Objective To investigate the circadian rhythm of peripheral blood cell counts in Chinese healthy volunteers and nasopharyngeal carcinoma patients. Methods A total of 13 nasopharyngeal carcinoma patients and 14 healthy volunteers were enrolled in this study. Venous blood was sampled every 4 hours during a 24-hour period. EDTA anticoagulated whole-blood was tested for blood cell counts immediately by automated hematology analyzer. The plasma cortisol level was determined by Radioimmunoassay. Data were analyzed by Analysis of Variance for Repeated Measures using SPSS 13.0 software and by Cosinor Analysis using Cosinor Analysis Software. Results Both healthy volunteers and nasopharyngeal carcinoma patients displayed clear circadian rhythms in red blood cells, hemoglobin, leukocytes, lymphocytes, and possibly platelets. Those blood cell counts also showed a significant variation during 24h. Conclusion Peripheral blood cell counts display significant circadian rhythms in both healthy volunteers and advanced nasopharyngeal carcinoma patients, suggesting the possibility of performing the time-selective collection and transfusion of blood.

T he finite element method (FE m) is a mathematical technique using modern computer tech-nology for stress analysis, and has been gradually used in simulating human body structures in the biomechanical field, especially more widely used in the research of thoracolumbar spine traumatology. T his paper reviews the establishment of the thoracolumbar spine FE m, the verification of the FE m, and the thoracolumbar spine FE mresearch status in different fields, and discusses its prospects and values in forensic thoracolumbar traumatology.

BACKGROUND: Fibular fixation and tantalum rod implantation are two commonly used methods for the treatment of early osteonecrosis of the femoral head (ONFH), both of which can effectively delay or even reverse the progress of ONFH. However, further comparative evaluation on their mechanical properties and therapeutic efficacy is required.OBJECTIVE: To compare the clinical efficacy of fibular fixation and tantalum rod implantation on ONFH at early stage.METHODS: Fifty-eight patients (81 hips) suffered from ONFH with ARCO stage 1 and stage 2, and underwent fibular fixation (30 cases, 41 hips) or tantalum rod implantation (28 cases, 40 hips). Postoperatively, both groups were followed up for over 2 years. The Harris scores of the hip were compared between two groups before and after treatment. With femoral head collapse and the collapse distance > 4 mm as observation points, the survival rate of the femoral head was compared between two groups.RESULTS AND CONCLUSION: The postoperative Harris scores of the two groups were significantly improved than before (P < 0.05). With the appearance of femoral head collapse as the observation point, the Kaplan-Meier survival curve showed that the overall survival rate of the hip was 83% in the fibular fixation group and 65% in the tantalum rod implantation group. After examined by log-rank (Mantel-Cox), there was a significant difference in the survival rate of the hip at Stage IIC between two groups (P=0.0431). With > 4 mm collapse as the observation point, the Kaplan-Meier survival curve showed that overall survival rate of the hip was 95% in the fibular fixation group and 83% in the tantalum rod implantation group. After examined by log-rank (Mantel-Cox), there was a significant difference in the survival rate of the hip at Stage IIC between two groups (P=0.0418). To conclude, both fibular fixation and tantalum rods implantation applied to ONFH at early stage can effectively improve the hip function, and the survival rate of the hip at ARCO Stage IIC is better in patients undergoing fibular fixation than tantalum rod implantation.

Objective To evaluate systematically whether administration of hypertonic saline transfusion affects clinical outcomes with compared to standard fluid in the early stage of resuscitation for traumatic shock patients.Methods Seven English and Chinese routine biology and medicine databases were searched for randomized controlled trials (RCTs) published from January 2002 to August 2012,and established inclusion and exclusion criteria to evaluate these RCTs.The quality assessment was based on the Cochrane Handbook for Systematic Reviews of Interventions Version 5.0.1 and Jadad' s score scale.RevMan 5.0 statistical software was used for meta-analysis.Results After evaluated 211 related literatures,five RCTs met all the inclusion criteria and were enrolled for meta-analysis.The meta-a nalysis demonstrated that early hypertonic transfusion did not decrease short-term (first 48 hours after admission) mortality (RR =1.04,P =0.74); nor did it decrease later-term (7day to 3month after injury) mortality (RR =0.97,P =0.72).It also did not decrease the total volume of fluid and blood transfusion required during the first day (P =0.38).Similarly,it did not affect the incidents of infections (RR =1.04,P =0.70),the length of stay in ICU (P =0.2) and total length of stay in the hospital.Conclusions Compared to standard fluid,there was no advantage on mortality and hospital infection by using hypertonic supplement transfusion in the early stage of resuscitation for traumatic shock patients.Hypertonic transfusion did not have any significant effect on the volume of total fluid and blood transfusion required the first day,and no trend of reduction for the length of ICU and hospital stay.Further well-designed randomized controlled trials are needed to demonstrate the cost effectiveness of hypertonic transfusion to traumatic shock patients while in ICU.

Objective To investigate the incidence of gluteal muscle contracture(GMC) of students in 18 primary and secondary schools in Rongchang county .Methods We used health screening tests to investigate students′health condition about gait and knee squat ,snapping levy ,obber levy ,hip muscles ,the hip joint activities .Results Among the 15 000 students in 18 primary and second‐ary schools in Rongchang county ,25 case(1 .67‰)were diagnosed with GMC ,70% of them had received muscular injection and 40% of them were Left‐behind children .Conclusion The incidence rate of GMC in Rongchang county is appropriate to other parts of our country ,the disease should be strengthened to prevent and treat .

Nutritional support therapy includes three main components:nutritional screening,nutritional assessment,and nutritional intervention.It is important to emphasize that nutritional screening and nutritional assessment are two different concepts and definitions,which are often confusing for many physicians,nurses,and dietitians.In this review,we present an overview on the main concepts about nutritional screening and nutritional assessment,highlight their features and complementarity,and discuss the future perspectives in the clinical practice.

To investigate the curative effect of electroacupuncture on luteinized unruptured follicle syndrome(LUFS) and its mechanism. Methods:Sixty LUFS patients were randomly allocated to treatment (electroacupuncture) group and control (hCG) group. The follicular condition and ovarian arterial flow under color Doppler ultrasonogaphy and a change in reproductive endocrine level were observed in the patients before and after treatments. The ovulation rates and pregnancy rates were compared between the two groups,and the mechanism was investigated. Results:Both ovulation rate and pregnancy rate were significantly higher in the treatment group than in the control group (P＜0.01). There was a significant difference in the improvement in ovarian arterial flow between the treatment and control groups (P＜0.01). The improvement in endocrine level was significantly more marked in the treatment group than in the control group(P＜0.01). Conclusion:Electroacupuncture has a good effect on luteinized unrupture follicle syndrome. Its mechanism may be related to the improvement in ovarian arterial blood supply and the regulation of endocrine level.

In China, the prevalence of overweight and obesity among adults is 34.3% and 16.4% respectively. Bariatric/metabolic surgery can effectively relieve morbid obesity by limiting nutrient absorption or regulating metabolism, consequently reducing obesity-related complications such as type 2 diabetes and hypertension and improving the quality of life for patients. Currently, the mainstream surgical methods are sleeve gastrectomy, Roux-en-Y gastric bypass, etc. Other new exploratory surgical methods, including combined laparoscopic sleeve gastrectomy, intragastric balloon, etc., are also undergoing continuous development. Here we reviewed the evolution of mainstream and emerging exploratory methods for bariatric/metabolic surgeries and discussed the merits and limitations of individual surgical methods, in aim to provide clinicians with more options for individualized treatment strategy for patients.

Objective One of the major challenges to emergency department is to provide high quality and time sensitive service under limitation of human/material resources,along with patients population with extremely complex conditions.We presented a study that based on a big data got from real world and used wavelet transform technique to analyze time-dependent diseases spectrum patterns and evolution patterns,which will provide solid methodological support for optimizing resources configuration for acute care surgery service.Methods Record data of patients admitted to acute care surgery from 2007-2014 were collected by using data management tool (Avaintec,Helsinki,Finland).The data were cleansed and were transformed to continuing spectrum according to time series of admission time points (per 9 hours).Matlab was used for wavelet transform,and applied five levels of wavelet decomposition and calculated the best decomposition levels by K-mean algorithm for each level.Then we used aprori algorithm for data mining (frequent patterns mining).Results A total of 23 795 cases were enrolled and acute abdomens were made up biggest proportion of admission.Meanwhile,it is found that the spectrum of acute care surgery admission frequency was a complex rising sequence.After wavelet decomposition,signal wave A reflexed trends evolution in a given time scale,and noise wave D reflexed minutia at relevant time scale.In another words,a principal wave A1 represented fluctuation at a cycle of 16 days.Noise wave D1 reflected intensity level in this 16 days' cycle.For example,the 5 · 12 episodes of massive earthquake in 2008 were included in the study,it is found that a significant noise wave at D3 level that indicated a 4 days' cycle.Clinically,it indicated explosive admissions to acute care surgery in 4 days.Conclusions The admission spectrum to acute care surgery is a phenomenon of multi-scale.Based on wavelet decomposing,we can easily analyze the rule of admission spectrum from electronic records of patients and can be used for optimization the emergency medicine resources.

Objective:To analyze the associations between the choroidal vasculature and submacular fluid (SMF) in central serous chorioretinopathy (CSC).Methods:A retrospective study. A total of 29 CSC patients (31 eyes) with complete records who visited the Department of Ophthalmology in Peking University People's Hospital from August 1, 2021 to March 1, 2023 were included in this study. The patients were divided into complete absorption and incomplete absorption groups according to the status of SMF in the last visit. All the patients underwent ultra-widefield swept-source optical coherence tomography angiography (UWF SS-OCTA) with a scanning range of 24 mm × 20 mm. The UWF SS-OCTA images were automatically analyzed in 9 regions (superotemporal, superior, superonasal, temporal, central, nasal, inferotemporal, inferior, and inferonasal). Alterations of choroidal vasculature in the nine subfields after SMF absorption were described, including choroidal thickness (CT), flow density of choriocapillaris layer, vessel density of large choroidal vessel layer, three-dimensional choroidal vascularity index (CVI), the mean choroidal vessel volume (mCVV), and the mean choroidal stroma volume (mCSV). The relevant factors affecting the complete absorption of SMF were additionally evaluated.Results:At baseline, CT ( Z=2.859, P=0.004), mCVV ( t=2.514, P=0.018), and mCSV ( Z=2.958, P=0.003) in the superotemporal region of the affected eyes in the incomplete absorption group were significantly higher than those in the complete absorption group. Compared with baseline, at the last visit, the proportion of asymmetric vortex veins in the complete absorption group was significantly decreased ( χ2=6.000, P=0.014), CVI in the superotemporal, superonasal, temporal, central, nasal, inferotemporal, and inferonasal regions ( t=-4.125, t=-3.247, Z=-3.213, t=-2.994, t=-3.417, t=-3.733, t=-3.795; P=0.001, 0.006, 0.001, 0.010, 0.005, 0.003, 0.002), the mCVV of 9 regions ( t=-2.959, t=-2.537, t=-2.235, t=-3.260, t=-3.022, t=-2.796, t=-2.747, Z=-2.107, t=-2.935; P=0.011, 0.025, 0.044, 0.006, 0.010, 0.015, 0.017, 0.035, 0.012) were significantly decreased. Compared to the complete absorption group, the choroidal blood flow changes in the non-complete absorption group were more limited, and CT in the upper region increased significantly at the last follow-up ( t=2.272, P=0.037). Multivariate logistic regression analysis revealed that baseline CT in the superotemporal region may be an independent risk factor affecting the complete absorption of SMF (odds ratio=0.981, 95% confidential interval 0.965-0.997, P=0.021). Conclusions:In the process of SMF absorption in CSC, significant reductions of choroidal blood flow were found in the large choroidal vessel layer, and there may be a locally compensatory increase in CT. In addition, baseline CT in superotemporal region is an independent risk factor affecting SMF absorption.