Objective To explore the effects on self-efficacy and health behavior change in elderly patients with chronic diseases in community by motivational interviewing and to provide the basis for the health behavior management of elderly patients with chronic diseases in community.Methods The study was based on a cross-section investigation by random cluster sampling which included a sample of 287 elderly patients.The questionnaire was localized good life club questionnaire of Australia,including demographic data,prevalence of chronic diseases,health-related indicators,self-health assessment,psychological pressure measurement,life satisfaction scale and assessment of behavior change stage.A total of 265 valid questionnaires were effective,and the effective rate was 92.3％.Results The scores of self-reported symptoms and life satisfaction of patients with chronic diseases after motivational interviewing were significantly higher than before (F=8.527,7.697; P＜0.05),the scores of stress scale and behavior change stages were significantly lower than before (F=229.483,91.613; P＜0.01).The score differences with health self-assessment,functional status and social function evaluation were not statistically significant(F=0.222,2.084,P＞0.05).The number of patients who believed their health are better rose from 102 to 114,the number of patients whose life satisfaction were moderate and above rose from 255 to 265,and the number of high risk of psychological stress reduced from 5 to 1.In the stages of behavior change,the number of people in the action stage rose from 1 to 20,and the number of people in the preparation stage rose from 138 to 215 after the intervention.Conclusion Motivational interviewing can strengthen the self-efficacy in elderly patients with chronic diseases in community significantly and promote healthy behavior change.It is necessary to provide ongoing support for motivational interviewing to consolidate its behavior change outcomes,because of the complexity of the development process of behavior change stages.

[Objective]To explore the effect of hip joint center on the stability of hip joint,the radiographic measurements were compared between preoperation and postoperation.[Method]A total of 155 hips from 120 patients with primary total hip replacement from resent years were studied,the hip joint center difference through radiographic measurements between preoperation and postoperation were compared.[Result]The coincident rate and the incoincident rate were 63.23%(group A,98 hips) and 36.77%(group B,57 hips) respectively.For loose,dislocation or low back pain,the rate of revision in group A and group B were 6.12% and 29.82% respectively.[Conclusion]The comeback of hip joint center was essential for stability of hip joint.

BACKGROUND: The main reason for the postoperative loosening of cemented prosthesis is interfacial debonding and bone cement internal damage. Most studies have suggested that both of them occur in the process of fatigue damage, however, little is reported on primary loading that results in the initial damage to the bone cement-stem interface and inside of bone cement. OBJECTIVE: To study the mechanical properties of bone cement-stem interface, and the effect of crack formation in bone cement on interfacial loosening. METHODS: The cement-titanium al oy handle implant components were prepared. The maximum adhesive force of bone cement-stem interface was measured using push-in experiment. The cement damage and crack in the process of bone cement-handle interfacial debonding were monitored online using acoustic emission tester. The non-destructive testing on the metal surface and the inner layer of bone cement cylinder was conducted using three-dimensional surface profiler, ultrasonic microscopy and X-ray detector. RESULTS AND CONCLUSION: The online monitoring results of debonding experiment and acoustic emission tester demonstrated that the initial damage of bone cement initiated in the primary loading of patients after operation, rather than at fatigue damage stage. Bone cement coffin caused cracks initiation mainly due to the combination effect of radial and axial stress. The bone cement-stem interfacial shear lag effect could not prevent the gradual extension of interface and inner coffin crack from top to bottom. The bone cement defects formed in solidification process was likely to affect the mechanical properties of the material, and eventual y induced the crystal face and macromolecular chain fractures, forming silver striated cracks and leading component failure.

Objective To examine the single nucleotide polymorphism(SNP) of apurinic/apyrimidinic endonuclease1 (APE1) in primary small cell carcinoma of esophagus(PSEC) ,then investigate the relationship between these SNPs and the prognosis.Methods Sixty cases first-treated patients with PSEC were recruited, patients with esophageal squamous cell carcinoma (ESCC) and healthy blood donors were recruited as positive and negative controls.APE1 (Asp148Glu) of the patients with PSEC and controls were genotyped by the TaqMan method.Every patient was treated with platinum-based chemotherapy(EP regimen for PSEC and TP regimen for ESCC)and radiotherapy(3D-CRT) ,then every case was followed-up for 2 years.The relationship between these SNPs and the follow-up outcome was analyzed.Results Compared with the ESCC group and control group, APE1 148 pure mutant(Glu/Glu) of PSEC group increased significantly(PSEC group was 40％ (12/30), ESCC group was 13.3％ (4/30) , control group was 10％ (2/20)), the difference was statistically significant (x2 =7.248,P =0.027).According to data of following-up, there was a significant increase in rate of progress (1year:40.0％ (12/30) vs 16.7％ (5/30), x2 =4.022, P =0.045;2 years: 86.7％ (26/30) vs 40.0％ (12/30) ,P =0.004) and a significant decrease in survival (33.3％ (10/30) vs 76.7％ (23/30)) of PSEC compared with ESCC.The SNPs of APE1 Asp148Glu was significantly correlated with frequency of progress, a significant increase was found in rate of progress of the patients with mutant type(Asp/Glu±Glu/Glu) compared with wild genotype(1 year: 50.0％(11/22) ,x2 =3.854,P=0.05;2 years: 81.8％ (19/22) ,x2 =10.519,P =0.001) ,the survival of the patients with mutant genotype was significantly lower than wild type (22.7％ (5/22) ,x2=10.77,P=0.001).Conclusion The most of polymorphisms of APE1(Asp148Glu) are mutation type in PSEC.Pure mutant genotype (APE1 148Glu/Glu) carry significant enhancement of progression.The polymorphisms of APE1 (Asp148Glu) maybe one of those molecular mechanisms of high frequency of progress and poor prognosis in PSEC.

Objective: To observe the behavior therapy efficacy in dental fear patients for dental extraction using video eyewear and N_2O inhalation. Methods: 100 patients were divided into two groups, one group only used N_2O and other group used N_2O with video eyewear. Compared two groups′ Frankl behavior rating scale and Houpt scale after dental extraction. The HR and SpO_2 were measured during dental extraction. Results: Using video eyewear and N_2O showed a significant good sedative effect on patients with dental fear. There were statistical difference in the Frankl behavior rating scale and Houpt scale between experiment group and control group(P<0.01). There were no significant changes in heat rate and SpO_2 before and after in two groups. Conclusion: Video eyewear and N_2O inhalation sedation is good for dental fear patient during dental extraction.

Objective:To study the efficacy and safety of natural calcined bone repair material(NCBM)in repairing bone defect af-ter tooth extraction.Methods:A randemized,double-blinded,parallel,positive control(Bio-Oss)and multi-center clinical trial was employed.Imaging examination was used as the main efficacy evaluation index,surgical wound healing,rejection reaction,bone me-tabolic changes,bone infection signs were the subordinate efficacy evaluation indexes,the incidence of adverse reactions was observed for safety evaluation.Results:280 cases were included,269 cases completed the trial.In NCBMand Bio-Oss group the effective rate of imaging examination was 93.08% and 93.70%(P >0.05)respectively.The wound healing time of the 2 groups was less than 7 days,no rejection reaction,bone metabolic change and bone infection sign were observed.The incidence of adverse events in NCBM and the Bio-Oss group was 0.72% and 2.14%(P >0.05)respectively.Conclusion:The efficacy and safety between natural cal-cined bone repair material is not inferior to Bio-Oss in repairing bone defect after tooth extraction.

Objective:To compare the outcomes of guide bone regeneration by calcined bovine bone and Bio-Oss graft material in alveolar ridge preservation after tooth extraction.Methods:280 patients were divided into two groups randomly.Each patient had single tooth extracted.The sockets were filled with calcined bovine bone in 140 patients and Bio-Oss graft in another 140 patients. After shaping,all the sockets were covered with Bio-Gide membrane.Buccal mucoperiosteal flap was released and sutured to close the alveolar sockets.The patients were regularly examined at the 1st,12th and 24th week after surgery.Physical examination and X-ray evaluation were applied to compare the outcomes of the two materials in alveolar ridge preservation.Results:No infection and re-jection occurred.The radiographic results showed the width and height of the alveolar bone were preserved well at the 12th and 24th weeks.No statistically difference was found in the two groups at the 1st and 24th weeks(P>0.05).Conclusion:The two graft ma-terials can effectively preserve alveolar bone after tooth extraction.

ObjectiveTo explore the efficacy of several skin flaps in treating of the soft tissue defect with or without osteomyelitis at foot in cold environment. MethodsThe damaged foot should be re-warmed immediately. Several kinds of skin flaps were transplanted for 35 cases of soft tissue defect at foot in particularly, among them, 11 cases were with osteomyelitis and bone exposuring. ResultsThere were 31 cases survived by the first intention, 4 case presented partial necroses and healing by dress changing at the second intention. The appearance and function of damaged feet recovered well.ConclusionImmediate re-warming and skin flaps transplant can repair the acute or old soft tissue defect with osteomyelitis in cold environment.

BACKGROUND:Artificial intelligence planning system can automatically establish a three-dimensional model and generate planning schemes,but its accuracy in predicting the prosthesis size has not been fully verified. OBJECTIVE:To investigate the accuracy of artificial intelligence planning system in predicting prosthesis size before total hip arthroplasty and its influence on clinical prognosis,and further analyze the risk factors affecting the accuracy of planning. METHODS:Clinical data of patients with unilateral initial total hip arthroplasty who were admitted to the Department of Orthopedics of Affiliated Hospital of Xuzhou Medical University from January 2021 to June 2022 were prospectively collected.The patients were randomly divided into the artificial intelligence planning system group(n=80)and the conventional template group(n=79).Intraoperative use of prostheses and preoperative planning of prosthesis matching were compared between the two groups.Postoperative follow-up Harris scores and the occurrence of complications such as leg length discrepancy,dislocation and prosthesis loosening were recorded in both groups.The effects of demographic indicators,preoperative diagnosis,and Dorr typing on the accuracy of femoral stem planning were explored using univariate and multivariate Logistic regression analyses. RESULTS AND CONCLUSION:(1)The prediction of the prosthesis size on the acetabular side and femoral side was 50%(40/80)and 55%(44/80)in the artificial intelligence planning system group,compared to 34%(27/79)and 37%(29/79)in the conventional template group,with statistically significant differences(P＜0.05).(2)The artificial intelligence planning system group had an accuracy rate within one size difference for the acetabular and femoral side prostheses of 91%(73/80)and 86%(69/80),compared to 82%(65/79)and 72%(58/79)in the conventional template group,with differences statistically different only on the femoral side(P＜0.05).(3)No dislocation or prosthesis loosening occurred in the two groups during postoperative follow-up.The difference in lower limb length between the artificial intelligence planning system and conventional template groups was(3.56±2.32)mm and(3.52±2.41)mm.At the last follow-up,the Harris scores of the artificial intelligence planning system and conventional template groups were(92.74±3.08)and(91.81±3.52),respectively;there was no significant difference in the above differences(P＞0.05).(4)Univariate analysis results showed that preoperative diagnosis as developmental dysplasia of the hip and osteonecrosis of the femoral head,and Dorr type B and C femurs had a significant effect on the accuracy of predicted prosthesis size using an artificial intelligence planning system(P＜0.05).(5)Multivariate logistic regression analysis showed that preoperative diagnosis of developmental dysplasia of the hip(OR=18.233,95%CI:2.662-124.888)was an independent risk factor for the prediction of femoral stem size by artificial intelligence planning system.(6)The artificial intelligence planning system has a higher accuracy in predicting prosthetic size than traditional two-dimensional templates,and there is not a significant difference in the risk of postoperative complications or joint function.The accuracy of the artificial intelligence planning system in patients with developmental dysplasia of the hip was low due to anatomical deformities and acetabular anatomical position reconstruction.

ObjectiveTo investigate the trends and significant determinants of delayed HIV diagnosis （DHD） among newly reported HIV/AIDS cases in Xuhui District， Shanghai between 2018 and 2022. MethodsIn the newly reported HIV/AIDS cases， patients died within one year without accident， HIV/AIDS cases with CD₄ cell count <200 cells·μL^-1， and AIDS cases with a CD₄ cell count between 200 to 499 cells·μL^-1 were defined as delayed diagnosis. Univariate and multivariate logistic analysis were employed to explore the influencing factors of DHD. ResultsAmong the 862 newly reported HIV/AIDS cases， The DHD rate was 39.79% without statistically significant difference by year（χ²=4.508， P=0.342）. Patients with CD₄ cell count <200 cells·μL^-1 contributed the largest proportion of DHD. During 2018‒2022， the DHD rate declined among HIV/AIDS patients who were younger than 35 years old or 45‒65 years old， never married， original diagnosis from tertiary specialized hospitals. Patients who were 65 years or older， married or divorced， with heterosexual transmitted HIV/AIDS， and original diagnosis from other types of testing and tertiary metropolitan hospital， had sustainably higher DHD rates. The number of HIV screening and diagnosed from voluntary counseling and testing （VCT） decreased during the COVID-19 epidemic， while the DHD rate increased sharply. Multivariate logistic regression analysis suggested the DHD rates were higher among older age， other types of testing（OR=3.805， 95%CI： 2.260‒6.406）and pre-operative testing（OR=2.411， 95%CI： 1.424‒4.081）. Patients who received CD₄ test in 15 days had a higher DHD rate compared to the cases received CD₄ test exceeding 90 days （OR=0.336， 95%CI： 0.216‒0.522）. ConclusionThere is no significant decrease of delayed HIV diagnosis rate in Xuhui District in recent years， and the number of HIV tests has decreased in 2022. Monitoring of newly reported HIV/AIDS should be conducted continuously. Expansion of HIV antibody screening should be conducted in non-infectious departments and inpatient departments in healthcare institutions， particularly metropolitan hospitals. Assistance should be provided to clinicians and elderly patients for improving their ability to recognize and perceive the risk of HIV/AIDS， in order to enhance early diagnosis and subsequent treatment.