data of 15 patients with non-traumatic elbow stiffness treated with arthroscopic release of elbow joint assisted by medial small incision ulnar nerve release between April 2019 and September 2023 were retrospectively analyzed. There were 6 males and 9 females with an average age of 46 years ranging from 34 to 56 years. The causes included rheumatoid arthritis in 3 cases, gouty arthritis in 2 cases, loose bodies in 3 cases, and elbow osteoarthritis in 7 cases. There were 4 cases with ulnar neuritis and 3 cases with synovial osteochondromatosis. The duration of elbow stiffness ranged from 6 to 18 months, with an average of 10 months. The operation time and intraoperative blood loss were recorded. The effectiveness was evaluated by visual analogue scale (VAS) score, range of elbow motion (maximum flexion, maximum extension, and total flexion and extension), Mayo score, and Hospital for Special Surgery (HSS) elbow score. RESULTS: The operation time was 60-90 minutes, with an average of 65 minutes, and the intraoperative blood loss was 40-100 mL, with an average of 62 mL. All patients were followed up 13-18 months, with an average of 14 months. There was no complication such as vascular and nerve injury, poor wound healing, collateral ligament injury, elbow joint space narrowing, osteophyte proliferation, or loose body formation around the joint. At last follow-up, the elbow range of motion (maximum flexion, maximum extension, and total flexion and extension), VAS score, and Mayo score significantly improved when compared with those before operation ( P<0.05). The HSS elbow score was 85-95, with an average of 92; 12 cases were excellent, 3 cases were good, and the excellent and good rate was 100%. CONCLUSION Arthroscopic release of elbow joint assisted by medial small incision ulnar nerve release is an effective way to treat non-traumatic elbow stiffness, which has the advantages of small trauma, short operation time, and good effectiveness. It can carry out early elbow rehabilitation training and significantly improve elbow function.
Humans ; Male ; Female ; Arthroscopy/methods* ; Adult ; Middle Aged ; Elbow Joint/physiopathology* ; Retrospective Studies ; Range of Motion, Articular ; Treatment Outcome ; Ulnar Nerve/surgery* ; Operative Time

OBJECTIVE: To review antibacterial/osteogenesis dual-functional surface modification strategy of titanium-based implants, so as to provide reference for subsequent research. METHODS: The related research literature on antibacterial/osteogenesis dual-functional surface modification strategy of titanium-based implants in recent years was reviewed, and the research progress was summarized based on different kinds of antibacterial substances and osteogenic active substances. RESULTS: At present, the antibacterial/osteogenesis dual-functional surface modification strategy of titanium-based implants includes: ① Combined coating strategy of antibiotics and osteogenic active substances. It is characterized in that antibiotics can be directly released around titanium-based implants, which can improve the bioavailability of drugs and reduce systemic toxicity. ② Combined coating strategy of antimicrobial peptides and osteogenic active substances. The antibacterial peptides have a wide antibacterial spectrum, and bacteria are not easy to produce drug resistance to them. ③ Combined coating strategy of inorganic antibacterial agent and osteogenic active substances. Metal ions or metal nanoparticles antibacterial agents have broad-spectrum antibacterial properties and various antibacterial mechanisms, but their high-dose application usually has cytotoxicity, so they are often combined with substances that osteogenic activity to reduce or eliminate cytotoxicity. In addition, inorganic coatings such as silicon nitride, calcium silicate, and graphene also have good antibacterial and osteogenic properties. ④ Combined coating strategy of metal organic frameworks/osteogenic active substances. The high specific surface area and porosity of metal organic frameworks can effectively package and transport antibacterial substances and bioactive molecules. ⑤ Combined coating strategy of organic substances/osteogenic active substancecs. Quaternary ammonium compounds, polyethylene glycol, N-haloamine, and other organic compounds have good antibacterial properties, and are often combined with hydroxyapatite and other substances that osteogenic activity. CONCLUSION The factors that affect the antibacterial and osteogenesis properties of titanium-based implants mainly include the structure and types of antibacterial substances, the structure and types of osteogenesis substances, and the coating process. At present, there is a lack of clinical verification of various strategies for antibacterial/osteogenesis dual-functional surface modification of titanium-based implants. The optimal combination, ratio, dose-effect mechanism, and corresponding coating preparation process of antibacterial substances and bone-active substances are needed to be constantly studied and improved.
Anti-Bacterial Agents/pharmacology* ; Coated Materials, Biocompatible/chemistry* ; Metal-Organic Frameworks/pharmacology* ; Osteogenesis ; Surface Properties ; Titanium/pharmacology* ; Prostheses and Implants

Objective:To translate the health literacy-sensitive communication scale into Chinese and examine its reliability and validity.Methods:Following Brislin′s translation principles, the HL-COM was translated and culturally adapted into Chinese. This cross-sectional study surveyed 434 outpatients and inpatients from three tertiary hospitals in Hubei Province using a questionnaire. Cronbach′s α coefficient and split half reliability were used to evaluate the reliability of the scale. Scale-level content validity index (S-CVI) and item-level content validity index (I-CVI) were used to evaluate the content validity. Exploratory factor analysis and confirmatory factor analysis were used to test the structural validity, while measurement equivalence across gender was examined.Results:The Chinese version of HL-COM contains 9 items, which was consistent with the original English version. Reliability of the scale: Cronbach′s ɑ Coefficient=0.938, Spearman-Brown half coefficient=0.926; Content validity: Scale-level content validity index (S-CVI)=0.926, Item-level content validity index (I-CVI) was 0.833-1.000; only one factor was extracted based on exploratory factor analysis, with a cumulative variance contribution rate of 68.541%. Confirmatory factor analysis indicated a good fit, with the fitting indexes of ?χ2/df=2.794, Normed Fit Index (NFI)=0.974, Standardized Root Mean Square Residual (SRMR)=0.025, Goodness-of-Fit Index (GFI)=0.962, Root Mean Square Error of Approximation (RMSEA)=0.089, Comparative Fit Index (CFI)=0.983. Multigroup confirmatory factor analysis indicated measurement invariance of the Chinese version of HL-COM across gender. Conclusion:The Chinese version of HL-COM demonstrates good reliability and validity, and serves as a valuable tool for assessing health literate in health care organization in China.

Objective To compare the action effect of traditional and modified lumbar massage obliquity manipulation with different degrees of lumbar degeneration. Methods The biomechanical model of quality-spring-damping system lumbar spine was established and massage forces from professional massage doctors were collected. The force was used as input of the model, and lumbar degeneration was simulated by increasing elastic coefficient of the spring and damping coefficient of the damping in the model. By using MATLAB/ Simulink simulation technology, the effects of massage obliquity manipulation ( the maximum relative displacement and maximum acceleration) with different degrees of lumbar degeneration were obtained for comparative analysis.Results When the lumbar spine was degenerative, the maximum relative displacement and maximum acceleration of each segment were obtained under two manipulations. With the increase of lumbar degenerationdegree, the maximum relative displacement and maximum acceleration of each segment under two manipulations showed a downward trend, and the attenuation rate of the maximum relative displacement and maximum acceleration of each segment under two manipulations was obtained. Conclusions When degenerative changes in the spine do not occur, the effectiveness of traditional lumbar massage obliquity manipulation is slightly better than that of modified lumbar massage obliquity manipulation, but the safety of modified lumbar massage obliquity manipulation is obviously better than that of the traditional lumbar massage obliquity manipulation, so the modified lumbar massage obliquity manipulation should be used. With the aggravation of lumbar degeneration, the action effects of two manipulations are attenuated in a power function. The attenuation rate of effectiveness of modified lumbar massage obliquity manipulation is significantly faster than that of traditional lumbar massage obliquity manipulation, indicating that the modified lumbar massage obliquity manipulation should not be used in the caseof lumbar degeneration.

Objective To investigate the prevalence of hypothyroidism during the second trimester and its relationship with thyroid peroxidase antibody (TPOAb). Methods Two thousand one hundred and forty one pregnant women whose gestational age between 14 to 28 weeks,accepted their prenatal care at the outpatient clinic of International Peace Maternity & Child Health Hospital from March 1,2010 to July 31,2010 were enrolled into this study. Serum TPOAb,thyroidstimulating hormone (TSH) and free thyroxine (FT4) of these women were detected. Logistic regression model was used to analyze the risk factors of subclinical hypothyroidism and positive TPOAb,while Spearman rank correlation was used to analyze the relationship between the levels of TSH,FT4 and TPOAb. Results (1) Subclinical hypothyroidism was detected in 13.36％ (286/2141) patients. Isolated maternal hypothyroxinemia occurs in 0.14％ (3/2141) of pregnant women.No overt hypothyroidism patient was detected and 6.26％ (134/2141) of all pregnant women exhibited positive TPOAb(≥50 U/ml).(2) Positive rate of TPOAb in subclinical hypothyroidism group,isolated maternal hypothyroxinemia group and normal thyroid function group was 13.64％ (39/286),0/3 and 5.06％ (86/1701) respectively,and there was difference among the three groups (x2 =30.82,P＜0.01).The positive rate of TPOAb did not relate to fetal gender,maternal age,gestational age,gravidity and parity.(3) TPOAb had positive relationship with TSH level (r=0.12,P＜0.01),while did not relate to FT4 level (r=-0.04,P=0.09). (4) Positive TPOAb (OR 3.18,95％ CI:2.10-4.83,P＜0.01) and gravidity (OR=1.21,95％ CI:1.02-1.43,P=0.030)were risk factors of subclinical hypothyroidism. Conclusions Hypothyroidism is common during the second trimester. It is necessary to screen TPOAb in pregnant women as TPOAb is an independent and important predictor of subclinical hypothyroidism.

Objective To study the value of dual-source CT(DSCT)in assessing aortic mechanical valve with 3D cardiovascular imaging technique.Methods Thirty-four patients with mechanical aortic valve transplantation were enrolled.Nineteen cases transplanted with On-x valve and 15 cases with St jude valre.CT scan was performed in all 34 patients and MRI scan in 30 patients.The CT imaging quality of On-x valve with St jude valve was compared by two independent samples Wilcoxon rank test.Two independent sampies test was used to compare tlle valve angle in the two kinds of valve and also in the same group.The relative functional index of left ventricle in CT and MR analysis by paired-samples t Test. Results The image quality was dirided into three grades.Six hundred and eighty phases in all 34 patients.which included 391 phases with grade 1,171 phases with grade 2 and 118 phases with grade 3.There were no significant different between two kinds of mechanical valve in image quality(image quality of grade 1:Z=-1.084,P=0.286;grade 2:Z=-0.088,P=0.945;grad 3:Z=-1.045,P=0.319).The mean bileaflet angle of 34 cases was 82.0°±4.4°in completely opening and 34.5°±5.7°in completely closing.The mean radian gradient over openess and closure was 47.5°±7.5°.The radian gradient of St iude group(55.0°±1.8°)was obviously larger than On-x group(41.5°±4.1°)(t=-11.732,P=0.000).But,there were no significant difference between dual-source CT and 1.5 T MR when evaluate the left ventrical fuction,including EF[MR.EF(57.2-1-2.8)%,CT-EF(57.9±2.8)%,f:-0.496,P=0.623],EDV[MR-EDV (121.6±9.1)ml,CT-EDV(132.9±11.2)ml,t=-1.198,P:0.240],ESV[MR-ESV(55.1±6.9)ml,CT-ESV(59.5±7.6)ml,t=-1.094,P=0.283],myocardium mass at ED[MR-Myo.mass (155.5 ±12.6)g,CT-Myo.mass(147.9±11.6)g,t=1.823,P=0.079]and CO[MR-CO(5.7±0.4)ml/min,CT-CO(5.9±0.5)ml/min,t=-3.211,P=0.775].Conclusions Dual source CT with 3D cardiovascular imaging technique is valuable and effective for evaluating aortic mechanical valve.The shape of the whole valve and movement of bileaflet reappears well.With the postprocessing software,it allows evaluating aortic mechanical valve function,reliable measurements of opening and closing leaflet angles and left ventrieal function.

AIM: To observe the changes in expression and activity of the transcription factor myocyte enhancer factor 2A (MEF2A) during hepatic stellate cells (HSC) activation, and to study the roles of MEF2A in the process of HSC activation. METHODS: Cultured HSC was isolated from male sprague-dawley rat liver on plastic dishes and were used as model of activation. The freshly isolated (0 day) and cultured HSC at time points of 1st, 2nd, 3rd, 4th, 5th, 6th, 7th and 8th day were collected. Expression of MEF2A mRNA was detected by real-time quantitative PCR. MEF2A and α-smooth muscle actin (α-SMA, a marker for activated HSC) were tested by Western blotting. Meanwhile, the MEF2A DNA binding activity was determined by electrophoretic mobility shift assays (EMSA). RESULTS: The expression of MEF2A mRNA was small amounts in the freshly isolated HSC and increased gradually after culture on plastic dishes. Western blotting revealed that the freshly isolated HSC expressed very low levels of MEF2A and α-SMA. The proteins of MEF2A and α-SMA were increased gradually in the process of HSC activation. Increased MEF2A protein was correlated with α-SMA. EMSA revealed that MEF2A DNA binding activity was increased gradually during HSC activation. CONCLUSION: In the process of HSC activation, expression and activity of MEF2A are increased gradually, indicating a role in HSC activation.

Objective To explore the roles of interleukin-6 (IL-6) and high sensitive C-reactive protein (hsCRP) in coronary heart disease (CHD). Methods One hundred and fifty patients diagnosed as angina pectoris by coronary angiography were enrolled and randomly divided into unstable angina pectoris group ( UAP group n =78) and stable angina group (SAP group n =72). At the same time,50 cases with normal coronary angiography were selected as control. The plasma level of IL-6 was measured by ELISA, and hsCRP was measured by immunonephelometry. Results The mean plasma levels of IL-6 and hsCRP were significantly higher in UAP group compared with SAP group ( IL-6 ( 36. 98 ± 9. 35 ) pg/L vs. ( 23.19 ± 7. 35 ) pg/L; hsCRP ( 2. 25 ± 0. 73 ) μg/Lvs 1.88 ± 0. 68 ) μg/L; P ＜ 0. 01 respectively), both were significantly higher than those of control group ( IL-6 (16. 93 ± 6. 15 )pg/L and hsCRP (1.28 ± 0.40)μg/L,P ＜0.01 respectively). We also found significantly positive relationship between IL-6 and hsCRP plasma level ( r = 0. 875, P ＜ 0. 05 ). Conclusions Inflammatory response might play an important role in CHD. IL-6 and hsCRP were of high value in prediction of angina pectoris and development of CHD.

Objective To evaluate left atrial(LA) function in patients with prophase type 2 diabetes mellitus(T2DM) combinated with or without hypertension using left atrial volume tracking method(LAVT). Methods Thirty-one simple T2DM(T2DMI group) ,21 T2DM accompany with hypertension(T2DM2 group) and forty-five healthy subjects (control group) were enrolled in this study. Ultrasound LAVT(EUB-6500, Hitachi Medical Corporation) was applied to display and analyzed the LA volume loop imaging on the standard LV apical two and four chamber views. The maximal and the minimal LA volume (LAVmax, LAVmin) and the volume before LA contraction (LAVp) were recorded from the LA volume loop. The body surface area was used to correct these volume indexs. The LA reservoir function was assessed by calculating the total of LA filling volume (LAVItotal) and the expansion index(iLAVIe). The passive and active emptying percentage of the total emptying volume(LAVIpass, LAVIact) and the emptying index(iLAVIpass,iLAVIact) were caculated as the parameters of the LA conduit and booster pump function. Results Compared with the values in the control group, the LAVhotal,LAVIact were significantly higher and the LAVlpass,iLAVlpass were lower in the T2DM group (all P<0.05) ,while the iLAVIact was higher only seen in the T2DM2 group(P<0. 05). The LAVlact, iLAVIact were higher and the LAVIpass was lower in T2DM2 group than those in the T2DM1 group (all P<0.05). Conclusions The LA conduit hypofunction in primary in the prophase T2DM,when combinated with hypertension the LA constriction function compensatorily increased, LAVT can evaluate the function of LA in patients with T2DM accurately and rapidly.

Objective To assess the characteristics of left ventricular(LV) systolic dyssynchrony in patients with chronic heart failure (CHF) using two dimensional speckle-tracking imaging(2D-STI) and validate the correlation between LV systolic dyssynchrony and its ejection fraction (EF) measured by traditional two dimensional echocardiography. Methods Forty-two patients with CHF, which were divided into group CHF1 with 35% ＜EF≤50% and group CHF2 with EF≤35%, and 35 healthy subjects as control group were enrolled in this study. Two-dimensional echocardiography Simpson's method was used to measure EF of LV. The time from the onset of QRS complexes to systole peak strain rate from the longitudinal, radial and circumferential vectors(Tsrsl, Tsrsr, Tsrsc)was recorded and measured using 2D-STI, respectively. The standard deviation and the maximal temporal difference of Tsrsl, Tsrsr, Tsrsc (Tsrsl-SD,Tsrsr-SD,Tsrsc-SD,Tsrsl-diff,Tsrsr-diff, Tsrsc-diff)of 18 segments were calculated as indicator of LV systolic dyssynchrony. Results The indices of LV systolic dyssynchrony Tsrsl-SD,Tsrsl-diff, Tsrsr-SD, Tsrsr-diff,Tsrsc-SD,Tsrsc-diff in group CHF1 and CHF2 were significantly higher than those in the control group (P<0.05). Compared with group CHF1, those indices in CHF2 were significantly longer (P<0.05). Meanwhile, Tsrsl-SD, Tsrsr-SD, Tsrsc-SD(r = - 0.904～0.912, all P<0.05) and Tsrsl-diff, Tsrsr-diff, Tsrsc-diff(r = - 0.916～0.967, all P<0.01) had singnificantly negative correlations with LVEF, and the correlation coefficients between radial and circumferential 2D-STI dyssynchrony parameters and LVEF were higher than those between the longitudinal parameters and LVEF. Conclusions 2D-STI is a useful modality to evaluate the LV systolic asynchrony of the CHF and there is a good correlation between LVEF and the LV systolic dyssynchrony indices derived from 2D-STI.