Objective To compare the clinical outcomes between radial head replacement and radial head resection for patients with radial head fractures.Methods 26 radial head fracture patients with type Ⅱ and Ⅲ according to Mason classification were treated.14 cases were treated with radial head replacement,12 cases were treated with radial head resection.Results All the 26 patients were followed up for 16.5 months in average,the excellent and good rate was 71.4％ of the radial head replacement group,while the excellent and good rate was 50.0％ of the radial head resection group in elbow joint score.The difference was statistically signifcant between the two groups ( x2 =4.98,P ＜ 0.05 ).Conclusion Radial head replacement could achieve better stability of elbow joint than radial head resection.

Objective To evaluate the effectiveness and safety of tanreqing injection to children bronchial pneumonia.Methods PubMed,Ovid,CNKI,and data retrieval system of all places were searched to identify relevant studies from 2003 to November of 2014.The final documents were examined with inclusive and exclusive criteria.Results were pooled with meta-analysis on RevMan software to assess the efficacy of tanreqing injection to children bronchial pneumonia.Results The database was derived from 13 qualified studies that included a total of 1479 patients.Meta analysis showed that,compared to the control group,tanreqing injection treatment group resulted in higher effective rate [OR =2.96,95％ CI (2.22,3.96),P ＜0.01],shorter time of recovering the normal temperature [MD----0.53,95％ CI (-0.77,-0.29),P ＜ 0.01],shorter time of disappearance of cough [MD =-1.25,95％ CI (-2.14,-0.37),P ＜0.01],shorter time of lungrale [MD=-1.00,95％ CI(-1.4,-0.6),P ＜0.01],and shorter time of hospitalization time [MD =-1.35,95％ CI (-1.83,-0.86),P ＜ 0.01].Significant difference was observed between control and treatment groups.Conclusions This study showed that tanreqing injection appeared to be more effective for children bronchial pneumonia.However,methodology showed low quality.The efficacy needs high-quality clinical trials to verify.

Objective To investigate the efficacy and safety of the minimally invasive percutaneous surgery in the treatment of thoracolumbar fracture combined with posterior ligament injury.Methods The 94 cases of thoracolumbar fracture combined with posterior ligament injury who were admitted into our hospital from Septenber 2012 to January 2016 were selected and equally divided into the observation group and the control group(47 cases in each group) according to different methods.Patients of the observation group were treated with short segment of minimally invasive percutaneous surgery,while patients of the control group were underwent single segment of minimally invasive percutaneous surgery.Recorded the outcomes and prognosis of the two groups.Results There was no significant difference in the operation time and blood loss between the two groups(P ＞ 0.05).The postoperative volume of drainage and the length of stay in the observation group were significantly shorter than those in the control group(P ＜ 0.05).The JOA score of the observation group 1 month after operation was significantly better than that of the control group(P ＜ 0.05).The incidence of complications including pedicle screw breakage,pedicle screw loosening,incision infection,and pulmonary infection in the observation group was 4.3％,which was significantly less than 21.3％ in control group (P ＜ 0.05).The Cobb's angle of the obervation group and control group 1 month after operation were (8.55 ± 1.34) ° and (16.30 ± 2.33) ° respectively,which were significantly lower than (32.19 ± 1.98) ° and (32.08 ± 2.08) ° before operation (P ＜ 0.05).And the Cobb's angle 1 month after operation in the observation group were significantly lower than that of the control group(P ＜ 0.05).Conclusion The short segment of minimally invasive percutaneous surgery for the treatment of thoracolumbar fracture combined with posterior ligament injury can reduce the incidence of postoperative complications,promote the patient's rehabilitation,correct the kyphosis and promote the recovery of neural function,which was safer and more efficient.

Objective The effects of candesartan,an angiotensin Ⅱ type 1 receptor blocker (ARB) were investigated on advanced glycation end-products accumulation and the receptor for AGE (RAGE) expression in type 2 diabetic KK/Ta mouse kidneys.MethodsKK/Ta mice(n=72)were random divided into three groups(n=24) and it was treated with candesartan [4 mg/(kg·d)] or vehicle from 6 or 12 to 28 weeks of age.BALB/c mice(n=24) treated with vehicle were used as controls.Body weight,blood pressure,blood glucose,urinary microalbumin,urinary creatinine and serum creatinine were measured every four weeks.At 28 weeks,renal expressions of carboxymethyllysine and RAGE were evaluated by immunohistochemistry and/or competitive RT-PCR.Results KK/Ta mice developed high body weight,high blood glucose,and high urinary microalbumin/creatinine ratio in KK/Ta mice at 28 weeks of age,and it was significantly higher than that of BALB/c mice [(427.49±89.37)mg/g vs (9.54±3.25)mg/g,P＜0.01 ].Protein and mRNA expressions of RAGE were upregulated in KK/Ta kidneys with increased immunostaining intensities of carboxymethyllysine.Candesartan treatment has markedly reduced urinary microalbumin/creatinine ratio [Early treatment group (32.18±9.41)mg/g,Late treatment group (53.20±7.26)mg/g,P＜0.01 ].Treatment with candesartan down-regulated the protein and mRNA expressions of RAGE and reduced the accumulation of carboxymethyllysine.There were no significant differences between the two treatment groups (from 6 or 12 weeks).ConclusionsThe results suggest that candesartan,an ARB,reduces advanced glycation end-products accumulation and subsequent albuminuria by down-regulating RAGE expression in type 2 diabetic KK/Ta mouse kidneys.

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Objective To analyse the risk factors of medical complications after hip fracture surgery.Methods Clinical data of 327 hip fracture patients undergoing surgical treatment in Beijing Haidian Hospital from January 2009 to December 2013 were retrospectively studied.There were 114 males and 213 females with a mean age of (75.1 ±15.6) years, 129 patients(39.4%) had femoral neck fractures, and 198 patients ( 60.6%) had intertrochanteric fractures.Fifty four patients had medical complications during hospitalization ( complication group) and 273 patients did not have complications ( non-complications group ) . The clinical features, presurgical comorbidities and operative parameters were documented and compared between two groups.The risk factors of medical complications were assessed by regression analysis.Results Univariate analysis showed that age ( t =2.85, P=0.007), lying in bed before fracture(χ2 =12.86,P =0.000), the history of chronic obstructive pulmonary diseases(COPD) (χ2 =9.45, P=0.000), coronary heart disease(χ2 =10.67,P=0.000), heart failure(χ2 =15.85,P=0.000), diabetes (χ2 =3.22,P=0.024), cerebrovascular disease(χ2 =4.21,P=0.008), anesthesia method(χ2 =8.67,P=0.018), American Society of Anesthesiologists(ASA) score ≥3 level(χ2 =2.01, P=0.042) and the delay time of operation (t=4.24, P=0.037) were significantly different between two groups.Multivariate regression analysis revealed that age(β=0.030, OR=1.030), lying in bed before fracture (β=2.303, OR=10.716), the history of COPD (β=0.831, OR =1.995), coronary heart disease(β=0.858, OR=2.392), heart failure(β=1.971, OR=7.333)and ASA score ≥3 level(β=0.809,OR=2.583) were the independent risk factors of medical complications after hip fracture surgery. Conclusion Age, lying in bed before fracture, the history of COPD, coronary heart disease, heart failure and ASA score≥3 level would increase the risk of postoperative medical complications for patients with hip fracture.

Abstract: Objective To investigate the prevalence and influencing factors of depressive symptoms among primary and middle school students in Xihu District, Hangzhou City, so as to provide insights into depression control among primary and middle school students. Methods: Students were sampled from two primary schools, two junior high schools, two ordinary high schools and one vocational high school in Xihu District using a stratified cluster random sampling method from September to November, 2021. Participants' demographics, diet, exercise, sleep and campus bullying were collected using questionnaire surveys. The depressive symptoms were evaluated using the Chinese version of the Center for Epidemiologic Studies-Depression Scale (CES-D), and factors affecting the depressive symptoms were identified among primary and middle school students using a multivariable logistic regression model. Results: A total of 1 518 students were investigated, including 518 primary school students (34.12%), 363 junior high school students (23.91%), 463 ordinary high school students (30.50%) and 174 vocational high school students (11.46%). Of all participants, there were 805 males (53.03%). The prevalence of depressive symptoms was 38.87% among the participants, and was 36.10%, 42.42%, 42.33% and 30.46% among primary school, junior high school, ordinary high school and vocational high school students, respectively. The multivariable logistic regression analysis showed that gender (OR=1.601, 95%CI: 1.289-1.989), type of school (junior high school, OR=1.299, 95%CI: 0.974-1.734; ordinary high school, OR=1.351, 95%CI: 1.025-1.780; vocational high school, OR=0.862, 95%CI: 0.585-1.272), frequency of fresh vegetable intake (less than once daily, OR=0.454, 95%CI: 0.304-0.679; once and more daily, OR=0.359, 95%CI: 0.235-0.548), duration spent on the internet (0.5 to 1 h daily, OR=1.447, 95%CI: 1.044-2.006; 1 h and longer daily, OR=1.456, 95%CI: 1.072-1.978), sufficient sleep (OR=0.525, 95%CI: 0.371-0.744), suffering from campus bullying (OR=1.992, 95%CI: 1.491-2.661) were associated with the development of depressive symptoms. Conclusions The prevalence of depressive symptoms is high among primary and middle school students in Xihu District. Gender, type of school, dietary behaviors, sleep duration and campus bullying are factors affecting the development of depressive symptoms.

Objective To identify susceptible miRNAs for the pathogenesis of diabetic nephropathy (DN) and the molecular targets of losartan treatment. Methods The 8-week age KKAy mice were divided into losartan treatment group (10 mg· kg-1· d-1) and non-treatment group,C57BL/6 mice were used as the control group.At age of 20 weeks,body weight,random blood glucose,urinary albumin and urinary creatinine were tested,and kidney morphology was observed.Glomeroli were separated by magnetic beads perfusion,and total RNA were extracted.MiRNAs expression profiles were analyzed by the Affymetrix GeneChip miRNAs arrays. Results At age of 20 weeks,KKAy mice developed higher body weight,higher blood glucose and higher urinary microalbumin creatinine ratio than C57BL/6 mice,and the glomerular basement membrane thickened,mesangial matrix widened.Losartan treatment markedly improved the level of urinary albumin creatinine ratio [(539.71±100.23) mg/g vs (728±177.19) mg/g,P＜0.05)] and pathological lesion of KKAy mice.The miRNA array analysis showed that there were 22 miRNAs differentially expressed between KKAy non-treatment mice and C57BL/6 mice glomeruli at age of 20 weeks.Among them,10 miRNAs were up-regulated,and 12 miRNAs were down-regulated.The expression of 4 miRNAs was down-regulated in glumeruli of KKAy mice treated by losartan compared with that of non-treatment mice.The expressions of miRNA-503 and miRNA-181d were significantly up-regulated in the glumeruli of KKAy mice and inhibited by losartan treatment, Conclusion The expressions of miRNA-503 and miRNA-181d are significantly up-regulated in the glumeruli of KKAy mice and inhibited by losartan treatment,which may be new therapeutic targets of DN.

Objective:To explore the application value of X-ray tomographic fusion technique in assessing bone healing and osteotylus growth after femoral neck system(FNS)internal fixation of femoral neck fracture.Methods:A total of 18 patients with femoral neck fracture who admitted to the Department of Orthopedics of Beijing Haidian Hospital from October 2019 to June 2020 were selected.All of them were treated with FNS internal fixation,and conventional X-ray and X-ray tomographic fusion imaging were performed respectively at 1 month and 12 months after operation for them.The displays of the two imaging techniques for the bone healing and osteotylus growth after FNS internal fixation of femoral neck fracture were evaluated,and the relevant parameters of the two imaging techniques for the process of image detection of FNS internal fixation of femoral neck fracture were counted by statistical method.Results:The detection rate of X-ray tomographic fusion technique for osteotylus at 1 month after surgery was significantly lower than that at 12 months after surgery.The detection rates(94.44% and 61.11%)of X-ray tomographic fusion technique for osteotylus at 1 month and 12 months after surgery were significantly higher than those(61.11% and 33.33%)of X-ray(x2=5.100,5.790,P<0.05),respectively.The rank-sum test indicated there were significant differences in the distribution of the scores of the image qualities of osteotylus growths at 1 month and 12 months after surgery for patients with femoral neck fracture between two imaging techniques(Z=2.113,2.018,P<0.05),and there were significant differences in the image qualities of bone healing at 1 month and 12 months after surgery between two imaging techniques(Z=2.868,2.258,P<0.05).The display effect of the detection image of fracture site before treatment under the guidance of X-ray tomographic fusion technique was ideal,which images were clear and could display more fully and clearly the fracture line of patient.After 12 months of surgery,the continuous osteotylus that passed fracture line could be found at the anterior lateral position of X-ray,which has reached to clinical healing.In the process of detecting image of FNS internal fixation of femoral neck fracture,the air Kerma,dose area product and effective dose of X-ray tomographic fusion technique were significantly lower than those of conventional X-ray imaging(t=5.900,2.466,32.255,P<0.05),respectively.Conclusion:In the diagnosis and evaluation of bone healing of patients with FNS internal fixation after femoral neck fracture,the use of X-ray tomographic fusion technique can better detect the osteotylus growth of patients and judge the degree of bone healing,especially the judgment effect of that for the postoperative recovery with longer time of patients is more better.In addition,this technique has better safety,which would cause less radiation damage in the process of detection.

Objective:To analyze the risk factors of intracranial hemorrhage after implanting 125-iodine seeds for brain tumors.Methods:A total of 234 patients with intracranial tumors receiving treatment of 125-iodine seeds from March, 2013 to November, 2020 were retrospectively analyzed. Patients were divided into bleeding group and non-bleeding group according to whether postoperative intracranial hemorrhage was reported. Univariate and multivariate analysis was performed by logistic regression to determine the independent risk factors of intracranial hemorrhage.Result:A total of 22 cases (9.4%) reported postoperative intracranial hemorrhage in 234 patients treated with 125-iodine seeds. Univariate analysis showed that the type of tumor and the history of anti-angiogenic drug within one month were possible risk factors ( P<0.1). Multivariate logistic regression analysis showed that anti-angiogenic drug within one month was the independent risk factor for intracranial hemorrhage ( P<0.05). Conclusions:The application of anti-angiogenic drugs within one month is the independent risk factor of intracranial hemorrhage with 125-iodine seeds for the treatment of brain tumors.