ObjectiveTo investigate the effectiveness of Youngswick-Akin osteotomy in the treatment of moderate hallux valgus combined with mild to moderate hallux rigidus. Methods The clinical data of 43 patients with moderate hallux valgus combined with mild to moderate hallux rigidus who were admitted between August 2019 and August 2022 and met the selection criteria were retrospectively analyzed. There were 8 males and 35 females. The age ranged from 28 to 77 years, with an average age of 59.0 years. The disease duration ranged from 10 to 35 months, with an average of 20 months. The degree of hallux rigidus included 2 cases of CoughlinⅠ degree, 29 cases of Ⅱ degree, 12 cases of Ⅲ degree. The preoperative hallux valgus angle ranged from 25° to 40°, with an average of 32°. All patients were treated with Youngswick-Akin osteotomy. The first metatarsophalangeal joint space was compared before operation and at 6 months after operation. The American Orthopaedic Foot and Ankle Society (AOFAS) score and visual analogue scale (VAS) score were used to evaluate the functional recovery and pain relief of the patients before operation and at 6 and 24 months after operation. According to the severity of hallux rigidus, the patients were divided into mild group (Ⅰ, Ⅱ degree) and moderate group (Ⅲ degree) to compare the prognosis, including the changes of AOFAS score, VAS score, and the first metatarsophalangeal joint space. Results The operation time was 60-75 minutes (mean, 65 minutes). The intraoperative blood loss was 10-30 mL (mean, 20 mL). Two cases had superficial infection of the incision margin after operation, and healed well after dressing change and antibiotic treatment. The incisions of the other patients healed by first intention, and no medial cutaneous nerve injury of the great toe occurred. All patients were followed up 24-31 months, with an average of 25.8 months. The patient’s hallux valgus deformity was corrected without recurrence; no complication such as osteomyelitis and hallux varus occurred. The AOFAS score, VAS score, and the first metatarsophalangeal joint space after operation significantly improved when compared with those before operation, the AOFAS score and VAS score at 24 months after operation further improved when compared with those at 6 months after operation, and the differences were significant (P<0.05). The change of VAS score in mild group was significantly better than that in moderate group (P<0.05); but there was no significant difference in the changes of AOFAS score and the first metatarsophalangeal joint space between the two groups (P>0.05). ConclusionYoungswick-Akin osteotomy for moderate valgus deformity with mild to moderate hallux rigidus can achieve good functional recovery, pain relief, and joint space improvement.
In order to investigate in greater detail the two methods based on Hertz model for analyzing force-distance curve obtained by atomic force microscopy, we acquired the force-distance curves of Hela and MCF-7 cells by atomic force microscopy (AFM) indentation in this study. After the determination of contact point, Young's modulus in different indentation depth were calculated with two analysis methods of "two point" and "slope fitting". The results showed that the Young's modulus of Hela cell was higher than that of MCF-7 cell,which is in accordance with the F-actin distribution of the two types of cell. We found that the Young's modulus of the cells was decreased with increasing indentation depth and the curve trends by "slope fitting". This indicated that the "slope fitting" method could reduce the error caused by the miscalculation of contact point. The purpose of this study was to provide a guidance for researcher to choose an appropriate method for analyzing AFM indentation force-distance curve.
The management of middle-aged and youth hypertension has become a challenge in clinical practice. The hypertension group of the Chinese Society of Cardiology published the expert consensus on the management of hypertension in young and middle-aged Chinese population in 2019. This paper interprets the key contents of the consensus and provides references for management of young and middle-aged hypertension.
ObjectiveTo observe the abnormal clinical manifestations of retinal blood vessels and the characteristic image characteristics of optical coherence tomography (OCT) in young myopia. MethodsA case observation study. From July to December 2020, 523 young patients with different myopia refractive powers who were treated in Department of Ophthalmology of The Second Hospital of Hebei Medical University were included in the study. Among them, 277 were males and 246 were females; the median age was 19.0 (5.0) years. All the affected eyes underwent best corrected visual acuity (BCVA), frequency domain OCT (SD-OCT) examination and axial length (AL) measurement. The BCVA examination was performed using the Snellen eye chart. The median myopia refractive power of the affected eye was 5.00 (3.25) D. Among them, low myopia, moderate myopia, and high myopia were 227, 405, and 414 eyes, respectively. The average AL of the affected eye was 25.6±2.8 mm. The frequency domain OCT instrument was used to scan the temporal side of the retina, the upper and lower nasal vascular arches and the macular fovea radially. The images of retinal vascular cysts, microfolds, and lamellar hole were acquired and stored. The prevalence, composition ratio, distribution rule and OCT imaging characteristics of retinal paravascular abnormalities were observed and analyzed. The distribution of paravascular abnormalities in the retina was compared by the χ2 test; the age, refractive power, and AL of different paravascular abnormalities were compared by the K-W rank sum test. ResultsOf the 1046 different diopters of myopic eyes, there were 227 eyes in mild myopia, 405 eyes in moderate myopia and 414 eyes in high myopia. Retinal paravascular abnormalities were detected by SD-OCT in 40 eyes (3.8%,40/1046). The prevalence of retinal paravascular abnormalities in moderate myopia was 0.7% (3/405) and high myopia was 8.9% (37/414). No retinal paravascular abnormalities were observed in mild myopia.Retinal paravascular cysts in 40 eyes (3.8%, 40/1046), retinal paravascular microfolds in 28 eyes (2.7%, 28/1046) and retinal paravascular lamellar holes in 13 eyes (1.2%, 13/1046). Of 40 eyes with retinal paravascular abnormalities, retinal paravascular cysts in all 40 eyes (100.0%, 40/40), retinal paravascular microfolds in 28 eyes (70.0%, 28/40) and retinal paravascular lamellar holes in 13 eyes (32.5%, 13/40). Twelve eyes with simple cyst cavity (30.0%, 12/40); 15 eyes were with cyst cavity with micro-wrinkles (37.5%, 15/40); 13 eyes were with cyst cavity, micro-wrinkles and lamellar holes (32.5%, 13/40). The temporal vascular arch retinal paravascular cysts (χ2=25.664), microfolds (χ2=14.973), and lamellar holes (χ2=13.499) were significantly more than those on the nasal side, and the difference was statistically significant (P＜0.001). ConclusionsThe total prevalence of retinal paravascular abnormalities in young myopia is 3.8%; it can occur in both moderate and high myopia. The paravascular cyst may be the earliest pathology of paravascular abnormalities in the retina. The three paravascular abnormalities are mostly distributed along the temporal arch of the retina.
Objective To explore the clinical value of shear wave elastography in the evaluation of quadriceps femoris lesions in patients with chronic obstructive pulmonary disease (COPD). Methods Fifty-eight COPD patients who were admitted to Chengdu First People’s Hospital and 55 healthy controls were included in the study between August 2021 and February 2022. The thickness, circumference, cross-sectional area and Young's modulus of quadriceps femoris in all subjects were measured using shear wave elastography combined with conventional two-dimensional ultrasound. The differences in ultrasound parameters between the two groups were compared, and the correlation between each ultrasound parameter and clinical evaluation indicators (modified British Medical Research Council Scale, COPD Assessment Test, six-minute walk test, and five-time sit-to-stand test) was analyzed. Results Young’s modulus values of the quadriceps femoris muscle were smaller in the COPD group than those in the healthy control group [COPD Group: rectus femoris 6.72 (6.22, 7.36) kPa, vastus medialis 6.25 (5.82, 6.79) kPa, vastus lateralis 6.94 (6.17, 7.48) kPa; healthy control group: rectus femoris 11.40 (10.23, 12.11) kPa, vastus medialis 10.77 (9.62, 11.42) kPa, vastus lateralis 11.14 (10.42, 12.52) kPa]. The differences were statistically significant (all P<0.05). The Young's modulus value of the rectus femoris muscle correlates with the aforementioned clinical evaluation indicators, with positive correlation with six-minute walk distance and negative correlation with COPD Assessment Test, modified British Medical Research Council Scale, five-time sit-to-stand time (P<0.05). Quadriceps thickness, circumference, and cross-sectional area measured by conventional two-dimensional ultrasound were not significantly different between the two groups, nor were there significant correlations between each parameter and clinical parameters (P>0.05). In addition, shear wave elastography has good reproducibility in the measurement of Young's modulus in quadriceps. Conclusions Shear wave elastography can identify quadriceps lesions earlier than conventional two-dimensional ultrasound in COPD patients, and there is a significant correlation between its measurements and the clinical condition of COPD patients. Shear wave elastography may provide a simple and noninvasive method for clinical evaluation of quadriceps femoris lesions in COPD patients.
Objective To investigate the effect of myopia on retinal vascular geometry in young subjects. Methods A retrospective cross-sectional study. From June 2018 to December 2018, 235 participants (235 eyes) who took part in routine physical examination in Huadong Sanatorium were included . There were 94 males and 141 females; age was (34.89±6.15) years old; equivalent spherical refraction (SE) was (－3.78±3.25) D. 59 (25.11%, 59/235) were divided into high myopia group (SE≤－6.0 D), along with 131 (55.74%, 131/235) low to moderate myopia group (－0.5 D＞SE＞－6.0 D), and 45 (19.15%, 45/235) emmetropia group (0.5 D≥SE≥－0.5 D). Retinal vascular geometric measurements, including central retinal arteriolar equivalent (CRAE), central retinal venular equivalent (CRVE), fractal dimension arteriole (FDa), fractal dimension venule (FDv), curvature tortuosity arteriole (CTORTa), curvature tortuosity venule, branch angle arteriole (BAa), branch angle venule, branch coefficient arteriole and branching coefficient venule, were extracted by using a validated computer program. One-way analysis of variance and analysis of covariance were performed to compare the measurements across the high myopia, low to moderate myopia, and emmetropia groups. Linear regression analysis was used to explore the relationship between SE and retinal vascular geometric parameters. ResultsThe differences in CRAE (F=65.11), CRVE (F=61.52), FDa (F=14.26), FDv (F=8.31), CTORTa (F=5.07) and BAa (F=6.51) among eys of high myopia group, low to moderate myopia group and emmetropia group remained significant (P＜0.05) after adjusting for age, glycosylated hemoglobin, mean arterial pressure, body mass index, and intraocular pressure. CRAE and CRVE were linearly correlated with the SE (P＜0.05). FDa, FDv, cTORTa and BAa decreased with the decrease of SE in high myopia (P＜0.05). ConclusionsMyopia is associated with the change of the retinal vascular geometric characteristics. With the deepening of myopia, the change of retinal vascular geometric characteristics gradually worsens.
ObjectiveTo explore the clinical and pathological characteristics of lung carcinoma in young adults, and improve the early diagnosis and treatment. MethodsWe retrospectively analyzed 129 patients with lung carcinoma aged from 18 to 35 years old who came to West China Hospital of Siduan University from January 1st 2008 to December 31st 2014.Also we collected 32 young adults with lung benign mass to make the comparison of the clinical and pathological characteristics with the patients. ResultsIn the 129 patients with lung carcinoma, there were 72 females and 57 males.Adenocarcinoma (88/129) was the most common type of pathology, while others included small cell carcinoma (18/129), squamous cell carcinoma (13/129), and other types of carcinoma (10/129).Among patients with lung carcinoma, 41(31.8%) complained of refractory dry cough and another 40(31.0%) presented coughing and expectoration.Twenty-nine patients (22.5%) were misdiagnosed in their first visits.In young adults with lung carcinoma, 55.8% were at the Ⅳ stage with metastasis at the first-time diagnosis.Comparing with patients with benign lung mass, patients with lung carcinoma presented significantly more dry cough (P=0.011), chest distress (P=0.007) and weight loss (P=0.007);while fever was found more patients with lung benign mass (P=0.040).The differences in cough, expectoration, and emptysis between the two groups were not significant (P > 0.05). ConclusionsLung carcinoma in young adults often has atypical clinical presentations.Therefore, it is more commonly misdiagnosed.
ObjectiveTo investigate the effectiveness of U-shape titanium screw-rod fixation system with bone autografting for lumbar spondylolysis of young adults. MethodsBetween January 2008 and December 2011, 32 patients with lumbar spondylolysis underwent U-shape titanium screw-rod fixation system with bone autografting. All patients were male with an average age of 22 years (range, 19-32 years). The disease duration ranged from 3 to 24 months (mean, 14 months). L3 was involved in spondylolysis in 2 cases, L4 in 10 cases, and L5 in 20 cases. The preoperative visual analogue scale (VAS) and Oswestry disability index (ODI) scores were 8.0±1.1 and 75.3±11.2, respectively. ResultsThe operation time was 80-120 minutes (mean, 85 minutes), and the blood loss was 150-250 mL (mean, 210 mL). Primary healing of incision was obtained in all patients without complications of infection and nerve symptom. Thirty-two patients were followed up 12-24 months (mean, 14 months). Low back pain was significantly alleviated after operation. The VAS and ODI scores at 3 months after operation were 1.0±0.5 and 17.6±3.4, respectively, showing significant differences when compared with preoperative ones (t=30.523,P=0.000;t=45.312,P=0.000). X-ray films and CT showed bone fusion in the area of isthmus defects, with the bone fusion time of 6-12 months (mean, 9 months). During follow-up, no secondary lumbar spondyloly, adjacent segment degeneration, or loosening or breaking of internal fixator was found. ConclusionThe U-shape titanium screw-rod fixation system with bone autografting is a reliable treatment for lumbar spondylolysis of young adults because of a high fusion rate, minimal invasive, and maximum retention of lumbar range of motion.
ObjectiveTo explore the clinical features and prognosis of ischemic cerebral infarction in young population,and to provide a reference for clinical prevention of cerebral infarction in young population. MethodsA total of 547 patients with ischemic cerebral infarction diagnosed between January 2008 and June 2013 were included,and the difference in clinical data and outcomes between young and old patients were retrospectively compared. ResultsThe 547 patients included 233 young and 314 old patients,and there were more male patients in young group.As compared to the old group,the proportion of hypertension was significantly lower in young group (51.9%,64.3%;P=0.004);while smoking (51.9%,5.7%;P=0.000) and alcoholism (53.2%,28.3%;P=0.000) were significantly higher in young group.Moreover,there were more patients with vascular malformations in young group than that in old group (7.3%,3.2%;P=0.028).And there were also more patients in young group received thrombolytic therapy and antiplatelet therapy (98.3%,86.9;P=0.000),and the prognosis of young patients was significantly better than that of old patients. ConclusionThe prognosis of young patients with ischemic stroke prognosis is relatively good,and changing bad habits would be an effective measure to prevent and reduce the occurrence of ischemic cerebral infarction in young population.
ObjectiveTo systematically evaluate the correlation between interpersonal stress and suicidal ideation. MethodsThe PubMed, EMbase, Cochrane Library, CBM, WanFang Data and CNKI databases were searched to collect studies on the correlation between interpersonal pressure and suicidal ideation from database inception to April 27, 2022. Two researchers independently screened the literature, extracted data and assessed the risk of bias of the included studies. Meta-analysis was then performed using Stata 14.0 software. ResultsA total of 42 studies including 3 cohort studies, and 39 cross-sectional studies, with a total sample size of 193 810 participants were included. Meta-analysis showed that the risk of suicidal ideation was higher in people who had experienced interpersonal pressure than in people who had not (OR=2.11, 95%CI 1.99 to 2.23, P<0.01). Subgroup analysis showed that people in the Americas who had experienced interpersonal pressure were more strongly associated with suicidal ideation than people in other regions of the studied area. Young adults in the study who had experienced interpersonal pressure were more strongly associated with suicidal ideation than other studied age groups; People who had experienced partner pressure were more strongly associated with suicidal ideation than those who had experienced other types of interpersonal pressure. ConclusionThis study shows that people who have experienced interpersonal pressure are at greater risk of suicidal ideation, and there are certain differences among study areas, subjects and types of interpersonal pressure. Due to the limited quantity and quality of the included studies, more high-quality studies are needed to verify the above conclusion.