Objective To investigate the effect total hip arthroplasty and hemiarthroplasty in treatment of displaced femoral neck fractures in elderly .Methods 83 cases of elderly patients with displaced femoral neck fractures were divided into two groups according the order randomly.The control group(n=53) was given hemiarthroplasty while the observation group ( n=30) took total hip arthroplasty .The clinical efficacy and occurrence of complications after surgery were compared.Results The observation group excellent rate was 90.00%(27/30), significantly higher than the 79.25%(42/53) (χ2 =11.23,P<0.05);The observation group′s operative time,blood loss and postoperative drainage were (145.33 ±6.21)min,(575.65 ±26.84)mL and (278.51 ±14.15)mL,which was more than the control group(80.12 ±5.36)min,(322.52 ±25.34)mL and (185.46 ±12.48)mL significantly(t=9.56, 8.83,10.03,all P<0.05);The observation group′s incidence of complications was 10.00%(3/30),which was sig-nificantly lower than the control group′s 22.64%(12/53) (χ2 =12.16,P <0.05).Conclusion The total hip arthroplasty has a significant effect in the treatment of femoral neck fractures in elderly ,patients have good recovery of joint function with a low incidence of complications which can be used as the preferred solution for clinical treatment .

Objective To study the diagnostic value of common inflammatory markers in patients with infectious diseases. Methods One hundred sepsis patients, 100 viral infection patients,100 pulmonary tuberculosis patients and 100 gonorrhea patients were analyzed retrospectively. The contents of procalcitonin (PCT), C-reactive protein (CRP), haptoglobin (HP), ceruloplasmin (CER), α1-acid glycoprotein (α1-AAG), α1-antitrypsin (α1-AAT), white blood cell count (WBC) and erythrocyte sedimetation rate (ESR) were measured. The receiver operating characteristic curve (ROC curve), sensitivity, specificity, positive predictive value, negative predictive value, Youden's index,positive and negative likelihood ratios and total coincidence rate were calculated respectively. Results The area under the ROC curve, sensitivity, specificity, Youden's index and positive likelihood ratios,positive predictive value and total coincidence rate of PCT in sepsis patients were 0. 895, 0.84, 0.92,0.76, 10.50, 0.91 and 0.88, respectively, which were superior to CRP, HP, CER, α1-AAG, α1-AAT, WBC and ESR. Conclusions PCT is a better inflammatory reactive parameter than other parameters currently applied in practice and may serve as a rapid and sensitive test in the early stage of severe bacterial infections.

The genus Xestospongia is one of the most widespread genera of sponges, containing abundant secondary metatolites with novel structures and potent bioactivities. The main structure types of secondary metatolites found in this genus are alkaloids, quinines, terpens, steroids, lipids, polyketones, etc. These metatolites exhibit a variety of bioactivities, such as cytotoxic, antibacterial and antiviral activities. This paper reviews the progress in the chemistry and pharmacological activities of the second metabolities from sponges of Xestospongia, especially for recent five years, with the aim for further research.

Objective To evaluate the effects of problem-based learning (PBL) teaching model in medical imaging education in China. Methods Such databases as PubMed, Medline, CNKI, WanFang, VIP Data were electronically searched for literature on PBL versus lecture-based learning (LBL) applied in medical imaging education in China up to April, 2015. According to the strict quality evaluation of the in-cluded studies, meta-analysis was performed using RevMan 5.2 software. Results Fourteen studies were included totally. Studies included 1 233 students, of whom the PBL group had 608 cases, while LBL group had 625 cases. Compared with LBL, PBL was superior in medical imaging theoretical scores [WMD=5.22, 95%CI(3.06, 7.37), P=0.000], and the case analysis scores [WMD=6.45, 95%CI(4.77, 8.12), P=0.000]. PBL was also superior in the autonomous learning ability [RR=1.78, 95%CI (1.47, 2.16), P=0.000], the unity cooperation ability [RR=1.42,95%CI (1.25, 1.61), P=0.000] and analysis ability [RR=1.73,95%CI (1.42, 2.11), P=0.000]. There were significant differences between PBL group and LBL group. Conclusion PBL can improve teaching results in medical imaging education.

[ABSTRACT]OBJECTIVETo study of the relationship of age and climate with the nasal mucosa lesions.METHODSAll the patients met with the inclusive criteria were registered and followed-up once a month and their nasal mucosal lesions were observed through nasal speculum and/or nasal endoscope. The recording data was analyzed by SPSS17.0 software.RESULTSA total of 259 patients, 555 person-times and 957 lesion spots were observed. The nasal mucosa was injured by airflow with the highest incidence rate from October to next year April. Patients numbers gradually increased after August, and significantly increased at November, December (P<0.05). Children aged from 2 to 12 years old and the adults aged from 40 to 80 years old were susceptible population (P<0.05), the incidence rate had a negative relation with humidity (P<0.05). The susceptible spots of the lesion were ranked as follows: Little area, inferior turbinate, mucosa of the both side of the deviated nasal septum, inferior meatus, middle meatus, middle turbinate and olfactory area. CONCLUSIONNasal mucosal injury relates to age and seasons. The nasal cavity airflow may be a factor of these lesions.

Objective: To identify the social ecological factors of individual, family, and physical environments for affecting the development of fundamental motor skills (FMS) among overweight and obese children, so as to provide a basis for the future intervention design and policy making. Methods: From March to April 2022, one public primary school was recruited from each of the 4 main urban areas in Shijiazhuang, and a total of 425 children in schools were recruited for data collection including individual, family, physical environmental factors, by using a stratified cluster random sampling approach. Test of Gross Motor Development-Third Edition (TGMD-3) was used to evaluate children s FMS. Hierarchical linear regression model was employed to analysis the associations between the 18 factors for individual, family, and physical environments, and the FMS of overweight and obese children. Results: Individual level including the child s age, gender and sleep duration, and family level including high family economic level, parental support for physical activity, and the physical activity environment surrounding the family and community were consistent predictors of movement skills ( B =0.422, -1.972, 0.014, 0.045, 1.042, 0.827, 1.898), ball skills ( B =0.858, 3.953, 0.013, 0.092, 2.141, 1.173, 1.954), and composite skills ( B =1.305, 1.915, 0.028, 0.142, 3.091, 1.962, 3.879) among overweight and obese children ( P <0.05). Furthermore, child s body mass index (BMI), moderate to vigorous physical activity, perceived motor competence, pleasure of exercise,as well as BMI and physical activity levels of their primary caregiver, were associated with different types of FMS ( P <0.05). Individual, family, and physical environmental factors had moderate to high predictive explanatory power for FMS among overweight and obese children ( 2=0.69, 0.75, 0.93, P <0.01). Conclusions The factors influencing the development of FMS in overweight and obese children are multifaceted, with individual, family, and physical environment factors all playing significant roles.Corresponding measures should be actively taken to improve FMS in overweight and obese children.

Objective:To investigate the effects of mesenchymal stem cells-derived exosomes (MSC-Exos) secreted by mesenchymal stem cells (MSCs) induced by astragaloside IV (AS-IV) on the biological function and pyroptosis of human umbilical vein endothelial cells (HUVECs) injured by high glucose.Methods:After human umbilical cord blood mesenchymal stem cells (hUCBMSCs) were intervened with 400 mg/L of AS-IV, exosomes were extracted, and then the morphology and specific markers of exosomes were identified. Human umbilical vein endothelial cells (HUVECs) were cultured in a medium with a glucose concentration of 30 mmol/L to prepare a high glucose-impaired HUVECs model. High glucose-impaired HUVECs were randomly divided into experimental and model groups, with the experimental group intervened with 100 μg/ml of MSC-Exos and the model group intervened with an equal volume of PBS solution, while a blank control group was also set up. Cell counting Kit-8 (CCK-8) cell proliferation assay, adhesion assay, matrigel tube formation assay and scratch assay were used to detect the effects of AS-IV-mediated MSC-Exos on the proliferation, adhesion, tube formation and migrationability of HUVECs; Western blot and real time fluorescence quantitative polymerase chain reaction (qRT-PCR) were used to detect the protein and mRNA expression of scorch death-related molecules, such as Caspase-1, GSDMD (Gasdermin D) and NLRP3 in each group.Results:The proliferation, adhesion number, tube number and migration width of HUVECs cells were significantly lower than those in the blank group ( P<0.05); The expression of Caspase-1, GSDMD, NLRP3 protein and their mRNA increased significantly ( P<0.001); Under the intervention of MSC-Exos mediated by AS-IV, the cell proliferation, adhesion number, tube number and migration width of HUVECs were significantly higher than those in the model group ( P<0.05); The expression of Caspase-1, GSDMD, NLRP3 protein and their mRNA decreased, with statistically significant difference ( P<0.05). Conclusions:AS-IV mediated MSC-Exos can significantly improve the biological function of high glucose-impaired endothelial cells, and its mechanism may be related to anti-pyroptosis.

Objective To observe the efficacy of oropharyngeal muscle exercise for relieving obstructive sleep apnea (OSAS) among stroke survivors.Methods Fifty stroke survivors with moderate OSAS were randomly divided into an observation group and a control group,each of 25.Both groups were given routine drugs and rehabilitation,while the observation group was additionally provided with oropharyngeal muscle exercises during the daytime for 20 minutes twice a day for6 weeks.The control group received deep breathing therapy.Before and after the 6 weeks of treatment,both groups were evaluated using polysomnography.Their sleep quality and daytime sleepiness were measured using the Pittsburgh sleep quality index and the Stanford sleepiness scale.Any changes in the patients' pharyngeal morphology after exercise were evaluated using MRI.Results After the oropharyngeal muscle exercises,the apnea hypoventilation index and minimum SaO2 ％,the snore index and sleep quality improved significantly.Daytime sleepiness was significantly relieved.Some structural remodeling of the pharyngeal airvay was observed by MRI,including significantly larger retropalatal distance and shorter length of the soft palate.The retropalatal distance was positively and correlated with the duration of exercise while the length of soft palate correlated negatively.Conclusion Exercising the oropharyngeal muscles is a promising alternative treatment for stroke survivors with moderate OSAS.It improves the morphology of the oropharynx to relieve obstruction during sleeping.

Objective Retrospective study and report on cases of "symptomatic facet of residual bone mass" caused by percutaneous transforaminal endoscopic discectomy (PTED),to analysis of its causes and revision strategies.Methods Seven cases of "symptomatic facet of residual bone mass" after PTED were found in six medical centers from July 2015 to November 2017.Weintroduced the course of diagnosis and treatment,to analysis of the causes,clinical features and revision strategies of the rare complication.Results Seven patients came from different medical centers (2 cases in Ningbo No.6 Hospital and 1 case in each of the other medical centers).The average age of the subject is 67.29±9.64 years (range from 57-83 years).Among them there were 1 male and 6 female.PTED was performed for all cases with lumbar disc herniation or stenosis.The operative segments were 1 of L2,3,2 of L3,4,3 of L4,5,1 of L5S1.Symptoms occurred immediately after surgery in all cases except one after a week of operation and another one month later.Two cases were appeared symptom of contralateral irritation,and the rest were aggravated by the original symptoms.Two cerebrospinal fluid leakage caused by bone mass piercing the dural sac.The bone mass compressed the nerve root and caused 1 case of lower limb muscle weakness.Foraminoplasty was performed during PTED in all patients.After CT scan,5 cases of bone mass were found on the same side of operation,and 2 cases were in the contralateral side.The shortest time for revision was 2 days and the longest 3 months.After conservative treatment,the symptoms were relieved in only one case.Revision surgeries were performed for all the other 6 cases,2 with microendoscopic discectomy (MED),1 mobile microendoscopic discectomy (MMED),1 small incision operation,1 PTED and 1 with minimal invasive surgery of transforaminal lumbar intervertebral fusion (MIS-TLIF).The VAS scores of low back pain and leg pain was significantly relieved from 8.67±0.52 to 1.50±0.55.Conclusion FTED may lead to residual bone mass in lumbar foraminoplasty.The penetration of the bone mass block into the spinal canal can cause the compression symptoms of the corresponding segment.The patients showed the corresponding spinal canal stenosis and nerve root irritation symptoms.A revision operation is required to remove the oppressed bone mass to relieve the symptoms as soon as possible if the conservative treatment not effective.

Objective To observe the differential expression of high mobility group box - 1 protein (HMGB1) in renal tissues of heat stroke mice models, and to explore its role in the pathogenesis of heat stroke associated acute kidney injury(HS-associated AKI). Methods According to random number table, 20 healthy male C57BL/6J mice were randomly divided into 2 groups, including normal control (n=10) and heat stroke group (n=10). The mice in heat stroke group were given with a 2-hour-exposure in biological simulation chamber (temperature 41℃, humidity 70％). Heat stroke was defined as anal temperature lasting more than 40 degrees Celsius. A 18F - deoxyglucose nuclide labeled vivo imaging was conducted with micro - positron emission tomography(PET)/computer tomography (CT). Serum creatinine was examined with blood example. In order to evaluate the pathological changes, HE stain was conducted with kidney tissue, and mitochondrial morphological changes in kidney tissue were observed by transmission electron microscopy. The expressions of HMGB1 and apoptosis inducing factor mitochondria associated 2 (Aifm2) were examined by immunohistochemical method, and the levels of HMGB1 and RAGE were examined by Western blotting. The cell apoptosis of renal tissue was detected by terminal deoxynucleotidyl transferase -mediated dUTP - biotin nick end labeling assay (TUNEL). The metabolomics of kidney tissue in mice were detected by liquid chromatography - mass spectrometry (LC - MS), and the pathway enrichment analysis was carried out by KEEG database. Results (1) The body temperature of the mice in heat shock group was significantly higher than that in normal control group 45 min after model establishment (P＜0.05). The level of serum creatinine in heat shock group was significantly higher than that in normal control group (P＜0.05), and the levels of 18F - deoxyglucose increased in skeletal muscle and visceral tissue of the mice in heat - shock group. (2) HE staining showed hemorrhage in collecting duct and tubular endothelial cell swelling, and mitochondrial swelling and deformation were observed by transmission electron microscopy in kidney tissue of the heat shock group. (3) Immunohistochemical method showed that the levels of Aifm2 and HMGB1 in heat shock group were higher (P＜0.05). (4) Western blotting showed that the levels of HMGB1 and RAGE in heat shock group were higher than those in normal control group (P＜0.05). (5) TUNEL showed that the number of cells with positive stain in kidney tissue of the heat shock group was higher than that in normal control group (P＜0.05). (6) Between normal control group and heat shock group, 136 differential metabolites were detected in kidney tissues. After analysis by KEGG database, pathway abnormalities such as unsaturated fatty acid metabolism disorder may be associated with HS - associated AKI, and many differential metabolites such as adrenic acid may be important regulatory points in the pathogenesis. Conclusion Acute kidney injury is a common complication of heat shock. It may be related to the dysfunction of renal mitochondria and activation of apoptotic pathway caused by systemic hypercatabolism, which may be related to the disorder of unsaturated fatty acid metabolism and activation of HMGB1. Some differential metabolites may be of high value in HS- associated AKI studies.