Objective To investigate the application of color Doppler flow imaging(CDFI) in the diagnosis of acute appendicitis in infants and children.Methods Color Doppler flow imaging was performed in 53 pediatric cases of acute appendicitis diagnosed clinically.Among them,41 were confirmed with color Doppler.All cases underwent appendectomies and postoperative pathologic examinations were performed routinely in all patients.Clinical data were analyzed by statistic software.Results Statistic data showed the accuracy of color Doppler flow imaging and clinical experience in diagnosis of pediatric acute appendicitis were 92.7%,and 67.9% respectively.There was significant difference between them.Conclusion Noninvasive color Doppler flow imaging seems to be a useful tool in the diagnosis of appendicitis in infants and children.

Objective: To explore the impact of sleep education programs on freshman sleep time, knowledge, attitudes, behavior and daytime sleepiness, so as to provide a reference for further improving the sleep status of college students. Methods: By using the method of cluster sampling, freshmen were invited from a university in Beijing (288 at baseline, 187 at posttest and 108 at follow up for experimental group (EG); 207 at baseline and 105 at posttest for control group (CG). The sleep education content was embedded into other courses and implemented in a blending learning mode for EG, lasting 10 weeks, while the CG received no intervention. Both groups were assessed using questionnaires at both baseline and 2 weeks after the intervention, and reassessed at 9 months follow up after posttest for EG. Results: After intervention, compared with CG, the weekday and weekend bedtime in EG was 21 min and 17 min earlier than that in CG respectively ( t=-2.78, -2.15, P <0.05). The sleep duration at night on weekday in EG was 19 min longer than that in CG ( t=3.51, P<0.01). In EG, the phenomenon of going to bed with electronic products before sleep, no delay in falling asleep, sleep knowledge, sleep attitude, sleep habit and daytime sleepiness were significantly better than those in CG ( χ 2/t =9.15, 2.82, 5.71, 3.98, 2.41, -4.90, P <0.05). After intervention, comparing with that at baseline, the weekday and weekend bedtime in EG were significantly earlier by 11 min and 17 min respectively ( t=3.50, 3.67, P <0.01), the sleep duration at nights on weekdays and weekend increased by 13 min and 18 min, respectively ( t=-3.01, -3.67, P <0.05), and the daytime sleepiness, going to bed with electronic products before sleep, no delay in falling asleep, sleep knowledge, sleep attitude and sleep habit were significantly improved ( χ 2/t =4.64, 15.19, -2.08, -9.31, -3.28, -2.14, P<0.05). At the 9 months follow up after the posttest, the bedtime on working day was significantly advanced by 8 min ( t =2.00), the sleep duration at night on working day was prolonged by 9 min ( t =-2.15), and the phenomenon of going to bed with electronic products before sleep and sleep knowledge were still significantly improved( χ 2/t =21.50, -6.26)( P <0.05). Conclusion Sleep education programs embedded in other courses and implemented in a blending learning mode can improve students sleep knowledge, sleep attitude and some habits, and reduce daytime sleepiness.

Objective: To explore the relationship between daytime or nighttime screen time, sleep duration, bedtime, sleep quality and depressive symptoms, so as to provide reference for preventing depression symptoms in college students. Methods: A total of 1 259 college students in one university in Beijing were recruited by using a cluster random sampling method for online and offline questionnaire surveys in October 2022 and April to May 2023. The sleeping quality, depression symptoms and screen time of participants were measured with the Pittsburgh Sleep Quality Index(PSQI), Chinese Version of the Beck Depression Inventory-II (BDI-II-C) and Screen Time Questionnaire. Logistic ordered regression and multiple linear regression were used to analyze the correlation among screen time, sleep parameters and depressive symptoms. Results: The prevalence of depressive symptoms was 24.9 %. There was no significant correlation between daytime screen time and depressive symptoms for a week after controlling for night screen time in a week, gender and age ( OR= 1.00 , 95%CI=1.00-1.01, P >0.05). There was a significant correlation between night screen time and depressive symptoms for a week ( OR=1.05, 95%CI=1.03-1.06, P <0.01) after controlling for daytime screen time in a week, gender and age. However, after controlling for the weekday sleep duration, weekend bedtime, and sleep quality step by step, there was no significant correlation between the night screen time for a week and the depressive symptoms ( OR=1.01, 95%CI= 0.99 -1.02, P >0.05). After adjusting for gender and age, multiple linear regression analysis found that the duration of one week s night vision screen had statistical significance in predicting weekday sleep duration, weekend sleep time and sleep quality ( β=-0.29, 0.45, 0.26, P <0.05). There were positive correlation between the duration of sleep on study days, the duration of sleep on rest days, and the quality of sleep with depressive symptoms（ OR =1.27,1.39,1.45， P <0.01）. Conclusions Excessive night screen time has a greater impact on sleep problems and depressive symptoms. Reducing nighttime video and improving sleep habits are potential intervention goals for reducing depression symptoms in college students.

Objective To explore the relationship between metabolic syndrome(MS) and corrected QT(QTc) interval prolongation.Methods A total of 1 260 participants having electrocardiogram examinations,aged over 18 years old from June 2015 to June 2016 were included and divided into the MS group and non-MS group.QTc was calculated according to the Bazett formula.The Logistic regression model was established for exploring the association between MS and QTc.Results There were 63 cases of QTc interval prolongation in the MS group,however,40 cases in the non-MS group(P＜0.01).In the unadjusted model,MS was a risk factor of QTc interval prolongation[OR =6.36,95 ％ CI(2.34,8.67),P＜ 0.01].After further adjusting confounders,MS was still correlated with QTc interval prolongation[OR =4.11,95 ％ CI(2.09,7.13,P＜ 0.01].In the study of the relationship between the MS groups with QTc interval prolongation,after adjusting confoundingfactors,only abdominal obesity[OR=2.76,95％ CI(1.43,7.56),P＜0.01] and hypertriglyceridemia[OR=1.75,95％CI(1.22,4.31),P=0.013)] were closely correlated with QTc interval prolongation.Conclusion MS is an independent risk factor of QTc interval prolongation.It is especially important to strengthen the management of blood lipid and abdominal circumference.

Objective To investigate the diagnostic value of head-up tilt test (HUT) in cough syncope (CS).Methods Forty-seven outpatients or inpatients with CS and 79 patients with suspected vasovagal syncope(SVVS) due to syncope history in our hospital from January 2011 to May 2015 served as the observation group and control group respectively.HUT was performed in the two groups.The cough response during HUT,changes of systolic pressure and diastolic pressure caused by cough,HUT positive results and hemodynamic type were observed,Results In the observation group,4 cases(8.51％) were cough caused syncope,26 cases (55.32 ％) were presyncope and 17 cases (36.17 ％) had no symptoms,while 79 cases in the control group had no symptoms,the differences were statistically significant (P＜ 0.05).The total positive rate of cough response in the observation group was 63.83％,and the specificity was 100.00％.The systolic blood pressure had statistical difference between the two groups(.P＜0.05).The diastolic pressure had statistical difference between the cases of non-symptoms with the cases of syncope and cases of presyncope in the observation group (P＜0.05),but had no statistical difference compared with the cases of non-symptoms in the control group(P＞0.05).The heart rate(HR) had no statistical difference among various groups(P＞0.05).The HUT positive rate in the observation group was lower than that in the control group(P＜0.05).The hemodynamic type had no statistical difference between the two groups(P＞0.05).Conclusion Severe coughing during HUT may cause the blood pressure decrease,induces syncope or presyncope,can increase the diagnostic sensitivity of CS patients,which is very useful in the suspected diagnosis of CS patients,especially for CS patients with a unclear history.

Objective:To compare the post-operative outcomes between extended lateral approach and L-shaped lateral approach in surgical treatment of Sanders type III intra-articular calcaneal fractures.Methods:A retrospective case-control study was made on clinical data of 34 patients with fresh Sanders type III intra-articular calcaneal fractures hospitalized in Langfang Hospital of Traditional Chinese Medicine from October 2014 to October 2017. There were 33 males and 1 female, with the age of 18-56 years [(42.5±9.4)years]. All fractures were fresh. Seventeen patients were fixed by the extended lateral approach (extended approach group) and seventeen patients by L-shaped lateral approach (L-shaped approach group). Operation duration, intraoperative bleeding volume, length of hospital stay, one-stage wound healing rate and complication rate were observed. B?hler and Gissane angle were measured before operation, one week after operation and 12 months after operation. American Orthopedic Foot and Ankle Society (AOFAS) ankle-hindfoot scale was applied to evaluate function recovery.Results:There were no significant differences between groups in operative time and intraoperative bleeding volume ( P>0.05). There were significant differences between extended approach group and L-shaped approach group in length of hospital stay [(15.7±4.0)days vs.(22.4±9.6)days], one-stage wound healing rate [88%(15/17) vs. 47%(8/12)] and postoperative complication rate [12%(2/17) vs. 47%(8/17)] ( P<0.05). The B?hler and Gissane angles did not differ significantly between groups before operation and one week and 12 months after operation ( P>0.05). At postoperative 12 months, the B?hler and Gissane angles were improved from preoperative (8.2±6.0)°, (85.3±10.5)° to (23.9±6.1)° and (119.3±6.2)° respectively in extended approach group, and those from preoperative (9.4±3.9)°, (85.5±7.1)° to (25.8±3.7)° and (122.2±5.6)° respectively in L-shaped approach group (all P>0.05). At 12 months after operation, the AOFAS score was (86.9±7.5)points in extended approach group, with the excellent and good rate of 88%; and was (83.3±12.5)points in L-shaped approach group, with the excellent and good rate of 76% ( P>0.05). While the score of hindfoot joint activity in extended approach group was (5.8±0.7)points, significantly higher than (3.4±1.0)points in L-shaped approach group ( P<0.05). Conclusion:For Sanders III intraarticular calcaneal fractures, compared with L-shaped approach group, plate fixation via extended approach can promote fracture healing, shorten hospital stay, reduce incidence of complications and facilitate function recovery of subtalar joint.