Objective:To investigate the clinical efficacy of extracorporeal shock wave (ESWT) combined with stretching training in the treatment of chronic plantar fasciitis.Methods:A prospective case-control study was conducted to include the patients with chronic plantar fasciitis who had been admitted to Department of Orthopaedic Trauma, Nanfang Hospital, Southern Medical University from June 2021 to June 2022. A SPSS random number generator was used to randomize the patients into an experimental group (receiving treatment with ESWT combined with stretching training) and a control group (receiving stretching training only). Shear wave elastography (SWE) was used to quantitatively evaluate the elastic modulus of the plantar fascia. The 2 groups were compared in terms of visual analogue scale (VAS) pain score, plantar fascia thickness, and elastic modulus of the plantar fascia in the patients at 12 weeks after treatment; the correlation between VAS pain score and elastic modulus of the plantar fascia was examined using Spearman analysis in the patients at 12 weeks after treatment.Results:This study included a total of 41 patients (52 feet), 20 males and 21 females with an age of (49.9±8.2) years. There were 16 left sides, 14 right sides and 11 bilateral sides affected. The course of the disease was 7.0 (6.0, 12.0) months. The 2 groups were comparable because there were no significant differences in the general data before treatment between them ( P>0.05). The VAS pain score at 12 weeks after treatment for the experimental group was 1.0 (1.0, 2.0) points, significantly lower than that for the control group [3.0 (2.0, 3.0) points] ( P<0.05). The elastic modulus of the plantar fascia at 12 weeks after treatment for the experimental group was (79.48 ± 17.65) kPa, significantly higher than that for the control group [(57.08 ± 14.16) kPa] ( P<0.05). However, there was no statistically significant difference between the 2 groups in the thickness of the plantar fascia at 12 weeks after treatment ( P>0.05). There was a significant correlation between VAS pain score and elastic modulus of the plantar fascia after 12 weeks of treatment ( r = -0.708, P<0.001). Conclusion:In the treatment of chronic plantar fasciitis, combination of ESWT and stretching training is more effective than stretching training only.

Trauma center is an important link of trauma treatment, which is beneficial for professional integrated treatment of trauma patients and reduction of disability and death rate. The establishment of trauma rescue and treatment system is conducive to improving the regional trauma treatment capacity, rationalizing the layout of medical resources and standardizing the trauma treatment. Making full use of geographic information system (GIS) to analyze the big data such as the number of trauma patients, population, ground traffic situation and geographic information in the region and scientifically plan the number and location of trauma centers in the region is crucial to further optimize the geographic layout of trauma treatment centers, coordinate regional trauma treatment resources and improve the overall treatment capacity and is conducive to optimizing trauma treatment resources, improving regional trauma treatment capacity and reducing the disability and death rate of trauma patients. Based on domestic and foreign literature researches, the authors discuss how to use GIS to optimize the trauma rescue and treatment system in China in order to provide a useful reference for construction of regional trauma rescue and treatment system.

Objective: To investigate the clinical benefits of prophylactic supraclavicular irradiation (PSCI) in high-risk patients with limit-ed-stage small cell lung cancer (LS-SCLC). Methods: LS-SCLC patients without supraclavicular lymph node (SCLN) involvement and treat-ed with concurrent chemoradiation in the Department of Radiotherapy, Tianjin Medical University Cancer Institute and Hospital, be-tween July 2006 and July 2011, were retrospectively analyzed. According to our previous study, some were defined as SCLN recurrence high-risk patients. The recurrence rates of SCLN involvement and cancer-specific overall survival (CSS) in the different cohorts were ob-served. Univariate and multivariate analyses were performed both in the whole cohort and high-risk patients with recurrent SCLN in-volvement. Results: One-hundred and one patients with a median age of 57 years were included. As many as 50% of the high-risk pa-tients had recurrent SCLN involvement at the last follow-up as compared to 13.6% of the low-risk patients. The patients with recurrent SCLN involvement had a dramatically lower five-year CSS than those without recurrent SCLN involvement. The five-year CSS of high-risk patients with PSCI was similar to that of the low-risk patients; however, it was significantly higher than the five-year CSS of the high-risk patients without PSCI. The multivariate analysis revealed that advanced stage and recurrent SCLN involvement were signifi-cantly associated with poor CSS in the overall cohort. In the high-risk patients with recurrent SCLN involvement alone, only PSCI was as-sociated with improved CSS. Conclusions: PSCI not only reduced the recurrence of SCLN involvement significantly but also improved CSS in high-risk patients with LS-SCLC.

Objective To explore the value of 18F-FDG PET/CT in diagnosis of retroperitoneal fibrosis (RPF).Methods Totally 12 RPF patients underwent 18 F-FDG PET/CT scanning,and the characteristics of metabolic activity,distribution of retroperitoneal lesions and maximum standardized uptake value (SUVmax) were analyzed retrospectively.Results Among 12 patients,7 were initial evaluation patients,5 were post-treatment patients.Of 7 initial evaluation patients,there were 4 patients with secondary RPF,including prostate carcinoma,breast cancer and IgG4-related disease.Retroperitoneal mass isodense with muscle surrounding the abdominal aorta or the iliac arteries were found in 12 patients,and ureteral involvement were found in 11 paients (11/12,91.67％).SUVmax in initial evaluation patients (4.21±1.76) was higher than that in patients after treatment (1.46±0.25,P＜0.05).According to PET/CT,3 idiopathic RPF patients as initial evaluation with high metabolic activity lesions received immunosuppressive therapy including corticosteroids and tamoxifen,and 4 secondary RPF patients with high metabolic activity lesions received treatment based on causes.Among 5 post-treatment patients,3 continued to accept current corticosteroids maintenance dose,while 2 did not receive any other treatment.Conclusion PET/CT may be used to evaluate the activity and extension of lesions in patients with RPF.

Objective To analyze the efficacy and safety of nalbuphine in patients with sedative analgesia in intensive care unit (ICU). Methods A prospective observation was conducted. The adult patients with mild and moderate analgesia in general ICU of the First Affiliated Hospital of Zhengzhou University from January to November in 2017 were enrolled, and they were divided into nalbuphine group and sufentanil group in proper order. The nabobrown group was given 40 mg nabobrown, the sufentanil group was given 0.1 mg sufentanil, both of which were injected with 50 mL normal saline for continuous intravenous infusion in micro-pump. Infusion speed was checked according to pain level. The analgesic target was critical-care pain observation tool (CPOT) score < 2. The change in hemodynamics of patients in both groups were observed, and CPOT score and Richmond agitation-sedation scale (RASS) score were recorded before and l, 3, 5, 12, 24 hours after administration. The analgesic and sedative effects of two drugs were evaluated. Results A total of 141 patients were enrolled, including 71 patients in nalbuphine group and 70 in sufentanil group. There was no significant difference in general data including gender, age, body weight, acute physiology and chronic health evaluation Ⅱ (APACHEⅡ) or pain source, as well as baseline hemodynamics parameter between the two groups. At 1 hour and 3 hours after administration, nalbuphine had no effect on blood pressure, but the heart rate was decreased slightly, while the heart rate and blood pressure of the sufentanil group were decreased obviously. The two drugs could make the heart rate and blood pressure fluctuate obviously with the time of medication, but there was no statistical difference between the two drugs. The two drugs had no significant effect on pulse oxygen saturation (SpO2) during analgesia. The average dosage of nalbuphine was 0.03 (0.02, 0.05) mg·kg-1·h-1in the nalbuphine group, and the patient was satisfied with the analgesic effect until 3 hours after the use of the drug, and CPOT score was significantly decreased as compared with that before administration [1.0 (1.0, 2.0) vs. 3.0 (2.0, 4.0), P < 0.01], and the sedative effect was increased, RASS score was significantly lower than that before administration [0 (0, 1.0) vs. 1.0 (1.0, 2.0), P < 0.01]. No patients in naporphine group were treated with sufentanil due to unsatisfactory analgesia. The average dosage was 0.11 (0.06, 0.14) μg·kg-1·h-1in the sufentanil group, the patient was satisfied with the analgesic effect until 5 hours after administration, and the CPOT score was significantly lower than that before administration [1.0 (1.0, 2.0) vs. 4.0 (3.0, 6.0), P < 0.01], and the sedative effect was significantly increased, RASS score was significantly lower than that before administration [0 (-1.0, 0) vs. 2.0 (1.0, 2.0), P < 0.01]. The scores of CPOT and RASS in the sufentanil group were significantly higher than those of the naporphine group before use, so the decrease in the CPOT and RASS scores of the two drugs was further analyzed, which indicated the decrease in CPOT score of naporphine group was significantly lower than that in sufentanil group from 3 hours on [1.0 (0, 2.0) vs. 2.0 (1.0, 3.0), P < 0.05], and the decrease in RASS score of naporphine group was significantly lower than that in sufentanil group from 1 hour on [0 (0, 1.0) vs. 1.0 (0, 2.0), P < 0.01]. It suggested that naporphine could achieve sustained and stable analgesic effect and avoid excessive sedation caused by sufentanil. Conclusions Naporphine had a sustained and stable analgesic effect on patients with mild and moderate ICU analgesia. The onset time of naporphine was equivalent to sufentanil, and it had a certain sedative effect and less influence on hemodynamics.

Objective To investigate the clinical value of 18 F?FDG PET/CT in staging multiple myeloma ( MM) and evaluating the glucose metabolic activity of MM. Methods A total of 25 MM patients ( 13 males, 12 females, age:39-67 years) from May 2010 to April 2015 were enrolled in this retrospective study. The SUVmax of each patient was recorded. D?S plus staging according to 18 F?FDG PET/CT was com?pared with the traditional D?S staging. The SUVmax and the percentage of plasmacytes of bone marrow of phase Ⅲ and non?phase Ⅲ ( phaseⅠand Ⅱ) according to D?S plus staging were compared. Two?sample t test and Wilcoxon rank sum test were used to analyze the data. Results In 25 MM patients, the range of SUVmax of lesions was 1.8-12?0 and the mean value was 5.15±2.74. According to D?S staging, the numbers of patients with phase Ⅰ,Ⅱ andⅢwere 7, 4 and 14, respectively. While the numbers were 3, 1 and 21 by D?S plus staging. Based on the D?S plus staging system, stages of 7 patients ( 28%, 7/25 ) were changed. According to the D?S plus staging system, the SUVmax between phaseⅢand non?phaseⅢpatients was significantly different (5.75±2.54 vs 3.00±0?70; t=2.12, P<0.05), while the percentage of plasma?cytes of bone marrow between the 2 groups had no significant difference ( 17. 50%( 4. 25%-41. 75%) vs 11?15%(10.25%-36.57%);z=0.05, P>0.05). Conclusion 18F?FDG PET/CT is of clinical importance for MM staging and metabolic activity assessment of MM.

Objective: To compare the clinical effects of robot-assisted minimally invasive transforaminal lumbar interbody fusion (TLIF) and traditional open TLIF in the treatment of lumbar spondylolisthesis. Methods: A total of 41 patients with lumbar spondylolisthesis accepted surgical treatment in Department of Spinal Surgery of Beijing Jishuitan Hospital From July 2015 to April 2016 were retrospectively analyzed. There were 16 cases accepted robot-assisted minimally invasive TLIF and 25 accepted traditional open TLIF. The operation time, X-ray radiation exposure time, perioperative bleeding, drainage volume, time of hospitalization, time for pain relief, time for ambulatory recovery, visual analogue scale (VAS), Oswestry disability index (ODI) and complications were compared. T test and χ² were used to analyze data. Results: There were no significant difference in gender, age, numbers, degrees, pre-operative VAS and ODI in spondylolisthesis (all P>0.05). Compared with traditional open TLIF group, the robot-assisted minimally invasive TLIF group had less perioperative bleeding ((187.5±18.4) ml vs. (332.1±23.5) ml), less drainage volume ((103.1±15.6) ml vs. (261.3±19.8) ml), shorter hospitalization ((7.8±1.9) days vs. (10.0±1.6) days), shorter time for pain relief ((2.8±1.0) days vs. (5.2±1.1) days), shorter time for ambulatory recovery ((1.7±0.9) days vs. (2.9±1.3) days) and less VAS of the third day postoperatively (2.2±0.9 vs. 4.2±2.4) (t=2.762-16.738, all P<0.05), but need more operation time ((151.3±12.3) minutes vs. (102.2±7.1) minutes) and more X-ray radiation exposure ((26.1±3.3) seconds vs. (5.5±2.1) seconds) (t=6.125, 15.168, both P<0.01). In both groups ODI was significantly lower in final follow-up than that of the pre-operation (t=12.215, 14.036, P<0.01). Intervertebral disc height of the final follow-up in both groups were significantly larger than that of the preoperation (robot-assisted minimally invasive TLIF group: (11.8 ± 2.8) mm vs. (7.5 ± 1.9) mm, traditional open TLIF group: (12.7 ± 2.5) mm vs. (7.9±2.0) mm), and so was the lumbar lordosis angle (robot-assisted minimally invasive TLIF group: (48.7±9.2)°vs. (39.6±7.9)°, traditional open TLIF group: (50.1±10.8)°vs. (41.4±8.8)°), the lordosis angle of the slippage segment (robot-assisted minimally invasive TLIF group: (18.7±5.6)°vs. (10.9±3.8)°, traditional open TLIF group: (17.6±6.1)°vs.(8.7±3.2)°) (t=4.128-16.738, all P<0.01). Slippage rate of the final follow-up in both groups were significantly smaller than those of the pre-operation (robot-assisted minimally invasive TLIF group: (5.3±2.3) % vs. (27.8±7.2) %, traditional open TLIF group: (6.6±2.8) % vs. (29.1±9.5) %) (t=11.410, 18.504, both P<0.01). There was no difference of the upper data between two groups (t=0.106-1.227, P>0.05). The results of the post-operative CT showed that the pedicle screws in the robot-assisted minimally invasive TLIF group were more precisely placed than traditional open TLIF group (χ²=4.247, P=0.039). The mean follow-up time was 8 months (ranging from 3 to 12 months). There were no significant difference in outcomes between the two groups (χ²=0.366, P=0.545). Conclusions In the treatment of lumbar spondylolisthesis, Robot-assisted minimally invasive TLIF can lead to less perioperative bleeding, less post-operative pain, and quicker recovery than traditional open TLIF surgery, but it needs more operation time and radiation exposure.

Objective To explore the impact of the ratio between pelvic tilt (PT) and sacral slope (SS) on the life quality of patients with ankylosing spndylitis (AS) after kyphosis correction. Methods From November 2008 to May 2011, 33 AS pa?tients were reviewed, including 31 males and 2 females, aged from 19 to 58 years old (average, 36 years old). The thoracolumbar kyphosis angle was 35.23° ± 13.98° (range, 15.12°-74.37° ) and the lumbar lordosis angle was 8.68° ± 18.27° (range,-23.70°-62.15°). The Scoliosis Research Society (SRS)?22 questionnaire was used to evaluate the quality of life and the Oswestry disability index (ODI) was used to evaluate the condition of pain. The pelvic incidence (PI), PT, SS, sagittal vertical axis (SVA) and osteoto?my angle were obtained from standing lateral full?spine radiographs. The correlations were analyzed from the subjective grading and the sagittal parameters in AS patients. Results The osteotomy site was in L1 (5 cases, 21.00°-54.59° , average 32.59° ± 13.44° ), L2 (19 cases, 28.63°-66.24° , average 37.89° ± 9.26° ), L3 (9 cases, 31.78°-60.90° , average 47.05° ± 9.20° ), respectively. The range of osteotomy angle was 39.59°±10.82° (range, 21.00°-66.24°). The subjective grading and spino?pelvic parameters were improved significantly after operation except PI, only postoperative PT/SS (0.93±0.65) and ODI standing (0.60±0.75)(r=0.681, P<0.05), osteotomy angle (39.59°±10.82°) and satisfaction of management (3.33±0.49)(r=0.478, P<0.05)had correlation with the subjective grading. Conclusion Compared with the change of PT, SS and SVA, the change of PT/SS is more closely related to the quality of life after operation in AS patients with kyphosis, which should be pay attention to by surgeon when designing operative schemes.

Objective To study the effect of ultrasound-mediated microbubble on the concentration of cefuroxime in rat prostate. Methods Twenty male SD rats were randomly divided into the experimental group ( ultrasound-mediated microbubble+cefuroxime group) and the control group ( cefuroxime group) . The experimental group was given cefuroxime and microbubble via the tail vein, and then the prostates were exposed to ultrasonic irradiation for five minutes. The control group was given cefuroxime and the same amount of normal salin via the tail vein, and then given sham ultrasonic irradiation for five minutes. After the prostate was taken, cefuroxime concentration in pros-tate was measured by high performance liquid chromatograph. Results Concentration of cefuroxime in the experimental and the control group were (16. 274 ± 9. 515) μg/mg and (8. 336 ± 6. 743) μg/mg respectively. Compared to the control group, the concentration of cefuroxime was significant higher in the experimental group, and the difference is statistically significant (P <0. 05). Conclusion Low-dose ultra-sound-mediated microbubble can significantly improve the permeability of rat prostate tissue, thereby enhancing the drug concentration in prostate tissue.

Objective To screen the best processing technology of prepared Rhubarb by multi- component composite score combined with response surface.Methods The composite score of seven components, i.e., gallicacid, chrysophanol-8-O-β-D-glucopyranoside, aloeemodin, rhein, emodin, chrysophanol, physcion, was taken as indicators. Three factors and three levels of response surface Box-Behnken were used in experimental design. The effects of factors including rice wine volume, moistening time, and steaming time on processing technology of stewed Rhubarb were studied, and the optimized processing parameters were chosen.Results Design Expert 8.05 software was used for data analysis. Multivariate quadratic mathematical model of the sample and examine factors composite score regression equation of seven ingredients content were set up. The best processing conditions of prepared Rhubarb were as following:adding 36.6 mL rice wine into per 100 g raw material;moistening time continued for 2.16 hours;steaming time continued for 10.96 h. According to actual production, the optimized processing conditions of prepared Rhubarb are as following:adding 35 mL rice wine per into 100 g raw material;moistening time continued for 2 h;steaming time continued for 11 h.Conclusion The optimized processing technology can reasonably control the quality of prepared Rhubarb, and provide the basis for the quality standards of its decoction pieces and clinical application.