ObjectiveTo observe the effectiveness of oral glucosamine hydrochloride and cupping therapy in the treatment of knee osteoarthritis. MethodsA total of 113 patients treated from February 2013 to February 2015 were randomly divided into three groups. All the three groups of patients underwent conventional treatment. The Cupping treatment group had 39 patients; 37 patients were treated with oral glucosamine hydrochloride, and another 37 patients accepted combined treatments of cupping therapy with oral glucosamine hydrochloride. Six weeks after treatment, pain degree of the patients and Lequesne index were used to assess the clinical efficacy of the treatments. Patients who had oral glucosamine hydrochloride underwent routine examinations of blood and urine, and received liver and kidney examinations. One year later, telephone follow-up was conducted to observe long-term efficacy. ResultsSix weeks after treatment, the combined treatment group was significantly better than the other two groups in terms of pain relief degree and effective rate (P ＜ 0.05) . One year after treatment, the combined treatment group and the oral treatmentgroup had a significant advantage over the cupping treatment group (P ＜ 0.05) , while there was no significant difference between the combined treatment group and oral treatment group. ConclusionsThe combined oral glucosamine hydrochloride and cupping therapy has an obvious short-term efficacy, which quickly relieves pain and improves the activity function of the knee. Oral glucosamine hydrochloride has a very good effect in the long-term treatment of osteoarthritis.
Post-stroke cognitive impairment (PSCI) which has been a barrier to the rehabilitation, could be prevented and treated. Early assessment of cognitive impairment, as well as diagnosis and comprehensive interventions of PSCI would improve rehabilitation of stroke patients. The rehabilitation, as an important component of the comprehensive intervention, could improve cognitive function, delay disease progression, and optimize the daily life. The widely-used rehabilitation methods include cognitive intervention, exercise training, music therapy, and neuromodulation techniques, etc. Comprehensive cognitive training covering multiple cognitive domains and multimodal intervention can significantly improve the overall cognitive function of patients. The research in the PSCI field is still in its infancy in China. Thus, It is necessary to pay more attention to the PSCI clinically, and unveil the unkown area in PSCI.
Objective To investigate the expression of c-met in tall cell variant of papillary thyroid carcinoma, and to compare it with other types of thyroid carcinoma and benign thyroid tissue. Methods The expressions of c-met in 60 cases of thyroid specimens were tested by immunohistochemical staining. Results The levels of expressed c-met in tall cell variant specimens were significantly higher than those in other types of papillary thyroid carcinoma and benign thyroid tissue. c-met expressions were significantly different in the following pairs of types: tall cell variant vs common papillary carcinoma of thyroid (P=0.000 1), tall cell variant vs follicular variant papillary thyroid carcinoma (P=0.000 1), and tall cell variant vs benign thyroid tissue (P=0.000 1). In addition, for all types of papillary carcinomas evaluated, c-met expression was significantly higher in specimens with extracapsular spread (P=0.010 0) and skeletal muscle invasion (P=0.020 0). Conclusion The high expression of c-met is a significant marker for tall cell variant papillary carcinoma of thyroid and its invasive behavior. This finding may explain the unusually aggressive behavior of this tumor and suggest a role for c-met in the early identification of patients with tall cell variant thyroid carcinoma.
Objective To determine risk factors of delayed recovery of consciousness after aortic arch surgery underdeep hypothermic circulatory arrest （DHCA） and antegrade selective cerebral perfusion （ASCP）. Methods We retrospectively analyzed clinical data of 113 patients who underwent aortic arch surgery under DHCA＋ASCP in the Affiliated Drum Tower Hospital， Medical School of Nanjing University from October 2004 to April 2012. According to whether they regained consciousness within 24 hours after surgery， all the 113 patients were divided into normal group （73 patients including 55 males and 18 females with their average age of 48.1±10.9 years） and delayed recovery group （40 patients including 29 males and 11 females with their average age of 52.2±11.4 years）. Risk factors of delayed recovery of consciousness after surgery were evaluated by univariate analysis and multivariate logistic regression analysis. Results Nine patients （8.0%） died postoperatively， including 5 patients with multi-organ failure， 2 patients with heart failure， 1 patient with mediastinal infection， and 1 patient with pulmonary hemorrhage. There were 7 deaths （17.5%） in the delayed recovery group and 2 deaths （2.7%） in the normal group， and the in-hospital mortality of the delayed recovery group was significantly higher than that of the normal group （P=0.016）. A total of 94 patients （including 65 patients in the normal group and 29 patients in the delayed recovery group） were followed up for 4-95 months. Eight patients （including 5 patients in the normal group and 3 patients in the delayed recovery group） died during follow-up， including 2 patients with stroke， 3 patients with heart failure， 2 patients with pulmonary hemorrhage and 1 patient with unknown cause. Ten patients were lost during follow-up. Univariate analysis showed that age （P=0.042）， hypertension （P=0.017）， emergency surgery （P=0.001）， cardiopu- lmonary bypass （CPB） time （P=0.007）， aortic cross-clamp time （P=0.021）， and blood transfusion（P=0.012）were risk factors of delayed recovery of consciousness after aortic arch surgery. Multivariate logistic regression showed that emergency surgery （P=0.005） and CPB time＞240 minutes （P=0.000） were independent risk factors of delayed recovery of consciousness after aortic arch surgery. Conclusion Delayed recovery of consciousness after aortic arch surgery is attributed to a combination of many risk factors. Correct patient diagnosis， lesion site and involved scope should be made clear preoperatively in order to choose appropriate surgical strategies. During the surgery， strengthened brain protection， shortened operation time， improved surgical techniques， and perioperative stable circulation maintenance are all important measures to prevent delayed recovery of consciousness after aortic arch surgery.
ObjectivesTo investigate the influence of the abduction angle of the upper extremities on the image quality of non-enhanced CT scan and clinical value of the patients who cannot lift with double upper limbs by vehicle accident.Methods60 patients with double upper limbs that could not lift by vehicle accidents were required to receive liver non-enhanced CT scan, the patients were divided into 3 groups according to the abduction angle (group A, B, C), 20 cases in each group, another 20 cases with standard pose as the control group (group D). The CT value and standard deviation of the liver region of interest, the erector and the background air were measured, and the contrast to noise ratio of liver images, image noise value were calculated, together with the assessment of image quality and statistic analysis.ResultsThe liver non-enhanced CT scan were completed successfully. The image quality of group D was significantly better than A, B, C (Z=–10.753, P<0.05;Z=–11.645, P<0.05;Z=–12.281, P<0.05), respectively. Group C was better than A and B (Z=–8.502, P<0.05;Z=–4.068, P<0.05), respectively. Group B was better than A (Z=–5.885, P<0.05). The CNR of the four groups of images increased gradually, group A (0.09±0.77), group B (1.56±0.83), group C (2.51±0.87), group D (2.59±0.97), respectively. There were significant differences between four groups (F=36.323, P<0.05). The image noise decreased systematically, group A (14.84±2.94), group B (13.04±1.59), group C (11.60±1.72), group D (10.44±1.13), respectively. There were significant differences between four groups (H=426.755, P<0.05).ConclusionOn the premise of safety inspection, with the enlargement of angle of the upper limbs of patients who cannot lift with double upper limbs by vehicle accidents, the image noise decreased and image quality is improved with the increase of signal noise ratio.
From Jan. 1980 to Dec. 1996, 138 cases of papillary adenocarcinoma of thyroid gland were surgically treated. To minimize the local recurrence and complication, resection of the involved lobe and the isthmus is an ideal surgical operation. Modified neck lymph node dissection should be performed, if the diameter of primary tumor is larger than 1.5 cm; whether the lymph node is palpable or not. Functional or classical radical neck lymph node excision should be taken, if the neck lymph node can be palpable.
The anti-oxidative ability of cirrhotic liver tissues was evalated in rat models of cirrhotic liver which were induced by injecting carbon tetrachloride subcutaneously. The superoxide dismutase (SOD), general anti-oxidative ability (GAOA) and malonyldiadehyde (MDA) levels were determined in cirrhotic and normal rats. It was found that SOD and GAOA leves decreased (Ｐ＜0.05, Ｐ＜0.01)respective and MDA level increased(Ｐ＜0.05) significantly in cirrhotic rat liver. The results suggest that cirrhotic livers hav little ability to eliminate the superoxide free radicals as compared with normals and are more sensitive to is chemic-reperfusion or other unjurie.