Objective To investigate the technique and clinical effects of pedicle screw fixation in treatment of unstable Hangman' s fractures in comparison with the conservative managements. Methods From January 1999 to July 2005, 36 patients with unstable Hangman' s fractures were treated in our department. Based on Levine- Edwards classification, 15 of them were treated with skull traction, and others with internal fixation with posterior pedicle screws (C2,3 fusion in 10 cases and C2- 4 fusion in 11 cases). After a posterior midline incision and clear exposure of posterior structure, the C2 screw was inserted through the center of the posterior aspect of lateral mass, inclining usually 20? to 30? towards the head of the transverse plane and 25? to 35? inwards to the medial incline of the sagittal plane. For C3,C4 screw insertion, the drilling was parallel to the joint plane of the relevant vertebra and inclined 35? to 40? outwards to the medial incline of the sagittal plane. The whole procedure was performed under the monitoring of C- arm screen for safety and accuracy. Results A mean follow- up time was 18 months (5 to 28 months). 6 cases treated by skull traction lost their anatomic reduction. Of the 21 cases treated by the pedicle screw fixation, 2 had loosened internal fixation but 19 experienced no screw loosening and their fractures were cured entirely without limited function of the cervical vertebra. Conclusions In treatment of unstable Hangman' s fractures, C2,3 or C2- 4 pedicle screw fixation is an effective method to achieve rigid reduction and early rehabilitation. However, there is no remarkable difference between C2,3 fusion and C2- 4 fusion

Objective To evaluate the methodological performance of the new enzymatic method for detecting glycated hemo-globin(HbAIc)and its influencing factors.Methods HbAIc was detected by the enzymatic method.The precision,anti-interfer-ence,recovery rate,accuracy and the influence of pre-processing(anti-coagulation,preservation,centrifugation)on the detection re-sults were evaluated,its correlation with HPLC and the bias degree were analyzed.Results The within-run coefficients of variation (CVs)for high,middle and low value QC samples in the enzymatic assay were 1.04%,1.26% and 1.37% respectively and the be-tween-run CVs were 1.83%,2.24% and 2.64%,respectively;the enzymatic method showed the linear correlation with HPLC(r=0.996,P <0.01);the HbA1c target value concentrations were 5.20%,6.40%,7.60%,8.80%,10.00% and 11.20% respectively, the recovery rates were 100.15%,98.91%,98.84%,98.20%,103.62% and 99.82% respectively;the interference test showed that this method had no significant interference on the detection results when glucose <15.50 mmol/L,UA<516.00 μmol/L,bili-rubin <217.00 μmol/L,triglyceride<10.20 mmol/L,urea<11.50 mmol/L,albumin<50 g/L and globulin <50 g/L.The HbA1c detection results in the samples with anti-coagulation by heparin sodium,EDTA-2K and sodium citrate stored for 3 d under -20-20 ℃ had no obvious change (P >0.05);the sample was centrifuged at 500,1 000 r/min(R=15 cm)for different time(1,2,5,10 min)and at 2 000 r/min for 1 min,their detection results had statistical differences compared with the sample centrifuged=3 000 r/min for 5 min (P <0.05).Conclusion The precision,anti-interference,accuracy and linearity range of the enzymatic method all conform to the clinical requirement.Compared with the conventional method,its correlation is good with small deviation,which can entirely satisfy the demand of the HbAIc detection in clinic.

Objective To observe the short?term clinical outcomes of kidney transplantation from brain and cardiac death donors (DBCD) and assess its feasibility to expand organ donor pool. Methods A retrospective analysis was performed on 48 cases of kidney transplantation from DBCD. The transplant recipients had finished 12?month follow?up in the First People's Hospital of Foshan from September 2011 to February 2015, with their renal function, rejection reaction and complications at 1 week, 1 month, 3 months, 6 months and 12 months after renal transplantation being collected. Survival rates of transplant recipients and transplant kidneys, incidence of delayed graft function (DGF) and its influence for recipients and graft survival were analyzed by statistics. Results In the 48 cases, the survival rates of recipients at 1, 3, 6 and 12 months after transplantation were 100.0%, 100.0%, 97.9%, 95.8%, and the survival rates of transplanted kidneys were 95.8%, 95.8%, 93.8%, 91.7%, respectively. DGF occurred in 8 of 48 (17.0%), but the occurrence of DGF did not adversely influence patient's survival (P=0.524) or graft survival (P=0.362). Conclusions The short?term clinical outcomes of kidney transplantation from DBCD are ideal. As the legislation of donation after brain death (DBD) has not been ratified in China, the kidney transplantation from DBCD could be an
important way to solve the shortage of organs, and increase the number of kidneys available for transplantation.

Objective To compare the influence of hemodialysis (HD) and peritoneal dialysis (PD) on early outcome of patients underwent kidney transplantation from donation after cardiac death (DCD).Methods Patients admitted in the First People's Hospital of Foshan with DCD kidney transplant from January 1st,2011 to June 30th,2016 were analyzed retrospectively.Recipients were grouped into HD group (n=61) and PD group (n=28) according to their pre-transplant dialysis modality.Their short-term outcomes after DCD kidney transplant were compared,including recovery of renal function,short-term complications and laboratory data.Results Patients had longer dialysis duration and lower hemoglobin,serum albumin and phosphorus in PD group than those in HD group (all P ＜ 0.05),but no significant difference shown in age,gender,body mass index,primary disease,blood pressure,and hepatitis B infection (all P ＞ 0.05).HD patients with 6.00(4.00,11.00) d recovery time of renal function,18.00(17.00,21.50) d hospital time,had 24.59％ the delayed graft function (DGF),3.28％ acute rejection and 16.39％ infection during hospitalization.While for PD patients the recovery time of renal function was 4.00(3.75,7.00) d;hospital time was 19.00(15.00,21.75) d;the incidence rate of DGF was 14.29％;acute rejection was 3.57％;and infection during hospitalization reached 17.86％.Above indexes were not significantly different between HD and PD groups (all P ＞0.05).Repeated measure ments showed that,compared with those before transplant surgery,after 1 month,3 months and 6 months HD and PD groups had decreased creatinine and phosphorus,and increased hemoglobinserum albumin and calcium;Serum albumin and calcium were different between the two groups (P ＜ 0.001,P=0.040),whereas creatinine,hemoglobin and phosphorus did not show difference (all P ＜ 0.05).After transplantation the trends of creatinine,hemoglobin,calcium and phosphorus were not different between the two groups (P values were 0.295,0.310,0.501 and 0.063,respectively).Conclusions No significant difference of the recovery regarding renal function,anemia,nutrition status and mineral metabolites was found between pre-transplant HD and PD modality in patients who underwent DCD kidney transplantations.

Objective To investigate the relationship between serum microRNA(miRNA)miR-130b-3p and miR-181a-5p expression and pregnancy outcome in patients with gestational diabetes mellitus.Methods From June 2020 to August 2022,a total of 124 pregnant women with gestational diabetes mellitus diagnosed and treated in Beijing Aerospace General Hospital and Beijing Obstetrics and Gynecology Hospital were selected as the study group.According to the pregnancy outcome,they were separated into a good group and an adverse group.Real-time fluorescence quantitative PCR method was applied to detect the expression of miR-130b-3p and miR-181a-5p in serum.Pearson method was applied to analyze serum miR-130b-3p,miR-181a-5p,and their correlation with blood lipids and blood glucose.Logistic regression was used to analyze the influencing factors of adverse pregnancy outcomes in patients with gestational diabetes mellitus.Results The levels of total cho-lesterol(TC),triglyceride(TG),low-density lipoprotein cholesterol(LDL-C),fasting blood glucose(FBG),fasting insulin(FINS),insulin resistance index(HOMA-IR),and the relative expression level of miR-130b-3p in the study group were higher than those in the control group(P<0.05).The relative expression level of miR-181a-5p was reduced compared to the control group(P<0.05).The levels of TC,TG,LDL-C,FBG,FINS,HOMA-IR and miR-130b-3p in the adverse group were higher than those in the good group(P<0.05),while the relative expression level of miR-181a-5p was lower than that in the good group(P<0.05).According to Pearson correlation analysis,serum miR-130b-3p was negatively correlated with miR-181a-5p(P<0.05),serum miR-130b-3p was positively correlated with TC,TG,LDL-C,FBG,FINS,HOMA-IR(P<0.05),and miR-181a-5p was negatively correlated with TC,TG,LDL-C,FBG,FINS,HOMA-IR(P<0.05).Logistic regression analysis showed that high levels of miR-130b-3p,TC,TG,LDL-C,FBG,FINS and low rel-ative expression level of miR-181a-5p were risk factors for adverse pregnancy outcomes of gestational diabetes mellitus(P<0.05).Conclusion The serum miR-130b-3p relative expression level in patients with gestational diabetes mellitus is increased and the serum miR-181a-5p relative expression level is decreased,both of which are closely related to the pregnancy outcome.

Objective:To provide family-centered interactive nursing intervention to children for early functional exercise of the affected limbs according to temperament assessment results in school-aged children with limb fractures and to analyze its effects on .the compliance with early functional exercise in these children.Methods:Totally 120 school-aged children with limb fractures that required surgery who were admitted into Yantaishan Hospital from July 2018 to August 2019 were selected and randomly divided into an observation group and a control group, with 60 cases in each group. Children in the observation group received family-centered interactive nursing intervention according to temperament assessment results, while children in the control group received routine care. The compliance with early functional exercise of the affect limbs after surgery for limb fractures in school-aged children.Results:There was a statistically significant difference in the compliance with early functional exercise of the affected limb of school-aged children after surgery for limb fractures in two groups (χ 2=10.053, P<0.05) . The family members' evaluation of nursing effects in the observation group of school-aged children were higher than those in the control group, and the differences were statistically significant ( P<0.05) . There was no significant swelling of the fractured limbs in the observation group, while 4 cases in the control group had swelling of the fractured limbs which needed to loosen the plaster. Conclusions:Family-centered interactive nursing measures for early functional exercise in school-aged children with limb fractures according to different temperaments can enhance the compliance with early functional exercise, improve family members' satisfaction, and reduce the occurrence of early compliance of fractured limbs in these children.