Objective To investigate the effects of treatment of proximal humeral fracture in the elderly with anatomical plate internal fixation.Methods Twenty-seven cases of proximal humeral fractures received operative treatment with anatomical plate.According to Neer classification,there were 18 patients with three-part fractures of the bone,there were 9 patients with four-part fractures of the bone.Results Twenty-seven patients were followed up for 6-24 months.According to the evaluation of Herscovici scales,the result were excellent in 17 cases,and good in 8,92.6％ (25/27) of all reductions were excellent or good.The excellent and good rate of Constant-Murley score was 88.9％(24/27 ).Conclusion It is an ideal way to treat the displaced proximal humeral fracture with anatomical plate,which can provide rigid fixation,it allows early functional treating.

Aim To evaluate the effect of expression inhibition of spermine oxidase(SMO)on the actitumor activity of polyamine analogue CPENSpm (N~1-cyclopropylmethyl-N~(11)-ethylnorspermine).Methods siRNA technique was used to inhibit expression of SMO in human lung cancer line A549.QT-RT-PCR and enzyme activity assay was performed to determine the expression level of SMO.The cell proliferation was detected by MTT assay.The apoptosis of A549 cells were evaluated by DNA degradation and Sub-G_1/flow cytometry assay.Results The A549 cell line with silenced SMO expression was successfully obtained.Basic SMO mRNA and enzyme activity levels in the SMO-siRNA plasmid transfected cells were 0.53% and 14% lower than that in the control cells respectively. Treating A549 control cells by 10 μmol·L~(-1) CPENSpm for 24 hours resulted in a 10-folds up-regulation of SMO in mRNA level and 20-fold increase in enzyme activity,but this drug-induced SMO expression was obviously prevented in SMO-siRNA plasmid transfected cells.MTT assay demonstrated that SMO expression inhibition decreased the sensitivity of A549 cells to CPENSpm exposure(0～20 μmol·L~(-1)).DNA degradation and sub-G_1 assay proved a deceased ability of CPENSpm to induce apoptosis in SMO-siRNA plasmid transfected cells.Conclusion Up-regulation of SMO by CPENSpm is possibly one of the molecular basics for its antitumor activity.

Aim To investigate subcellular distribution and accumulation of ADR in the sensitive and multidrug-resistant HL-60 cells and its relation to multidrug resistance.Methods The subcellular distribution and accumulation of ADR were studied by confocal scanning laser microscope and flow cytometry.The effects of verapamil,BSO,brefeldin A and chloroquine on ADR distribution and accumulation in HL-60/ADR cells were also examined.Rhodamine123,NBD-ceramide and neutral red were used as fluorescent probes to stain the mitochondria,Golgi apparatus and lysosomes respectively were used to identify the subcellular compartments where ADR was sequestered.Results In drug-sensitive cell line HL-60,ADR fluorescence distributed evenly in the nucleus and cytoplasm,while in multidrug-resistant cell line HL-60/ADR,ADR fluorescence distributed in a punctated pattern in the cytoplasm and was reduced in the nucleus.The mode of ADR distribution in HL-60/ADR cells is highly similar to that of NBD-ceramide.BSO and brefeldin A,instead of verapamil and chloroquine could reverse the abnormal distribution and accumulation of ADR in HL-60/ADR cells.Conclusions The change of ADR distribution and reduction of ADR accumulation in multidrug-resistant cell line was involved in the mechanism of multidrug resistance.

Objective: To understand cognition and willingness of EV71 vaccination among parents of children, so as to provide scientific basis for vaccination. Methods: A cross-sectional survey (census) was adopted. A questionnaire survey was conducted among parents of 2 783 preschool children from 12 kindergartens to analyze the parents’ cognition towards EV71 vaccine and willingness of vaccination of EV71 vaccine. Results: Among the 2 783 parents surveyed, 1 843 heard of EV71 vaccine. The parents’ awareness rate of EV71 vaccine was 51.9%. The main source of EV71 vaccinerelated information was obtained through hospitals(n=887), followed by schools(n=752). 1 014 received EV71 vaccine. The main reason of EV71 vaccination was that vaccine was believed to be effective in preventing hand,foot and mouth disease(HFMD) (76.1%), while the main reason for unwillingness for vaccination was lack of knowledge(31.7%). And 2 478 considered that EV71 vaccine should be included in planned immunization. Multivariate Logistic regression analysis showed that children in public schools(OR=0.72, 95%CI=0.59-0.89), mothers from urban residents(OR=0.76, 95%CI=0.64-0.90), parents lack of EV71 vaccine awareness(OR=0.42,95%CI=0.35-0.49), and perceived high price of EV71 vaccine (OR=0.66, 95%CI=0.47-0.92) had a low vaccination rate. Higher EV71 vaccination rate was related to children’ status as baby class (OR=2.55,95%CI=1.18-5.52),bottom class (OR=2.24,95%CI=1.54-3.24) and middle class(OR=1.51, 95%CI=1.05-2.15)(P<0.05). Conclusion EV71 vaccination in preschool children in our jurisdiction was relatively high. School type, mother’s household registration, children’s grade and the parental percption of EV71 vaccine price are the main factors influencing EV71 vaccine vaccination in preschool children.

Purpose To explore the application of single index,double exponential and tensile density index model diffusion weighted imaging and other parameters on endometrial carcinoma diagnosis to offer new ideas for it.Materials and Methods Intravoxel incoherent motion imaging data of 28 endometrial carcinoma patients and 24 patients of normal endometrium were analyzed retrospectively.Single index,double exponential and DWI parameter of endometrial carcinoma tissue and normal endometrial tissue were measured respectively,including standard apparent diffusion coefficient (ADC-stand),slow apparent diffusion coefficient (ADC-slow),fast apparent diffusion coefficient (ADC-fast,perfusion fraction (f),distributed diffusion coefficient (DDC) and a.Receiver operator characteristic (ROC) curve was adopted to assess threshold value and diagnostic efficiency of each parameter,and analyzed difference among each parameter in two groups and relativity of each parameter in the same group.Results ADC-stand,ADC-slow,f,DDC and a in endometrial carcinoma group were all lower than those in normal endometrium group.The difference was statistically significant (P＜0.05).The difference of ADC-fast was not statistically significant (P＞0.05).Areas of ADC-stand and ADC-slow on ROC curve were 0.949 and 0.911 respectively,and threshold values were 1.245×10-3 mm2/s and 0.998× 10-3 mm2/s.ADC-stand in endometrial carcinoma group was positive correlated with ADC-slow and DDC value (r=0.787 and 0.880,P＜0.05).ADC-slow was significantly lower than ADC-stand (P＜0.05).Conclusion The differences in single index,double exponential and DWI can provide new ideas for endometrial carcinoma diagnosis.

Objective To evaluate the potential clinical value of T2 mapping and mDixon Quant in the diagnosis of early interver-tebral disc degeneration.Methods A total of 79 volunteers who underwent lumbar MRI examination were enrolled.All subjects were examined for 3.0T MR with T2WI,T2 mapping,and mDixon Quant while recording the condition of low back pain.The differ-ences between T2 mapping(map)value and fat fraction(FF)values of the vertebral(V)and nucleus pulposus(NP)within the Pfir-rmann Ⅰ and Pfirrmann Ⅱ intervertebral disc(grade Ⅰ 76,grade Ⅱ 87)were statistically analyzed.Receiver operating characteristic(ROC)curve analyses were performed for meaningful parameters.Results V-FF showed a mild positive correlation with degenera-tive intervertebral disc lesions,and NP-FF and NP-map values showed a mild negative correlation with lesions.There were statistically significant differences between the two groups in V-FF(P＜0.001),NP-FF(P=0.005),and NP-map(P＜0.001).Some measure-ments had statistically significant differences when different intervertebral disc segments were compared.Conclusion V-FF,NP-FF,and NP-map are associated with intervertebral disc degeneration.T2 mapping and mDixon Quant are potentially valuable as diagnostic tools to quantitatively assess early intervertebral disc degeneration and help diagnose.

Objective To investigate the change patterns of functional brain networks and their relations with cognitive function in patients with end-stage renal disease (ESRD).Methods Sixty-two patients with ESRD (ESRD group),admitted to our hospital from July 2018 to June 2019,and 36 age-,gender-,and education level-matched healthy controls (HC group) were enrolled.Mini-mental State Examination (MMSE),Montreal Cognitive Assessment (MoCA),Trail Making Test A (TMT-A),TMT-B and Symbol Digit Modalities Test (SDMT) were used to evaluate the cognitive function for all subjects.Resting-state functional magnetic resonance imaging data were acquired;after data preprocessing,the brain functional networks were constructed and the topological parameters were calculated.Statistical methods were used to compare the differences of cognitive function scores and topological parameters between the two groups,and to analyze the correlations between these topological parameters and cognitive function scores in the ESRD group.Results The MMSE,MoCA and SDMT scores of the ESRD group were significantly lower than those of the HC group (P＜0.05),and the ESRD group took significantly longer time to complete TMT-A and TMT-B than the HC group (P＜0.05).The ESRD group had significantly lower normalized clustering coefficient (γ),small-worldness (σ) and local efficiency (Elocal) values than the HC group (P＜0.05).Patients in the ESRD group exhibited significantly decreased nodal efficiency in the paralimbic-limbic network (including the bilateral insula,median cingulate and paracingulate gyri,hippocampus,parahippocampal gyrus,amygdala,temporal pole:superior temporal gyrus,and temporal pole:middle temporal gyrus),right heschl gyrus and left superior temporal gyrus,and exhibited significantly increased nodal efficiency in the visual network (including the right distal-shaped gyrus,bilateral wedge,and left superior and middle occipital gyrus) as compared with the HC group (P＜0.05).In the ESRD group,the area under the curve (AUC) ofγ and σ was positively correlated with MoCA scores (r=0.698,P=0.000;r=0.661,P=0.000),and the AUC of Elocal showed positive correlation with MMSE scores (r=0.407,P=0.003).Conclusion Abnormal topological organization of the functional brain networks is revealed in patients with ESRD,which affects the cognitive function of these patients.

Objective:Surgical site infection (SSI) can markedly prolong postoperative hospital stay, aggravate the burden on patients and society, even endanger the life of patients. This study aims to investigate the national incidence of SSI following abdominal surgery and to analyze the related risk factors in order to provide reference for the control and prevention of SSI following abdominal surgery.Methods:A multicenter cross-sectional study was conducted. Clinical data of all the adult patients undergoing abdominal surgery in 68 hospitals across the country from June 1 to 30, 2020 were collected, including demographic characteristics, clinical parameters during the perioperative period, and the results of microbial culture of infected incisions. The primary outcome was the incidence of SSI within postoperative 30 days, and the secondary outcomes were ICU stay, postoperative hospital stay, cost of hospitalization and the mortality within postoperative 30-day. Multivariable logistic regression was used to analyze risk factors of SSI after abdominal surgery.Results:A total of 5560 patients undergoing abdominal surgery were included, and 163 cases (2.9%) developed SSI after surgery, including 98 cases (60.1%) with organ/space infections, 19 cases (11.7%) with deep incisional infections, and 46 cases (28.2%) with superficial incisional infections. The results from microbial culture showed that Escherichia coli was the main pathogen of SSI. Multivariate analysis revealed hypertension (OR=1.792, 95% CI: 1.194-2.687, P=0.005), small intestine as surgical site (OR=6.911, 95% CI: 1.846-25.878, P=0.004), surgical duration (OR=1.002, 95% CI: 1.001-1.003, P<0.001), and surgical incision grade (contaminated incision: OR=3.212, 95% CI: 1.495-6.903, P=0.003; Infection incision: OR=11.562, 95%CI: 3.777-35.391, P<0.001) were risk factors for SSI, while laparoscopic or robotic surgery (OR=0.564, 95%CI: 0.376-0.846, P=0.006) and increased preoperative albumin level (OR=0.920, 95%CI: 0.888-0.952, P<0.001) were protective factors for SSI. In addition, as compared to non-SSI patients, the SSI patients had significantly higher rate of ICU stay [26.4% (43/163) vs. 9.5% (514/5397), χ 2=54.999, P<0.001] and mortality within postoperative 30-day [1.84% (3/163) vs.0.01% (5/5397), χ 2=33.642, P<0.001], longer ICU stay (median: 0 vs. 0, U=518 414, P<0.001), postoperative hospital stay (median: 17 days vs. 7 days, U=656 386, P<0.001), and total duration of hospitalization (median: 25 days vs. 12 days, U=648 129, P<0.001), and higher hospitalization costs (median: 71 000 yuan vs. 39 000 yuan, U=557 966, P<0.001). Conclusions:The incidence of SSI after abdominal surgery is 2.9%. In order to reduce the incidence of postoperative SSI, hypoproteinemia should be corrected before surgery, laparoscopic or robotic surgery should be selected when feasible, and the operating time should be minimized. More attentions should be paid and nursing should be strengthened for those patients with hypertension, small bowel surgery and seriously contaminated incision during the perioperative period.

Objective:Surgical site infection (SSI) can markedly prolong postoperative hospital stay, aggravate the burden on patients and society, even endanger the life of patients. This study aims to investigate the national incidence of SSI following abdominal surgery and to analyze the related risk factors in order to provide reference for the control and prevention of SSI following abdominal surgery.Methods:A multicenter cross-sectional study was conducted. Clinical data of all the adult patients undergoing abdominal surgery in 68 hospitals across the country from June 1 to 30, 2020 were collected, including demographic characteristics, clinical parameters during the perioperative period, and the results of microbial culture of infected incisions. The primary outcome was the incidence of SSI within postoperative 30 days, and the secondary outcomes were ICU stay, postoperative hospital stay, cost of hospitalization and the mortality within postoperative 30-day. Multivariable logistic regression was used to analyze risk factors of SSI after abdominal surgery.Results:A total of 5560 patients undergoing abdominal surgery were included, and 163 cases (2.9%) developed SSI after surgery, including 98 cases (60.1%) with organ/space infections, 19 cases (11.7%) with deep incisional infections, and 46 cases (28.2%) with superficial incisional infections. The results from microbial culture showed that Escherichia coli was the main pathogen of SSI. Multivariate analysis revealed hypertension (OR=1.792, 95% CI: 1.194-2.687, P=0.005), small intestine as surgical site (OR=6.911, 95% CI: 1.846-25.878, P=0.004), surgical duration (OR=1.002, 95% CI: 1.001-1.003, P<0.001), and surgical incision grade (contaminated incision: OR=3.212, 95% CI: 1.495-6.903, P=0.003; Infection incision: OR=11.562, 95%CI: 3.777-35.391, P<0.001) were risk factors for SSI, while laparoscopic or robotic surgery (OR=0.564, 95%CI: 0.376-0.846, P=0.006) and increased preoperative albumin level (OR=0.920, 95%CI: 0.888-0.952, P<0.001) were protective factors for SSI. In addition, as compared to non-SSI patients, the SSI patients had significantly higher rate of ICU stay [26.4% (43/163) vs. 9.5% (514/5397), χ 2=54.999, P<0.001] and mortality within postoperative 30-day [1.84% (3/163) vs.0.01% (5/5397), χ 2=33.642, P<0.001], longer ICU stay (median: 0 vs. 0, U=518 414, P<0.001), postoperative hospital stay (median: 17 days vs. 7 days, U=656 386, P<0.001), and total duration of hospitalization (median: 25 days vs. 12 days, U=648 129, P<0.001), and higher hospitalization costs (median: 71 000 yuan vs. 39 000 yuan, U=557 966, P<0.001). Conclusions:The incidence of SSI after abdominal surgery is 2.9%. In order to reduce the incidence of postoperative SSI, hypoproteinemia should be corrected before surgery, laparoscopic or robotic surgery should be selected when feasible, and the operating time should be minimized. More attentions should be paid and nursing should be strengthened for those patients with hypertension, small bowel surgery and seriously contaminated incision during the perioperative period.