The purpose of this study is to analyze the biomechanics of ankle cartilage and ligaments during a typical Tai Chi movement–Brush Knee and Twist Step (BKTS). The kinematic and kinetic data were acquired in one experienced male Tai Chi practitioner while performing BKTS and in normal walking. The measured parameters were used as loading and boundary conditions for further finite element analysis. This study showed that the contact stress of the ankle joint during BKTS was generally less than that during walking. However, the maximum tensile force of the anterior talofibular ligament, the calcaneofibular ligament and the posterior talofibular ligament during BKTS was 130 N, 169 N and 89 N, respectively, while it was only 57 N, 119 N and 48 N during walking. Therefore, patients with arthritis of the ankle can properly practice Tai Chi. Practitioners with sprained lateral ligaments of the ankle joint were suggested to properly reduce the ankle movement range during BKTS.
Objective To investigate the quality of life (QOL) of Beichuan cadres 1 year after Wenchuan earthquake, so as to provide references for promoting psychological intervention and improving QOL. Methods With the adoption of WHOQOL-BREF, questionnaire survey on basic conditions of cadre victims, and PCL-C scale, cross-section survey was conducted for 2 055 cadres of Beichuan public institutions in aspects of their QOL, social demographic characteristics and psychological trauma. Results a) Compared with domestic norm, although the Beichuan cadres had higher score in social relation domain (14.31 ± 2.59, Plt;0.01), their QOL scores in each dimensions (physical domain score: 14.16 ± 2.43; psychological domain score: 13.79 ± 2.59, environmental domain score: 11.20 ± 2.74) were lower with significant difference (Plt;0.01); b) The group with population under the age of 30 scored higher than other age groups in the psychological and environmental domains; men scored higher than women in the psychological domain; the widowed group scored lower than other groups in all domains; the Han nationality group scored higher than the Qiang nationality group in all domains; the primary education group scored lower than other groups in the social relation domain; the group with relatives, houses and physical loss or damage scored lower than the non-loss group in all domains; and the higher the score in PCL-C, the lower the scores in all domains (all Plt;0.05). Conclusion Beichuan cadres are severely affected in their physical, psychological and environmental domains even one year after Wenchuan earthquake, especially the female, the Qiang nationality, the old, the lost, and the psychological injured cadres are more badly affected with worse QOL, so those population should be concerned in particular with sustainable psychological service and other measures. The finding of social relation domain score being higher than general population suggests that it is important to promote the satisfaction with social relation through the timely effective support from both government and civil society, and the resettlement of sample housing area as well.
Objective To explore the effect of total glucosides of Cistanche deserticola on oxidative stress and cognitive function in rats with intermittent hypoxia. Methods Adult male Wistar rats (n=72) were randomly divided into three groups: a blank control group, a 5% intermittent hypoxia group (IH group) and a total glucosides of Cistanche deserticola intervention group (TGs intervention group). The 5% intermittent hypoxia rat model was simulated by using the self-made cabin of intermittent hypoxia. The rats in the IH group and the TGs intervention group were given 5% intermittent hypoxia respectively, and the rats in the TGs intervention group were treated with total glucosides of Cistanche deserticola simultaneously. Learning and memory function was tested by Morris water maze in three groups at the 2nd, 4th, 6th and 8th week respectively. The expressions of superoxide dismutase (SOD) and malondialdehyde (MDA) in hippocampus were detected by test kit. Results Compared with the blank control group, the escape latency time of the rats in the IH group and the TGs intervention group was significantly prolonged at the 2nd, 4th, 6th and 8th week respectively (P<0.05). The time to cross the target quadrant in the IH group and the TGs intervention group was gradually shortened at the 2nd, 4th, 6th and 8th week respectively (P<0.05). Compared with the IH group, the escape latency gradually shortened at the 2nd, 4th, 6th and 8th week in the TGs intervention group (P<0.05), while the time to cross the target quadrant was gradually prolonged at the 2nd, 4th, 6th and 8th week (P<0.05). The expressions of MDA in hippocampal tissue in the IH group and the TGs intervention group increased at the 2nd, 4th, 6th and 8th week (P<0.05), which were significantly higher than those in the blank control group; and the expressions of SOD at the 2nd, 4th, 6th, and 8th week were all lower than those in the blank control group(P<0.05). Compared with the IH group, the expression of MDA protein in hippocampal tissue in the TGs intervention group decreased at the 2nd, 4th, 6th and 8th week, while the expression of SOD protein at the 2nd, 4th, 6th and 8th week increased, and the differences were statistically significant (P<0.05). Conclusion The total glycosides of Cistanche deserticola can improve the learning and memory function of intermittent hypoxia rats by inhibiting oxidative stress.
ObjectiveTo summarize and analyze the clinical characteristics of patients with acute diffuse lung changes and respiratory failure.MethodsThe clinical data of patients in the Department of Critical Care Medicine, Dazhou Central Hospital between January 2016 and December 2018 were retrospectively collected, whose main clinical manifestation was acute respiratory distress syndrome with acute onset (<3 weeks) and main imaging manifestation was diffuse changes in both lungs. The clinical characteristics of patients were summarized, and the causes of the disease were explored.ResultsA total of 65 patients with acute diffuse lung changes and respiratory failure were enrolled, including 42 males (64.6%) and 23 females (35.4%). The average age was (57.1±18.4) years, the average time from onset to treatment was (7.5±5.9) d, and the average length of stay in the intensive care unit was (8.9±4.1) d. A total of 23 cases died, with a case-fatality rate of 35.4%. Among the 65 patients, there were 50 case (76.9%) of infectious diseases, including 36 cases of bacterial infections (including 4 cases of tuberculosis), 8 cases of viral infections (all were H1N1 infections), and 6 cases of fungal infections (including 1 case of pneumocystis infection); and there were 15 cases (23.1%) of non-infectious diseases, including 4 cases of acute left heart failure, 2 cases of interstitial pneumonia, 2 cases of vasculitis, 1 case of myositis dermatomyositis, 1 case of aspiration pneumonia, 1 case of acute pulmonary embolism, 1 case of acute drug lung injury, 1 case of neurogenic pulmonary edema, 1 case of drowning, and 1 case of unknown origin.ConclusionsInfectious diseases are the main cause of acute diffuse lung changes and respiratory failure, while among non-infectious diseases, acute heart failure and immune system diseases are common causes.
Objective To evaluate the mental status of survivors after Wenchuan earthquake, so as to provide relevant information for psychological and medical intervention. Methods Demographic data was recorded and the post-traumatic stress disorder (PTSD) Checklist-Civilian Version (PCL-C) was evaluated. The acute stress disorder (ASD) were assessed with the DSM-IV criteria in the survivors from the central earthquake area who are now living in two shelters in Chengdu. Results Among the 780 retrieved questionnaires, 729 baseline registration forms and 450 PCL-C were valid. In the 729 baseline registration forms, male to female ratio was 1:1.31 and the mean age was 36.73±20.82. 9.5% of subjects suffered from physical diseases, 9.7% needed assistance in daily activities, 70.7% were passive and didn’t participate in community activities, 9.1% suffered from severe psychological problems. In the present study, 30.9% of subjects were found to meet the DSM-IV criteria for ASD. 41.3%, 22.2% and 18.4% of subjects had a PCL-C score ≥ 38, ≥ 45 and ≥50, respectively. Consistency check showed there was no significant difference between the screening result of PCL-C score ≥45 and clinical diagnosis (Kappa=0.780, P=0.033). There was significant difference in the age of subjects between ASD and non-ASD groups (Plt;0.05). Conclusion The earthquake survivors suffered from psychological problems after the disaster in the early stage. Thus, in addition to life rescue, we should pay more attention to psychological intervention.
ObjectiveTo investigate the clinical characteristics and contribution factors in severe coronavirus disease 2019 (COVID-19).MethodsThe clinical symptoms, laboratory findings, radiologic data, treatment strategies, and outcomes of 110 COVID-19 patients were retrospectively analyzed in these hospitals from Jan 20, 2020 to Feb 28, 2020. All patients were confirmed by fluorescence reverse transcription polymerase chain reaction. They were classified into a non-severe group and a severe group based on their symptoms, laboratory and radiologic findings. All patients were given antivirus, oxygen therapy, and support treatments. The severe patients received high-flow oxygen therapy, non-invasive mechanical ventilation, invasive mechanical ventilation or extracorporeal membrane oxygenation. The outcomes of patients were followed up until March 15, 2020. Contribution factors of severe patients were summarized from these clinical data.ResultsThe median age was 50 years old, including 66 males (60.0%) and 44 females (40.0%). Among them, 45 cases (40.9%) had underlying diseases, and 108 cases (98.2%) had different degrees of fever. The common clinical manifestations were cough (80.0%, 88/110), expectoration (33.6%, 37/110), fatigue (50.0%, 55/110), and chest tightness (41.8%, 46/110). Based on classification criteria, 78 (70.9%) non-severe patients and 32 (29.1%) severe patients were identified. Significant difference of the following parameters was found between two groups (P<0.05): age was 47 (45, 50) years vs. 55 (50, 59) years (Z=–2.493); proportion of patients with underlying diseases was 27 (34.6%) vs. 18 (56.3%) (χ2=4.393); lymphocyte count was 1.2 (0.9, 1.5)×109/L vs. 0.6 (0.4, 0.7)×109/L (Z=–7.26); C reactive protein (CRP) was 16.2 (6.5, 24.0) mg/L vs. 45.3 (21.8, 69.4) mg/L (Z=–4.894); prothrombin time (PT) was 15 (12, 19) seconds vs. 18 (17, 19) seconds (Z=–2.532); D-dimer was 0.67 (0.51, 0.82) mg/L vs. 0.98 (0.80, 1.57) mg/L (Z=–5.06); erythrocyte sedimentation rate (ESR) was 38.0 (20.8, 59.3) mm/1 h vs. 75.5 (39.8, 96.8) mm/1 h (Z=–3.851); lactate dehydrogenase (LDH) was 218.0 (175.0, 252.3) U/L vs. 325.0 (276.5, 413.5) U/L (Z=–5.539); neutrophil count was 3.1 (2.1, 4.5)×109/L vs. 5.5 (3.7, 9.1)×109/L (Z=–4.077). Multivariable logistic analysis showed that there was positive correlation in elevated LDH, CRP, PT, and neutrophil count with the severity of the disease. Currently, 107 patients were discharged and 3 patients died. Total mortality was 2.7%.ConclusionsOld age, underlying diseases, low lymphocyte count, elevated CPR, high D-dimer and ESR are relevant to the severity of COVID-19. LDH, CPR, PT and neutrophil count are independent risk factors for the prognosis of COVID-19.
ObjectiveTo detect the concentration of 8-isoprostane (8-iso-PG) in exhaled breath condensate (EBC) of patients with or at risk for ARDS in ventilation, and investigate its clinical significance.MethodsFifty-five patients with or at risk for ARDS in ventilation admitted between February 2014 and June 2016 were recruited as an experimental group, and simultaneous 30 normal cases were recruited as a control group. Their EBC was collected with EcoScreen condenser. The EBC 8-iso-PG level of the patients between different grades of ARDS (mild, moderate, and sever) or at risk for ARDS was compared, and the correlation of EBC 8-iso-PG with the clinical indicators was analyzed.ResultsThe 8-iso-PG levels in EBC and serum of the patients with or at risk for ARDS in ventilation were higher than those in the control group [EBC: (44.83±11.58) ng/L vs. (19.47±4.06) ng/L; serum: (481.53±444.94) ng/L vs. (19.91±17.60) ng/L] (all P<0.05). The EBC 8-iso-PG of the patients with moderate ARDS (n=15) and severe ARDS (n=7) [(47.18±11.68) ng/L and (50.29±11.06) ng/L] was higher than those with mild ARDS (n=7) or at risk for ARDS (n=26) [(33.04±7.62) ng/L) and (37.17±11.08) ng/L] (all P<0.05). However EBC 8-iso-PG was not different between the patients with mild ARDS and those at risk for ARDS (P>0.05 ). The increased EBC 8-iso-PG could predict ARDS with an area under the receiver operating curve of 0.73. The EBC 8-iso-PG of the patients with or at risk for ARDS was correlated with lung injury score (r=0.418, P<0.01), PaO2/FiO2 (r=–0.378, P<0.05), chest radiograph scores (r=0.410, P<0.05), AaDO2 (r=0.368, P<0.05), and APACHEⅡ score (r=0.718, P<0.05).ConclusionEBC 8-iso-PG can reflect the oxidative stress in lung of ARDS patients in ventilation, and can contribute to the diagnosis and evaluation for moderate and severe ARDS.
Objective To evaluate the psychological trauma incurred by the hospitalization survivor of Zhouqu district after the Zhouqu debris flow so as to provide relevant information for psychological and medical interventions. Methods The psychological state of 67 hospitalized survivors of the disaster and other 47 inpatients with similar complaints but not coming from the disaster area was investigated through a mental health self-assessment questionnaire, self-rating anxiety scale (SAS), self-rating depression scale (SDS) and PTSD-SS scale. Results The post-disaster survivors had different levels of psychological problems and post-traumatic stress disorder, and there were significant differences compared to the control group (Plt;0.01, Plt;0.01). The SDS score and the SAS score of the survivor were 48.44+15.648 and 52.92+11.672, respectively, which were all much higher than those of the control group (Plt;0.01, Plt;0.05). Conclusion The debris flow disaster bring serious psychological trauma to the victims. It is necessary to pertinently carry out post-disaster psychological relief including psychological intervention and regulation for the hospitalized survivors, so as to alleviate and reduce their psychological suffering.
Objective To investigate the expression of S100A12 protein in peripheral blood of patients with acute respiratory distress syndrome (ARDS) and its clinical significance. Methods Sixty ARDS patients admitted between October 2015 and December 2016 were included in the study. They were divided into a mild group (n=20), a moderate group (n=20) and a severe group (n=20) according to the oxygenation state. Meanwhile they were divided into a survival group (n=37) and a death group (n=23) according to the 30-day prognosis. Sixty simultaneous healthy subjects were selected as a control group. The clinical data of all subjects were collected. Fasting venous blood was collected in the morning for measurement of S100A12 expression in peripheral blood by ELISA method. Results Compared with the control group, the levels of S100A12, interleukin-1 (IL-1), tumor necrosis factor alpha (TNF-α) in peripheral blood and APACHEⅡ score were significantly increased in the ARDS patients, and PaO 2/FiO 2 was significantly decreased (all P<0.05). The level of S100A12 in peripheral blood was positively correlated with the severity of ARDS. The level of S100A12 was much higher in the severe group than that in the moderate group and the mild group, and higher in the moderate group than that in the mild group (allP<0.05). Correlation analysis showed that S100A12 level in peripheral blood of the ARDS patients was positively correlated with IL-1, TNF-α and APACHEⅡ score (P<0.05), but negatively correlated with PaO 2/FiO 2 (P<0.05). Logistic regression analysis showed that IL-1, TNF-α, APACHEⅡ score and S100A12 were independent risk factors for prognosis of ARDS. PaO 2/FiO 2 was an independent protective factor for prognosis of ARDS. ROC curve analysis showed that the S100A12 level had a certain predictive value for ARDS and could be used as a prognostic indicator. Conclusions The level of S100A12 in peripheral blood of ARDS patients is significantly increased and is closely related to the severity of ARDS. It has a potential clinical value for early diagnosis, treatment and prognosis of ARDS.
Objective To analyze different characteristics of extra-vascular lung water ( EVLW) in the patients with acute respiratory distress syndrome( ARDS) , and examine its prognostic value. Methods 23 patients with ARDS admitted between November 2010 and December 2011 were divided into a survival group( n=13) and a dead group( n =10) according to the outcome. The hemodynamic status including extravascular lung water index( EVLWI) was measured in 3 consecutive days, and the relationship between EVLWI and the prognosis of patients was analyzed. Results On the first day of diagnosis, the EVLWI was higher in both groups in comparison with normal value. It was ( 13. 9 ±3. 45) mL/kg in the survival group and ( 14. 87 ±5. 75) mL/kg in the dead group( P gt;0. 05) . However, on the second day, the EVLWI in the survival group dropped significantly after intensive intervention, but the patients in the dead group did not respond well to the treatment and the EVLWI declined slightly. The EVLWI of both groups began to diverge significantly fromeach other, showing average value of ( 11. 07 ±2. 51) mL/kg and ( 15.63 ±5. 05) mL/kg, respectively( P lt; 0. 05) . On the third day, this difference between two groups was still more remarkable, resulting in ( 10.32 ±1.57) mL/kg vs. ( 16. 6 ±4. 33) mL/kg( P lt; 0. 01) . Conclusions The changes of EVLWI can be used to evaluate the effectiveness of treatment and predict the prognosis of patients with ARDS. EVLWI would likely be an indicator to evaluate the pulmonary capillary leakage.