Objective:To evaluate the effectiveness of a family physician-integrated "Pulmonary Health Home" (PHH) grid management model for community-based prevention and management of chronic obstructive pulmonary disease (COPD).Methods:A randomized controlled trial (RCT) was conducted in Machong Town of Dongguan City from October 1st 2021 to September 30th 2024. The PHH platform was established, screening high-risk populations using the COPD Screening Questionnaire (COPD-SQ). Individuals scoring ≥16 underwent confirmatory pulmonary function tests (post-bronchodilator FEV?/FVC<0.7). A total of 120 clinically stable COPD patients were randomized to either the intervention group (PHH platform management) or control group (routine care). Outcomes including smoking behavior, COPD Assessment Test (CAT) scores, modified Medical Research Council (mMRC) dyspnea scale scores, frequency of acute exacerbations, and other indicators were assessed before the preintervention and after one year of management.Results:Among 4 572 screened individuals, 345 COPD cases were confirmed (detection rate: 7.55%), representing a 259% increase from the pre-intervention baseline (96 cases). After one year, compared to controls, the intervention group showed: significantly lower annual cigarette consumption (165.8±61.3 vs. 321.3±70.2, t=12.856),greater reduction in CAT scores (16.06±5.92 vs. 19.25±5.24, t=3.182), fewer acute exacerbations (0.71±0.32 vs. 2.46±0.48 times/year, t=24.503), higher patient satisfaction (87.9%(51/58) vs. 62.5%(35/56), χ2=10.203), better mastery of inhalation technique (82.4% (48/58) vs. 48.2%(27/56), χ2=13.843), increased clinician-patient interactions (13.5±3.2 vs. 4.2±1.5 times/year, t=19.876) (all P<0.05). Conclusion:The family physician-integrated PHH grid management model significantly enhances community-based COPD outcomes.

Objective:To evaluate the effectiveness of a family physician-integrated "Pulmonary Health Home" (PHH) grid management model for community-based prevention and management of chronic obstructive pulmonary disease (COPD).Methods:A randomized controlled trial (RCT) was conducted in Machong Town of Dongguan City from October 1st 2021 to September 30th 2024. The PHH platform was established, screening high-risk populations using the COPD Screening Questionnaire (COPD-SQ). Individuals scoring ≥16 underwent confirmatory pulmonary function tests (post-bronchodilator FEV?/FVC<0.7). A total of 120 clinically stable COPD patients were randomized to either the intervention group (PHH platform management) or control group (routine care). Outcomes including smoking behavior, COPD Assessment Test (CAT) scores, modified Medical Research Council (mMRC) dyspnea scale scores, frequency of acute exacerbations, and other indicators were assessed before the preintervention and after one year of management.Results:Among 4 572 screened individuals, 345 COPD cases were confirmed (detection rate: 7.55%), representing a 259% increase from the pre-intervention baseline (96 cases). After one year, compared to controls, the intervention group showed: significantly lower annual cigarette consumption (165.8±61.3 vs. 321.3±70.2, t=12.856),greater reduction in CAT scores (16.06±5.92 vs. 19.25±5.24, t=3.182), fewer acute exacerbations (0.71±0.32 vs. 2.46±0.48 times/year, t=24.503), higher patient satisfaction (87.9%(51/58) vs. 62.5%(35/56), χ2=10.203), better mastery of inhalation technique (82.4% (48/58) vs. 48.2%(27/56), χ2=13.843), increased clinician-patient interactions (13.5±3.2 vs. 4.2±1.5 times/year, t=19.876) (all P<0.05). Conclusion:The family physician-integrated PHH grid management model significantly enhances community-based COPD outcomes.

Inflammation is a major underlying mechanism in the progression of numerous cardiovascular diseases (CVDs). Regulatory T cells (Tregs) are typical immune regulatory cells with recognized immunosuppressive properties. Despite the immunosuppressive properties, researchers have acknowledged the significance of Tregs in maintaining tissue homeostasis and facilitating repair/regeneration. Previous studies unveiled the heterogeneity of Tregs in the heart and aorta, which expanded in CVDs with unique transcriptional phenotypes and reparative/regenerative function. This review briefly summarizes the functional principles of Tregs, also including the synergistic effect of Tregs and other immune cells in CVDs. We discriminate the roles and therapeutic potential of Tregs in CVDs such as atherosclerosis, hypertension, abdominal arterial aneurysm, pulmonary arterial hypertension, Kawasaki disease, myocarditis, myocardial infarction, and heart failure. Tregs not only exert anti-inflammatory effects but also actively promote myocardial regeneration and vascular repair, maintaining the stability of the local microenvironment. Given that the specific mechanism of Tregs functioning in CVDs remains unclear, we reviewed previous clinical and basic studies and the latest findings on the function and mechanism of Tregs in CVDs.
Humans ; T-Lymphocytes, Regulatory ; Cardiovascular Diseases ; Atherosclerosis ; Myocardial Infarction ; Phenotype

OBJECTIVETo evaluate the clinical outcome of arthroscopic reconstruction of anterior cruciate ligament (ACL) with remnant preserving technique.

METHODSFrom May 2008 to October 2010,68 patients with ACL deficiency (33 males and 35 females, with an average age of 25.8 years, ranged from 17 to 43 years) were treated with arthroscopy. The average duration of the disease was (4.5 +/- 1.1) months. The pivot shift test showed positive results in 55 cases, Lachman test showed positive results in 68 cases, and the ADT (anterior drawer test) showed positive results in 68 cases. The anterior transition of the tibia measured by KT2000 instrument was (7.2 +/- 2.3) mm (5 to 9 mm) more than that of the opposite knee. The average Lysholm score was 55.7 +/- 5.4 (45 to 67). The average Tegner activity scores was 3.1 +/- 0.6 (2 to 4). The tibial tunnels and femoral tunnels were drilled in the middle of the footprint of the ACL, and the graft was wrapped by the remnant. Grafts were fixed with cross pin at the femoral side and with biodegradable interference screw at the tibial side. Postoperative symptoms and signs were observed in the follow-up duration. The anterior transition of the tibia was measured by KT2000, the Lysholm and Tegner scores were used to evaluate knee functions.

RESULTSAll the patients were followed up, and the duration ranged from 24 to 42 months, with a mean of (31.5 +/- 2.4) months. At the latest follow-up, there was no patients had positive result by civot shift test, while the Lachman test showed results of negative or positive of grade I, and the ADT test showed results of negative or positive of grade I or II. The anterior transition of the tibia measured by KT2000 instrument decreased to (1.9 +/- 0.7) mm (0 to 3 mm) more than that of the opposite knee (t = 21.15, P = 0.000 1). The postoperative Lysholm score 86.0 +/- 5.1(81 to 97) and Tegner score 7.8 +/- 0.3 (6 to 9) all increased compared with preoperative 55.7 +/- 5.4 and 3.1 +/- 0.6 (t = 18.55, P = 0.001 0; t = 9.11, P = 0.000 5). According to Lysholm score, excellent results were obtained in 55 cases, good in 10, poor in 3 and no bad results.

CONCLUSIONThe ACL remnant provide vascular and nerve supply for the graft, promoting union and remodeling of grafts.

Adolescent ; Adult ; Anterior Cruciate Ligament ; surgery ; Anterior Cruciate Ligament Reconstruction ; methods ; Arthroscopy ; methods ; Female ; Humans ; Knee Injuries ; surgery ; Male ; Treatment Outcome ; Young Adult

OBJECTIVETo evaluate and analyze mechanism of Pizhen for the treatment of pain in patients with knee osteoarthritis.

METHODSEighty-five patients (85 knees) were divided into two groups according to random number table method. Among 35 patients in the experimental group, 6 patients were male and 29 patients were female, 1 patient lost follow-up, the average age was (56.65 +/- 4.89) years, and the patients were treated with Pizhen. Among 50 patients in the control group,there were 6 males and 44 females, the average age was (57.54 +/- 4.91) years, and the patients were treated with intra-articular injection with sodium hyaluronate. The VAS score and the data of algometer from the most obvious tenderness around the knee were used to evaluate the clinical effects.

RESULTSThere were significant differences of scores in the experimental group before and after treatment (P<0.01). There were significant differences of scores in the control group before and after treatment (P<0.01). After treatment, there were no statistical differences of VAS score and the data of algometer between experimental and control groups ( P>0.01). There was negative correlation between VAS score and the data of algometer.

CONCLUSIONThe Pizhen is an effective method to treat pain in patients with knee osteoarthritis by relaxing tendon of soft tissue around pain point of knee joint, and relaxing compress and stimulation of nerves.

Acupuncture Analgesia ; Aged ; Case-Control Studies ; Female ; Humans ; Male ; Middle Aged ; Osteoarthritis, Knee ; physiopathology ; therapy ; Pain Measurement

OBJECTIVETo evaluate the clinical effects of titanium miniplate in cervical expansive open-door laminoplasty in treating cervical spondylosis.

METHODSFrom February 2009 to April 2011, 16 patients underwent expansive open-door laminoplasty by titanium miniplate fixation were classified as group A; 18 patients with conventional unilaterally open-door laminoplasty from March 2007 to January 2009 were served as control (group B). The operative time, blood loss during the operations, JOA score of the 6 months after operation, the incidence of axial symptom, curvature of cervical vertebrae were compared respectively between the two groups.

RESULTSOperative time, blood loss, improvement rate of JOA in group A were respectively (122.0 +/- 26.8) min, (153.0 +/- 46.7) ml, (59.4 +/- 11.6)%; and in group B were (119.0 +/- 28.6) min, (151.0 +/- 50.4) ml, (58.7 +/- 12.7)%. Those showed no significant difference between two groups (P > 0.05). Three cases (18.75%) occurred obviously axial symptom in group A and six cases (33.33%) occurred in group B, there was significant difference in the incidence of axial symptom between two groups (P < 0.01). Preoperative and postoperative curvature of cervical vertebrae in group A was (17.9 +/- 5.2) degrees and (18.2 +/- 4.8) degrees, without significant difference; in group B, postoperative curvature of cervical vertebrae decreased obviously than the preoperative [(16.3 +/- 5.9) degrees vs (18.1 +/- 6.3) degrees] (P < 0.05).

CONCLUSIONBoth surgical protocols are effective on preventing reclose of opened laminae, moreover the modified laminoplasty is advanced on reducing the occurrence of axial symptoms and loss of cervical curvature.

Adult ; Aged ; Bone Plates ; Case-Control Studies ; Cervical Vertebrae ; surgery ; Female ; Fracture Fixation, Internal ; instrumentation ; Humans ; Laminectomy ; methods ; Male ; Middle Aged ; Spondylosis ; surgery ; Titanium

Medial patellofemoral ligament (MPFL) is the major static structure to restrain lateral patellar dislocation. There are always MPFL injuries in patellar dislocations. The medial ligamentous deficiency will lead to recurrent patellar dislocation or patellar instability. Surgeon used to suture all those structures in the medial knee compartment before MPFL is recognized. Reconstruction of MPFL becomes an important method to treat patellar dislocation since it is anatomically recognized. Many techniques have invented MPFL reconstruction. The goal of this article is to develop a current understanding of MPFL and its clinical significance, especially MPFL reconstruction. The anatomical double bundle reconstruction of MPFL by bone anchors is a safe, easy and effective way to treat patellar dislocations.
Humans ; Patellar Dislocation ; physiopathology ; surgery ; Patellar Ligament ; injuries ; physiopathology ; surgery ; Reconstructive Surgical Procedures ; instrumentation ; methods ; Suture Anchors ; Suture Techniques ; instrumentation

OBJECTIVETo investigate the effect of Wuzi Yanzong Decoction (WYD) in treating Leber hereditary optic neuropathy (LHON).

METHODSThirty patients of LHON up to the requirement were assigned to two groups, the treated group administered with WYD plus coenzyme Q10, and the control group with coenzyme Q10 alone, all for 3 months. Patients' visual acuity, visual field, vision evoked potential (VEP) and their Chinese medicine syndrome were observed before and after treatment.

RESULTSAfter treatment, all the above-mentioned indexes were improved to some extents in the treated group, but showed no evident change in the control group excepting visual acuity, comparison between groups showed the differences were significant in all items.

CONCLUSIONWYD shows certain clinical therapeutic effect for treatment of LHON.

Adolescent ; Adult ; Drugs, Chinese Herbal ; therapeutic use ; Evoked Potentials, Visual ; Female ; Humans ; Male ; Optic Atrophy, Hereditary, Leber ; drug therapy ; genetics ; Phytotherapy ; Ubiquinone ; analogs & derivatives ; therapeutic use ; Visual Acuity ; Young Adult