Objective Analysis of applies the Cleveland needle , Miniature steel plate , Outside the steady rest in treatment palm phalanx bone fracture .Methods Three hundred and twenty -six example 394 palms, phalanx bone fractures .A group of 126 example 157 use in the Cleveland needle fixed;B group of 81 example 99 use in the AO steel plate fixed;Outside C group of 93 example 108 use the steady rest to be fixed;D group of 26 example 30use may absorb in the nail fixed . Surgery time,technique the joint func-tion restores the situation , the bone fracture cicatrization time and the complication occurrence were ana-lyzed.Results TAFS grades:A group was 77.8%;B group was 96.3%;C group was 96.7%.D group was 96.2%( P<0.05 ) .Conclusion Because of different to loss degree palm , we should select and use the different inner or outside fixture respectively .

Objective To investigate the effect of positive ventilation pressure on the radiotherapy of primary cancer of stage Ⅲ.Methods 19 patients diagnosed as of primary,cancer of stage Ⅲ were randomly divided into two groups:the combining therapy group and the simple radiotherapy group.The patients of combining therapy group were treated with positive pressure ventilation using BIPAP respirator and radiotherapy.The recently therapy results and the radiotherapy associated side effects were observed between these two groups.Results(1)The combination of radiotherapy and BI- PAP provides significant superiority of local effects over radiotherapy.P

Objective To investigate the level and proportional relationship of free fluorine and soluble fluoride in different brands of toothpaste,and analyze possible risk factors.Methods A total of 54 samples of commercially available toothpastes of domestic,joint venture and imported in Guiyang City were collected,and the levels of free fluoride and soluble fluorine were determined,respectively,using fluorideion selective electrode.method (GB 8372-2008).Results The number of the toothpaste was 32,12,10,respectively,in domestic,joint venture and imported.The levels of free fluorine ranged from 0.98 to 1 603.50 mg/kg,3.22 to 617.50 mg/kg and 306.80 to 1 590.80 mg/kg,respectively,in toothpastes of domestic,joint venture and imported; the number of exceeding the standard free fluorine was 3,0 and 1,respectively,in toothpastes of domestic,joint venture and imported; the rate of exceeding the standard free fluorine was 9.4％,0.0％ and 10.0％,respectively,in toothpastes of domestic,joint venture and imported.The levels of soluble fluorine ranged from 3.06 to 4 302.50 mg/kg,9.02 to 1 667.30 mg/kg and 9.18 to 4 013.20 mg/kg,respectively,in toothpastes of domestic,joint venture and imported; the number of exceeding the standard soluble fluorine was 9,2 and 3,respectively,in toothpastes of domestic,joint venture and imported; the rate of exceeding the standard soluble fluorine was 34.4％,16.7％ and 30.0％,respectively,in toothpastes of domestic,joint venture and imported.The proportion of free fluorine and soluble fluoride was:domestic 1.0 ∶ 2.7,joint venture 1.0 ∶ 2.7,imported 1.0 ∶ 2.5,respectively.The confidence limit (R/d) was 0.98.Conclusion The fluoride level in different brands of toothpaste has exceeded the standard,the content and proportion of soluble fluoride are obviously higher than those of free fluoride,and there is a risk on tooth damage from fluoride,and factories should strengthen quality control in adding fluoride.

Objective To investigate the operative indications for polypoid lesions of gallbladder(PLG) and avoid cholecystectomy for PLG without operation signs.Methods Retrospective analysis of 828 cases of PLG confirmed by pathologic examination was made.Results (1)Cancer should be suspected when a patient is older than 50 years or has a polypoid lesion larger than 1.0 cm.(2)The cholecystectomies for PLG accounted for 2.7%-7.1%of all cholecystectomies in the corresponding period,and cholesterol polyps accounted for 86.11%of all PLG,and carcinoma of gallbladder accounted for 1.92%of all PLG.Conclusion At present most of PLG accepting cholecystectomy are cholesterol polyps,so the high-risk factors of the neoplastic polyps and the operative indications for PLG should be considered deliberately.

ObjectiveTo investigate the clinical manifestations of portal vein thrombosis (PVT) and related risk factors in patients with liver cirrhosis. MethodsA total of 541 patients with liver cirrhosis who were admitted to the General Hospital of Ningxia Medical University from April 2008 to April 2015 were included in the study; 76 patients with PVT were enrolled in the study group, and another 76 patients without PVT matched for sex, age, and Child-Pugh class were enrolled in the control group. The clinical data and related indicators were analyzed and compared between the two groups. The t-test was applied for comparison of continuous data between groups, the chi-square test was applied for comparison of categorical data between groups, and the unconditional logistic regression model was used to determine the independent risk factors for PVT in liver cirrhosis. ResultsIn the patients with liver cirrhosis and PVT, 421% (32/76) had an insidious onset and 579% (44/76) had obvious clinical manifestations. Most patients had Child-Pugh class B and C cirrhosis. There were significant differences between the two groups in platelet count, blood glucose, percentage of neutrophils, severe esophageal and gastric varices, plasma D-dimer, portal vein width, and thickness of the spleen (all P＜0.05). The unconditional logistic regression model analysis showed that percentage of neutrophils (OR=1.044, P=0.040), plasma D-dimer (OR=0.091, P=0.000), portal vein width (OR=0.030, P=0.008), and thickness of the spleen (OR=0.427, P=0.003) were the influencing factors for PVT. ConclusionPVT may have an insidious onset in patients with liver cirrhosis, or have different clinical manifestations. Cirrhotic PVT usually occurs in patients with advanced liver cirrhosis, and plasma D-dimer, portal vein width, thickness of the spleen, and percentage of neutrophils are the independent influencing factors for PVT in patients with liver cirrhosis.

Objective To assess sleep quality and daytime sleepiness in patients on maintenance high flux hemodialysis, and discussed the associated factors. Methods A total of 112 high flux hemodialysis patients and 53 normal subjects were estimated by Pittsburgh sleep quality index (PSQI) and Epworth Sleep Scale (ESS) to assess the sleep quality and day time sleepiness. Global score of these questionnaires were analyzed. Seven components' scores and 9 reasons for sleep disturbances were compared between "good" (global PSQI ≤5) and "bad" (global PSQI＞5) sleepers. Sleep quality was compared among different shifts of hemodialysis. The impact of clinical factors on sleep quality were analyzed by multivariate linear regression and logistic regression. Results Compared with control group, hemodialysis group had a higher PSQI (7.02±4.94 vs 3.28±2.79, P＜0.05) and a lower ESS score [3(0-6) vs 8(4.25-11.75), P＜0.05] . 58% patients were "bad" sleepers and sleep latency was longer (30 min vs 15 min, P＜0.05). Insomnia was the main problem. Patients on morning shift, afternoon shift and night shift had similar subjective sleep quality. Age (OR=1.75, P=0.003), dialysis vintage (OR=1.26, P=0.008),hemoglobin (OR=0.64, P=0.008), calcium phosphate product (OR=1.60, P=0.02) were significantly related to sleep quality score. Conclusions Sleep disturbance is common in hemodialysis patients. Older age, longer dialysis vintage, anemia and higher calcium phosphate product are risk factors for poor sleep quality.

Objective:To investigate the clinic opathological features, treatment and prognosis of children newly diagnosed with ependymoma.Methods:Clinical data of 127 pediatric ependymoma (EPN) patients (0-16 years old) treated with tumor resection and postoperative radiotherapy at Xinhua Hospital Affiliated to Shanghai Jiao Tong University between 2001 and 2021 were retrospectively analyzed. Among them, 53 children were female and 74 were male. Local control (LR), event-free survival (EFS) and overall survival (OS) rates were analyzed by Kaplan-Meier method. The relationship between clinic opathological factors and clinical prognosis, and the effect of treatment on clinical prognosis of patients were analyzed by Cox proportional hazards model.Results:At a median follow-up time of 29 months (3-251 months), the 3-year OS and EFS rates were 89.5% and 71.5%, respectively. For patients undergoing incomplete resection followed by postoperative adjuvant radiotherapy, the 3-year LR, OS and EFS rates were 78.3%, 65.8% and 85.7%, respectively. A total of 43 children were aged <3 years old when diagnosed and 84 aged ≥3 years old. The interval time between surgery and radiotherapy in children aged <3 years old was 91 d, and 35.5 d in those aged ≥3 years old ( P<0.001). For patients <3 years old, the median EFS was 90 months when initiating radiotherapy within ≤70 d after surgery, compared to 43 months for those who initiated radiotherapy at >70 d after surgery ( P=0.053). According to fifth edition of the WHO classification of tumors of the central nervous system (WHO CNS5), 39 children were classified as posterior fossa ependymoma group A (PFA group). The OS and EFS rates in the PFA group were significantly less than those in other groups (3-year OS rate were 69.2% vs. 94.6%, P<0.001; 3-year EFS rate were 46.9% vs. 79.1%, P<0.001). In the PFA group, 12 patients received postoperative adjuvant chemotherapy, 14 did not receive chemotherapy, and whether chemotherapy was given was unknown in 13 cases. No significant differences were observed in OS and EFS between patients treated with and without chemotherapy ( P=0.260, P=0.730). Univariate Cox analysis showed that tumor location and WHO CNS5 molecular classification were significantly associated with EFS, and WHO CNS5 molecular classification was significantly correlated with OS. Multivariate Cox analysis showed that tumor location in the posterior fossa was an independent risk factor for EFS ( HR=2.72, 95% CI=1.1~6.71, P=0.03). Conclusions:Patients newly diagnosed with pediatric ependymoma can obtain favorable survival after surgery combined with postoperative adjuvant radiotherapy. Patients with residual tumors can achieve favorable LC and survival after postoperative adjuvant radiotherapy. Delaying of radiotherapy tends to lead to poor survival for patients aged <3 years old when diagnosed. Children in the PFA group obtain worse prognosis compared to their counterparts in other groups. The tumor location in the posterior fossa is an independent risk factor for pediatric ependymoma.

Objective:To investigate the clinical features of pediatric patients with intracranial primary non-germinomatous germ cell tumors (NGGCT) and evaluate the treatment outcomes and prognostic factors of NGGCT.Methods:Clinical data of 40 children with NGGCT who were treated with radiotherapy (RT) at our department between November 2008 and June 2019 were retrospectively analyzed. Ninety percent of them received craniospinal irradiation (CSI). All children received platinum-based chemotherapy. Survival analysis was conducted using the Kaplan-Meier estimate. The prognostic factors were analyzed by log-rank test.Results:The primary sites were pineal gland, sellar / suprasellar region and basal ganglia. The median age of onset was 108 months (20-204 months). The median follow-up time was 33 months (8-131 months), and the 3-year and 5-year overall survival (OS) rates were 82.0%. The 3-year and 5-year progression-free survival (PFS) rates were 78.6% and 73.0%. Univariate analysis showed that increased alpha-fetoprotein (AFP) ( P=0.02), age at first diagnosis>10 years ( P=0.006), metastasis at first diagnosis ( P<0.001), and the pathological type (choriocarcinoma, yolk sac tumor and / or embryonal carcinoma) ( P=0.036) were independent adverse prognostic factors. Conclusions:Increased AFP, age>10 years at first diagnosis, tumor metastasis and pathological type were independent adverse prognostic factors of NGGCT. The overall prognosis of NGGCT children is worse than that of their counterparts with germinoma, and multidisciplinary intensive therapy is needed to improve survival.

Objective To explore the diagnostic value of cytologic examination of cerebrospinal fluid (CSF) combined with cell immunochemical staining examination in the patients with meningeal carcinomatosis in the clinical track.Methods CSF was centrifuged and precipitated using the StatSpin Cytofuge 12 centrifuge. It was dyed by the May-Grunwald-Giemsa Staining (MGG) method and cell immunochemical staining (S-P method). Clinical data of 16 cases with the diagnosis of meningeal carcinomatosis were retrospectively analyzed. Results Sixteen patients diagnosed meningeal carcinomatosis prior to imaging findings in 11 of 16 patients were diagnosed meningeal carcinomatosis through the cerebrospinal fluid cytology combined with cell immunochemical staining prior to imaging findings. CSF cytology observed the cancer cell pleomorphism. Cell immunochemical staining examination clearly distinguished classification organic source of meningeal carcinomatosis. Conclusions CSF cytology combined with cell immunochemical staining examination is one of the important means in tracking intracranial metastatic tumor in clinic.

Objective:To investigate the efficacy of the nomogram model based on multiparametric MRI combined with clinical features for differential diagnosis of benign and malignant breast imaging reporting and data system (BI-RADS) 4 lesions.Methods:This study was a cross-sectional study. Clinical and imaging data of 56 patients (66 lesions) with pathologically confirmed BI-RADS 4 breast lesions from January 2020 to June 2022 at Second Affiliated Hospital of Shantou University Medical College were retrospectively analyzed. The patients were all females aged 42 (17, 71) years old. All patients underwent the breast MRI, including T 1WI, T 2WI, diffusion-weighted imaging, diffusion kurtosis imaging (DKI), and dynamic-enhanced MRI (DCE-MRI), and the patient clinical characteristics, imaging characteristics as well as relevant MRI quantitative parameters were recorded. Comparisons of the indicators of benign and malignant BI-RADS 4 lesions were performed by sample t-test , Mann-Whitney U, or χ 2 test. The least absolute shrinkage and selection operator regression was utilized to further select indicators with statistically significant differences in univariate analyses, and finally, nomogram models were constructed and reclassified all the lesions. Results:Of the 66 lesions in 56 patients, 24 lesions were found in 24 malignant patients and 42 lesions in 32 benign patients. The differences in age, body mass index, and menopausal status between benign and malignant patients were statistically significant (all P<0.05); the differences in tumor longest diameter, type of lesion enhancement, time-single intensity curve type, mean diffusivity and mean kurtosis (MK) between benign and malignant lesions were statistically significant (all P<0.05). After feature selection, MK ( OR=27.952, 95% CI 1.301-600.348, P=0.033), age ( OR=1.140, 95%CI 1.040-1.249, P=0.005), and the type of lesion enhancement ( OR=0.045, 95%CI 0.006-0.316, P=0.005) were the independent influences in predicting BI-RADS 4 malignant lesions. Using this to construct a nomogram model, its area under the curve for predicting BI-RADS 4 malignant lesions was 0.946, and the accuracy of reclassifying 66 BI-RADS 4 lesions as benign versus malignant was 86.36% (57/66). Conclusion:The nomogram model constructed with MK from DKI parameters, the type of lesion enhancement from DCE-MRI, and age is valuable in diagnosing the benign and malignant nature of BI-RADS 4 lesions.