The "Will Rogers effect" on stage grading

Will Rogers phenomenon affects survival statistics applied to clinical research and could determine a misreading of results. Stage migration due to new methods of diagnostic imaging and staging invasive procedures could improve actuarial survival in each stage. TNM System is impaired when survival rates come from different inhomogeneous countries, regions and eras. Randomized trials suffer this fallacious phenomenon when staging depends on the different treatments which are to be evaluated.     

The "plateau effect" of cis-platinum-induced hearing loss

Cis-platinum-induced hearing loss has been reported to exhibit a "plateau effect" over the 2 to 8 kHz range. We examined serial audiometry data from 27 patients treated with cis-platinum. Although a plateau at 60 to 70 dB HL often occurred, this hearing loss was clearly exceeded in a number of patients. We identified 14 patients with sufficient cis-platinum-induced sensorineural hearing loss to evaluate a plateau limit to hearing loss over the 4 to 8 kHz range. Half of these 14 patients had hearing losses that exceeded the plateau level. More severe 4 to 8 kHz hearing losses did not correlate with number of treatments, cumulative dosages of cis-platinum, pre-existing hearing loss, radiation therapy, other chemotherapeutic agents, or even hearing losses below 4 kHz. Although cis-platinum therapy can induce a plateau of moderate hearing impairment for some patients over the 4 to 8 kHz range, a significant proportion of patients will experience more severe hearing impairment in this range, even after only one or two courses of cis-platinum.     

The effect of osteopontin immobilized collagen granules in the seed crystal method

Osteopontin (OPN) is a urinary protein which inhibits calcium oxalate (CaOx) crystal growth in the seed crystal system. The aim of this study was to evaluate the effects of OPN immobilized on collagen granules (CG) for CaOx crystal growth and aggregation in this system. OPN-immobilized CG showed a 30% decrease in inhibitory activity compared with non-OPN-immobilized CG. Scanning electron microscopy revealed that 1) OPN-immobilized CG showed more marked aggregation and adhesion of seed crystals (smaller than 0.5 microm in diameter) than non-OPN-immobilized CG, 2) the amount of adherent large type crystals (2-3 microm in diameter) did not differ between OPN immobilized and non-OPN-immobilized CG. In conclusion, immobilized OPN promotes aggregation and adhesion of CaOx crystals smaller than 0.5 microm on CG. These observations suggest that crystal adhesion to immobilized OPN plays a role in the retention of crystals in the kidney.     

The effect of "Jingzhizhu" capsule on male fertility

Objective: To study the effect of "Jingzhizhu" capsule on male fertility, especially sperm density, motility and morphology. Methods: (1) Assess the semen quality of the 50 patients with oligospermia and/or asthenospermia after taking "Jingzhizhu" for one month; (2) Observe the fecundity, pathology and ultrastructure of testes and epididymes of mice after feeding "Jingzhizhu"; (3) Test the acute toxicity on mice. Results: "Jingzhizhu" capsule can significantly improve semen quality of the patients with oligospermia and/or asthenospermia, reverse the pathological change of testes and epididymes of mice. Toxicity test showed no toxic change. Conclusions: "Jingzhizhu" is safe and effective for male infertility.     

"精之助"胶囊对生殖功能影响的研究

目的　研究“精之助”胶囊对生殖功能尤其是对精子密度、活动力及形态的影响。方法　 (1)对 5 0例少精子症及 (或 )弱精子症患者应用“精之助”一个月 ,观察精液指标变化情况 ;(2 )对小白鼠进行药效学实验 ,观察一般情况、产仔情况、睾丸及附睾组织学及超微结构变化等 ;(3)对小白鼠进行急性毒性实验。结果　“精之助”胶囊可显著改善少精子症及 (或 )弱精子症患者精液指标 ,逆转小白鼠睾丸、附睾超微结构病理变化。急性毒性实验证明该中药制剂无毒性。结论　“精之助”胶囊是男性不育的安全、有效的中药制剂     

The "small patella" syndrome.

Twelve closely related members of one family were found to have small or absent patellae. Seven of these patients also had abnormalities of the pelvic girdle and upper femora. There was a resemblance to the nail--patella syndrome in the patellar abnormalities but not in the associated conditions, and it would therefore appear that the syndrome described is a new variety of congenital abnormality of the knee.     

The effect of inflammatory synovial fluid on the breaking strength of new "long lasting" absorbable sutures.

The effect of inflammatory synovial fluid upon several absorbable sutures potentially useful for arthroscopic procedures, e.g., meniscus repair and shoulder stabilization, was studied by implanting lengths of these sutures into unstable, arthritic rabbit knees and testing their breaking strength after varying time periods (up to 18 weeks). Polyglyconate (Maxon) sutures retained no significant strength at 6 weeks. Polydioxanone (PDS) sutures began to lose breaking strength at 3 weeks, retained only 40% of their original strength 6 weeks after implantation, and had no measurable strength at 9 weeks. Polycaprolactone (LTS) sutures showed a slow reduction in strength and retained approximately 90% of their original breaking strength after 18 weeks of implantation. Green braided polyester (Mersiline) sutures showed no loss of breaking strength over the testing period. Measurements of inherent viscosity were made to give an indirect indication of the decline in molecular weight of these sutures. These data paralleled the breaking strength decline in every case. The surgeon selecting an absorbable suture must consider the length of time the suture will hold the target tissue. This information should be helpful to surgeons considering an absorbable suture for procedures such as meniscus repair and shoulder stabilization.     

地塞米松对护骨素基因敲除小鼠骨微结构的影响

目的探讨小剂量地塞米松对生长期小鼠骨密度及骨微结构的影响及其与OPG途径的关系。方法 20只4周龄OPG~(-/-)雌性小鼠及20只野生型小鼠随机分四组(n=10):野生型安慰剂组(WT+saline),野生型地塞米松干预组(WT+DEX,地塞米松1mg/kg体重,肌肉注射,每周3次),OPG~(-/-)敲除小鼠安慰剂组(OPG~(-/-)+saline),OPG~(-/-)敲除小鼠DEX干预组(OPG~(-/-)+DEX,地塞米松1 mg/kg体重,肌肉注射,每周3次)。6周后处死小鼠,一侧胫骨行显微CT扫描分析。结果OPG~(-/-)组的组织骨密度、骨小梁体积分数、骨小梁数量、骨小梁厚度均较其他三组降低(P0.05)。OPG~(-/-)+DEX组的组织骨密度、骨小梁体积分数、骨小梁数量、骨小梁厚度均较WT及WT+DEX组降低(P0.05)。OPG~(-/-)组的骨小梁模型因子及骨小梁分离度均较其他三组增加(P0.05);OPG~(-/-)+DEX组的骨小梁模型因子及骨小梁分离度均较WT及WT+DEX组增加(P0.05)。WT及WT+DEX组之间骨小梁微结构参数均无统计学差异。结论在生长期小鼠OPG基因功能缺失时,地塞米松有部分拮抗骨量丢失的作用,表明除了OPG/RANKL途径,地塞米松对骨代谢的影响是多途径的。     

The CarboMedics "Top-Hat" supraannular prosthesis.

BACKGROUND: The CarboMedics "Top-Hat" supraannular prosthesis was designed to permit the implantation of a larger prosthesis. METHODS: Between June 1993 and November 1996, 127 patients (average age, 61.8+/-10.2 years) received a CarboMedics "Top-Hat" supraannular aortic prosthesis. The average follow-up was 15.7 months, and all surviving patients underwent echocardiographic study. This group is compared with 656 patients in whom a standard CarboMedics prosthesis was implanted and also with 2,927 patients who received other aortic prostheses. RESULTS: Using the standard and the supraannular sizers, there was an average increase of one size in favor of the supraannular prosthesis: 18.9+/-2.8 mm standard versus 20.8+/-2.6 mm supraannular (p < 0.005). For each prosthesis size (19 to 23 mm), the body surface area of the patients in whom a CarboMedics supraannular prosthesis was implanted was significantly smaller than that in those who received a CarboMedics standard prosthesis or any other model. Hospital mortality was 3.9%, and late mortality was 5.5%. The actuarial survival was 86.5%+/-3.9% at 42 months. CONCLUSIONS: Using the CarboMedics supraannular prosthesis allows implantation of a larger prosthesis compared with the standard CarboMedics prosthesis or other models. This advantage is especially important in patients with a small aortic root.     

基层医院开展“互联网+上门护理服务”效果探讨

目的 为社区有就医需求患者提供及时方便的上门护理服务，改善患者就医体验。 方法 在医院微信服务号建立子系统“护理服务到家”，设基础护理17项、专科护理6项、母婴护理5项、检验服务11项共4类39项服务项目；对医护人员进行培训后正式运行（线上下单，上门服务）。 结果 “护理服务到家”运行128 d，上门服务652单；上门护士1 196人次、医生108人次；患者满意度为100%；上门服务项目均顺利完成，未发生投诉和不良事件，未发生医生护士相关安全问题。 结论 基层医院实施“互联网+上门护理服务”，改善了患者就医体验，同时有助于体现护士职业价值感，以及缓解看病难的社会问题。