[Objective] To investigate the causes of failures of long bone fractures with internal fixations and to study the treatments and effects of reoperations of long bone fractures with inter-locking intramedullary nail and limited open reduction.[Method]Twenty-four patients of failures of long bone fractures with internal fixations were retreated with inter-locking intramedullary nail and limited open reduction.There were 15 cases of femoral fracture,7 cases of tibial fracture and 2 cases of humerus shaft fracture.Of the femoral fracture,there were 14 cases of fractures of shafts of femurs and 1 case of supracondylar fracture of femur;11 male,4 female;7 left cases,8 right cases;1 case complicated with bending of bone plate and screw,6 cases with breakages of plate;1 case with bending of common intramedullary nail,2 cases with breakages of common intramedullary nails,1 case of screw and wire lock fixation complicated with pseudoarticulation formation,4 cases with nonunion of fracture.Of the cases of tibial shaft fracture,there were 6 male,l female;3 left cases,4 righe cases;3 cases complicated with breakages of bone plate and screw,1 case with failure of external fixator,3 cases with nonunion of fracture.Of the cases of humerus shaft fracture,there were 2 cases of male and left ones;1 case complicated with breakage of bone plate and screw,1 case with breakage of common intramedullary nail.The ages of patients ranged from 18 to 68 years old with mean ages 43.7 years old.All fixation failure cases were retreated with inter-locking intramedullary nails and limited open reductions with autogenous iliac bone grafts or bone allografts.[Result]The average follow-up time was 25 months(12～35 months).All cases were cured with bone unions.Complications with submerge,breakages and bending of intramedullary nails did not occur.In the reoperating cases of femoral and filial fractures,the knee function were excellent in 18 cases,good 2 cases,fair 1 case and poor 1 case according to Karlstrom scale.Among the reoperating cases of humeral fractures,there were 1 case excellent and 1 good of shoulder function according to HAN score.[Conclusion]Reoperations with inter-locking intramedullary nail and limited open reduction are effective methods for treatment of internal fixation failure of long bone fracture.

Objective To analyze cancer incidence and mortality in Fujian in 2012 and to provide sci-entific basis for tumor prevention .Methods In accordance with the methods and criteria of data quality control made by NCCR,7 regristries data qualified from 9 submitted regritries in Fujian after data assessment were mer-ged and analyzed.Results In 2012,the cancer incidence rate was 251.44/105 (308.44/105 in male and 193.03/105 in female),age standardized incidence by Chinese standard population (ASR China)and by world standard population(ASR world)were 205.15/105 and 201.11/105.The cumulative incidence(0~74 age)was 23.51%.The mortality rate was 161.85/105(220.87/105 in male and 101.37/105 in female).ASR China and ASR world were 128.54/105 and 127.70/105 the cumulative incidence(0~74 age)was 15.04%.The age-spe-cific incidence and mortality reached maximum value in 75 ages and 80 ages respectively .The top 5 cancer inci-dences were lung cancer ,stomach cancer ,liver cancer ,esophagus cancer and breast cancer .The top 5 cancer mor-tality were lung cancer ,liver cancer ,stomach cancer ,esophagus cancer and colorectum cancer .Conclusion Di-gestive malignancies ,lung cancer ,and breast cancer in female were the most frequent in Fujian province ,and the prevention and control for those cancers should be enhanced .

Objective:To explore the effects of different health education methods on patients with enterostomy using a network Meta-analysis, so as to provide a theoretical basis for patients with enterostomy to choose the health education method.Methods:Randomized controlled trials (RCTs) on the effects of different health education methods in patients with enterostomy were electronically searched in PubMed, Web of Science, Embase, Cochrane Library, Medline, CINAHL, China National Knowledge Infrastructure, China Biology Medicine disc, VIP, and WanFang Data, supplemented by other manual search methods. The search period was from database establishment to May 31, 2023. This study extracted data, conducted methodological quality evaluation, and used Stata 15.0 software for network Meta-analysis.Results:A total of 30 RCTs were included, involving 7 health education methods. The probability ranking of the network Meta-analysis showed that in terms of enhancing self-care ability, the effects were ranked from high to low as personalized education, internet platform education, nursing pathway education, visual education, mind mapping education, peer support education, and routine health education. In terms of promoting the level of stoma adaptation, the order of effects from high to low was visual education, internet platform education, peer support education, and routine health education. In terms of improving quality of life, the order of effects from high to low was internet platform education, personalized education, peer support education, and routine health education.Conclusions:Personalized education has certain advantages in enhancing the self-care ability of patients with enterostomy, visual education is advantageous in promoting the social adaptation of patients, and internet platform education has certain advantages in improving the quality of life. This study can effectively guide clinical nurses to choose appropriate health education methods based on the purpose of health education, in order to heighten the effectiveness of patient health education.

Objective:To explore the status and influencing factors of positive feelings of caregivers of patients with enterostomy, so as to provide a reference for targeted interventions.Methods:From May to October 2021, convenience sampling was used to select 130 caregivers of patients with enterostomy who received follow-up visits in the Stoma Clinic of the First Affiliated Hospital of Xi'an Jiaotong University as the research subject. The survey was carried out using the General Information Questionnaire, the Positive Aspects of Caregiving (PAC) , and the Care Preparedness Scale (CPS) . A total of 130 questionnaires were distributed, and 127 valid questionnaires were recovered, with a valid recovery rate of 97.69%.Results:Among 127 caregivers of patients with enterostomy, the total score of PAC was (32.69±4.99) , and the self-affirmation dimension score was (18.39±2.84) , and the life outlook dimension score was (14.36±2.53) , and the total score of CPS was (17.76±4.36) . Multiple linear regression analysis showed that caregiver gender, education level, work status, and readiness were the influencing factors of positive feelings of caregivers of patients with enterostomy ( P<0.05) , which explained 43.7% of the total variance. Conclusions:The positive perception of caregivers of patients with enterostomy is at an upper-middle level. Nurses should formulate targeted humanistic care strategies according to the influencing factors, increase the positive feelings of caregivers, help patients adapt to the stoma as soon as possible, and then improve the quality of life of patients.

China ; epidemiology ; Humans ; Incidence ; Neoplasms ; epidemiology ; mortality ; Registries

Objective:To explore the pathogenesis of major depressive disorder(MDD) by comparing the serum glucose and lipid metabolism indicators, levels of glucagon-like peptide-1(GLP-1) in plasma and feces, and the content of specific intestinal flora ( Lactobacillus, Bifidobacterium) between patients with MDD who were diagnosed for the first time and healthy controls. Methods:Totally 80 MDD patients hospitalized from January 1, 2020 to March 30, 2021 and 80 healthy volunteers with normal physical examination in the same period were selected. Blood and fecal samples of patients with MDD and healthy controls were collected respectively. The indicators of serum glucose and lipid metabolism were detected by automatic biochemical analyzer, the concentrations of GLP-1 in plasma and feces were detected by ELISA, and the relative contents of Lactobacillus and Bifidobacterium in feces were detected by real-time PCR. The differences between two groups of glucose and lipid metabolism indicators, GLP-1 levels and the relative contents of Lactobacillus and Bifidobacterium in feces were analyzed. SPSS 22.0 software was used for statistical analysis. Independent sample t-test and analysis of variance were used for inter group comparison, and Pearson correlation analysis was used for correlation analysis. Results:Compared with the control group, the levels of serum TC, HDL, and LDL in the MDD group decreased ((3.99±0.85)mmol/L , (4.78±0.86)mmol/L; (1.18±0.29)mmol/L, (1.30±0.28)mmol/L; (2.64±0.70)mmol/L, (3.19±0.69)mmol/L; t=5.559, 2.371, 4.695, all P<0.05). The plasma and fecal GLP-1 levels of the MDD group were lower than those of the control group (plasma: (0.81±0.22)pmol/mL, (1.05±0.26)pmol/mL , t=4.509, P<0.01; feces: (2.23±0.46)pmol/mL , (2.47±0.37)pmol/mL, t=2.533, P<0.05). Compared with the control group, the relative contents of Lactobacillus(2.56±1.59, 3.51±2.21) and Bifidobacterium(2.24±1.89 , 3.17±2.08) in the MDD group decreased ( t=2.218, 2.082, both P<0.05). The level of plasma GLP-1 in the MDD group was negatively correlated with FPG, TG, and disease severity ( r=-0.281, -0.221, -0.437, P<0.05). The level of plasma GLP-1 in the control group was negatively correlated with FPG ( r=-0.580, P<0.01). The fecal GLP-1 level of the MDD group was negatively correlated with the severity of the disease ( r=-0.298, P<0.01), and the fecal GLP-1 level of the control group was positively correlated with fecal Lactobacillus and Bifidobacterium ( r=0.685, 0.428, P<0.01). Conclusion:MDD patients have abnormal glucose and lipid metabolism, decreased GLP-1 level and decreased relative content of intestinal Lactobacillus and Bifidobacterium. Changes in intestinal flora affect GLP-1 levels. GLP-1 can affect glucose and lipid metabolism and depressive symptoms in patients with MDD by binding to specific receptors in intestinal tract and central nervous system.

Objective To study the factors affecting hospital death in elderly patients with novel coronavirus infec-tion/disease 2019(COVID-19),and to build a risk prediction model.Methods According to the diagnostic criteria of Diagnosis and Treatment Protocol for COVID-19 Infection(Trial 10th Edition).Totally 775 elderly patients(≥60 years old)diagnosed as COVID-19 infection in the emergency department and fever clinic of the First Hospital of Changsha were selected as the research objects.General data and serum biomarkers of patients were collected.After treatment,the patients'data were divided into survival group and hospital death group.Binary Logistic regres-sion was used to screen the independent influencing factors of death,and ROC curve was used to analyze the pre-dictive value of related indicators on hospital death.Results After treatment,712 patients(91.9%)survived and 63 patients(8.3%)died in hospital.Binary Logistic regression analysis showed that:≥90 years old[OR=5.065,95%CI(1.427,17.974)],type 2 diabetes mellitus[OR= 3.757,95%CI(1.649,8.559)],COPD[OR= 5.625,95%CI(2.357,13.421)],monocyte ratio[OR=0.908,95%CI(0.857,0.963)],plasma fibringen[OR=1.376,95%CI(1.053,1.800)]and lactate dehydrogenase[OR=1.005,95%CI(1.001,o1.008)]were independent factors of in-hospital death(P＜0.05).The predictive value of diabetes mellitus+COPD+age+monocyte ratio+plasma fibrinogen+lactate dehydrogenase was proved in hospital death from COVID-19 infected patients:the area under the curve(AUC)was 0.883(95%CI:0.827,0.940,P＜0.001),the critical value≥0.710 suggested the risk of death in hospital,the specificity was 0.851,the sensitivity was 0.857.Conclusions The hospital mortality of the elderly after COVID-19 infection is higher and closely related to type 2 diabetes,COPD,monocyte ratio,plasma fibrinogen and lactate dehydrogenase.

In order to understand the status quo of ethical review of clinical research on the defecation function of patients with rectal cancer after sphincter-preserving surgery, analyze its causes and put forward corresponding suggestions, to arouse researchers’ attention to ethical review in subsequent relevant clinical studies. The ethical review of literatures related to the defecation function of patients with rectal cancer after sphincter-preserving surgery published on CNKI in recent 10 years was sorted out and summarized. The results showed that the ethical review of clinical research papers on defecation function of patients with rectal cancer after sphincter-preserving surgery was not optimistic. We should strengthen the ethical training of researchers, improve the ethical awareness of researchers, strictly implement the ethical norms of paper publication, strengthen the ethical requirements of manuscript contracts, perfect the ethical review system, and pay attention to the examination and supervision of informed consent, so as to promote the construction of ethical examination and approval norms of clinical research documents.

In order to understand the status quo of ethical review of clinical research on the defecation function of patients with rectal cancer after sphincter-preserving surgery, analyze its causes and put forward corresponding suggestions, to arouse researchers’ attention to ethical review in subsequent relevant clinical studies. The ethical review of literatures related to the defecation function of patients with rectal cancer after sphincter-preserving surgery published on CNKI in recent 10 years was sorted out and summarized. The results showed that the ethical review of clinical research papers on defecation function of patients with rectal cancer after sphincter-preserving surgery was not optimistic. We should strengthen the ethical training of researchers, improve the ethical awareness of researchers, strictly implement the ethical norms of paper publication, strengthen the ethical requirements of manuscript contracts, perfect the ethical review system, and pay attention to the examination and supervision of informed consent, so as to promote the construction of ethical examination and approval norms of clinical research documents.

Objective:To investigate the clinical application of carbon nanoparticles mapping lymph nodes in curative resection for colorectal carcinoma.Methods:Patients diagnosed with colorectal cancer before operation and undergoing radical surgery with intact postoperative pathological data in the Sixth Affiliated Hospital, Sun Yat-sen University from March 2016 to March 2018 were included in this retrospective case-control study. Those who were diagnosed with ileus, recurrent carcinoma or underwent emergency operation were excluded. A total of 1421 cases were included, with 156 cases in the carbon nanoparticles mapping group and 1265 cases in the control group. Using 1∶3 case control matching based on gender, weight, TNM staging and neoadjuvant chemotherapy, 145 and 435 cases were finally recruited in the carbon nanoparticles mapping group and control group, respectively. Patients in the carbon nanoparticles mapping group underwent preoperative colonoscopy with carbon nanoparticles submucosal injection 2.4 (1.0 - 14.0) days before operation. Carbon nanoparticles of 0.25 ml was injected at 4 points (3, 6, 9 and 12 o'clock each) 0.5-1.0 cm around the tumor. The number of eliminated lymph node, number of positive lymph node and positive rate between the two groups were compared, and the number of eliminated lymph node in different subgroups of T stage, N stage, TNM stage and neoadjuvant chemotherapy was analyzed and compared.Results:After case control matching, total number of eliminated lymph nodes in the carbon nanoparticles mapping group was significantly higher than that in the control group (22.2±11.2 vs. 19.0±9.5, t=3.025, P=0.003). However, no statistically significant differences were found in the number of positive lymph node and lymph node positive rate between two groups (all P>0.05). Subgroup analysis showed that as compared to the control group, total number of eliminated lymph nodes in the carbon nanoparticles mapping group was significantly higher in T3 stage subgroup (median: 22 vs. 18, Z=2.435, P=0.015), N0 stage subgroup (median: 20.5 vs. 17.5, Z=2.772, P=0.006), TNM II stage subgroup (median: 23.5 vs. 19.0, Z=2.654, P=0.008) and neoadjuvant chemotherapy (median: 22.5 vs. 13.0, Z=3.287, P=0.001), while compared to the control group, the number of positive lymph node (median: 4.0 vs. 6.5, Z=-2.530, P=0.011) and the lymph node metastasis degree (median: 16% vs. 31%, Z=-2.862, P=0.004) were lower in the carbon nanoparticles mapping group in N2 subgroup. Conclusion:Carbon nanoparticles mapping lymph nodes can effectively enhance the number of eliminated lymph nodes in curative resection for colorectal cancer.