Everyday footwear: An overview of what we know and what we should know on ill-fitting footwear and associated pain and pathology

Footwear has been used to protect feet for millennia with socially exclusive population adopting stylish and fashionable shoes with expensive materials. In terms of historic timeline, only more recently footwear has been worn by all classes in the western world as an integral part of their apparel. Traditionally, footwear has been constructed from natural materials, mainly leather, but has recently benefitted from the flexibility that technology has provided with a plethora materials and new design innovations. Although it has expanded the availability for a variety of consumers, the choice and fit continue to be problematic with many individuals wearing shoes that are ill-fitting. Provision of specific footwear advice for problem feet is poorly evidenced and is heavily practitioner dependant limiting its efficacy. There is limited understanding as to the changes that can occur from regularly wearing footwear that is unsuitable in shape, style and construction which is referred to as ill-fitting. Current research on the effect that everyday footwear has on foot function and pain focuses mainly on women’s shoes, particularly high heels. Defining what is a good fitting shoe, that does not damage the foot or mechanics of walking, may need to be individualised, but best fit is based on loose historical parameters rather than research evidence. The aim of this overview is to highlight aspects of current research, establishing what is known about the effect’s shoes have on the feet as well as exploring the mythology around footwear fit and advice that is often historical in nature.     

针刺配合肠炎散保留灌肠治疗肛窦炎临床研究

目的观察肛窦炎应用针刺配合肠炎散保留灌肠治疗的效果。方法选取2017年10月-2018年10月就诊的72例肛窦炎患者,采用随机数字表法分为观察组(n=36)与对照组(n=36)。对照组给予肠炎散保留灌肠治疗,观察组为针刺配合肠炎散保留灌肠治疗,比较2组症状、疗效及安全性。结果观察组症状(放射痛、指诊症状及镜检症状)少于对照组,总有效率高于对照组,差异有统计学意义(P<0.05);2组安全性相比,差异无统计学意义(P>0.05)。结论针对肛窦炎患者,予以针刺配合肠炎散保留灌肠治疗效果确切,可减少临床症状,加快疾病转归,且治疗安全性较好。     

Cesarean Scar Pregnancy: Comparing the Efficacy and Tolerability of Treatment with High-Intensity Focused Ultrasound and Uterine Artery Embolization

The aim of this study was to investigate the clinical efficacy of high-intensity focused ultrasound (HIFU) for the treatment of a cesarean scar pregnancy compared with uterine artery embolization (UAE) and intra-arterial methotrexate infusion combined with uterine curettage. In this retrospective cohort study, 31 patients were treated with HIFU (HIFU group), and 45 patients were treated with UAE (UAE group). We compared the treatment and recovery of the patients, including follow-up. After UAE treatment, serum levels of the β subunit of human chorionic gonadotropin declined significantly on the first day, and the residual lesions disappeared in 3–17 wk. One patient underwent hysterectomy; intrauterine adhesions were found by hysteroscopic examination after 6 mo in 2 patients, whose menstrual function did not return to normal. The remainder of the 42 patients recovered normal menstrual functioning during the 3- to 18-wk follow-up. In the patients who underwent HIFU treatment, serum β-HCG levels did not decline rapidly; serum β-HCG levels increased in many patients and then declined to normal steadily within 2–12 wk. Lesions detached in 3–14 wk in all patients, and menstrual functioning was recovered in 3–9 wk without uterine curettage. Compared with the UAE group, the HIFU group had less pain and fewer complications; the patients in the HIFU group were not hospitalized or anesthetized and had lower costs. HIFU is an efficient, tolerable and non-invasive treatment.     

阿那曲唑和他莫昔芬对绝经后乳腺癌患者血脂影响的对比研究

目的:比较阿那曲唑(ANA)和他莫昔芬(TAM)对绝经后激素受体阳性乳腺癌患者术后辅助治疗的血脂影响.方法:随机将64例乳腺癌患者分为治疗组(ANA)和对照组(TAM).分别采集两组患者服药不同时间段的空腹静脉血,检测血脂指标:总胆固醇(TC)、高密度脂蛋白胆固醇(HDLC)、低密度脂蛋白胆固醇(LDLC)、甘油三酯(TrG).结果:A组服药后12个月时TC升高明显,但是各时间段比较未见统计学差异(P＞0.05).B组服药前后TG、HDLC变化无统计学差异(P＞0.05),服药后6、12个月TC、LDLC有所下降,具有统计学意义(P＜0.05).结论:TAM对绝经后雌激素受体阳性乳腺癌患者血脂的影响优于ANA,故对于长期使用ANA患者应监测血脂变化,并TAM可能是临床上心血管疾病高危人群的乳腺癌患者的更佳选择.     

Surgical treatment of the severe thoracic gastrocutaneous fistula by pedicled muscle flap filling and thoracoplasty after oesophagectomy for oesophageal squamous cell carcinoma: A case report

Background: Thoracic anastomotic fistula (TAF) is a severe postoperative complication of oesophagectomy, and its occurrence coupled with a thoracic gastrocutaneous fistula (TGCF) and tracheostenosis is very unusual and may lead to a fatal consequence.Case presentation: We describe a case of an old female diagnosed with mid-oesophageal carcinoma, who presented with a TAF after oesophagectomy, which was healed by an effective treatment, while a severe TGCF and tracheostenosis appeared one month postoperation. The complications were detected by gastroscopy, barium oesophagogram and thoracic computed tomography (CT). Through surgical treatments, including pedicled muscle flap filling and thoracoplasty, and a correlated corrective procedure, the patient completely recovered and was discharged six months after the admission.Conclusion: Treatment by pedicled muscle flap filling and thoracoplasty after oesophagectomy for oesophageal squamous cell carcinoma can be a curative alternative for the severe thoracic gastrocutaneous fistula.     

Brn3b基因对视神经损伤条件下视网膜神经节细胞的保护作用

目的　探讨Brn3b过表达对视神经损伤条件下视网膜神经节细胞（retinal ganglion cells，RGCs）的保护作用。方法　选取雄性健康成年BALB/c小鼠60只，用微型视神经夹将小鼠右眼球后视神经夹持损伤，按视神经损伤后的天数依次分为第1、3、5、7、14天组，小鼠左侧正常眼作为空白组，明确视神经损伤天数条件。选取雄性健康成年BALB/c小鼠40只，用微量进样器以小鼠右眼玻璃体内注射的方法将腺相关病毒载体转染小鼠视网膜，建立Brn3b过表达模型并分组:Brn3b过表达组［转染Brn3b过表达腺相关病毒载体（Brn3b overexpressed adeno-associated viral vector，AAV-CMV-Brn3b）］和阴性对照组［转染空白腺相关病毒载体（blank adeno-associated viral vector，AAV-CMV-GFP）阴性对照物］，每组20只；之后，取Brn3b过表达组和阴性对照组各10只，用微型视神经夹将小鼠右眼球后视神经夹持损伤，构建模拟小鼠视神经损伤（controlled optic nerve crush，CONC）模型并分组:CONC-Brn3b过表达组和CONC-阴性对照组。利用视网膜铺片和切片免疫荧光标记相关蛋白表达量，检测Brn3b过表达对视神经损伤条件下RGCs、Brn3b和Caspase3蛋白表达的影响，并对其共定位情况做出统计分析。结果　与阴性对照组相比，Brn3b过表达组小鼠视网膜Brn3b的表达水平明显增加。在小鼠CONC模型制作后的第7天RGCs的总凋亡数量达到65%，第14天RGCs的凋亡数量未见进一步改变。免疫荧光标记的蛋白表达量及其共定位分析显示，在视神经损伤条件下，与CONC-阴性对照组相比，CONC-Brn3b过表达组小鼠RGCs的凋亡量以及凋亡因子Caspase3的表达量均明显减少，差异均有统计学意义（均为P＜0.001）。结论　Brn3b基因对视神经损伤条件下RGC具有明确的保护作用，Brn3b基因对凋亡因子Caspase3的表达可能具有一定的抑制作用。     

GSK-3β suppresses the proliferation of rat hepatic oval cells through modulating Wnt/β-catenin signaling pathway

Aim:

Glycogen synthase kinase 3β (GSK-3β) plays a crucial role in hepatic biology, including liver development, regeneration, proliferation and carcinogenesis. In this study we investigated the role of GSK-3β in regulation of growth of hepatic oval cells in vitro and in liver regeneration in partially hepatectomized rats.

Methods:

WB-F344 cells, the rat hepatic stem-like epithelial cells, were used as representative of oval cells. Cell viability was examined using a WST-8 assay. The cells were transfected with a recombinant lentivirus expressing siRNA against GSK-3β (GSK-3βRNAiLV) or a lentivirus that overexpressed GSK-3β (GC-GSK-3βLV). Adult rats underwent partial (70%) hepatectomy, and liver weight and femur length were measured at d 7 after the surgery. The expression of GSK-3β, phospho-Ser⁹-GSK-3β, β-catenin and cyclin D1 was examined with immunoblotting assays or immunohistochemistry.

Results:

Treatment of WB-F344 cells with the GSK-3β inhibitor SB216763 (5 and 10 μmol/L) dose-dependently increased the levels of phospho-Ser⁹-GSK-3β, but not the levels of total GSK-3β, and promoted the cell proliferation. Knockout of GSK-3β with GSK-3βRNAiLV increased the cell proliferation, whereas overexpression of GSK-3β with GC-GSK-3βLV decreased the proliferation. Both SB216763 and GSK-3βRNAiLV significantly increased the levels of β-catenin and cyclin D1 in the cells, whereas GSK-3β overexpression decreased their levels. In rats with a partial hepatectomy, administration of SB216763 (2 mg/kg, ip) significantly increased the number of oval cells, the levels of phospho-Ser⁹-GSK-3β, β-catenin and cyclin D1 in liver, as well as the ratio of liver weight to femur length at d 7 after the surgery.

Conclusion:

GSK-3β suppresses the proliferation of hepatic oval cells by modulating the Wnt/β-catenin signaling pathway.     

Prevalence and clinical outcomes of cardiac injury in patients with COVID-19: A systematic review and meta-analysis

Background and aimsEmerging data have linked the presence of cardiac injury with a worse prognosis in novel coronavirus disease 2019 (COVID-19) patients. However, available data cannot clearly characterize the correlation between cardiac injury and COVID-19. Thus, we conducted a meta-analysis of recent studies to 1) explore the prevalence of cardiac injury in different types of COVID-19 patients and 2) evaluate the association between cardiac injury and worse prognosis (severe disease, admission to ICU, and mortality) in patients with COVID-19.Methods and resultsLiterature search was conducted through PubMed, the Cochrane Library, Embase, and MedRxiv databases. A meta-analysis was performed with Stata 14.0. A fixed-effects model was used if the I² values ≤ 50%, otherwise the random-effects model was performed. The prevalence of cardiac injury was 19% (95% CI: 0.15–0.22, and p < 0.001) in total COVID-19 patients, 36% (95% CI: 0.25–0.47, and p < 0.001) in severe COVID-19 patients, and 48% (95% CI: 0.30–0.66, and p < 0.001) in non-survivors. Furthermore, cardiac injury was found to be associated with a significant increase in the risk of poor outcomes with a pooled effect size (ES) of 8.46 (95% CI: 3.76–19.06, and p = 0.062), severe disease with an ES of 3.54 (95% CI: 2.25–5.58, and p < 0.001), admission to ICU with an ES of 5.03 (95% CI: 2.69–9.39, and p < 0.001), and mortality with an ES of 4.99 (95% CI: 3.38–7.37, and p < 0.001).ConclusionsThe prevalence of cardiac injury was greatly increased in COVID-19 patients, particularly in patients with severe disease and non-survivors. COVID-19 patients with cardiac injury are more likely to be associated with poor outcomes, severity of disease, admission to ICU, and mortality.