ObjectiveTo investigate early effectiveness of arthroscopic superior fulcrum reconstruction in the treatment of irreparable massive rotator cuff tear (IMRCT). Methods A retrospective analysis was conducted on the clinical data of 24 patients with IMRCT who met the inclusion criteria between January 2020 and April 2022. Among them, there were 11 males and 13 females with an average age of 56.2 years (range, 42-68 years). There were 12 cases of falling injuries, 3 cases of traction injuries, and the other 9 cases had no obvious causes. The disease duration ranged from 1 to 25 months (median, 6 months). The rotator cuff tears were classified as Hamada grade 2 in 18 cases and grade 3 in 6 cases, and Goutallier grade 1 in 3 cases, grade 2 in 20 cases, and grade 3 in 1 case. All patients were treated with arthroscopic superior fulcrum reconstruction. Visual analogue scale (VAS) score, Constant-Murley score, the University of California at Los Angeles (UCLA) score, and the American Shoulder and Elbow Surgeons (ASES) score were recorded before operation and at 1, 3, 6, and 12 months after operation. Results The operations were all successfully completed. The incisions healed by first intention and no related complications occurred. All patients were followed up 12-33 months (mean, 24.6 months). The VAS, Constant-Murley, UCLA, and ASES scores at different time points after operation were superior to those before operation (P<0.05). All of the above indicators further improved with time. Except for no significant difference in VAS and Constant-Murley scores between 6 and 12 months (P>0.05), the differences between the other time points were significant (P<0.05). At 12 months after operation, according to UCLA scoring standard, shoulder joint function was rated as excellent in 4 cases, good in 19 cases, and poor in 1 case, with an excellent and good rate of 96.0%. MRI showed that there was no graft re-tear and the transplanted tendon and bone tunnel healed. Conclusion The arthroscopic superior fulcrum reconstruction for IMRCT can effectively relieve the pain, improve the shoulder range of motion, and restore good shoulder function.
People with Parkinson’s disease (PD) exhibit multi-system damaged. Medication mainly targets impairments related to dopaminergic lesions. Moreover, in later stages of the disease, medication becomes less effective. Rehabilitation therapy is believed that it can improve multiple functional disorders, including myotonia, bradykinesia, and postural gait abnormalities. It not only reduces the severity of non-motor symptoms and improves the quality of life in PD patients, but also delays the development of PD and improves the activity of daily life of patients. This article summarizes the progress of rehabilitation assessment and the therapy of PD.
【摘要】 目的 探討左氧氟沙星聯合阿奇霉素治療老年難治性呼吸道感染的療效及安全性。 方法 選擇2005年2月-2010年9月收治的高齡難治性呼吸道細菌感染患者68例，隨機分為治療組和對照組。治療組34例，給予左氧氟沙星聯合阿奇霉素；對照組34例，給予左氧氟沙星，兩組總療程皆為15 d。觀察兩組患者的臨床療效、細菌清除率和不良反應。 結果 治療組的總有效率為64.71%，對照組總有效率為32.35%，兩組差異有統計學意義（Plt;0.05） 。治療組細菌清除率為76.19%，對照組細菌清除率為36.36%，兩組差異有統計學意義（Plt;0.05） 。治療組和對照組的不良反應發生率分別為5.88%和8.82%，差異無統計學意義（Pgt;0.05）。結論 左氧氟沙星聯合阿奇霉素治療老年難治性呼吸道感染療效高， 能有效清除細菌， 不良反應較少， 值得臨床推廣應用。【Abstract】 Objective To evaluate the efficacy and safety of levofloxacin combined with azithromycin on refractory respiratory infections in elder patients. Methods A total of 68 elder patients with refractory respiratory infections in our hospital from February 2005 to September 2010 were randomly divided into two groups: treatment group (n=34) and control group (n=34). The patients in treatment group were treated with levofloxacin combined with azithromycin; while the patients in the control group were treated with levofloxacin alone. The total treatment periods of both groups were 15 days. The therapeutic efficacy, eradication rate of pathogens and the rate of aelverse reactions were observed. Results The therapeutic effect rate was 64.71% in the treatment group and 32.35% in the control group, and the difference between the two groups was statistically significant (Plt;0.05). The eradication rate of pathogens was 76.19% in the treatment group and 36.36% in the control group, and the difference was significant (Plt;0.05). The rate of the adverse reaction was 5.88% in the treatment group and 8.82% in the control group, and there were no significant differences between the two groups (Pgt;0.05). Conclusion Levofloxacin combined with Azithromycin is effective on refractory respiratory tract infection in elder patients, which can effectively remove the bacteria with few adverse reaction.
【摘要】 目的 探討老老年患者留置尿管內壁細菌生物被膜形成情況及其對導管相關感染(CRI)的影響。〖HTH〗方法〖HTSS〗 分析2007年2月—2009年10月住院的175例留置尿管患者,均為男性,年齡75~96歲,平均86歲。不同留置時間(7~15 d 53例、16~30 d 49例、31~45 d 44例、gt;45 d 29例)的尿管,于拔出尿管后運用超聲震蕩使尿管內表面生物被膜完全脫落,梯度稀釋后進行生物被膜活菌計數,細菌的培養分類及構成比分析；采用掃描電鏡觀察尿管內壁細菌生物被膜形成的情況；觀察尿管留置時間與生物被膜CRI的關系。結果 隨著尿管留置時間的延長,尿管內表面生物被膜活菌計數呈指數趨勢增長,CRI發生率有升高趨勢,各置管時段組間尿管內表面生物被膜活菌計數及CRI發生率比較差異均有統計學意義(Plt;0.05)。掃描電鏡見生物被膜的形成隨時間的延長而明顯增多。結論 細菌生物被膜形成是老老年患者留置尿管相關性尿路感染的重要致病因素,尿管留置時間越長,尿管生物被膜感染的危險性及幾率越高。更換尿管或縮短留置時間仍是防止尿管生物被膜感染的主要方法。
Objective To evaluate the efficacy of specific immunotherapy in combination with budesonide formoterol dry powder inhaler ( BUD/FM) in the treatment of moderate to severe bronchial asthma. Methods The data of 93 patients with moderate to severe asthma from September 2006 to September 2008 were analyzed. 46 cases who received BUD/FM therapy were recorded as a BUD/FM treatment group, and 47 cases who received BUD/FMand dustmite specific immunotherapy were recorded asa combination treatment group. After 6, 12, 18, and 24 months, asthma symptom scores, pulmonary function,effective rate, and scores of Asthma Quality of Life Questionnaire ( AQLQ) were compared in the two treatment groups. Results Compared with the BUD/FMtreatment group, the effective rate was significantlyhigher ( 83. 0% vs. 65. 2% , P lt;0. 05) , the lung function improvements in FEV1% pred and expiratory peak flow were more significant in the latter period of treatment, and AQLQ scores improved more significantly after 24 months’treatment in the combination treatment group. Conclusion For patients with moderate tosevere asthma, specific immunotherapy in combination with BUD/FMcan improve asthma symptoms and lung function with good compliance and long lasting efficacy.
Objective To explore the role of hydrogen peroxide (H2O2) in inducing chronic oxidative stress in microglia aging. Methods BV2 microglia purchased from ATCC in less than 10 generations were treated with 0, 50, 100, 200 μmol/L H2O2 at different concentrations. According to the concentration of H2O2 used, the BV2 microglia were divided into a control group and H2O2 -50 μmol/L Group, H2O2 -100 μmol/L Group, H2O2 -200 μmol/L Group. Cell proliferation was measured by CCK8 cell proliferation assay. Age-related β-galactosidase (SA-β-gal) staining assay, and expression of age-related cyclin molecules p16, p21, p53 and senescence sssociated secretory phenotype interleukin 1 beta (IL-1β), transforming growth factor-β (TGF-β) and matrix metalloprotein 9 (MMP9) detected by quantitative real-time polymerase chain reaction were used to measure celluar senescence. Results During the induction process, H2O2-200 μmol/L caused significant damage to BV2 microglia, therefore no subsequent testing was conducted. Finally, the control group, H2O2-50 μmol/L group and H2O2-100 μmol/L group cells were collected. The differences in cell survival rate (F=46.176, P<0.001) and positive rate of SA-β-gal staining (F=553.1, P<0.001) among the three groups were statistically significant. The cell survival rate of H2O2-50 μmol/L group had no significant change (P>0.05), while the cell survival rate of H2O2-100 μmol/L group decreased significantly (P<0.001). The positive rate of SA-β-gal staining in H2O2-50 μmol/L group and H2O2-100 μmol/L group was increased (P<0.001), and the positive rate of SA-β-gal staining in H2O2-100 μmol/L group was higher than that in H2O2-50 μmol/L group (P<0.001). The mRNA levels of senescence related cyclin molecules p16, p21 and p53 were up-regulated under the induction of 50, 100 μmol/L H2O2 (P<0.05), and the expressions of IL-1β, TGF-β and MMP9 of senescence associated secretory phenotype were increased (P<0.05). The increase of H2O2-50 μmol/L group was more obvious (P<0.05). Conclusion The aging model of BV2 microglia can be successfully established by inducing 8 d with 100 μmol/L H2O2, and the mechanism may be related to promoting the secretion of p16, p21, p53, IL-1β, TGF-β and MMP9.
Objective To explore the pathological diagnostic value of optical coherence tomography (OCT) in lung cancer. Methods This study selected patients who underwent general anesthesia and electronic bronchoscope biopsy at the Respiratory Endoscopy Center of Sichuan Provincial People’s Hospital from January 1, 2023, to December 1, 2023. White-light bronchoscopy (WLB), auto-fluorescence bronchoscopy (AFB), and OCT examinations were performed in all patients. Lesions were assessed for benign or malignant characteristics based on AFB and OCT before biopsy. The final pathological results were determined according to pathology report. Results A total of 124 patients were included in the study. The accuracy of OCT in differentiating the nature of lesions was 93.55%, significantly higher than AFB (accuracy 83.06%). The accuracy, sensitivity, and specificity of OCT were all higher than AFB. For squamous carcinoma, adenocarcinoma, and small cell lung cancer, the accuracy rates of OCT imaging characteristics were 91.94%, 94.35%, and 94.35%, respectively. Conclusion OCT can improve the accuracy of pre-bronchoscopic tissue pathology biopsy in determining the nature of lesions and provide rapid pathological typing basis, potentially further promoting the development of non-invasive histological biopsy.
ObjectiveTo analyze the status of real world studies (RWS) through registration information of the Chinese Clinical Trials Registry (ChiCTR). MethodsThe website of ChiCTR was searched with the real world as the search term to collect relevant registered items in the real world from inception to May 4, 2022. Descriptive analysis method was used. ResultsA total of 642 registered items were included. The median sample size was 482 cases. RWS were mainly observational studies, and the number of intervention studies was increasing year by year. There were 267 studies (41.59%) at the stage of post-marketing drugs or phase Ⅳ clinical trials. Most of the main measures were endpoints (56.23%), and the most commonly used was overall survival (15.79%). 62.15% of the registered projects met the minimum requirements for registration. ConclusionThe number of RWS registered by ChiCTR shows an increasing trend. At present, the research purpose of RWSs is unclear, and the completeness of registered studies and the overall content compliance of the studies need to be improved.
