BACKGROUND:In clinical work,the stiffness of neck soft tissue in patients with neck and shoulder pain is mainly detected through palpation,which is highly subjective and lacks an objective basis.Real-time shear wave elastography is a quantitative elastic ultrasound technique that can objectively assess muscle elasticity and muscle status. OBJECTIVE:To apply real-time shear wave elastography to assess the stiffness of scalene muscles in patients with neck and shoulder pain and to observe the characteristics of muscle stiffness changes in the bilateral anterior,middle and posterior scalene muscles in patients with neck and shoulder pain. METHODS:From December 2021 to June 2022,36 healthy subjects(control group)and 36 patients with neck and shoulder pain(test group)were recruited at the Shenzhen Hospital of Guangzhou University of Chinese Medicine.Real-time shear wave elastography was applied to measure the mean values of elastic modulus and cross-sectional area of the anterior and middle and posterior scalene muscles bilaterally in the neutral and lateral flexion positions of the neck in both groups. RESULTS AND CONCLUSION:In the same position,there were no significant differences between the mean Values of elastic modulus of the left and right anterior scalene muscles as well as between the mean Values of elastic modulus of the left and right middle scalene muscles in each group(P>0.05);there were no significant differences between the cross-sectional area of the left and right anterior scalene muscles as well as the cross-sectional area of the left and right posteromedial scalene muscles in each group(P>0.05);and the elastic modulus and cross-sectional area of the posteromedial scalene muscles were significantly higher than those of the anterior scalene muscles in both groups(P<0.01,P<0.001).The mean Values of elastic modulus of the anterior and posteromedial scalene muscles were higher in the test group than in the control group in the neutral and lateral neck flexion positions(P<0.001),while the cross-sectional areas of the anterior and posteromedial scalene muscles were lower than those in the control group(P<0.01,P<0.001).To conclude,real-time shear wave elastography can be used to visually evaluate the differences in the mean Values of elastic modulus of the anterior and posteromedial scalene muscles in different states of the neck muscles in patients with neck and shoulder pain,whose bilateral scalene muscles are in a state of strain and stiffness.

[Objective] To explore the characteristics of lifestyle behaviors and mental health status among blood donors in Guangzhou, and to investigate the correlation between donation frequency and these factors. [Methods] A cross-sectional study was conducted among 13 042 whole blood donors from 17 street blood donation sites of Guangzhou Blood Center from May to August 2020. Descriptive analysis was used to describe the characteristics of lifestyle behaviors and mental health status among blood donors in Guangzhou. Ordinal multinomial logistic regression model was used to analyze the correlation between donation frequency and these factors. [Results] It was found that some of 13 042 blood donors had unhealthy habits, such as 6.8% (698/10 214，2 828 missing values) had severe tobacco dependence, 30.6% (3 997/13 042) had low exercise levels, 38.8%（5 056/13 042）had poor sleep quality, and 2.2% (271/12 159，883 missing values) had alcohol dependence. In addition, 2.8% (364/13 042) and 1.3% (172/13 042) of the donors may have moderate to severe depression and anxiety symptoms, respectively. The results of the ordinal multinomial logistic regression model showed that exercise level was significantly negatively correlated with the degree of depression and anxiety among blood donors. With the decrease in exercise level, the possibility of depression and anxiety among donors increased significantly. BMI, household income, education level, marital status, donation frequency, alcohol consumption and smoking had no significant correlation with the mental health status of donors. [Conclusion] Improving the exercise habits of blood donors may help enhance their mental health level. It is recommended that blood station staff strengthen the content of exercise when providing health education to blood donors to maintain a healthy lifestyle. It also suggests that there may be a certain degree of under-diagnosis of mental health problems in the process of health consultation before blood donation, and conducting more comprehensive and effective mental health assessments for blood donors is recommended.

ObjectiveTo observe the therapeutic effect of Chaishao Longmu decoction on insomnia in the patients with the syndrome of live depression and spleen deficiency and explore the correlation between infrared thermal imaging and insomnia with liver depression and spleen deficiency. MethodA total of 72 insomnia patients treated in the outpatient department of Shenzhen Hospital of Guangzhou University of Chinese Medicine （Futian） from May to December in 2022 were selected and randomized into a treatment group and a control group， with 36 patients in each group. The patients in the treatment group were treated with Chaishao Longmu decoction and those in the control group with eszopiclone for 4 weeks. The clinical efficacy， Pittsburgh sleep quality index （PSQI） score， TCM syndrome score and infrared thermal imaging characteristics ［temperature and temperature changes of frontal sleep line， frontal region， anterior trunk， Zhongwan （CV12）， conception vessel （CV）， left hypochondrium， right hypochondrium， dorsal trunk， and governor vessel （GV）］ of two groups were determined before and after treatment. ResultAfter treatment， the clinical response rate in treatment group was 91.67% （33/36）， which was higher than that （66.67%， 24/36） in the control group （Z=-2.617， P<0.01）. The treatment in both groups decreased the PSQI score and TCM syndrome score （P<0.01）， and the decreases were more significant in treatment group than in the control group （P<0.01）. After treatment， the total response rate of sleep line improvement in the treatment group was 86.11% （31/36）， which was higher than that （66.67%， 24/36） in the control group （Z=-2.591， P<0.05）. The frontal temperature of the two groups decreased （P<0.01） after treatment. Compared with those before treatment， the temperatures of anterior trunk， CV12， CV， left hypochondrium， right hypochondrium， dorsal trunk， and GV rose after treatment （P<0.01）. After treatment， the treatment group had lower frontal temperature and higher temperatures of anterior trunk， CV12， CV， left hypochondrium， right hypochondrium， dorsal trunk， and GV than the control group （P<0.01）. The treatment in the treatment group reduced the ∆T values of GV （P<0.01） and increased that of the CV12， CV， left hypochondrium， and right hypochondrium （P<0.05，P<0.01）. The treatment in the control group increased the ∆T value of CV12 （P<0.01）. After treatment， the treatment group had lower ∆T values of GV （P<0.01） and higher ∆T value of CV12， CV， left hypochondrium， and right hypochondrium （P<0.05， P<0.01） than the control group. Compared with that before treatment， the temperature difference between GV and CV in the two groups increased after treatment （P<0.01）. According to the infrared thermal image characteristics， the normal temperature difference between GV and CV was within the range of 0.5-1. The median value after treatment in the treatment group was 0.69 （0.52， 0.88）， which was within the normal range， indicating that the treatment group outperformed the control group. ConclusionChaishao Longmu decoction can alleviate short-term insomnia by soothing liver， invigorating spleen， harmonizing the middle energizer， and regulating GV and CV. With definite clinical effect， this decoction deserves promotion. Furthermore， the frontal temperature， sleep line， CV12， CV ∆T， and temperature difference between GV and CV revealed by the infrared thermal images could be used for the diagnosis and of insomnia with liver depression and spleen deficiency.

Objective To evaluate the efficacy of the retroperitoneal laparoscopic pyelolithotomy (RLP) and the percutaneous nephrolithotomy (PCNL) in treating renal pelvic stone.Methods The data of 89 patients diagnosed as renal pelvic stone were retrospectively reviewed from January 2009 to July 2016,of whom 43 patients underwent RLP and 46 underwent PCNL.Statistical analysis was performed regarding operation time,blood loss,mean hospital stay,complication rate,and stone-free rate.Results The operation time in RLP group and PCNL group was (117.5 ± 16.7) min and (118.3 ± 16.6) min,respectively,and there was no significant difference (P =0.547).For the two groups,the mean hospital stay was (4.5 ± 0.5) d and (6.1 ± 0.9) d,the mean hemoglobin decrease was (4.5 ± 1.2) g/L and (18.1 ± 3.4) g/L,the post-operative blood transfusion rate was 2.3％ and 14.0％,the post-operative septic shock rate was 0 and 9.3％,respectively,with significant difference between the two groups (P ＜ 0.05).The stone-free rate in both groups was 97.7％ and 95.3％ with no significant difference (P =0.557).Conclusions RLP has the advantages of quick recovery,less blood loss and lower complication rate than PCNL.It could be a minimally invasive option for the treatment of renal pelvic stone.

Objective To compare the clinical outcomes between conventional percutaneous vertebroplasty (PVP) and targeted PVP in the treatment of osteoporotic vertebral compression fractures (OVCFs).Methods A retrospective cohort study was designed to review 215 cases of single level OVCFs hospitalized between January 2014 and December 2015.According to the procedure techniques,the patients were assigned to targeted PVP group (89 cases) and conventional PVP group (126 cases) which was further divided into sufficient filled subgroup (110 cases) and insufficient filled subgroup (16 cases) on basis of cement distribution.Key techniques of targeted PVP included accurate needle insertion to fractured area and cement injection using a push rob with a side opening.Operating time,cement injection volume,rate and types of cement leakage,cement distribution in the fractured area and visual analogue score (VAS) of back pain were compared between the two groups.Results Operating time in targeted PVP group was longer than that in conventional PVP group (P ＜ 0.05).There were no significant differences in cement injection volume and rate and types of cement leakage between the two groups (P ＞ 0.05).None in targeted PVP group showed insufficient cement distribution in fractured area,while 16 cases (12.7％) in conventional PVP group (P ＜ 0.05).No significant differences in preoperative VAS of back pain existed among targeted PVP group,sufficient subgroup and insufficient subgroup (P ＞ 0.05).VAS of back pain was significantly decreased after PVP in three groups (P ＜ 0.05).Difference in postoperative VAS of back pain between targeted PVP group and sufficient filled subgroup was insignificant (P ＞0.05).However,postoperative VAS of back pain in insufficient filled subgroup was significantly increased compared with targeted PVP group and sufficient filled subgroup (P ＜ 0.05).Conclusion Targeted PVP provides sufficient cement to fill the fractured area and decreases incidence of unsatisfactory clinical outcome compared with traditional PVP,indicating a secure and effective new technique in the treatment of OVCFs.

Objective To analyze the relationship of oxidized low density lipoprotein (ox-LDL) and homocysteine (Hcy) with coronary in-stent restenosis (ISR),and to discuss the clinical predictors of ISR after rapamycin-eluting coronary stent implantation.Methods A total of 400 patients,who had received rapamycin-eluting coronary stent implantation,were enrolled in this study.According to follow-up coronary angiography findings,the patients were divided into ISR group and non-ISR group.Plasma ox-LDL and Hcy levels were tested before percutaneous coronary intervention (PCI) as well as at the time of follow-up coronary angiography.Multivariate logistic regression analysis was used to evaluate ISR-related clinical parameters,angiographic features and surgical factors.Results ISR group had 48 patients and non-ISR group had 352 patients,the clinical incidence rate of ISR was 13.6％.Compared with non-ISR group,the plasma ox-LDL and Hcy levels tested before stent implantation and at the time of follow-up coronary angiography were strikingly increased,the differences were statistically significant (P＜0.05).The results of multivariate logistic regression analysis showed that the independent correlative factors for ISR included hypertension (OR=1.12,95％CI:1.02-3.92;P=0.033),diabetes (OR=2.61,95％CI:1.93-4.26;P=0.016 0),Hcy (OR=2.45,95％CI:1.57-4.48;P=0.036),ox-LDL (OR=2.18,95％CI:1.45-4.96;P=0.006),taking statins (OR=0.50,95％CI:0.26-0.82;P=0.013),smoking (OR=5.62,95％CI:4.13-7.18;P=0.002),coronary artery disease (OR=3.32,95％CI:2.12-5.34;P=0.017),coronary bifurcation lesion (OR=3.51,95％CI:2.36-5.58;P=0.021),chronic total occlusion (OR=2.01,95％CI:1.22-4.84;P=0.014),reference vessel diameter (OR=0.25,95％CI:0.12-0.62;P=0.001),preoperative vascular stenosis degree (OR=2.06,95％ CI:1.21-4.32;P=0.024),stent diameter (OR=0.20,95％CI:0.10-0.53;P=0.001) and stent length (OR=2.60,95％CI:1.22-4.84;P=0.036).Conclusion Clinically,ISR is not an uncommon finding in patients who have received rapamycin-eluting coronary stent implantation.This study indicates that hypertension,diabetes,Hcy,ox-LDL,taking statins,smoking,coronary artery disease,coronary bifurcation lesion,chronic total occlusion,reference vessel diameter,preoperative vascular stenosis degree,stent diameter and stent length are the independent factors for ISR.Long-term use of statins can reduce the risk of ISR.

Objective To compare the safety,efficacy and complications of laparoscopic pyelolithotomy (LPL) and percutaneous nephrolithotomy (PCNL) for treatment of renal pelvic stones larger than 2.5 cm.Methods From 2011 to 2016,32 patients underwent LPL and another 32 patients received PCNL for renal pelvic stones larger than 2.5 cm.The baseline characteristics of the patients,stone size,mean operative time,estimated blood loss,postoperative hospital stay,stone-free rate,postoperative analgesia,blood transfusion,and the intraoperative,early postoperative and long-term complications were compared between the two groups.Results The baseline characteristics and stone size were comparable between the two groups.The mean operative time of LPL and PCNL was 117±23.12 and 118.16±25.45 min,respectively (P＞0.05).The two groups showed significant differences in the mean estimated blood loss (63±11.25 vs 122±27.78 mL,P＜0.01) and blood transfusion rate (0 vs 6.2％,P＜0.01) but not in postoperative hospital stay (4.5±1.34 vs 4.8±2.2 days,P＞0.05),stone-free rate (93.1％ vs 87.5％,P＞0.05) or the postoperative analgesia time (1.7± 0.5 and 1.9 ± 0.6 days,P＞0.05).The incidence of intraoperative complications were significant lower in LPL group than in PCNL group (6.2％ vs 25.0％,P＜0.01),but the incidences of early postoperative complications (25.0％ vs 34.4％,P＞0.05) and long-term postoperative complications (9.4％ vs 12.5％,P＞0.05) were sinilar between them.Conclusion PCNL is the standard treatment for pelvic stones larger than 2.5 cm,but for urologists experienced with laparoscopic technique,LPL provides a feasible and safe option for management of such cases.

Objective To compare the safety,efficacy and complications of laparoscopic pyelolithotomy (LPL) and percutaneous nephrolithotomy (PCNL) for treatment of renal pelvic stones larger than 2.5 cm.Methods From 2011 to 2016,32 patients underwent LPL and another 32 patients received PCNL for renal pelvic stones larger than 2.5 cm.The baseline characteristics of the patients,stone size,mean operative time,estimated blood loss,postoperative hospital stay,stone-free rate,postoperative analgesia,blood transfusion,and the intraoperative,early postoperative and long-term complications were compared between the two groups.Results The baseline characteristics and stone size were comparable between the two groups.The mean operative time of LPL and PCNL was 117±23.12 and 118.16±25.45 min,respectively (P＞0.05).The two groups showed significant differences in the mean estimated blood loss (63±11.25 vs 122±27.78 mL,P＜0.01) and blood transfusion rate (0 vs 6.2％,P＜0.01) but not in postoperative hospital stay (4.5±1.34 vs 4.8±2.2 days,P＞0.05),stone-free rate (93.1％ vs 87.5％,P＞0.05) or the postoperative analgesia time (1.7± 0.5 and 1.9 ± 0.6 days,P＞0.05).The incidence of intraoperative complications were significant lower in LPL group than in PCNL group (6.2％ vs 25.0％,P＜0.01),but the incidences of early postoperative complications (25.0％ vs 34.4％,P＞0.05) and long-term postoperative complications (9.4％ vs 12.5％,P＞0.05) were sinilar between them.Conclusion PCNL is the standard treatment for pelvic stones larger than 2.5 cm,but for urologists experienced with laparoscopic technique,LPL provides a feasible and safe option for management of such cases.

OBJECTIVETo observe the effects of different loading doses of atorvastatin calcium on the outcomes of percutaneous coronary intervention (PCI) in elderly patients with coronary heart disease (CHD).

METHODSA total of 120 CHD patients aged over 80 years were randomly assigned into 3 equal groups to receive intensive pretreatment with statin at the doses of 20, 40, or 60 mg prior to PCI performed within 48 to 72 h after admission. The changes of postoperative cardiac biochemical markers including creatine kinase isoenzyme (CKMB), troponin I (cTNI) and high-sensitivity c-reactive protein (hs-CRP) were observed and the incidence of major adverse cardiac events (MACE, including cardiac death, myocardial infarction, and target vessel revascularization) were recorded within 30 days after PCI.

RESULTSThirty-four patients in 20 mg statin group, 40 in 40 mg statin group, and 38 in 60 mg statin group completed this study. In all the 3 groups, hs-CRP level significantly increased at 12 and 24 h after PCI compared with the preoperative levels (P<0.05). The patients in 60 mg statin group showed significantly lower levels of CKMB, cTNI, and hs-CRP at 24 h after PCI than those in 20 mg statin group (P<0.05), and had also a significantly lower incidence of total MACE within 30 days after PCI (2.6% vs 26.5%, P=0.003) resulting primarily from significantly reduced myocardial infarction associated with PCI (2.6% vs 20.6%, P=0.016). The adverse drug reactions were comparable among the 3 groups (P>0.05).

CONCLUSIONSIntensive pretreatment with 60 mg/day atorvastatin calcium can significantly reduce myocardial infarction related to PCI with good safety in elderly patients with CHD.

Aged, 80 and over ; Atorvastatin Calcium ; Biomarkers ; metabolism ; Coronary Disease ; drug therapy ; surgery ; Dose-Response Relationship, Drug ; Heptanoic Acids ; therapeutic use ; Humans ; Hydroxymethylglutaryl-CoA Reductase Inhibitors ; therapeutic use ; Myocardial Infarction ; prevention & control ; Percutaneous Coronary Intervention ; Pyrroles ; therapeutic use

BACKGROUND:It is generaly recognized that cervical rotation manipulation can increase the risk of detachment of unstable plaques in carotid atherosclerosis, but few studies are reported on the influence of cervical rotation manipulation on the stable plaque in early carotid atherosclerosis. OBJECTIVE:To explore the influence of the cervical rotation manipulation on the lipid contents in carotid atherosclerotic plaque in a rabbit model of early carotid atherosclerosis. METHODS:After being fed for 15 days with normal diet, 30 male New Zealand White rabbits were further fed for 18 weeks with normal diet (n = 10; control group) or a high-fat diet containing 2% cholesterol, 10% lard and 88% normal granules to build rabbit models of early carotid atherosclerosis with stable carotid plaque (n = 20). At 14 weeks of feeding with high-fat diet, the experimental rabbits fed with high-fat diet were randomly divided into a cervical rotation manipulation group (n = 10) and a model group (n = 10). The rabbits in the cervical rotation manipulation group underwent cervical rotation manipulation to the left and right sides, once each side, with the maximal range of rotation. Total five cervical rotation manipulations, once every 3 days, were performed. RESULETS AND CONCLUSION:The 1 450 cm-1 and 1 660 cm-1 peaks of the Raman spectrum of lipid in the carotid atherosclerotic plaque of rabbit models were not distinctly present in the control group, however, they were obviously observed in the cervical rotation manipulation group and model group. Nevertheless, the relative intensity differences at spectrum characteristic peaks were not significant between cervical rotation manipulation group and model group (P > 0.05). The environmental findings indicate that the lipid content in carotid atherosclerotic plaque of rabbit models of early carotid atherosclerosis cannot be increased after short-term administration of cervical rotation manipulation.