Objective:To evaluate early weight-bearing walking with inflatable boots after repair of acute Achilles tendon rupture based on the concept of rapid rehabilitation.Methods:A retrospective study was conducted to analyze the data of 69 patients with acute Achilles tendon rupture who had been treated at Department of Orthopaedics, The Second Fuzhou Hospital Affiliated to Xiamen University from April 2020 to July 2021. There were 56 males and 13 females with a mean age of 37.0(31.0, 47.0) years and a body mass index of (23.7±2.6) kg/m 2. There were 55 cases of closed injury and 14 cases of open injury; 62 cases had simple Achilles tendon injury and 7 cases were complicated with neurovascular tendon injury. The patients were divided into 2 groups according to their rehabilitation methods. The treatment group of 23 cases was subjected to weight-bearing walking with inflatable boots early after repair while the control group of 46 cases to traditional plaster bracket fixation for 4 weeks before weight-bearing walking with inflatable boots. The 2 groups were compared in terms of hospitalization time, wound infection rate, return to sports time, single heel lifting time, Achilles tendon re-rupture rate, Victorian Institute of Sports Assessment (VISA-A), Achilles tendon total rupture score (ATRS), and American Orthopaedic Foot & Ankle Society ankle-hindfoot score (AOFAS-AH). Results:There was no statistically significant difference in the comparison of preoperative general data between the 2 groups, showing comparability ( P>0.05). All patients were followed up for 11 (10, 11) months after surgery. In the treatment group, the hospitalization time [4 (3, 5) days] and single heel lifting time [(12.5±1.4) weeks] were significantly shorter than those in the control group [6 (5, 9) days and (17.0±1.5) weeks], the return to sports time [21 (20, 22) months] was significantly earlier than that in the control group [23 (22, 24) months], and the VISA-A score [(89.4±1.3) points] was significantly higher than that in the control group [(78.5±1.7) points] ( P<0.05). There was no statistically significant difference in the wound infection rate between the 2 groups ( P>0.05). At 3 and 6 months after surgery, respectively, the treatment group had significantly higher ATRS scores [(85.5±1.4) and (89.0±1.6) points] and AOFAS ankle-hindfoot scores [(89.0±1.7) and (92.0±1.5) points] than the control group [(79.3±1.8) and (87.0±1.3) points; (80.2±1.9) and (88.4±1.9) points] (all P<0.05). In all patients, the AOFAS ankle-hindfoot score at 6 months postoperatively was significantly higher than that at 3 months postoperatively ( P<0.05). Achilles tendon re-rupture occurred in none of the patients. Conclusion:After repair of acute Achilles tendon rupture, compared with traditional plaster bracket fixation, early weight-bearing walking with inflatable boots can lead to better short-term clinical outcomes to enhance recovery after surgery without increasing the rate of open wound infection or re-rupture.

Objective To explore whether CT perfusion imaging (CTPI)parameters can early predict the curative effect of anlotinib hydrochloride and their predictive accuracy for the treatment in lung cancer patients.Methods 2 6 patients with advanced nonGsmall cell lung cancer (NSCLC)were treated with anlotinib hydrochloride and underwent CTPI scanning before chemotherapy,after the first and second treatment cycle respectively.The average values of perfusion value (PV),peak enhancement image (PEI),time to peak (TTP),blood volume (BV)and the change rate of these parameters after one treatment cycle every time were measured and recorded. According to the response evaluation criteria in solid tumors 1.1 (RECIST1.1),the maximum diameter of the target tumor was measured and the tumor regression rate after two treatment cycles was calculated.Then a correlation analysis was conducted between the change rate of perfusion parameters (PV%,PEI%,TTP%,BV%)after one treatment cycle and the tumor regression rate (D%)after two treatment cycles. The ROC curve was performed to evaluate the accuracy of those parameters.Results PV after one treatment cycle was significantly lower than that before treatment,and PV% showed a statistical difference (P＝0.00).The PV% after one treatment cycle was positively correlated with D% after two treatment cycles (r＝0.56).In addition,the AUC of PV% and BV% were 0.99 and 0.88 respectively, and specificity were both 100%,with sensitivity respectively 75.7% and 82.6%.Conclusion CTPI can early reflect the curative effect of anlotinib hydrochloride for advanced NSCLC and provide more options for clinical evaluation.

Objective: To explore the application of extensive pterional approach combined with cutting of the zygomatic arch for the resection of large sphenoid ridge meningioma. Methods: Thirty-three patients with large sphenoid ridge meningioma underwent operation using the extensive pterional approach combined with cutting of the zygomatic arch. Twenty patients with large sphenoid ridge meningioma received operation with the traditional pterional approach as the control. The resection rate, operative time, intraoperative blood loss, and postoperative complications were compared between the groups. Results: Two groups of patients underwent craniotomy under microscope. The Simpon grade I resection and grade Ⅱ resection rate was 93.9％ in the cutting of the zygomatic arch approach group and 60.0％ in the control group (P<0.01). The operative time was (325.2±121.3) min in the cutting of the zygomatic arch approach group, which was significantly shorter than that in the control group with (406.4±182.9) min (P<0.05). The intraoperative blood loss was (502.5±101.8) mL and (697.7±115.4) mL in the two groups (P<0.05). In addition, postoperative complication rate was 15.2％ and 45.0％ in the cutting the zygomatic arch approach group and the control group, respectively (P<0.05). No death was reported in both groups. Conclusion: Extensive pterional approach combined with cutting of the zygomatic arch can fully expose the anatomical structures of the skull base and the sellar region to eliminate the influence of temporal muscle in the exposure of the surgical area. The operative field is exposed to reduce the stretch injury to only the frontotemporal brain tissue, which might be helpful for the complete resection of large sphenoid ridge meningioma, and is more conducive to neurovascular anatomy and relevant functional protection.

OBJECTIVE: To investigate the expression of vascular endothelial growth factor in the nasal mucosa of chronic rhinosinusitis with nasal polys patients, and explored the regulation of clarithromycin on VEGF. METHOD: RT-PCR was used to detect the expression of VEGF in nasal mucosa from healthy control and CRSwNP. Nasal mucosal tissue explant culture measure and ELISA were used to explore the effect of clarithromycin on VEGF expression. RESULT: (1) VEGF mRNA expression level was significantly increased in CRSwNP compared with control and showed a statistic difference (P < 0.01). (2) There was a significant decrease in CRSwNP group undergo clarithromycin treatment on protein expression level of VEGF and showed a statistic difference (P < 0.05). CONCLUSION VEGF were overexpressed in CRSwNP group, which presume that play an important role in the pathogenesis of nasal polyps. Clarithromycin may play a therapeutical role on chronic rhinosinusitis through down-regulated the expression of VEGF.
Adult ; Chronic Disease ; Clarithromycin ; pharmacology ; Female ; Humans ; Male ; Nasal Mucosa ; metabolism ; Nasal Polyps ; complications ; Rhinitis ; complications ; metabolism ; Sinusitis ; complications ; metabolism ; Vascular Endothelial Growth Factor A ; metabolism ; Young Adult

This article elaborated the connotation and characteristics of research-oriented hospital as well as its inner connection with the development of key disciplines , based on the system dynamics model data analysis of the National TCM Clinical Research Base . It gave suggestions in increasing discipline input , strengthening personnel training , and improving achievement output to research-oriented hospital construction in order to promote the construction of research-oriented hospitals .

This article took the research work of 16 national clinical research base construction units as its background in order to dig the connotation of health service efficiency . Through data envelopment analysis , a comprehensive exposition was given on the inputs and outputs relation of medical and health service efficiency in order to propose appropriate policy recommendations. The study was guided by the scientific development concept in order to gradually improve the efficiency of health services and achieve a comprehensive , coordinat-ed and sustainable development of the hospital .

OBJECTIVE: To investigate the expression of NOD1 and NOD2 in the nasal mucosa of healthy individuals and allergic rhinitis(AR), and explored the regulation of glucocorticoids on them. METHOD: RT-PCR and immunohistochemistry were used to detect the expression of NOD1 and NOD2 in nasal mucosa from healthy control and AR. Nasal explant culture was used to explore the effect of glucocorticoids on NOD1 and NOD2 expression. RESULT: NOD1 and NOD2 mRNA expression level was significantly increased in AR compared with control. Immunohistochemical staining demonstrated that NOD1 and NOD2 were mainly expressed by epithelial cells and some unknown cells in lamina propria and there were significantly more positive staining cells were observed in AR tissue when compared with control. Glucocorticoids down-regulated NOD1 and NOD2 expression in AR. CONCLUSION NOD1 and NOD2 as two PRRs may take part in the pathogenesis of AR, glucocorticoids may play a therapeutical role on allergic rhinitis through down-regulated the expression of NOD1 and NOD2.
Adult ; Case-Control Studies ; Female ; Gene Expression Regulation ; Glucocorticoids ; pharmacology ; Humans ; Male ; Middle Aged ; Nasal Mucosa ; drug effects ; metabolism ; Nod1 Signaling Adaptor Protein ; metabolism ; Nod2 Signaling Adaptor Protein ; metabolism ; Rhinitis, Allergic ; Rhinitis, Allergic, Perennial ; metabolism ; Young Adult

OBJECTIVE: To study the early gene diagnosis of hereditary hemorrhagic telangiectasia (HHT) induced severe nosebleed. METHOD: Clinical features of 23 family members in two HHT pedigrees were examined. Genomic DNA was extracted from peripheral blood samples. PCR amplification was conducted to screen ENG and ACVRL-1 genes with their specific primers. Direct sequencing was performed to detect the mutation. Mutation analysis was carried out to evaluate its significance. RESULT: A heterozygous c. 263A > G mutation was identified in exon 3 of ACVRL-1 in 6 out of 11 members in NMG-1 pedigree. In GD-2 pedigree, 5 of 11 members carried c. 199C > G mutation. Mutation detection rate was 100% in subjects with nosebleed history and 25% in family members without epistaxis. CONCLUSION Gene diagnosis characterized by high sensitivity and specificity is of great practi-cal significance and early genetic screening should be a clinical routine test for HHT induced severe nosebleed.
Activin Receptors, Type II ; genetics ; Adolescent ; Adult ; Antigens, CD ; genetics ; DNA Mutational Analysis ; Endoglin ; Epistaxis ; diagnosis ; etiology ; genetics ; Exons ; Female ; Genetic Testing ; Humans ; Male ; Middle Aged ; Pedigree ; Receptors, Cell Surface ; genetics ; Telangiectasia, Hereditary Hemorrhagic ; complications ; diagnosis ; genetics ; Young Adult

Objective To investigate the effect of glucocortieoids on tenasein C(TNC) expression in nasal polyp tissues and airway epithelia,and explore the possible mechanism of glucocorticoids inhibiting remodeling of nasal polyp tissue.Methods The enzyme linked immunosorbent assay(ELISA) was used to detect the protein levels of tenascin C and transforming growth factor-β1(TGF-β1) in nasal polyp tissues from intranasal glucocorticoids (Budesonide,BUD) treated group and untreated group.The cell culture,real-time RT-PCR and in situ ELISA were employed to investigate the regulatory effects of budesonide on the TNC mRNA and protein expression in BEAS-2B immortalized human bronchial epithelial cells.Results The protein levels of TNC and TGF-β1 were decreased in nasal polyp tissues from intranasal BUD-treated group as compared with untreated group(P<0.01).There was a significantly positive correlation between TNC and TGF-β1 protein levels in nasal polyp tissues (r =0.68,P<0.01).After preincubation with BUD,TNC mRNA and protein expression induced by TGF-β1 in BEAS-2B cells was significantly decreased(P<0.01).Conclusion Glucocorticoids might participate in the regulation of tissue remodeling in nasal polyp by inhibiting the TGF-β1 expression in nasal polyp tissue and suppressing the induction of TGF-β1 to up-regulatie the TNC expression in airway epithelia.

OBJECTIVE: To investigate the expression of Clara cell 10-KDa protein (CC010) in sinonasal mucosa of murine bacterial chronic rhinosinusitis (BCRS) model. METHOD: A murine BCRS model was established by Streptococcus pneumoniae inoculation plus Merocel ostiomeatal obstruction. After 12 week's intervention, histological changes of sinonasal mucosa in BCRS model were examined by hematoxylin and eosin stain, periodic acid-schiff stain, and Masson-Trichrome stain. The mRNA and protein expression of CC10 in sinonasal mucosa were determined by reverse transcription polymerase chain reaction and immunohistochemistry methods. The number of CC10 positive cells in sinonasal epithelium was also counted. RESULT: In BCRS model group, polymorphonuclear neutrophils (PMN), subepithelial collagen deposition, goblet cells, and epithelial thickness were significantly increased, compared with control group (P<0.01). However, CC10 positive cells, CC10 mRNA and protein expression in sinonasal mucosa of BCRS model group were significantly decreased, compared with control group (P<0.01). Moreover, the number of CC10 positive cells was significantly negatively correlated with PMN (r=-0.734, P<0.01), subepithelial collagen deposition (r=-0.776, P<0.01), epithelial goblet cells (r=-0.841, P<0.01), and epithelial thickness (r=-0.805, P<0.01), respectively. CC10 average grayscale value was significantly positively correlated with PMN (r=0.771, P<0.01), subepithelial collagen deposition (r=0.802, P<0.01), epithelial goblet cells (r=0.887, P<0.01), and epithelial thickness (r=0.855, P<0.01), respectively. CONCLUSION The expression of CC10 is downregulated in sinonasal mucosa in BCRS model. As an important endogenous modulin, CC10 might play a crucial role in the pathogenesis of chronic rhinosinusitis.
Animals ; Chronic Disease ; Disease Models, Animal ; Male ; Mice ; Mice, Inbred C57BL ; Pneumococcal Infections ; metabolism ; Sinusitis ; metabolism ; microbiology ; Uteroglobin ; metabolism