Objective To evaluate the efficacy of arthroscopic double row suture technique combined with knotless suture bridge technique in repairing medium and large rotator cuff tears.Methods 92 medium and large rotator cuff tears patients from January 2018 to October 2022 were randomly divided into two groups with 46 cases in each group.The observation group was administrated with arthroscopic double row suture combined with knotless suture bridge technique,while the control group was treated with arthroscopic single row suture combined with knotless suture bridge technique.The two groups were compared before and 3,6,and 12 months after surgery in terms of intermediate,medial and lateral T2 values of supraspinatus tendons,shoulder joint range of motion,and the scores on related scales[Constant-Murley scale,University of California,Los Angeles(UCLA)shoulder joint grading system,visual analogue scale(VAS)score],as well as the acromion-humeral head distance(A-H distance).And the joint stiffness and rotator cuff tears were collected from the two groups within 12 months after the operation.Results At 3,6 and 12 months after surgery,the intermediate,medial and lateral T2 values of supraspinatus tendons in both groups were gradually decreased,and were significantly lower than those before surgery,the differences were statistically significant(P<0.05),and the intermediate,medial and lateral T2 values of supraspinatus tendons at each time point in the observation group were significantly lower than those in the control group,the differences were statistically significant(P<0.05);At 3,6,and 12 months after surgery,the anterior flexion range of motion,lateral rotation range of motion,and A-H head distance of both groups were seeing a gradual increase,and the values were significantly higher than those before the treatment,the differences were statistically significant(P<0.05).The anterior flexion range of motion,lateral rotation range of motion and A-H head distance at each time point in the observation group were significantly greater than those in the control group,the differences were statistically significant(P<0.05);At 3,6,and 12 months after surgery,the Constant-Murley and UCLA scales of both groups were seeing a gradual increase,and the values were significantly higher than those before the treatment,the differences were statistically significant(P<0.05),and The Constant-Murley and UCLA scales of the observation group at each time point were significantly higher than those of the control group,the differences were statistically significant(P<0.05);At 3,6,and 12 months after surgery,the VAS score in both groups was lower than that before operation,the difference was statistically significant(P<0.05),the VAS score of the observation group at 3 months after surgery was significantly lower than that of the control group,the difference was statistically significant(P<0.05);12 months after surgery,the incidence of joint stiffness and rotator cuff retear in observation group were 2.17%and 0.00%,significantly lower than those in control group(17.39%and 13.04%),the differences were statistically significant(P<0.05).Conclusion The application of arthroscopic double row suture combined with knotless suture bridge technique can effectively promote postoperative rotator cuff tissue healing,improve the range of motion,function of the shoulder joint and A-H head distance,relieve shoulder pain and greatly reduce the occurrence of postoperative rotator cuff tear and joint stiffness compared with arthroscopic single row suture combined with knotless suture bridge technique.It is worthy clinical application.

Endotoxins are common exogenous pyrogens. Excessive endotoxins in medical devices and injections can lead to serious consequences such as sepsis, septic shock, and even death. Therefore, endotoxin detection plays a crucial role in medical, pharmaceutical, and food sectors. The wide application of Limulus amebocyte lysate (LAL) has led to a sharp decline in the number of horseshoe crabs. Moreover, the LAL assay has limitations such as interbatch variations and difficulty in quantification. The recombinant factor C (rFC) assay is stable between batches, highly sensitive, and capable of quantitation, and thus it can be used as an alternative for the LAL assay. However, the high cost and complex procedures involved in producing recombinant factor C have limited the widespread application of this method. In order to simplify the preparation and reduce the production cost of recombinant factor C, this study focuses on the production of recombinant factor C based on the baculovirus expression system. Multiple measures such as a high-yield and anti-apoptotic vector qBac-IIIG, the optimal signal peptide, and the optimized codon were used to reach the goal of endotoxin detection with cell supernatant. This method simplifies the steps of protein purification. The sensitivity of the supernatant reached 0.05 EU/mL in a 1-L fermentation system, and 500 000 detecting reactions can be supported per liter of fermentation broth. This study increases the yield and activity of recombinant factor C, simplifies the procedures of protein purification, and reduces the cost, laying a foundation for the promotion and application of recombinant factor C in endotoxin detection.
Animals ; Recombinant Proteins/genetics* ; Horseshoe Crabs/chemistry* ; Baculoviridae/metabolism* ; Endotoxins/analysis* ; Protein C/biosynthesis* ; Genetic Vectors/genetics* ; Arthropod Proteins/genetics* ; Enzyme Precursors ; Serine Endopeptidases

Objective To evaluate the efficacy of arthroscopic double row suture technique combined with knotless suture bridge technique in repairing medium and large rotator cuff tears.Methods 92 medium and large rotator cuff tears patients from January 2018 to October 2022 were randomly divided into two groups with 46 cases in each group.The observation group was administrated with arthroscopic double row suture combined with knotless suture bridge technique,while the control group was treated with arthroscopic single row suture combined with knotless suture bridge technique.The two groups were compared before and 3,6,and 12 months after surgery in terms of intermediate,medial and lateral T2 values of supraspinatus tendons,shoulder joint range of motion,and the scores on related scales[Constant-Murley scale,University of California,Los Angeles(UCLA)shoulder joint grading system,visual analogue scale(VAS)score],as well as the acromion-humeral head distance(A-H distance).And the joint stiffness and rotator cuff tears were collected from the two groups within 12 months after the operation.Results At 3,6 and 12 months after surgery,the intermediate,medial and lateral T2 values of supraspinatus tendons in both groups were gradually decreased,and were significantly lower than those before surgery,the differences were statistically significant(P<0.05),and the intermediate,medial and lateral T2 values of supraspinatus tendons at each time point in the observation group were significantly lower than those in the control group,the differences were statistically significant(P<0.05);At 3,6,and 12 months after surgery,the anterior flexion range of motion,lateral rotation range of motion,and A-H head distance of both groups were seeing a gradual increase,and the values were significantly higher than those before the treatment,the differences were statistically significant(P<0.05).The anterior flexion range of motion,lateral rotation range of motion and A-H head distance at each time point in the observation group were significantly greater than those in the control group,the differences were statistically significant(P<0.05);At 3,6,and 12 months after surgery,the Constant-Murley and UCLA scales of both groups were seeing a gradual increase,and the values were significantly higher than those before the treatment,the differences were statistically significant(P<0.05),and The Constant-Murley and UCLA scales of the observation group at each time point were significantly higher than those of the control group,the differences were statistically significant(P<0.05);At 3,6,and 12 months after surgery,the VAS score in both groups was lower than that before operation,the difference was statistically significant(P<0.05),the VAS score of the observation group at 3 months after surgery was significantly lower than that of the control group,the difference was statistically significant(P<0.05);12 months after surgery,the incidence of joint stiffness and rotator cuff retear in observation group were 2.17%and 0.00%,significantly lower than those in control group(17.39%and 13.04%),the differences were statistically significant(P<0.05).Conclusion The application of arthroscopic double row suture combined with knotless suture bridge technique can effectively promote postoperative rotator cuff tissue healing,improve the range of motion,function of the shoulder joint and A-H head distance,relieve shoulder pain and greatly reduce the occurrence of postoperative rotator cuff tear and joint stiffness compared with arthroscopic single row suture combined with knotless suture bridge technique.It is worthy clinical application.

Objective: This study aims to investigate the epidemiological distribution of HFMD and quantify the association of temperature with the incidence of children’s HFMD in Nanjing, China. Methods: Daily counts of HFMD in children under 5 years and daily meteorological variables during 2011-2016 were obtained. Descriptive statistics were used to describe the epidemiological characteristics and distributed lag non linear model (DLNM) was used to assess the associations of temperature on HFMD cases. Results: A total of 104 977 HFMD cases aged 0-5 years were reported in Nanjing during the study period and the male to female sex ratio was 1.49∶1. The average annual incidence was 213.5 per 100 000. A bimodal seasonal pattern was observed and the south and west were found to be the high incidence areas in the city. Of these laboratory confirmed enteroviruses positive cases, 32.5% cases were positive for EV-A71 infections, 29.1% cases were positive for CV-A16 infections and 38.4% cases were positive of other enteroviruses infections. The temperature HFMD relationships were non linear and showed obvious lag effects. The cumulative relative risk presented as an approximately inverted U shape over 14 days and peaked at 25.7 ℃ with value of 2.71(95%CI=1.93-3.81). Subgroup analyses revealed that males and children aged <1 year were more vulnerable to temperature variations. Conclusion Epidemiological characteristics of HFMD among children aged 0-5 years old in Nanjing presented temporal and regional distribution. The temperature has significant impact on children’s HFMD occurrence.

Objective To explore the protective effect and mechanism of vitamin D combined with puerarin on liver fibrosis.Methods The rats were divided into normal control group (C),tetrachloromethone group (CCl4),vitamin D group (V),puerarin group(P) and vitamin D combined with puerarin group(V+P).After 8 weeks,the rats were sacrificed and blood and liver samples were collected.The level of blood hyaluronic acid(HA) was tested.The hydroxyproline(Hyp) level in the liver was measured.The liver paraffin sections were made and examined by the sirius red staining.The mRNA levels of collagen Ⅰ and collagen Ⅲ in the liver tissue were detected by RT-PCR,and the levels of NF-κB and TNF-α in the liver were detected by Western blot.Results The CCl4 group appeared obvious liver fibrosis.The liver fibrosis degree was significantly improved in the group V,P and V+P,the blood HA level and liver Hyp level were reduced.The mRNA levels of collagen Ⅰ and collagen Ⅲ as well as the protein levels of NF-κB and TNF-α in the liver were significantly decreased.Among them.The liver fibrosis improvement degree in the V+P group was most significant.Conclusion Vitamin D combined with puerarin can protect rat liver fibrosis induced by CCl4 and its mechanism may be related with reducing the activation of hepatic stellate cells(HSC) and decreasing the collagenous fibers secretion.

Objective To develop the Chinese version of modified body image scale(MBIS) questionnaires, and to validate them in Chinese population. Methods The original English MBIS questionnaire was translated into Chinese, following the WHO cross-cultural adaptation of health-related quality of life measures. The reliability and validity of the Chinese version of MBIS questionnaires were evaluated in Chinese population, MRKH syndrome patients. Results Totally 50 patients with MRKH syndrome completed the MBIS and short-form 12-item health survey(SF-12)questionnaires.The Cronbach′s alpha of MBIS was 0.741,intraclass correlation coefficients were 0.472-0.815(P<0.01).MBIS scores were positively correlated with SF-12 scores(Spearman correlation coefficient was-0.409, P<0.01). Factor analysis showed that MBIS had one common factor. Conclusion Chinese version of MBIS has high reliability and validity in Chinese population,therefore is suitable for clinic and research.

OBJECTIVE:To systematically evaluate therapeutic efficacy and safety of pitavastatin comparison of atorvastatin in the treatment of primary hypedipemia in Chinese adults,and to provide evidence-based reference for clinic.METHODS:Retrieved from The Cochrane Library,PubMed,Chinese Journal Full-text Database,Wanfang database,and manually search Google Scholar,Baidu academic search engine,randomized controlled trials (RCTs) about pitavastatin (trial group) vs.atorvastatin (control group) in the treatment of primary hyperlipemia in Chinese adults were collected.After literature screening,data extraction,quality evaluation of included studies with modified Jadad scale,Meta-analysis of the levels of total cholesterol (TC),low density lipoprotein cholesterol (LDL-C),triglyceride (TG) and high-density lipoprotein cholesterol (HDL-C),response rate and the incidence of ADR was conducted by using Rev Man 5.3 statistical software.RESULTS:A total of 5 RCTs were included,involving 456 patients.Results of Meta-analysis showed that the decrease of TC level [MD=0.09,95％CI(0.01,0.16),P=0.03] in trial group was more better than control group,while the increase of HDL-C level [MD=0.08,95％ CI (0.01,0.14),P=0.03] and the decrease of the TG level [MD=-0.13,95％ CI (-0.20,-0.06),P=0.000 4] in trial group were worse than control group,with statistical significance.There was no statistical difference in the decrease of LDL-C[MD=-0.01,95％ CI (-0.13,0.10),P=0.84],response rate [OR=0.75,95％CI (0.15,3.66),P=0.72] or the incidence of ADR [OR=0.68,95 ％ CI (0.44,1.05),P=0.08] between 2 groups.CONCLUSIONS:Pitavastatin has better therapeutic efficacy in decreasing TC,but its therapeutic efficacy in decreasing LDL-C is similar to that of atorvastatin;its therapeutic efficacy in decreasing TG and increasing HDL-C is worse than that of atorvastatin.The safety of them is equivalent.

A 48-year-old middle aged male presented swelling lymph nodes and mass in neck for 5 years. Physical examination shows swollen mass in head and neck regions. The masses could be touched in bilateral parotids and neck with a little movement and moderate tenderness. The level of IgG was normal, but Eosinophi count was high. The function of heart liver and kidney was normal. The result of B-mode ultrasonography reveals bilateral parotids and subcutaneous near parotids were widely swollen and several swollen lymph nodes in neck. pathological examination displays features of a large number of lymph follicles hyperplasia, acidophilic granulocyte infiltration, capillary hyperplasia and fibrosis of different level. The disease were eventually diagnosed by pathological examination. Method of treatment includes glucocorticoid drug therapy, surgical resection and local radiotherapy. The last treatment of patients with Kimura's disease should be combined with the clinical manifestation of them to determine the individualized treatment, so as to improve the quality of life of patients.
Angiolymphoid Hyperplasia with Eosinophilia ; diagnosis ; pathology ; therapy ; Glucocorticoids ; therapeutic use ; Humans ; Lymph Nodes ; pathology ; Male ; Middle Aged ; Neck ; Parotid Gland ; pathology

Objective To observe the clinical effect of temozolomide combined with radiotherapy in the treatment of malignant gliomas. Methods A total of 64 patients with pathologically confirmed glioblastoma received radiotherapy combined with chemotherapy in our hospital from January 2008 to January 2014, radiotherapy synchronized with TMZ chemotherapy were used in 39 patients (synchronized group) and radiotherapy sequential with TMZ chemotherapy in 25 patients (sequential group).1 year and 3 year survival rates, response rate and drug safety were compared between the two groups. Results The patients were followed up for 6 months to 3 years, the synchronous group of patients 1 years and 3 years survival rates (74.4%, 38.5%) were higher than the sequential group(64.0%, 28.0%) (P<0.05), objective re-sponse rate of two groups were 64.1%and 44.0%, the difference was statistically significant(P<0.05), gastrointestinal re-action rates of two groups were 23.1% and 20.0%, the difference was not statistically significant (P>0.05). Adverse re-actions were statistically significant (P<0.05). Conclusion The effect of radiotherapy synchronized combined with TMZ chemotherapy is better than radiotherapy sequential with TMZ chemotherapy for glioblastoma, it is still the first choice for the treatment of glioblastoma although the clinical manifestations of toxicity increased than the sequential group.

Objective To investigate the effect of neuronavigation assisted microscopic transsphenoidal resection of non-invasived pituitary tumor. Methods Retrospective analysis of clinical data of 72 cases of transsphenoidal operation for non-invasived pituitary tumor from January 2012 to January 2014. Results All patients were successfully completed the surgery, total resection in 65 cases, subtotal resection in 4 cases, partial resection in 3 cases, 7 cases in subtotal resection were treated with gamma knife radiotherapy after operation, hyperprolactin were given bromocriptine treatment after surgery. Patients were followed up for 6 months to 3 years, the remission rate was 89.2% in the postoperative headache, visual disorder remission rate 68.6%, endocrine disorders and the remission rate was 57.6%. 5 cases of post-operative cerebrospinal fluid rhinorrhea underwent repair, 8 cases had diabetes insipidus, 1 case of partial resection progressed to suprasellar and parasellar after 1.5 years, underwent craniotomy operation again. Conclusion For non-in-vasived pituitary tumor, microscopic transsphenoidal sugery is safe, convenient, and has no significant difference com-pared with the effect of endoscopic endonasal transsphenoidal approach.