Objective:To compare the arthroscopic autologous osteochondral transfer (AOT) and arthroscopic subscapularis augmentation (ASA) in the treatment of recurrent anterior shoulder dislocation complicated with scapular glenoid bone injury less than 20%.Methods:A retrospective analysis was conducted of the clinical data of 42 patients who had been treated at Department of Orthopaedics, The Second Hospital of Lanzhou University for recurrent anterior shoulder dislocation complicated with scapular glenoid bone injury less than 20% from January 2022 to January 2023. There were 30 males and 12 females, with an age of (32.2±15.2) years. Altogether 12 left shoulders and 30 right shoulders were affected. The patients were divided into 2 groups according to their surgical methods: an AOT group in which 15 cases were treated with AOT and an ASA group in which 27 cases treated with ASA. The Rowe score, American Shoulder and Elbow Surgeons (ASES) score, visual analogue scale (VAS), and shoulder range of motion were compared between groups at the last follow-up. All the above indexes were compared between pre-surgery and post-surgery in each group. The incidence of complications in the 2 groups was recorded.Results:There were no statistically significant differences in the preoperative general data between the 2 groups, indicating comparability ( P > 0.05). A total of 42 patients were followed up for (17.2±5.9) months after surgery. At the last follow-up, in the ASA group and the AOT group respectively, the Rowe score was (97.0±4.4) points and (98.3±2.4) points, the ASES score (97.9±5.2) points and (99.1±3.7) points, and the VAS score 0 (0, 0) point and 0 (0, 1) point, showing no significant difference between the 2 groups ( P > 0.05). The above items in the 2 groups were significantly improved compared with those before surgery ( P < 0.05). At the last follow-up, in ASA group and AOT group respectively, shoulder abduction was 169.2°±3.0° and 168.3°±3.1°, and flexion 171.9°±4.0° and 173.3°±4.1°, showing no significant difference between the 2 groups ( P > 0.05); the abduction 90° external rotation was 67.3°±3.2° in the AOT group, significantly better than that in the ASA group (64.4°±3.5°) ( P < 0.05). The above items in the 2 groups were significantly improved compared with those before operation ( P < 0.05). Follow-ups revealed no infection or osteoarthritis. After surgery, 1 case of shoulder re-dislocation and 6 cases of shoulder pain occurred in the ASA group, while no cases of shoulder re-dislocation or shoulder pain occurred in the AOT group. There was no significant difference between the 2 groups in the incidence of complications ( P > 0.05). Conclusions:In the treatment of patients with recurrent anterior shoulder dislocation complicated with scapular glenoid bone injury less than 20%, both AOT and ASA can improve shoulder function, but AOT is superior to ASA in 90° external rotation.

OBJECTIVE: To investigate the effect of autologous osteochondral tissue and periosteum transplantation on tendon-bone healing of rotator cuff in rabbits. METHODS: Twenty-four male New Zealand white rabbits were randomly divided into autologous osteochondral tissue and periosteum transplantation group (experimental group, n=12) and simple suture group (control group, n=12). Both groups were subjected to acute supraspinatus tendon injury and repaired with corresponding techniques. At 4, 8, and 12 weeks after operation, 4 specimens from each group were taken from the right shoulder joint for histological examination (HE staining, Masson staining, and Safranin O-fast green staining), and the left shoulder was subjected to biomechanical tests (maximum tensile load and stiffness). RESULTS: Both groups of animals survived until the completion of the experiment after operation. At 4 weeks after operation, both groups showed less collagen fibers and disorder at the tendon-bone junction. At 8 weeks, both groups showed reduced inflammation at the tendon-bone junction, with more organized and denser collagen fibers and chondrocytes. The experimental group showed better results than the control group. At 12 weeks, the experimental group showed typical tendon-bone transition structure, with increased generation of collagen fibers and chondrocytes, and the larger cartilage staining area. Both groups showed an increase in maximum tensile load and stiffness over time ( P<0.05). The stiffness at 4 weeks and the maximum tensile load at 4, 8, and 12 weeks in the experimental group were superior to control group, and the differences were significant ( P<0.05). There was no significant difference in stiffness at 8, 12 weeks between the two groups ( P>0.05). CONCLUSION Autologous osteochondral tissue and periosteum transplantation can effectively promote the fiber and cartilage regeneration at the tendon-bone junction of rotator cuff and improve the biomechanical effect of shoulder joint in rabbits.
Animals ; Rabbits ; Male ; Wound Healing ; Transplantation, Autologous ; Periosteum/transplantation* ; Rotator Cuff Injuries ; Rotator Cuff/surgery* ; Tendons/surgery* ; Biomechanical Phenomena ; Chondrocytes/transplantation* ; Tendon Injuries/surgery* ; Tensile Strength

Objective:To compare the arthroscopic autologous osteochondral transfer (AOT) and arthroscopic subscapularis augmentation (ASA) in the treatment of recurrent anterior shoulder dislocation complicated with scapular glenoid bone injury less than 20%.Methods:A retrospective analysis was conducted of the clinical data of 42 patients who had been treated at Department of Orthopaedics, The Second Hospital of Lanzhou University for recurrent anterior shoulder dislocation complicated with scapular glenoid bone injury less than 20% from January 2022 to January 2023. There were 30 males and 12 females, with an age of (32.2±15.2) years. Altogether 12 left shoulders and 30 right shoulders were affected. The patients were divided into 2 groups according to their surgical methods: an AOT group in which 15 cases were treated with AOT and an ASA group in which 27 cases treated with ASA. The Rowe score, American Shoulder and Elbow Surgeons (ASES) score, visual analogue scale (VAS), and shoulder range of motion were compared between groups at the last follow-up. All the above indexes were compared between pre-surgery and post-surgery in each group. The incidence of complications in the 2 groups was recorded.Results:There were no statistically significant differences in the preoperative general data between the 2 groups, indicating comparability ( P > 0.05). A total of 42 patients were followed up for (17.2±5.9) months after surgery. At the last follow-up, in the ASA group and the AOT group respectively, the Rowe score was (97.0±4.4) points and (98.3±2.4) points, the ASES score (97.9±5.2) points and (99.1±3.7) points, and the VAS score 0 (0, 0) point and 0 (0, 1) point, showing no significant difference between the 2 groups ( P > 0.05). The above items in the 2 groups were significantly improved compared with those before surgery ( P < 0.05). At the last follow-up, in ASA group and AOT group respectively, shoulder abduction was 169.2°±3.0° and 168.3°±3.1°, and flexion 171.9°±4.0° and 173.3°±4.1°, showing no significant difference between the 2 groups ( P > 0.05); the abduction 90° external rotation was 67.3°±3.2° in the AOT group, significantly better than that in the ASA group (64.4°±3.5°) ( P < 0.05). The above items in the 2 groups were significantly improved compared with those before operation ( P < 0.05). Follow-ups revealed no infection or osteoarthritis. After surgery, 1 case of shoulder re-dislocation and 6 cases of shoulder pain occurred in the ASA group, while no cases of shoulder re-dislocation or shoulder pain occurred in the AOT group. There was no significant difference between the 2 groups in the incidence of complications ( P > 0.05). Conclusions:In the treatment of patients with recurrent anterior shoulder dislocation complicated with scapular glenoid bone injury less than 20%, both AOT and ASA can improve shoulder function, but AOT is superior to ASA in 90° external rotation.

OBJECTIVE：To investiga te main risk factors for adverse drug reactions （ADR）of skin by intravenous injection of iodine contrast agent. METHODS ：From Jan. 2009 to Apr. 2020，the patients suffering from skin ADR after enhanced CT with iodine contrast agent were collected from our hospital. The basic information ，laboratory test results before using iodine contrast agent and ADR related information were collected through hospital information system （HIS）. The use of iodine contrast agent ，main manifestations of skin ADR and drug combination were analyzed statistically. Taking the sex ，age，body mass index （BMI），the dosage of iodine contrast agent ，length of stay ，laboratory examination ，tumor history ，basic disease ，allergy history ，drinking history as independent variables ，the incidence of skin ADR related to iodine contrast agent was analyzed by single factor analysis ，and the variables with statistically significant were selected for multivariate Logistic stepwise regression analysis. RESULTS ：There were 157 cases of skin ADR ，involving 79 males（50.3％）and 78 females（49.7％）. The age ranged from 19 to 86 years old ，being（52.68± 18.73）years old in average. BMI was 14.6-40.7 kg/m2，being（22.5±3.7） kg/m2. 67 cases（42.68％）were treated with iprodione ，34 cases（21.66％）with iodixanol ，31 cases（19.74％）with iohexol and 25 cases（15.92％）with iopamidol ；the dose of iodine contrast agent were 50-100 mL，being（73.06±13.29）mL in average. There was no significant difference among different dosage of 4 kinds of iodine contrast agents （P≤0.05）. Among 4 kinds of iodine contrast agents ，the incidence of skin ADR induced by iopromide was the highest（0.197％）. The skin ADR related to iodine contrast agent was mainly acute （89.2％），the severity was mild （75.2％），and urticaria（38.9％）was the most common. After symptomatic treatment ，135 cases were cured ，13 cases were improved and 9 cases were not improved. Among the patients with iodine contrast agent related skin ADR ，the incidence of ADR induced by combined use of anti infective drugs was the highest （33.1％）；however，the combined use of anti-tumor drugs was the main cause of severe skin ADR. The length of stay ｛11～20 d[OR＝1.21，95％CI（1.07，1.20），P＝0.042]、21～30 d[OR＝1.39，95％CI（1.12，1.52），P＝0.035]、31～40 d[OR＝1.15，95％CI（1.03，1.37），P＝0.008]、＞40 d[OR＝1.33，95％CI（1.28，1.53），P＝0.003]｝，respitatory and circulatory system tumor history[OR ＝1.51，95％CI（1.35，1.61），P＝0.037]，injection allergy history[OR ＝1.50，95％CI（1.37，1.59），P＝0.005] can significantly increase the incidence of iodine contrast agent related skin ADR. CONCLUSIONS ：The main manifestation of skin ADR related to iodine contrast agent was urticaria. The main risk factors of skin ADR related to iodine contrast agent were length of stay （＞ 10 d），respiratory and circulatory system tumor history and injection allergy history.

OBJECTIVE： To investigate the effects of full coverage policy for essential hypertension medicines on economic burden of hypertensive patients in Taizhou of Zhejiang Province， and to further provide reference for the practice and promotion of the policy for essential medicines. METHODS： By querying electronic health records database of hypertension patients and statistics of health bureaus in different districts and counties of Taizhou city， the data of electronic health records of hypertension patients were extracted 1 year before and during 3 years after the implementation of full coverage policy for essential medicines in all districts and counties. The patients who had consistently taken free medicines were included in the policy group； the patients who had never taken free medicines were included in the control group. The policy group and control group were matched 1 ∶ 1 by propensity score matching method. Per capita drug cost and per capita hospitalization cost of patients before and after the implementation of full coverage policy for essential medicines were calculated. The input-output ratios of the policy were calculated. RESULTS： During the 3 years after the implementation of the policy， each patient saved 91.3， 272.0 and 464.1 yuan respectively. The hospitalization cost for each patient increased by 65.6 and 46.2 yuan in the first and second year， and decreased by 352.8 yuan in the third year， respectively. A three-year per capita input of policy was 50.0， 147.2 and 278.5 yuan， with input-output ratio of 0.51， 1.28 and 2.25. CONCLUSIONS： The full coverage policy for essential hypertension medicines in Taizhou city demonstrates economic efficiency to some extent， but researches about the impact of policy on disease treatment needed to be conducted. It is necessary for the government departments to invest continuously for a long time and improve the supporting measures so as to make the policy more profitable.

Objective:To investigate the preventive effect of tetramethylpyrazine (TMP) on hypoxic pulmonary hypertension in rats and the underlying mechanism.Methods:Thirty-six male Sprague-Dawley rats were randomly divided into three groups:the normal control group,hypobaric and hypoxic group and TMP group (100 mg·kg-1·d-1).After the animal models of hypobaric and hypoxic pulmonary hypertension were established,mean pulmonary artery pressure (mPAP),mean carotid artery pressure (mCAP),ratio of right ventricular/(lift ventricular + interventricular septum) (RVHI) and morphological changes of pulmonary vessels were observed and the rates of wall thickness/external diameter (WT%) and wall area/total vascular area (WA%) were calculated.The contents of nitric oxide (NO),endothelin-1 (ET-1),hypoxic-inducible factor-1 (HIF-1) and vascular endothelial growth factor (VEGF) were detected in serum after the 21-day treatment with TMP.Results:The values of mPAP,RVHI,WT% and WA% of hypobaric and hypoxic group were significant higher than those of the normal control group (P<0.05 or P<0.01),and those of TMP group were obviously lower than those of hypobaric and hypoxic group (P<0.05 or P<0.01).The condition of hypobaric and hypoxic had no significant effect on mCAP,and there were no significant differences among the groups (P>0.05).The values of NO in serum of hypobaric and hypoxic group was lower than those of the normal control group (P<0.05) and those of TMP group were obviously higher than those of hypobaric and hypoxic group (P<0.05).The values of ET-1,HIF-1α and VEGF in serum of hypobaric and hypoxic group were higher than those of the normal control group (P<0.05) and those of TMP group were obviously lower than those of hypobaric and hypoxic group (P<0.05).Conclusion:TMP can effectively prevent pulmonary hypertension induced by hypobaric and hypoxic and structural remodeling of pulmonary arterioles.The mechanism may be related to the content up-regulation of NO and activity down-regulation of ET-1,HIF-1α and VEGF in serum of rats.

Broth microdilution method was hired to measure the minimum inhibitory concentrations (MICs) of luteolin against Trueperella pyogenes,Escherichia coli,Salmonella and Streptococcus in order to evaluate the antimicrobial activity of luteolin in vitro.Meanwhile,the bacteria growth curves in medium containing sub-inhibitory concentration of luteolin were measured in this test.The results indicated that Tureperella pyogenes was the most sensitive to luteolin with a MIC of 0.078 g/L than that of these strains;and Salmonella was also sensitive to luteolin (MIC:1.25 g/L).However,The inhibitory effect of luteolin on Escherichia coli and Streptococcus is relatively weak,and shared the same MIC with 2.5 g/L.Luteolin showed inhibitory effects on the growth curves of all the strains in this test at sub-inhibitory concentration,and the inhibitory effects on the growth curves increased with the concentration of luteolin(P＜0.05).

OBJECTIVE:To provide the scientific evidence and reference for improving medical reform. METHODS:Based on background ofSanming Medical Reform,self-designed questionnaires were used to investigate the cognition and satisfaction of local patients. The results of investigation were analyzed statistically. RESULTS:A total of 275 paper questionnaires were sent out and all were collected;345 electronic questionnaires were sent out by Wechat and all collected. Among 620 questionnaires,372 valid questionnaires were collected with effective rate of 60.00%. More patients(31.45%)thought the cost of treatment decreased, and less (22.31%) thought the cost increased. The proportion of high-income people who thought cost reduced was significantly higher than the proportion of low-income people (P=0.018). 27.42% of patients believed shortage of drugs,and tertiary hospi-tals were more prone to drug shortage than other medical institutions(P=0.062). The patients'satisfaction with medical staff and healthcare reform were both high(86.56% and 79.03%),but the satisfaction of rural patients was lower than that of urban patients (P=0.051). Understanding of patients onSanming Medical Reformwas in low level. Only 20.70% of the patients fully under-stood or generally understood ofSanming Medical Reform. The patients who thought the skills of medical staff were improved (40.32%)were more than those who thought the skills of medical staff were reduced(5.91%). CONCLUSIONS:Most patients are satisfied withSanming Medical Reform,and agree the achievements;but some problems are not solved,such as the shortage of some drugs,lack of grass-roots medical personnel,not understand medical policy.

Background and objective Lung cancer is the leading cancer-related death worldwide.Patients with lung cancer mainly died of tumor metastasis and invasion.Protein kinase CK2 is an ubiquitous sefine/threonine protein kinase and is frequently upregulated in various human tumors.This study aims to explore the effect and molecular mechanism of the invasion and migration of lung adenocarcinoma A549 cells after knock-down of CK2α expression.Methods The pSilencerTM 4.1-siCK2α-eGFP oflentiviral-me-diated shRNA was constructed.The expression of CK2α was knock-downed,and a stable A549 cell line was established.The invasion and migration ofA549 cell line was detected through Transwell and Boyden chamber assays.The protein expression of the PI3K/Akt signaling pathway and mesenchymal-to-epithelial transition (EMT) was evaluated using Westem blot analysis.Results The invasion and migration of A549 cells were significantly inhibited after the knockdown of CK2α expression compared with that in the control group,p-PTEN,Akt,p-Akt473,p-Akt308,p-PDK1,p-c-Raf,and p-GSK-3β were significantly downregnlated,whereas PTEN was upregulated.Moreover,vimentin,β-catenin,Snail,MMP2,and MMP9 were significantly downregnlated after reducing the CK2α expression.Conclusion CK2α might regulate the invasion and migration of A549 cells through the PI3K/Akt/GSK-3β/Snail signaling pathway,which controls EMT in lung adenocarcinoma.

Objective To observe the leading effect of end-tidal pressure of carbon dioxide in artery ( PET CO2 ) on mechanical ventila-tion in New Zealand white rabbits, and to establish parameters for medical animal experiments in terms of hemodynamics, blood gas, blood glucose, electrolyte. Methods 31 anesthetized New Zealand rabbits were practiced tracheostomy tube and mechanical ventilation. Respira-tion rate was 40 breaths/min and tidal volume was adjusted so that PET CO2 was 29 mmHg. Invasive blood pressure, electrocardiogram and PET CO2 were monitored. Blood gas analysis, electrolyte, hemoglobin and blood glucose were tested. Results When PET CO2 was maintained at 29 mmHg, the results were as follows:PH (7.42 ±0.07), 95% confidenceinterval (7.40~7.45);PaCO2(38.5 ±5.8) mmHg, 95%confidenceinterval (36. 4~40. 6) mmHg;BE (1. 45 ± 2. 80) mmol/L,95% confidenceinterval (0. 43~2. 48) mmHg. Conclusion Moni-toring of PET CO2 is good to guide mechanical ventilation in New Zealand white rabbits.